Partnership Context of First Births in Russia: The Enduring Significance of Marriage

While cohabitation and non-marital childbearing have been increasing in Russia since 1990, the share of marital first births that are conceived prior to marriage has changed very little since the Soviet era. The prior findings on the stability of trends in premarital conceptions in Russia have been contradictory and inconclusive. This study aims to extend the existing empirical evidence on premarital conceptions in Russia and to contribute to the discussion on the persistence of marriage as the preferred partnership context for parenthood. We focus on births that occurred within the first two years of marriage, and compare the childbearing patterns of Russian women who married in different historical periods. For our investigation of fertility among marital cohorts who married during the Soviet era (1960–1991), we use individual-level data from the 1994 microcensus. For our examination of fertility among more recent marital cohorts (2000, 2011, and 2016), we draw on data from birth records in civil registers. We also use relevant complementary data sources. Our findings show that there has been a marked shift in the relationship between conception and marriage in Russia. Increasingly, conceptions have been occurring before marriage, and in the most recent marital cohorts, the level of premarital first conceptions has even surpassed the level of marital first conceptions. The average interval between conception and entry into marriage has also been lengthening. We describe this unique pattern of childbearing and discuss some potential explanations for the ongoing association between marriage and childbearing in Russia.

Audit on clozapine dose and plasma level correlation for patients with chronic treatment-resistant psychosis

AimsClozapine is associated with a risk of severe adverse events for which there are current monitoring systems are in place; however, there are no established regimens for monitoring of clozapine plasma levels. Recent Medicines and Healthcare products Regulatory Agency (MHRA) guidance advises clozapine levels should be monitored in certain clinical situations where toxicity may be suspected. This audit aimed to evaluate current practice of clozapine level monitoring within one Local Mental Health Team (LMHT).MethodElectronic (RiO) records of 41 patients (33 male, 8 female; aged from 27 to 76 years; mean age 45 years) registered to the ZTAS system within the Nottingham City Central LMHT were reviewed. 46% had been on clozapine for over 16 years. 73.3% of patients were within clusters 12 and 13; 25.4% of patients were in cluster 11, with one patient in cluster 8. Dates of clozapine plasma level tests for each patient between 2006 and 2020 were found on the electronic NoTIS system, along with clozapine, norclozapine and total clozapine levels. Concurrent clozapine dose and regimens were obtained from pharmacy records from 2018 onwards.Result273 clozapine plasma levels were conducted between 2006 and 2020. The average interval between levels taken was 10 months, 2 weeks but had a wide range, the shortest interval being 2 days, the longest being 13 years. 88 levels taken were >600 ug/L, suggesting increased toxicity risk. 108 levels were <350 ug/L, suggesting possible sub-optimal dosing or non-compliance. Statistical tests on correlation coefficient, although statistically non-significant (R = 0.37), showed a positive trend between total clozapine dose and the plasma level between all 3 parameters (i.e. clozapine, norclozapine and total clozapine).ConclusionThere does not appear to be any routine plasma clozapine level monitoring throughout the LMHT with an average interval between tests of 10 months. There was a non-significant but positive trend between total daily dose of clozapine and clozapine level. 32% of clozapine levels returned were higher than the recommended level. We would recommend as suggested in the guidelines from MHRA, clozapine plasma levels should be monitored in certain clinical situations with increased toxicity risk. Trough levels should be taken with records of time of previous dose taken. Limitations of this study included a small sample size (41 patients) with data collection reliant on electronic systems. It was unclear if these results represent trough levels, making values difficult to interpret. Multifactorial impact on clozapine metabolism causes wide patient variability in plasma levels.

Two-Year Follow-Up Study of the Relationship Between Brain Structure and Cognitive Control Function Across the Adult Lifespan

Age-related decline in cognitive control and general slowing are prominent phenomena in aging research. These declines in cognitive functions have been shown to also involve age-related decline in brain structure. However, most evidence in support of these associations is based on cross-sectional data. Therefore, the aim of this study is to contrast cross-sectional and longitudinal analyses to re-examine if the relationship between age-related brain structure and cognitive function are similar between the two approaches. One hundred and two participants completed two sessions with an average interval of 2 years. All participants were assessed by questionnaires, a series of cognitive tasks, and they all underwent neuroimaging acquisition. The main results of this study show that the majority of the conclusions regarding age effect in cognitive control function and processing speed in the literature can be replicated based on the cross-sectional data. Conversely, when we followed up individuals over an average interval of 2 years, then we found much fewer significant relationships between age-related change in gray matter structure of the cognitive control network and age-related change in cognitive control function. Furthermore, there was no “initial age” effect in the relationships between age-related changes in brain structure and cognitive function. This finding suggests that the “aging” relationship between brain structure and cognitive function over a short period of time are independent of “initial age” difference at time point 1. The result of this study warrants the importance of longitudinal research for aging studies to elucidate actual aging processes on cognitive control function.

Pengaruh Locus of Control Terhadap Motivasi Belajar Siswa

Motivation to learn can be interpreted as a desire that arises in a person to carry out learning activities in order to obtain the expected goals. This desire comes from outside yourself or comes from within a person. One of the internal factors that influence learning motivation is locus of control (LoC). LoC is a person's self-control towards the success he achieves in his daily activities. The purpose of this study was to determine the direct effect of LoC on student learning motivation. This type of research is a causal survey with path analysis type. The number of research samples were 95 students who were selected by multistage random sampling randomly from 1729 students. The results of the study of LoC variables and learning motivation were collected through an attitude scale then processed statistically. The description of the results of the student learning motivation data reached an average of 121.97, the standard deviation value was 121.97, the mode value was 114.77, the median value was 118.39; with 43 students (45%) obtaining scores below the mean interval. It was obtained that 34 students (36%) obtained the value lies in the average interval score, as many as 18 students (19%) achieved a value above the average interval. The results of the independent variable data (LoC) achieved an average value of 150.89, a median value of 158, 57, a mode value of 146.64 and a standard deviation of 25.53, with 42 students (44%) obtaining a score below the average interval . As many as 19 students (20%) obtained scores that were located on the average interval, then 34 students (36%) obtained scores above the average interval. Based on the results of data analysis, it is concluded that LoC has a positive direct effect on the learning motivation of students at State Junior High Schools in Gorontalo City. The creation of student learning motivation is influenced by their LoC.

Anticoagulation Quality of Warfarin and the Role of Physician–Pharmacist Collaborative Clinics in the Treatment of Patients Receiving Warfarin: A Retrospective, Observational, Single-Center Study

Background: The management of patients receiving warfarin is complicated. This study evaluated the anticoagulation quality of warfarin, explored potential predictors associated with poor anticoagulation quality, and elucidated the role of clinical pharmacists in the management of warfarin treatment.Methods: We retrospectively collected data on patients who either initially received warfarin or returned to warfarin after withdrawal between January 1, 2015 and January 1, 2020. The primary outcome was time in therapeutic range (TTR), and a TTR of ≥60% was considered as good anticoagulation quality. The secondary outcomes included thromboembolic and bleeding events during the follow-up. We assessed the TTR of each participant and investigated the potential predictors of poor anticoagulation quality (TTR &lt; 60%) using logistic regression analysis. Additionally, we compared the warfarin anticoagulant quality and the incidence of clinical adverse events between atrial fibrillation patients in physician–pharmacist collaborative clinics (PPCCs) and general clinics.Results: Totally, 378 patients were included. The mean TTR of patients was 42.6 ± 29.8%, with only 32% of patients having achieved good anticoagulation quality. During a mean follow-up period of 192 ± 92 days, we found no significant differences in the incidences of thromboembolic events (5.0% vs. 5.1%, p = 0.967) and bleeding events (1.7% vs. 4.7%, p = 0.241) between patients with good and those with poor anticoagulation quality. The presence of PPCCs (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.25–0.90, p = 0.022) was an independent protective factor of poor anticoagulation quality, while the presence of more than four comorbidities (OR: 1.98, 95% CI: 1.22–3.24, p = 0.006) and an average interval of international normalized ratio monitoring of &gt;30 days (OR: 1.74, 95% CI: 1.10–2.76, p = 0.019) were independent risk factors of poor anticoagulation quality. Compared with atrial fibrillation patients in general clinics, patients in PPCCs were found to have a significantly increased mean TTR level (48.4% ± 25.7% vs. 38.0% ± 27.6%, p = 0.014).Conclusion: The anticoagulation quality of warfarin was relatively low at our institution. The presence of more than four comorbidities and an average interval of international normalized ratio monitoring of &gt;30 days independently contributed to poor anticoagulation quality. Meanwhile, the use of PPCC model improved the anticoagulation quality of warfarin.

Predicting Pathologic Bone Lesions Using Scout Computed Tomography (CT) Imaging

The purpose of this study is to evaluate the benefit of reviewing scout CT images, obtained for routine oncologic surveillance, for the early identification of pathologic bony lesions. A retrospective review was conducted on patients who previously underwent surgical treatment by two orthopedic oncology surgeons at a tertiary care institution from 2009–2019 for pathologic lesions or fractures of the humerus or femur. Radiographic records were reviewed to identify patients in this cohort who had available scout views from CT imaging prior to official diagnosis of the bony lesion or fracture. CT scout images were assessed by two independent reviewers to identify any pathologic lesions, and radiographic reports were reviewed to identify if the lesions were noted by radiology at the time of the initial scan interpretation. One hundred and forty-four patients were identified, and thirty-nine had an available scout CT image prior to official diagnosis of the lesion. Twenty-five patients (64.1%) had lesions identified by authors on scout CT versus only 9 (23.1%) who had lesions that were documented in the initial CT radiologic report. There was a total of 29 lesions identified by the study authors on scout CT, and 19 (65.5%) were not reported in the initial radiographic interpretation with an average interval between observation by authors and official diagnosis of 202 days. Of the impending fractures, three patients (16.7%) went on to complete fracture prior to referral to orthopedics with an average interval between these missed lesions on scout CT and their presentation with fracture of 68 days. This study advocates for the careful review of all scout CT imaging as an essential part of the work up for metastatic disease and encourages all practitioners to utilize this screening tool for the identification of pathologic bony lesions which may help expedite early treatment to reduce patient morbidity.

Short-term Efficacy and Safety of CalliSpheres Drug-loaded Microsphere Embolization in Primary Hepatocellular Carcinoma

Background To evaluate the short-term clinical efficacy, side effects, and risk factors affecting the clinical effectiveness of CalliSpheres drug-loaded bead-transcatheter arterial chemoembolization (DEB-TACE) in the treatment of primary hepatocellular carcinoma (HCC).Methods A total of 172 consecutive patients with HCC undergoing DEB-TACE (loaded with doxorubicin) from August 2016 to July 2018 were prospectively enrolled. Short-term local tumor response was evaluated by the modified RECIST criteria. Postoperative complications and liver function disorders were analyzed based on examinations and clinical symptoms.Results The median follow-up period was 310 days. Based on the mRECIST criteria, objective response rates (CR+PR) were 78.7%, 71.6% and 63.2%, and disease control rates (CR+PR+SD) were 95.3%, 92.1% and 85.9% at 2, 4 and 6 months post-treatment, respectively. Multivariate logistic regression analysis showed that nodule number >3, high BCLC stage, vascular leak, and previous cTACE treatment were associated with poor ORR (P<0.05). Post-operation, liver function showed transient changes. Postoperative complications were tolerated and relieved by symptomatic treatment. The average interval of TACE before D-TACE was 43 days, compared with 70 days for average interval of DEB-TACE. The average hospital stay was 1.87 days.Conclusions DEB-TACE has improved short-term efficacy and lower incidence of complications in primary HCC and prolongs the interval of TACE. It significantly increases the ORR, especially in patients with no extra-hepatic metastasis pre-treatment. DEB usage actually improves treatment efficacy and provides more benefits to patients.

PERAN KINERJA PENYULUH DAN EFEKTIVITAS PELAKSANAAN PENYULUHAN PADA PROGRAM INTENSIFIKASI JAGUNG

The purpose of this research it is analyzing the role of extension performance and the effectiveness of the agricultural extension on corn intensification program. The object of this research is extension agricultural who conducted the program intensification of corn. Research undertaken in Gorontalo Utara Regency of November 2018 until January 2019. Research methodology is descriptive quantitative analysis by the use of research semantic differential. The results of the study showed that the role of the performance of agricultural extension on corn intensification program was instrumental good with an average interval 44,77 that acts as motivator, facilitators, educator, and the communicators in the implementation of the corn intensification program. While the implementation of agricultural extension services on the program intensification corn is very effective with rata-rata scales intervals 23,95 adapted to the intensification of phases of the program from provision of corn seed until after the harvest.

11 Conception rate of high-producing dairy cows at first service using prostaglandin F2α and oestradiol benzoate

We have shown that a simplified oestrus synchronization protocol using prostaglandin F2α (PG) and oestradiol benzoate (EB) resulted in a satisfactory conception rate, similar to that obtained in high-producing dairy cows with natural oestrus (Yamaguchi et al. 2018 Reprod. Fertil. Dev. 30, 147 abstr). However, we found no significant effect of PG+EB protocols on the first-service conception rates (CR) of dairy cows. This study investigated the effect of the first-service CR by using PG+EB protocols in the high-producing dairy cows that had not exhibited oestrus expression after calving. Data concerning the first-service CR were obtained for 481 Holstein cows from 4 commercial dairy herds in Hokkaido and Ibaraki, Japan, from 2014 to 2017. The average number of parity, average interval between calving and the first service, and average milk yield (at 305 days) of the cows were 2.2±1.3, 89.7±26.1 days, and 10314±1994kg, respectively. We carried out the PG+EB protocols on cows not showing evident standing heat from Days 50 to 150 postpartum regardless of the presence of a corpus luteum in the ovary. The statuses of ovaries of cows were confirmed using ultrasonography before starting the treatment. Prostaglandin F2α (25 mg; Lutalyse, Pfizer, New York, NY, USA) was injected into cows with a &gt;20mm cutoff for functional corpus luteum diameter at a random stage of oestrus, and EB (1 mg; Ovahormon®, Aska Animal Health Co., Tokyo, Japan) was injected 24h later, and AI was carried out 24 to 48h after EB injection. Cows with a natural oestrus service from Days 50 to 150 postpartum were used as control. All the cows were inseminated after the onset of standing heat or removal of the tail chalk. Pregnancy diagnoses were performed using ultrasonography 30 to 45 days after AI. The CR and intervals of partum to conception were analysed using a chi-square test and ANOVA. The first-service CR (i.e. the number of pregnant cows/total number of cows in the treatment group) of the natural oestrus (n=330) and PG+EB (n=151) groups were 42.7 and 41.1%, respectively, and there were no significant differences between these 2 groups (P=0.7). The average interval between calving and the first service of the PG+EB groups was significantly longer than that of the natural oestrus groups (86.4±1.5 days v. 96.9±1.9 days; P&lt;0.01). The average days open of the natural oestrus and PG+EB groups were 88.5±3.2 days and 98.1±2.3 days, respectively (P&lt;0.05). These results confirmed that the first-service CR in the PG+EB and natural oestrus groups of high-producing dairy cows were similar. We suggest that conducting PG+EB protocols was effective in the high-producing dairy cows that had not exhibited oestrus expression after calving. Moreover, using PG+EB protocols could prevent the further increase in the number of days open.

PENGGUNAAN MEDIA LAGU POP DALAM PEMBELAJARAN MENULIS CERPEN REALIS SISWA KELAS IX A SMP NEGERI 9 KOTA JAMBI TAHUN PELAJARAN 2016/2017

The purpose of this research is to describe students ability in writing realist short story at students class IX A SMP Negeri 9 Kota Jambi Academic Year 2016/2017. The type of this research is qualitative descriptive. The data of this research is primary and secondary data. The primary data is taken directly, from students exercise in writing realist short story while secondary data is taken from some sources in Batanghari University library and province library. The data is collected by using observation, interview, exercise, and documentation. From the analysis, it shows that there are 5 students fall into very good criteria (interval up to 80), there are 21 students fall into good criteria (interval 70-79), there are 11 students fall into fair criteria (interval 60-69),and there is 1 student falls into below average (interval up to 59). So, it can be concluded that students ability in wiritng realist short story fall into good criteria with interval 70.Kata Kunci:pop song, realist short story, students