scholarly journals Teenage pregnancy: The impact of maternal adolescent childbearing and older sister’s teenage

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Elizabeth Wall-Wieler ◽  
Leslie Roos ◽  
Nathan Nickel
Keyword(s):  
Teenage Pregnancy ◽  
Missing Values ◽  
Educational Achievement ◽  
Administrative Databases ◽  
Teenage Childbearing ◽  
Original Cohort ◽  
Adolescent Childbearing ◽  
Logistic Regression Models ◽  
First Child ◽  
The Impact

ABSTRACTBackgroundRisk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother’s teenage childbearing or an older sister’s teenage pregnancy more strongly predicts teenage pregnancy in a younger sister. MethodsThis study used linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP). The original cohort consisted of 17,115 women born in Manitoba between April 1, 1979 and March 31, 1994, who stayed in the province until at least their 20th birthday, had at least one older sister, and had no missing values on key variables. Propensity score matching (1:2) was used to create balanced cohorts for two logistic regression models; one examining the impact of an older sister’s teenage pregnancy on a younger sister's teenage pregnancy and the other analyzing the effect of the mother’s teenage childbearing on a younger sister's teenage pregnancy odds.ResultsThe adjusted odds of becoming pregnant between ages 14 and 19 for teens with at least one older sister having a teenage pregnancy were 3.06 (99% CI 2.53 - 3.64) times higher than for women whose older sister(s) did not have a teenage pregnancy. Teenage daughters of mothers who had their first child before age 20 had 1.51 (99% CI 1.29 - 1.78) times higher odds of pregnancy than those whose mothers had their first child after age 19. Educational achievement was adjusted for in a sub-population examining the odds of pregnancy between ages 16 and 19. After this adjustment, the odds of teenage pregnancy for teens with at least one older sister who had a teenage pregnancy were reduced to 2.34 (99% CI 1.92-2.86) and the odds of pregnancy for teen daughters of teenage mothers were reduced to 1.35 (99% CI 1.15-1.59).ConclusionGiven that an older sister’s teenage pregnancy has a much stronger impact than a mother’s teenage pregnancy, this study suggests social modeling to be a stronger risk factor for teenage pregnancy than living in an adverse environment created by a mother's adolescent childbearing. This study contributes to understanding of the broader topic “who is influential about what” within the family.

scholarly journals Adolescent pregnancy termination and childbearing – the impact of an older sister’s pregnancy outcome

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Elizbaeth Wall-Wieler ◽  
Leslie Roos ◽  
Nathan Nickel
Keyword(s):  
Pregnancy Outcome ◽  
Teenage Pregnancy ◽  
Missing Values ◽  
Pregnancy Termination ◽  
Teenage Mother ◽  
Administrative Databases ◽  
Logistic Regression Models ◽  
Pregnancy Status ◽  
The Impact ◽  
The Relationship

ABSTRACTBackgroundAn older sister's teenage pregnancy status is known to influence whether or not a younger sister also has a teenage pregnancy. This study examines whether a younger sister’s odds of teenage pregnancy are impacted by her older sister’s teenage pregnancy status (no pregnancy, teenage mother, termination), and if she does become pregnant, if the older sister’s teenage pregnancy status impacts her odds of terminating that pregnancy. MethodsA birth cohort created with the linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP) is used to examine these questions. The cohort consisted of 17,169 teenage girls born in Manitoba between April 1, 1979 and March 31, 1994, who stayed in the province until at least their 20th birthday, had at least one older sister, and were not missing values on any key variables. Logistic regression models, controlling for a variety of confounders, are used to examine the relationship between sisters’ teenage pregnancy outcomes. First, the relationship between an older sister’s teenage pregnancy status (no teenage pregnancy, terminated teenage pregnancy, and teenage mother) and a younger sister’s teenage pregnancy is examined. Second, for those who had a teenage pregnancy, the likelihood of her terminating that pregnancy is examined based on her older sister’s teenage pregnancy status.ResultsTeenagers whose older sister had been a teenage mother (OR = 3.2; 95% CI 2.8-36) and those whose older sister terminated her teenage pregnancy (OR= 2.6; 95% CI 2.2-3.0) had significantly higher odds of having a teenage pregnancy than those whose older sister did not have a teenage pregnancy. For those who did have a teenage pregnancy, termination of that pregnancy was more likely if she had an older sister who terminated her teenage pregnancy (OR = 2.7; 95% CI 1.9-3.7) or did not have a teenage pregnancy (OR = 1.8; 95% CI 1.3-2.4) than if her older sister was a teenage mother.ConclusionAn older sister's teenage pregnancy outcome has a significant impact on whether or not a younger sister becomes pregnant and whether she terminates her teenage pregnancy. Younger sisters are most likely to become pregnant if their older sisters had been teenage mothers; these girls were also least likely to terminate their teenage pregnancy.

scholarly journals Trend analysis of teenage pregnancy in Nigeria (1961-2013): how effective is the contraceptive use campaign

2019 ◽  
Vol 8 (2) ◽  
pp. 163 ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Rotimi F. Afolabi ◽  
Oyindamola B. Yusuf
Keyword(s):  
Teenage Pregnancy ◽  
Contraceptive Use ◽  
Educational Achievement ◽  
Public Health Problem ◽  
Significance Level ◽  
North West ◽  
North East ◽  
The North ◽  
History Of ◽  
The Impact

<span lang="EN-ZA">Teenage pregnancy (TP) is a recurrent global and public health problem. It poses both social and health challenges. Considering the massive campaign on the use of modern contraceptives to prevent TP in recent decades, we assessed trends in TP in Nigeria between 1961 and 2013. Pregnancy and contraception history of 70,811 women who were at least 20 years old when the Nigerian DHS was conducted in 1990, 2003, 2008, and 2013 respectively were used for the study, and descriptive statistics, time analysis techniques and multiple logistic regression were used to analyze the data at 5% significance level. </span><span lang="EN-GB">The overall prevalence of TP between 1961 and 2013 was 49.5% which fluctuated insignificantly during the studied period. The TP prevalence among women who entered adulthood in 1961 was 39.2%; it peaked in 1978 at 58.9% before its unsteady decline to 39.6% in 2012, and then rose sharply to 55.6% in 2013. We </span><span lang="EN-ZA">predicted TP prevalence as 49.0%, 49.9% and 51.0% in 2014, 2015 and 2016 respectively. The odds of TP were over 4 times higher in the North East and 5 times higher in the North West than in the South West. Teenagers with no education had higher odds of TP and it was higher among teenagers from the poorest households (OR=5.64, 95% CI: 5.36-5.94). Rather than reducing with the worldwide acknowledged increase in contraceptive campaigns, TP increased over the years studied. </span><span lang="EN-GB">As far as TP is concerned in Nigeria, the impact of the campaign on MC use is far from being effective. </span><span lang="EN-ZA">To achieve the objective of fewer TPs, fewer resources should be spent on access to contraception and instead diverted to areas more likely to achieve results such as improvements in educational achievement amongst girls.</span>

scholarly journals Sex differences in multimorbidity and polypharmacy trends: A repeated cross-sectional study of older adults in Ontario, Canada

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250567
Author(s):  
Colleen J. Maxwell ◽  
Luke Mondor ◽  
Anna J. Pefoyo Koné ◽  
David B. Hogan ◽  
Walter P. Wodchis
Keyword(s):  
Older Adults ◽  
Sex Differences ◽  
Cross Sectional Study ◽  
Administrative Databases ◽  
Sectional Study ◽  
Cross Sectional ◽  
Absolute Increase ◽  
Logistic Regression Models ◽  
The Impact ◽  
Over Time

Background Multimorbidity is increasing among older adults, but the impact of these recent trends on the extent and complexity of polypharmacy and possible variation by sex remains unknown. We examined sex differences in multimorbidity, polypharmacy (5+ medications) and hyper-polypharmacy (10+ medications) in 2003 vs 2016, and the interactive associations between age, multimorbidity level, and time on polypharmacy measures. Methods and findings We employed a repeated cross-sectional study design with linked health administrative databases for all persons aged ≥66 years eligible for health insurance in Ontario, Canada at the two index dates. Descriptive analyses and multivariable logistic regression models were conducted; models included interaction terms between age, multimorbidity level, and time period to estimate polypharmacy and hyper-polypharmacy probabilities, risk differences and risk ratios for 2016 vs 2003. Multimorbidity, polypharmacy and hyper-polypharmacy increased significantly over the 13 years. At both index dates prevalence estimates for all three were higher in women, but a greater absolute increase in polypharmacy over time was observed in men (6.6% [from 55.7% to 62.3%] vs 0.9% [64.2%-65.1%] for women) though absolute increases in multimorbidity were similar for men and women (6.9% [72.5%-79.4%] vs 6.2% [75.9%-82.1%], respectively). Model findings showed that polypharmacy decreased over time among women aged < 90 years (especially for younger ages and those with fewer conditions), whereas it increased among men at all ages and multimorbidity levels (with larger absolute increases typically at older ages and among those with 4 or fewer conditions). Conclusions There are sex and age differences in the impact of increasing chronic disease burden on changes in measures of multiple medication use among older adults. Though the drivers and health consequences of these trends warrant further investigation, the findings support the heterogeneity and complexity in the evolving association between multimorbidity and polypharmacy measures in older populations.

scholarly journals Resident-Level Predictors of Dementia Pharmacotherapy at Long-Term Care Admission: The Impact of Different Drug Reimbursement Policies in Ontario and Saskatchewan: Prédicteurs de la pharmacothérapie de la démence au niveau des résidents lors de l’hospitalisation dans des soins de longue durée : l’impact de différentes politiques de remboursement des médicaments en Ontario et en Saskatchewan

2020 ◽  
Vol 65 (11) ◽  
pp. 790-801
Author(s):  
Laura C. Maclagan ◽  
Susan E. Bronskill ◽  
Michael A. Campitelli ◽  
Shenzhen Yao ◽  
Christoffer Dharma ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Long Term Care ◽  
Administrative Databases ◽  
Term Care ◽  
Drug Reimbursement ◽  
Logistic Regression Models ◽  
Rural Residency ◽  
The Impact ◽  
To Receive

Objectives: Cholinesterase inhibitors (ChEIs) and memantine are approved for Alzheimer disease in Canada. Regional drug reimbursement policies are associated with cross-provincial variation in ChEI use, but it is unclear how these policies influence predictors of use. Using standardized data from two provinces with differing policies, we compared resident-level characteristics associated with dementia pharmacotherapy at long-term care (LTC) admission. Methods: Using linked clinical and administrative databases, we examined characteristics associated with dementia pharmacotherapy use among residents with dementia and/or significant cognitive impairment admitted to LTC facilities in Saskatchewan (more restrictive reimbursement policies; n = 10,599) and Ontario (less restrictive; n = 93,331) between April 1, 2009, and March 31, 2015. Multivariable logistic regression models were utilized to assess resident demographic, functional, and clinical characteristics associated with dementia pharmacotherapy. Results: On admission, 8.1% of Saskatchewan residents were receiving dementia pharmacotherapy compared to 33.2% in Ontario. In both provinces, residents with severe cognitive impairment, aggressive behaviors, and recent antipsychotic use were more likely to receive dementia pharmacotherapy; while those who were unmarried, admitted in later years, had a greater degree of frailty, and recent hospitalizations were less likely. The direction of the association for older age, rural residency, medication number, and anticholinergic therapy differed between provinces. Conclusions: While more restrictive criteria for dementia pharmacotherapy coverage in Saskatchewan resulted in fewer residents entering LTC on dementia pharmacotherapy, there were relatively few differences in the factors associated with use across provinces. Longitudinal studies are needed to assess how differences in prevalence and characteristics associated with use impact patient outcomes.

scholarly journals Impact of co-occurring hearing and visual difficulties in childhood on educational outcomes: a longitudinal cohort study

2019 ◽  
Vol 3 (1) ◽  
pp. e000389 ◽  
Author(s):  
Matilda Hill ◽  
Amanda Hall ◽  
Cathy Williams ◽  
Alan M Emond
Keyword(s):  
Cohort Study ◽  
Educational Outcomes ◽  
Educational Achievement ◽  
Negative Impact ◽  
Otitis Media With Effusion ◽  
Poor Performance ◽  
Birth Cohort Study ◽  
Confounding Factors ◽  
Logistic Regression Models ◽  
The Impact

BackgroundMild hearing and visual difficulties are common in childhood, and both may have implications for educational achievement. However, the impact of co-occurring common hearing and visual difficulties in childhood is not known.ObjectiveTo determine the prevalence and impact of co-occurring common hearing and visual difficulties of childhood on educational outcomes in primary and secondary school.MethodsThe sample was drawn from the Avon Longitudinal Study of Parents and Children, a longitudinal birth cohort study in England. The exposures were hearing and visual difficulties at age 7 (defined as conductive hearing loss or otitis media with effusion, and amblyopia, strabismus or reduced visual acuity, respectively). The outcomes measured were achievement of level 4 or above at Key Stage 2 (KS2) in English, Maths and Science, respectively, at age 11, and attainment of five or more General Certificate of Secondary Education (GCSEs) at grades A*–C at age 16. Multiple logistic regression models assessed the relationship between hearing and visual difficulties and educational outcomes, adjusting for potential confounding factors.Results2909 children were included in the study; 261 had hearing difficulties, 189 had visual difficulties and 14 children had co-occurring hearing and visual difficulties. Children with co-occurring hearing and visual difficulties were less likely to achieve the national target at KS2 compared with children with normal hearing and vision, even after adjustment for confounding factors (OR 0.30, CI 0.15 to 0.61 for KS2 English). Differences in IQ, behaviour, attention and social cognition did not account for this relationship. The impact of co-occurring hearing and visual difficulties on GCSE results was explained largely by poor performance at KS2.ConclusionsCo-occurring hearing and visual difficulties in childhood have an enduring negative impact on educational outcomes. Identification of affected children and early intervention in primary school is essential.

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

Outcomes of Passable and Non-passable Strictures in Clinical Trials of Crohn’s Disease: A Post-hoc Analysis

2021 ◽  
Author(s):  
Neeraj Narula ◽  
Emily C L Wong ◽  
Parambir S Dulai ◽  
John K Marshall ◽  
Jean-Frederic Colombel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Symptom Improvement ◽  
Logistic Regression Models ◽  
Post Hoc Analysis ◽  
Endoscopic Remission ◽  
Post Hoc ◽  
The Impact

Abstract Background and Aims There is paucity of evidence on the reversibility of Crohn’s disease [CD]-related strictures treated with therapies. We aimed to describe the clinical and endoscopic outcomes of CD patients with non-passable strictures. Methods This was a post-hoc analysis of three large CD clinical trial programmes examining outcomes with infliximab, ustekinumab, and azathioprine, which included data on 576 patients including 105 with non-passable strictures and 45 with passable strictures, as measured using the Simple Endoscopic Score for Crohn’s Disease [SES-CD]. The impact of non-passable strictures on achieving clinical remission [CR] and endoscopic remission [ER] was assessed using multivariate logistic regression models. CR was defined as a Crohn’s Disease Activity Index [CDAI] &lt;150, clinical response as a CDAI reduction of ≥100 points, and ER as SES-CD score &lt;3. Results After 1 year of treatment, patients with non-passable strictures demonstrated the ability to achieve passable or no strictures in 62.5% of cases, with 52.4% and 37.5% attaining CR and ER, respectively. However, patients with non-passable strictures at baseline were less likely to demonstrate symptom improvement compared with those with passable or no strictures, with reduced odds of 1-year CR (adjusted odds ratio [aOR] 0.17, 95% CI 0.03–0.99, p = 0.048). No significant differences were observed between patients with non-passable strictures at baseline and those with passable or no strictures in rates of ER [aOR 0.82, 95% CI 0.23–2.85, p = 0.751] at 1 year. Conclusions Patients with non-passable strictures can achieve symptomatic and endoscopic remission when receiving therapies used to treat CD, although they are less likely to obtain CR compared with patients without non-passable strictures. These findings support the importance of balancing the presence of non-passable strictures in trial arms.

516 Impacts of Chronic Nausea and Vomiting on Daytime Sleepiness and Fatigue

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A203-A203
Author(s):  
Maurice Ohayon ◽  
Y J Chen ◽  
Marie-Lise Cote
Keyword(s):  
Longitudinal Study ◽  
Daytime Sleepiness ◽  
Nausea And Vomiting ◽  
Prospective Longitudinal Study ◽  
Logistic Regression Models ◽  
Related Quality ◽  
Health Related ◽  
Chronic Nausea ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Introduction Chronic nausea and vomiting (CNV), common symptoms in patients with GI disorders like gastroparesis, can be a debilitating health problem with considerable impact on patients’ health-related quality of life during daytime. Yet, little is known about how CNV may impact on sleepiness and fatigue during the daytime. Our aim was to examine the impact of CNV on daytime sleepiness and fatigue based on the data from a longitudinal study. Methods Prospective longitudinal study with two waves: 12,218 subjects interviewed by phone during wave 1 (W1); 10,931 during wave 2 (W2) three years later. The sample was representative of the US general population. Analyses included subjects participating to both waves (N=10,931). CNV was defined as episodes of nausea and vomiting occurring at least twice a month for at least 1 month (outside pregnancy). Logistic regression models were employed to determine whether CNV is a predictive variable for excessive sleepiness or fatigue. Results Out of all W1 participants, 9.8% (95% CI: 9.2%-10.4%) reported nausea only while 3% (95% CI: 2.7%-3.3%) reported CNV. In W2, 7.7% (95% CI: 7.2%-8.2%) reported nausea only and 2.5% (95% CI: 2.2%-2.8%) reported having CNV. Of the subjects who participated in both W1 and W2, 25.7% of them reported CNV in W1. CNV subjects reported more frequently excessive daytime sleepiness (53.5% vs. 25.9%) and being moderately or severely fatigued (38.6% vs, 5.4%) compared with the participants without nausea or vomiting. After controlling for age, sex, BMI, health status, alcohol intake, sleep disorders and psychiatric disorders that might impact on daytime sleepiness or fatigue, it was found that subjects with CNV at both W1 and W2 had a significantly higher relative risk of reporting daytime sleepiness (RR: 2.7 (95% CI:1.9–3.9) p&lt;0.0001) and fatigue (RR: 4.9 (95% CI:3.2–7.5) p&lt;0.0001) at W2, compared with the participants without nausea or vomiting. Conclusion Many factors are likely to influence daytime sleepiness. CNV appears to be an important contributor even after controlling for several factors that can explain the sleepiness. This underlines the extent to which alertness could be disturbed and impacted by chronicity of nausea/vomiting symptoms. Support (if any) This analysis study was funded by Takeda Pharmaceutical Company

scholarly journals EPID-34. THE DETRIMENTAL EFFECT OF BIOPSY PRECEDING RESECTION IN SURGICALLY ACCESSIBLE GLIOBLASTOMAS: RESULTS FROM THE NATIONAL CANCER DATABASE

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii85-ii86
Author(s):  
Ping Zhu ◽  
Xianglin Du ◽  
Angel Blanco ◽  
Leomar Y Ballester ◽  
Nitin Tandon ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Failure Time ◽  
Binary Logistic Regression ◽  
Rank Test ◽  
Imaging Features ◽  
National Cancer Database ◽  
Prolonged Length ◽  
Logistic Regression Models ◽  
Operative Outcomes ◽  
The Impact

Abstract OBJECTIVES To investigate the impact of biopsy preceding resection compared to upfront resection in glioblastoma overall survival (OS) and post-operative outcomes using the National Cancer Database (NCDB). METHODS A total of 17,334 GBM patients diagnosed between 2010 and 2014 were derived from the NCDB. Patients were categorized into two groups: “upfront resection” versus “biopsy followed by resection”. Primary outcome was OS. Post-operative outcomes including 30-day readmission/mortality, 90-day mortality, and prolonged length of inpatient hospital stay (LOS) were secondary endpoints. Kaplan-Meier methods and accelerated failure time (AFT) models with gamma distribution were applied for survival analysis. Multivariable binary logistic regression models were performed to compare differences in the post-operative outcomes between these groups. RESULTS Patients undergoing “upfront resection” experienced superior survival compared to those undergoing “biopsy followed by resection” (median OS: 12.4 versus 11.1 months, log-rank test: P=0.001). In multivariable AFT models, significant survival benefits were observed among patients undergoing “upfront resection” (time ratio [TR]: 0.83, 95% CI: 0.75–0.93, P=0.001). Patients undergoing upfront GTR had the longest survival compared to upfront STR, GTR following STR, or GTR and STR following an initial biopsy (14.4 vs. 10.3, 13.5, 13.3, and 9.1, months), respectively (TR: 1.00 [Ref.], 0.75, 0.82, 0.88, and 0.67). Recent years of diagnosis, higher income and treatment at academic facilities were significantly associated with the likelihood of undergoing upfront resection after adjusting the covariates. Multivariable logistic regression revealed that 30-day mortality and 90-day mortality were decreased by 73% and 44% for patients undergoing “upfront resection” over “biopsy followed by resection”, respectively (both p &lt; 0.001). CONCLUSIONS Pre-operative biopsies for surgically accessible tumors with characteristic imaging features of Glioblastoma lead to worse survival despite subsequent resection compared to patients undergoing upfront resection.

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