scholarly journals Declining realisation of reproductive intentions with age

2019 ◽  
Vol 34 (10) ◽  
pp. 1906-1914 ◽  
Author(s):  
Éva Beaujouan ◽  
Anna Reimondos ◽  
Edith Gray ◽  
Ann Evans ◽  
Tomáš Sobotka

Abstract STUDY QUESTION What is the likelihood of having a child within 4 years for men and women with strong short-term reproductive intentions, and how is it affected by age? SUMMARY ANSWER For women, the likelihood of realising reproductive intentions decreased steeply from age 35: the effect of age was weak and not significant for men. WHAT IS KNOWN ALREADY Men and women are postponing childbearing until later ages. For women, this trend is associated with a higher risk that childbearing plans will not be realised due to increased levels of infertility and pregnancy complications. STUDY DESIGN, SIZE, DURATION This study analyses two waves of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey. The analytical sample interviewed in 2011 included 447 men aged 18–45 and 528 women aged 18–41. These respondents expressed a strong intention to have a child in the next 3 years. We followed them up in 2015 to track whether their reproductive intention was achieved or revised. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Multinomial logistic regression is used to account for the three possible outcomes: (i) having a child, (ii) not having a child but still intending to have one in the future and (iii) not having a child and no longer intending to have one. We analyse how age, parity, partnership status, education, perceived ability to conceive, self-rated health, BMI and smoking status are related to realising or changing reproductive intentions. MAIN RESULTS AND THE ROLE OF CHANCE Almost two-thirds of men and women realised their strong short-term fertility plans within 4 years. There was a steep age-related decline in realising reproductive intentions for women in their mid- and late-30s, whereas men maintained a relatively high probability of having the child they intended until age 45. Women aged 38–41 who planned to have a child were the most likely to change their plan within 4 years. The probability of realising reproductive intention was highest for married and highly educated men and women and for those with one child. LIMITATIONS, REASONS FOR CAUTION Our study cannot separate biological, social and cultural reasons for not realising reproductive intentions. Men and women adjust their intentions in response to their actual circumstances, but also in line with their perceived ability to have a child or under the influence of broader social norms on reproductive age. WIDER IMPLICATIONS OF THE FINDINGS Our results give a new perspective on the ability of men and women to realise their reproductive plans in the context of childbearing postponement. They confirm the inequality in the individual consequences of delayed reproduction between men and women. They inform medical practitioners and counsellors about the complex biological, social and normative barriers to reproduction among women at higher childbearing ages. STUDY FUNDING/COMPETING INTEREST(S) This research was partly supported by a Research School of Social Sciences Visiting Fellowship at the Australian National University and an Australian Research Council Discovery Project (DP150104248). Éva Beaujouan’s work was partly funded by the Austrian Science Fund (FWF) project ‘Later Fertility in Europe’ (Grant agreement no. P31171-G29). This paper uses unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the authors and should not be attributed to either DSS or the Melbourne Institute. The authors have no conflicts of interest.

2016 ◽  
Vol 116 (4) ◽  
pp. 395-409 ◽  
Author(s):  
Shraboni Patra ◽  
Arokiasamy Perianayagam ◽  
Srinivas Goli

Purpose – The level of mother’s health knowledge influences not only her health, but also significantly predicts her children’s health and medical care, and spending on medical care. This relationship has not yet been empirically assessed in India. The purpose of this paper is to measure the level of health knowledge of mothers in India and its association with the short-term illness in their children, medical care and medical care expenditure. Design/methodology/approach – The authors used data from India Human Development Survey, 2004-2005. An index of “health knowledge” was constructed by using factor analysis. Multivariate binary logistic regression, multinomial logistic regression and multiple classification analysis were employed to analyze the relationship between mother’s health knowledge and child illness. Pearson’s χ2 test and ANOVA test were used to estimate levels of statistical significance in bivariate analyses. Findings – The results revealed that children of mothers with medium and high-health knowledge were significantly less likely to have short-term illness (OR=0.390, p < 0.01 and OR=0.543, p < 0.01) than those children whose mothers had no or low-health knowledge (OR=1.00, p < 0.01) cutting across all background characteristics. Similarly, the attainment of modern medical care for short-term illness of children was nearly two times greater (OR=1.97, p < 0.05) in mothers with higher health knowledge as compared to mothers with no or low-health knowledge (OR=1.00, p < 0.01). The results also showed that mothers with higher health knowledge spent more on medical care for their children’s short-term illness than mothers with no and low-health knowledge. Practical implications – The findings suggested a significant effect of mother’s health knowledge on the prevalence of short-term illness among their children, medical care and expenditure on the medical care. Appropriate health knowledge for women is crucial to the wellbeing of their children. Besides, social equity in terms of the distribution of facilities, to gain health knowledge and medical care, are essential to be established in India. Originality/value – To the knowledge, this study is the first attempt to measure the health knowledge of women in reproductive age and its association with the prevalence of short-term illness, medical care and medical expenditure of their children in India. In general, a health knowledge index could be a significant composite predictor of the health in a population.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1616-1616
Author(s):  
Brad Dykstra ◽  
Sandra Olthof ◽  
Martha Ritsema ◽  
Gerald De Haan

Abstract Abstract 1616 The C57BL/6 mouse is one of the best studied models of hematopoietic stem cell (HSC) aging. Characteristic age-related changes include an increase in HSC frequency, a corresponding decrease in functional activity, myeloid skewing, and decreased in vivo homing ability. Studies of age-dependent differences in homing have primarily relied upon the injection of young or old bone marrow into irradiated recipients, with subsequent quantification of functional homed HSCs using secondary transplantation assays (e.g. Liang et al, Blood 2005). While this is a relevant and informative approach, it is limited because it measures homed cells indirectly, using an assay that itself is dependent on homing. To study this phenomenon more directly, we compared the short-term homing efficiency of purified HSCs from old and young mice by co-injecting them into old or young recipients. This approach enabled us to ascertain whether the previously reported decrease in homing efficiency is due to differences in physical homing to the bone marrow, or a reduced function per homed cell, or some combination of both. Second, it allowed us to determine the relationship between the decreased in vivo homing efficiency of old HSCs and their functional properties when assayed in a homing-independent stem cell assay. Third, by varying the age and irradiation status of the homing recipients, we could test directly the influence of these factors on HSC homing and function. To accomplish these objectives, we purified HSCs (CD150+CD48-LSK bone marrow cells) from old (23-26 months) GFP+ and young (3-4 months) CFP+ mice, combined them at known ratios, and injected them into non-irradiated young, non-irradiated old, or lethally irradiated young recipients. 22 hours later, these recipients were sacrificed and the ratio of GFP+ and CFP+ cells found homed to the bone marrow were compared to the ratio in which they were injected. In this way, we determined that relative to their young counterparts, the 22-hour homing efficiency of old CD150+CD48-LSK cells was consistently 2-fold lower when injected into young recipients. However, when the same cells were injected into non-irradiated old recipients, the relative homing efficiency varied from 2-fold lower to 1.1-fold higher. This suggests that the factors affecting homing are similar between individual young recipients, while the microenvironments of individual old recipients are variable in their relative ability to support homing of young and old HSCs. We recently demonstrated that the proportion of purified old HSCs that were functional when assayed clonally in vitro (cobblestone area forming cell [CAFC] assay) declined approximately 2-fold compared to young HSCs. To determine whether the non-homed HSCs were the same cells that were non-functional in the CAFC assay, we compared the CAFC seeding efficiency of old and young cells before and after homing. There was no functional improvement in homed old LSK150+48- cells, suggesting that the homing defect and reduced CAFC efficiency are non-overlapping and may be characteristics of all old HSCs. To determine if the homing microenvironment also had an effect on the function of the homed cells, CAFC assays were initiated with old and young HSCs before and after homing into each of the three recipient types. This analysis revealed that the function of the homed cells was significantly decreased for age-mismatched or irradiated recipients compared to pre-homed cells. In contrast, CAFC activity of young or old cells homed to non-irradiated age-matched recipients did not change. This suggests that the environment of an age mismatched and/or irradiated recipient can have a negative effect on the function of homed cells within a matter of hours. In conclusion, these co-homing studies reveal that compared to young HSCs, old HSCs are physically less able to home and migrate into the bone marrow within a 22-hour period post-transplantation. However, this relative homing defect is most pronounced and consistent when injected into young recipients. Second, the homing defect and reduced CAFC efficiency are non-overlapping and may be characteristics of all old HSCs. Third, old or young HSCs that do successfully home to irradiated or age-mismatched recipients become functionally compromised compared to pre-homed HSCs, suggesting that the homing defects of old HSCs can be ameliorated or exacerbated depending on the microenvironment in which they are transplanted. Disclosures: No relevant conflicts of interest to declare.


2000 ◽  
Vol 39 (05) ◽  
pp. 127-132 ◽  
Author(s):  
Nicole Sieweke ◽  
K. H. Bohuslavizki ◽  
W. U. Kampen ◽  
M. Zuhayra ◽  
M. Clausen ◽  
...  

Summary Aim of this study was to validate a recently introduced new and easy-to-perform method for quantifying bone uptake of Tc-99m-labelled diphosphonate in a routine clinical setting and to establish a normal data base for bone uptake depending on age and gender. Methods: In 49 women (14-79 years) and 47 men (6-89 years) with normal bone scans as well as in 49 women (33-81 years) and 37 men (27-88 years) with metastatic bone disease whole-body bone scans were acquired at 3 min and 3-4 hours p.i. to calculate bone uptake after correction for both urinary excretion and soft tissue retention. Results: Bone uptake values of various age-related subgroups showed no significant differences between men and women (p >0.05 ). Furthermore, no differences could be proven between age-matched subgroups of normals and patients with less than 10 metastatic bone lesions, while patients with wide-spread bone metastases revealed significantly increased uptake values. In both men and women highest bone uptake was obtained (p <0.05 ) in subjects younger than 20 years with active epiphyseal growth plates. In men, bone uptake slowly decreased with age up to 60 years and then showed a tendency towards increasing uptake values. In women, the mean uptake reached a minimun in the decade 20-29 years and then slowly increased with a positive linear correlation of age and uptake in subjects older than 55 years (r = 0.57). Conclusion: Since the results proposed in this study are in good agreement with data from literature, the new method used for quantification could be validated in a large number of patients. Furthermore, age- and sexrelated normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Julian Wier ◽  
Ian F Hulsebos ◽  
Haig A Yenikomshian ◽  
Justin Gillenwater

Abstract Introduction Inhalation injury (INHI) has strong associations with increased rates of in-patient mortality and pneumonia. Data describing long-term health outcomes after inhalation injury are scarce and the true sequelae are largely unknown. The aim of the study is to review long-term pulmonary outcomes in inhalation injury patients. We hypothesize that INHI patients are at greater risk of developing long-term pulmonary sequelae. Methods We present a retrospective case-control of burn patients admitted to an ABA certified facility. We included burn patients with or without medically confirmed INHI who were admitted between 06/2016 to 11/2019 and were part of the regional Department of Health Services (DHS) system. The experimental group was patients with bronchoscopy confirmed INHI. The control groups were ventilated patients with confirmed non-inhalation injury (V) and non-ventilated patients with confirmed non-inhalation injury (NV). These were matched for age, TBSA, sex, previous comorbid pulmonary disease, and smoking status. Primary study outcomes were rates of post-discharge pulmonary sequelae, including ineffective airway clearance, infections, shortness of breath, and malignancy. Secondary outcomes included rates of post-discharge surgeries and readmission, post-discharge non-pulmonary sequelae, and post-discharge days to pulmonary/non-pulmonary sequelae. Results The study population included 33 INHI, 45 V, and 50 NV patients. There were no significant differences in age (P=.98), sex (P=.68), TBSA (P=.18), pulmonary comorbidity (P=.5), or smoking status (P=.92). Outpatient pulmonary sequelae were significantly higher for both INHI and V groups as compared to NV (21% and 17% vs 4%, P=.023, .043). The number of days from discharge to pulmonary sequelae was significantly shorter in the INHI group versus the V group (162±139 days vs 513±314 days, P=.024). Multinomial logistic regression for both INHI and V groups using the variables comorbid pulmonary disease, smoking status, and inpatient course and complications, indicated no effect on post-discharge pulmonary sequelae (all P &gt;.05). All other measures were not significant when comparing INHI to V or NV (all P &gt;.05). Conclusions Both INHI and V groups resulted in higher rates of outpatient pulmonary sequelae independent of inpatient course as compared to NV. While outpatient pulmonary sequelae were not significantly different between INHI and V, the INHI patients presented with complaints earlier. Thus one can conclude that ventilation alone is a significant contributing factor for the long-term pulmonary sequelae reported in this patient population.


Incarceration ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 263266632198901
Author(s):  
Marguerite Schinkel ◽  

This article takes a life-course perspective to the meaning of persistent short-term imprisonment and introduces the significance of ‘penal careers’. Examining a total of 62 interviews with men and women in Scotland with long careers of (progression through) criminal punishment, it uses to the concept of belonging as a lens to interpret their experiences. While some participants already felt early on in their career that they belonged in prison because of their shared characteristics with other prisoners, the repetition of imprisonment meant that they increasingly felt displaced from life outside and saw life in prison as ‘easier’ and ‘safer’. Nevertheless, looking back on their many sentences, they felt their cumulative meaning was ‘a waste of life’. The article concludes by considering steps towards tackling the conditions that create this sense of belonging in a place of punishment.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Querques ◽  
Riccardo Sacconi ◽  
Francesco Gelormini ◽  
Enrico Borrelli ◽  
Francesco Prascina ◽  
...  

AbstractThere is a lack of treatment aimed at the regression of reticular pseudodrusen (RPD) secondary to age-related macular degeneration (AMD). The aim of this prospective, pilot study is to evaluate the safety and short-term efficacy of subthreshold laser treatment (SLT) in patients affected by RPD secondary to dry AMD (dAMD). Twenty eyes of 20 patients (mean age 78.4 ± 6.8 years) with RPD secondary to dAMD were prospectively enrolled. All patients were treated in an extrafoveal area of 1.27 mm2 using end-point management yellow subthreshold laser and followed for 3 months. Best-corrected visual acuity was 0.140 ± 0.09 LogMAR at the baseline and no changes were observed during the follow-up (p = 0.232). No significant worsening was disclosed before and after the treatment analyzing the macular sensitivity of the treated area (p = 0.152). No topical and/or systemic side effects were disclosed during the 3-month follow-up. The distribution among the RPD stages changed after the treatment (p < 0.001). In detail, in the treated area, we observed a significant increase in the number of Stage 1 RPD during the follow-up (p = 0.002), associated with a significant decrease of Stage 3 RPD (p = 0.020). Outer nuclear layer (ONL) thickness analysis showed a significant increase after the treatment associated with RPD regression (p = 0.001). End-point management SLT appears a safe treatment for RPD secondary to dAMD, showing short-term safety outcomes. Our results suggest that SLT could be effective in inducing a RPD regression in terms of RPD stage and ONL thickening.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040480
Author(s):  
Amaya Ayala-Garcia ◽  
Laura Serra ◽  
Monica Ubalde-Lopez

ObjectivesTo assess the relationship between early working life patterns, at privately and publicly held companies, and the course of sickness absence (SA) due to mental disorders.MethodsCohort study of workers aged 18–28 years, affiliated with the Spanish social security system, living in Catalonia, who had at least one episode of SA due to mental disorders between 2012 and 2014. Individual prior working life trajectories were reconstructed through sequence analysis. Optimal matching analysis was performed to identify early working life patterns by clustering similar individual trajectories. SA trajectories were identified using latent class growth modelling analysis. Finally, the relationship between early working life patterns and subsequent SA trajectories was assessed via multinomial logistic regression models.ResultsAmong both men and women, four labour market participation (LMP) patterns were identified: stable permanent employment (reference group), increasing permanent employment, fluctuating employment and delayed employment. Among women, an increasing permanent employment pattern in early working life was related to a decrease of accumulated SA days over time (adjusted OR (aOR) 2.08; 95% CI 1.18 to 3.66). In men, we observed a trend towards a middle stable accumulation of SA days in those with fluctuating employment (aOR 1.25, 95% CI 0.57 to 2.74) or delayed employment (aOR 1.79; 95% CI 0.59 to 5.41). In both men and women, an early working life in big companies was related to a more favourable SA trajectory.ConclusionsEarly LMP patterns characterised by an increasing stability—decreased number of transitions between temporary contracts and lack of social security coverage towards permanent contracts—were related to a better future SA course due to mental diagnosis.


Author(s):  
E. Sutton ◽  
◽  
J. A. Lane ◽  
M. Davis ◽  
E. I. Walsh ◽  
...  

Abstract Purpose To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041705
Author(s):  
Ben Wamamili ◽  
Sheleigh Lawler ◽  
Mark Wallace-Bell ◽  
Coral Gartner ◽  
David Sellars ◽  
...  

ObjectivesExamine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics.DesignCross-sectional studies.SettingThe University of Queensland (UQ), Australia and eight New Zealand (NZ) universities.ParticipantsStudents at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women).MethodsΧ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international).ResultsSmoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%.Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes.Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use.ConclusionsResults suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping.


Author(s):  
Ila R Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia Furquim de Almeida ◽  
Rosemeire L Fiaccone ◽  
Natanael J Silva ◽  
...  

ABSTRACT Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.


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