Correcting contraceptive failure rates for sample composition and sample selection bias

Abstract

There is reason to believe that in the short run marriages are becoming more stable in some Western African countries such as Cameroon. One of the crucial questions facing these countries is whether fertility rates can be expected to increase or decrease due in part to the increased stability of marriages. Analyzing 1978 Cameroon World Fertility Survey data and using a multivariate regression model which compares the fertility rate of women who have had at least one marital disruption with that of continuously married women, we studied the relationship between marital instability and fertility. The results show that fertility rates for women married more than once are significantly lower than those for continuously married women even before the end of their first marriage. Furthermore, marital disruption significantly reduces fertility rates after the dissolution of the first marriage. Finally, even after the length of reproductive time lost is controlled, there is an inverse relationship between the number of marriages and fertility. The results are discussed in the context of economic development, modernization, and urbanization.     

未婚人工流产女性生殖健康知识知晓现状调查及其影响因素分析

摘要 目的：探究未婚人工流产女性生殖健康知识知晓现状,并分析其影响因素。方法：随机选取2018年3月~2021年5月期间在同济大学附属第一妇婴保健院计划生育科终止妊娠的未婚女性486例作为研究对象。其中,拒绝调查者21例,实际调查465例,应答率95.68%（465/486）,数据清理后有效问卷459份,有效率为98.71%（459/465）。调查未婚人工流产女性生殖健康知识知晓现状,未婚人工流产女性生殖健康知识知晓情况的危险因素采用单因素及多因素Logistic回归分析。结果：研究对象中,女性生殖健康知识知晓总分最低分17分,最高分为92分,平均（65.74±10.82）分;得分大于80分者179例,优良率为39.00%（179/459）。得分在80分及其以下的女性280例。未婚人工流产女性生殖健康知识知晓情况与年龄、女方文化程度、父母婚姻状况、流产次数、工作性质、居住地、恋爱经历、男方文化程度有关（P<0.05）。而与家庭月收入、更换工作次数无关（P>0.05）。年龄、男方文化程度工作性质、居住地、女方文化程度、流产次数、父母婚姻状况是未婚人工流产女性生殖健康知识知晓情况的影响因素（P<0.05）。结论：未婚人工流产女性生殖健康知识知晓水平一般,受到年龄、女方文化程度、父母婚姻状况等多种因素影响,应针对其影响因素特点加强生殖健康知识的宣教,以降低人工流产的风险。     

News notes

Abstract

This paper is concerned with the efficacy of genetic counseling with respect to schizophrenia. Evidence for the genetic basis of schizophrenia is reviewed, as are data demonstrating increases in the marital and reproductive rates of schizophrenic patients. The dilemmas of genetic counseling are discussed, and a strategy for early identification of individuals with a predisposition to schizophrenia is described.     

Reproductive health among married and unmarried mothers aged less than 18, 18–19, and 20–24 years in the United States, 2014–2019: A population-based cross-sectional study

BackgroundStudies in low- and middle-income regions suggest that child marriage (<18 years) is a risk factor for poor reproductive outcomes among women. However, in high-income-country contexts where childbearing before age 18 occurs predominantly outside marriage, it is unknown whether marriage is adversely associated with reproductive health among mothers below age 18. This study examined the joint associations of marriage and adolescent maternal age group (<18, 18–19, and 20–24 years) with reproductive, maternal, and infant health indicators in the United States.Methods and findingsBirth registrations with US resident mothers aged ≤24 years with complete information on marital status were drawn from the 2014 to 2019 Natality Public Use Files (n = 5,669,824). Odds ratios for the interaction between marital status and maternal age group were estimated using multivariable logistic regression, adjusting for covariates such as maternal race/ethnicity and nativity status, federal program participation, and paternal age. Marriage prevalence was 3.6%, 13.2%, and 34.1% among births to mothers aged <18, 18–19, and 20–24 years, respectively. Age gradients in the adjusted odds ratios (AORs) were present for most indicators, and many gradients differed by marital status. Among births to mothers aged <18 years, marriage was associated with greater adjusted odds of prior pregnancy termination (AOR 1.64, 95% CI 1.52–1.77, p < 0.001), repeat birth (AOR 2.84, 95% CI 2.68–3.00, p < 0.001), maternal smoking (AOR 1.24, 95% CI 1.15–1.35, p < 0.001), and infant morbidity (AOR 1.07, 95% CI 1.01–1.14, p = 0.03), but weaker or reverse associations existed among births to older mothers. For all maternal age groups, marriage was associated with lower adjusted odds of late or no prenatal care initiation, sexually transmitted infection, and no breastfeeding at hospital discharge, but these beneficial associations were weaker among births to mothers aged <18 and 18–19 years. Limitations of the study include its cross-sectional nature and lack of information on marriage timing relative to prior pregnancy events.ConclusionsMarriage among mothers below age 18 is associated with both adverse and favorable reproductive, maternal, and infant health indicators. Heterogeneity exists in the relationship between marriage and reproductive health across adolescent maternal age groups, suggesting girl child marriages must be examined separately from marriages at older ages.

In a population-based study, Andrée-Anne Fafard St-Germain and colleagues examine the joint associations of marriage and adolescent maternal age group (<18, 18-19, and 20-24 years) with reproductive, maternal, and infant health indicators in the United States.     

Children's health and their mothers’ risk of divorce or separation

Abstract

The purpose of this study is to determine how children's health conditions are related to their mothers’ risk of divorce or separation. The study is based on data from over 7,000 children born to once‐married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers’ risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers’ prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.     

Health related quality of life in adult cancer survivors: Importance of social and emotional support

BackgroundAdult cancer survivors (ACS) are at increased risk for developing various comorbid conditions and having poor health-related quality of life (HRQOL) when compared to adults with no history of cancer. The effect of social and emotional support on HRQOL among ACS is not fully elucidated. The purpose of this study was to understand the role of social and emotional support on HRQOL in ACS and to examine if the association between social and emotional support and HRQOL is modified by gender, time since cancer diagnosis, or marital status.MethodsData for this study were obtained from the 2009 Behavioral Risk Factor Surveillance System. Statistical analysis was based on ACS with complete data (n = 23,939) on all variables considered. Multivariable logistic regression models were used to model the association between social and emotional support and indicators of HRQOL (i.e., general health, physical health, mental health, and activity limitation). To examine if gender, marital status, or the number of years since cancer diagnosis modify the association, separate stratified analyses were conducted.ResultsWhen compared to ACS who reported that they Rarely/Never received social and emotional support, those who reported that they Always received were 32 % less likely to report Fair/Poor General health, 23 % less likely to report frequent unhealthy days of Physical health, 73 % less likely to report frequent unhealthy days of Mental health and 38 % less likely to report frequent unhealthy days of Activity limitation. Social and emotional support was positively associated with all four domains of HRQOL among ACS who were female, unmarried, or greater than 5 years since cancer diagnosis, while this positive association was evident only with one or two domains of HRQOL among their corresponding counterparts (i.e., male, married, less than 5 years since diagnosis).ConclusionsSocial and emotional support is an important factor directly related to a better HRQOL, but it is modified by gender, marital status, and time since diagnosis. Findings from this study should inform health care providers about the importance of a support system for ACS in improving their overall quality of life.     

Submitting articles to the BMJ

ObjectiveTo determine whether people whose marital partners have depression, diabetes, hypertension, ischaemic heart disease, stroke, hyperlipidaemia, peptic ulcer disease, or asthma or chronic obstructive pulmonary disease are at increased risk of the same disease.DesignCross sectional study.Setting10 practices from the Trent Focus Collaborative Research Practice Network.Participants8386 married couples (16 772 individuals) from a population of 29 014 participants aged 30-74 years.OutcomesRisk of disease in participants whose marital partner had that disease compared with those whose partner did not.ResultsAfter both partners'' age, smoking, and obesity and which general practice they attend were adjusted for, participants whose marital partner had asthma, depression, hypertension, hyperlipidaemia, and peptic ulcer disease were at increased risk of having the same disease. The adjusted odds ratios were 1.69 (95% confidence interval 1.43 to 2.98) for asthma, 2.08 (1.71 to 2.54) for depression, 1.32 (1.04 to 1.67) for hypertension, 1.44 (1.19 to 1.75) for hyperlipidaemia, and 2.01 (1.48 to 2.73) for peptic ulcer disease.ConclusionPartners of people with specific diseases are at increased risk of the disease themselves—at least 70% increased risk for asthma, depression, and peptic ulcer disease. This implicates shared environmental causes in some diseases in addition to any genetic or distant exposure or shared behaviours with respect to seeking health care.

What is already known on this topic

People whose spouses have hypertension are at increased risk of hypertensionLittle is known about the risks of disease for spouses of patients with diseases other than hypertension

What this study adds

People whose marital partner had asthma, depression, and peptic ulcer disease were at increased risk of having the same diseaseShared environmental factors contribute to the risk of diseasesThe costs and benefits of screening people for diseases of their spouses needs to be considered     

上海市杨浦区社区2型糖尿病患者周围神经病变患病率调查及其影响因素分析

摘要 目的：调查上海市杨浦区社区2型糖尿病（T2DM）患者周围神经病变（DPN）患病率,并分析其影响因素。方法：于2019年3月~2020年3月在上海市杨浦区所辖社区中随机选取5个社区,采用分层随机抽样法从每个社区选取100例T2DM患者进行调查,统计T2DM患者DPN患病率,采用多因素Logistic回归分析DPN发生的影响因素。结果：本次研究共发放500份调查问卷,回收498份,回收率为99.60%（498/500）,其中DPN患者222例,DPN发生率为44.58%（222/498）,纳为DPN组,276例未发生DPN纳为非DPN组。单因素分析结果显示：DPN组与非DPN组在腰围、合并糖尿病视网膜病变（DR）、合并下肢血管病变（PVD）、吸烟史、高血压、脑梗死病史、文化程度、婚姻状况、收缩压（SBP）、空腹血糖（FPG）、葡萄糖达标时间百分比（TIR）、载脂蛋白B、尿酸方面比较有差异（P<0.05）。进一步多因素Logistic回归分析结果显示：合并DR、合并PVD、有吸烟史、有脑梗死病史、婚姻状况为未婚/离异/丧偶、FPG水平较高是T2DM患者发生DPN的危险因素（P<0.05）。结论：T2DM患者中DPN的患病率较高,合并DR、PVD、吸烟史、脑梗死病史以及婚姻状况是DPN发生的影响因素,应重视DPN筛查并进行干预,针对上述影响因素对T2DM患者开展健康宣教,减少DPN的发生。     

Against the trend: increasing numbers of breeding Northern Lapwings Vanellus vanellus and Black-tailed Godwits Limosa limosa limosa on a German Wadden Sea island

Capsule The increase in population sizes over the last 30 years cannot be explained by reproductive success.

Aims To establish whether the positive population trends are due to increasing and self-sustaining populations or to immigration.

Methods We studied the population development of breeding lapwings from 1971 until 2005 and of godwits from 1977 until 2005 on Wangerooge, a German Wadden Sea island. Both species increased significantly during the last three decades. For each species we used a logistic growth model to derive the reproductive output required to explain the past population development without assuming immigration. We compare the values derived by this model with empirical findings of reproductive output of the respective populations.

Results For neither lapwings nor godwits can empirical reproductive success explain the observed population development.

Conclusion Our results imply that the increase in breeding pairs of Northern Lapwing and Black-tailed Godwit on Wangerooge Island is not due to reproductive output. We propose that it is mainly caused by immigration onto the island.     

Human Papillomavirus Infection and Fertility Alteration: A Systematic Review

BackgroundHPV is the most prevalent sexually transmitted infection and its effect in cancer induction is well documented. HPV infections are mostly asymptomatic, but it is unclear whether HPV infections can result in alterations of reproductive health.ObjectiveTo determine the relationship between human papillomavirus infections and reproductive health in both men and women.MethodsA systematic literature review was performed in PubMed and ScienceDirect data bases from January 1994 through August 2014.ResultsHPV infections are shown to be significantly associated to many adverse effects in the reproductive function. These adverse effects were reported in different levels from cells production to pregnancy and may be related to the infecting genotype.ConclusionsIt appears from this study that HPV detection and genotyping could be of great value in infertility diagnosis at least in idiopathic infertility cases. Like for the risk of carcinogenesis, another classification of HPV regarding the risk of fertility alteration may be considered after deep investigations.     

The breeding success of Common Swifts Apus apus is not correlated with the abundance of their Louse Fly Crataerina pallida parasites

Capsule Parasitism has no apparent detrimental effect.

Aims To determine whether parasitism by a haematophagous nest ectoparasite, the Louse Fly Crataerina pallida has a detrimental effect on the reproductive success of its Common Swift Apus apus hosts.

Methods An association between C. pallida abundance and various host life‐history parameters indicative of host reproductive success were sought.

Results No relationship was found between measures of parasite load and clutch size, brood size, length of time required to reach nestling asymptotic weight, the length of time from hatching to fledging, fledging success per nest, fledgling weight, and fledgling size.

Conclusion Parasitism has no apparent detrimental effect upon its hosts. Louse Flies may have evolved low levels of virulence or the negative effects expected as a consequence of its parasitism may be expressed on life‐history traits other than those studied here.     

Changes in Hidatsa Residence Patterns: a Cross-Cultural Interpretation

Abstract

Changes in Hidatsa marital residence patterns are described on the strength of ethnohistoric and ethnographic data. Such changes include a shift from a predominantly matrilocal to a multilocal pattern during the period 1780-1870. An interpretation for this change is offered in light of cross-cultural studies: multilocal residence is a response to depopulation due to infectious epidemic diseases in societies with some dependence on horticulture. A revision for the coding of Hidatsa marital residence in the Ethnographic Atlas is also suggested.     

淋巴瘤幸存者复发恐惧的影响因素及认知行为干预对患者生活质量和心理状态的影响

摘要 目的：分析淋巴瘤幸存者复发恐惧（FCR）的影响因素,并分析认知行为干预对患者生活质量和心理状态的影响。方法：本次研究为回顾性调查研究,选取2018年7月~2021年6月期间我院收治的淋巴瘤患者80例,根据病历资料获取患者婚姻状况、疾病分期、工作状况、年龄、治愈时间、文化程度、疾病类型、性别、医疗费用承担情况、家庭人均月收入。采用多因素Logistic回归分析淋巴瘤幸存者FCR的影响因素。将80例淋巴瘤患者分为对照组和干预组,各为40例。对照组给予常规处理,干预组在此基础上接受认知行为干预,对比两组生活质量和心理状态变化。结果：淋巴瘤幸存者FCR总分为（86.90±5.96）分。不同婚姻状况、年龄、疾病分期、家庭人均月收入的患者FCR总分对比差异有统计学意义（P<0.05）。多因素Logistic回归分析显示家庭人均月收入、婚姻状况、疾病分期、年龄是淋巴瘤幸存者FCR的影响因素（P<0.05）。干预后,两组生理职能、躯体疼痛、精神健康、生理功能、总体健康、情感职能、活力、社会功能维度评分均较干预前升高,且干预组高于对照组（P<0.05）。干预组干预后的恐惧疾病进展简化量表（FoP-Q-SF）评分低于对照组（P<0.05）。结论：淋巴瘤幸存者的FCR应得到重视,尤其针对年龄偏低、婚姻状况为离异/未婚/丧偶、家庭人均月收入偏低、疾病分期高的人群,给予认知行为干预后,可提高患者的生活质量和心理状态。     

Household crowding and reproductive behavior

Abstract

Ethological studies suggest that animal populations that live in crowded conditions display a number of behaviors that tend to limit the size of the population, such as aberrant forms of sexual behavior, small litter sires, a higher incidence of spontaneous abortion, ineffectual maternal care, and even cannibalism of their young. Studies of household crowding in North America cities have produced only modest and selective evidence that crowding has similar effects among humans. In this paper, we examine the effect of household crowding on marital sexual relations, on desire for additional children, and on fetal and child loss in Bangkok, Thailand, a city with a much wider range of household crowding than is typically found in North America. In spite of the wider range, and higher mean level of crowding, we find that both the objective and subjective dimensions of crowding have only modest selective effects on sexual and reproductive behavior.     

Tribulus terrestris and female reproductive system health: A comprehensive review

BackgroundTribulus terrestris L. (T. terrestris) positive performance on the male sexual system has been confirmed, but little is known about its effects on the female reproductive system.PurposeThis review discussed in detail the beneficial impact of T. terrestris and its secondary metabolites on the female reproductive system.Study design and methodsIn this review, the scientific Databases of Science direct, Pubmed, Web of Science, Google, Google Scholar, Researchgate, EMBASE, Scientific Information (SID), and Elsevier were searched profoundly. Studies about the pharmacological activities of T. terrestris on the female reproductive system in each aspect of investigations: human, in vivo, and in vitro studies, in the period from 1998 to 2020 were admitted. Our study was not limited by the language of publications.Results23 articles about the effects of T. terrestris on the female reproductive system were found. These studies approved the T. terrestris efficacy on improvements in histological features of the ovary and uterus of polycystic ovary syndrome patients as well as the well-working of normal ovaries, enhancements in the sexual desire of postmenopausal syndrome, improve ovarian and breast cancers.ConclusionThese studies showed that the positive effect of T. terrestris on the female reproductive system was due to the presence of a secondary metabolite called protodioscin; a steroidal saponin compound, as the dominant active component of this plant.     

Cultural inheritance of the desire for male offspring and the incidence of a sex‐linked lethal disease

Abstract

This paper studies the effect of having at least one male offspring on a sex‐linked recessive disease and the fraction of affected males due to fresh mutations. The equilibrium frequency of heterozygous females depends not only on the intensity of the reproductive compensation, but also on the time of mutational change. It has been shown that the frequency ranges from 4u without reproductive compensation to √2u or √3u with strict compensation, where u is the mutation rate from the wild type allele to lethal gene. The frequency √2u is achieved when mutation occurs in mature germ cells, whereas, √3u achieved when mutation occurs in early development of germ cells. This increased frequency of heterozygous females due to reproductive compensation reduces considerably the proportion of affected males due to fresh mutation.     

The role of individual variation in flowering and pollination in the reproductive success of a crepuscular buzz-pollinated plant

Background and AimsPlant individuals within a population differ in their phenology and interactions with pollinators. However, it is still unknown how individual differences affect the reproductive success of plants that have functionally specialized pollination systems. Here, we evaluated whether plant individual specialization in phenology (temporal specialization) and in pollination (pollinator specialization) affect the reproductive success of the crepuscular-bee-pollinated plant Trembleya laniflora (Melastomataceae).MethodsWe quantified flowering activity (amplitude, duration and overlap), plant–pollinator interactions (number of flowers visited by pollinators) and reproductive success (fruit set) of T. laniflora individuals from three distinct locations in rupestrian grasslands of southeastern Brazil. We estimated the degree of individual temporal specialization in flowering phenology and of individual specialization in plant–pollinator interactions, and tested their relationship with plant reproductive success.Key Results Trembleya laniflora presented overlapping flowering, a temporal generalization and specialized pollinator interactions. Flowering overlap among individuals and populations was higher than expected by chance but did not affect the individual interactions with pollinators and nor their reproductive success. In contrast, higher individual generalization in the interactions with pollinators was related to higher individual reproductive success.ConclusionsOur findings suggest that individual generalization in plant–pollinator interaction reduces the potential costs of specialization at the species level, ensuring reproductive success. Altogether, our results highlight the complexity of specialization/generalization of plant–pollinator interactions at distinct levels of organization, from individuals to populations, to species.     

Breeding patterns in the oniscid isopod,Porcellio ficulneus Verh., at high temperature and under different photophases

Summary

Porcellio ficulneus Verhoeff inhabits xeric Mediterranean grassland habitats. During winter vitellogenesis takes place and mancas are released in April. Under natural conditions some oocytes (about 20%) were lost. Both high temperature (25°C) at long or short photophases affected the reproductive pattern. Thus at 25°C and constant light vitellogenesis was markedly shorter than under field conditions. Oocytes matured sooner, but many were resorbed. The marsupium was formed earlier and contained fewer eggs. In some cases mancas that had developed could not emerge from the marsupium and died inside. In conclusion, P. ficulneus responds to warmer conditions by breeding earlier and reducing the number of offspring.     

Voluntary stepping behavior under single- and dual-task conditions in chronic stroke survivors: A comparison between the involved and uninvolved legs

ObjectiveIf balance is lost, quick step execution can prevent falls. Research has shown that speed of voluntary stepping was able to predict future falls in old adults. The aim of the study was to investigate voluntary stepping behavior, as well as to compare timing and leg push-off force–time relation parameters of involved and uninvolved legs in stroke survivors during single- and dual-task conditions. We also aimed to compare timing and leg push-off force–time relation parameters between stroke survivors and healthy individuals in both task conditions.MethodsTen stroke survivors performed a voluntary step execution test with their involved and uninvolved legs under two conditions: while focusing only on the stepping task and while a separate attention-demanding task was performed simultaneously. Temporal parameters related to the step time were measured including the duration of the step initiation phase, the preparatory phase, the swing phase, and the total step time. In addition, force–time parameters representing the push-off power during stepping were calculated from ground reaction data and compared with 10 healthy controls.ResultsThe involved legs of stroke survivors had a significantly slower stepping time than uninvolved legs due to increased swing phase duration during both single- and dual-task conditions. For dual compared to single task, the stepping time increased significantly due to a significant increase in the duration of step initiation. In general, the force time parameters were significantly different in both legs of stroke survivors as compared to healthy controls, with no significant effect of dual compared with single-task conditions in both groups.ConclusionsThe inability of stroke survivors to swing the involved leg quickly may be the most significant factor contributing to the large number of falls to the paretic side. The results suggest that stroke survivors were unable to rapidly produce muscle force in fast actions. This may be the mechanism of delayed execution of a fast step when balance is lost, thus increasing the likelihood of falls in stroke survivors.     

Population based study of social and productive activities as predictors of survival among elderly Americans

ObjectivesTo examine any association between social, productive, and physical activity and 13 year survival in older people. DesignProspective cohort study with annual mortality follow up. Activity and other measures were assessed by structured interviews at baseline in the participants’ homes. Proportional hazards models were used to model survival from time of initial interview.SettingCity of New Haven, Connecticut, United States.Participants2761 men and women from a random population sample of 2812 people aged 65 and older.ResultsAll three types of activity were independently associated with survival after age, sex, race/ethnicity, marital status, income, body mass index, smoking, functional disability, and history of cancer, diabetes, stroke, and myocardial infarction were controlled for.ConclusionsSocial and productive activities that involve little or no enhancement of fitness lower the risk of all cause mortality as much as fitness activities do. This suggests that in addition to increased cardiopulmonary fitness, activity may confer survival benefits through psychosocial pathways. Social and productive activities that require less physical exertion may complement exercise programmes and may constitute alternative interventions for frail elderly people.

Key messages

• Little is known about predictors of survival among elderly people
• Physical activity is clearly good for health, but the potential benefits of social activities have not been studied
• Social and productive activities are as effective as fitness activities in lowering the risk of death
• Enhanced social activities may help to increase the quality and length of life