Sexual intercourse among adolescents in Santiago, Chile: a study of individual and parenting factors

OBJECTIVE: To examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. METHODS: Data were taken from the first wave of the Santiago Longitudinal Study conducted in January 2008–November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low-to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklist’s Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. RESULTS: Seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex was inversely associated with withdrawn-depressed symptoms (Odds Ratio [OR] = 0.84, Confidence Interval [CI] = 0.72–0.97), but positively associated with somatic complaints (OR = 1.20, CI = 1.04–1.38) and rule breaking behavior (OR = 1.21, CI = 1.08–1.36), after adjusting for demographic and other individual and parenting variables. The majority (80%) of the youth who had had sex reported using protection at the time of last intercourse. CONCLUSIONS: Findings highlight the role that mental health problems—some of them not commonly associated with onset of sexual activity—may play in a youth’s decision to have sex. The potential protective effects of several parenting and family characteristics disappeared with youth age and youth behavioral problems.R01 HD033487 - NICHD NIH HHS; R01 DA021181 - NIDA NIH HHS; DA021181 - NIDA NIH HH

Family and parenting characteristics associated with marijuana use by Chilean adolescents

OBJECTIVE: Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America. METHODS: Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables. RESULTS: Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. CONCLUSION: Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children's development and potential use of marijuana.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109755/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109755/Accepted manuscrip

Prevalence and determinants of anxiety and depression in end stage renal disease (ESRD). A comparison between ESRD patients with and without coexisting diabetes mellitus

Objective: To compare anxiety and/or depressive symptoms between patients with end-stage renal disease with and without comorbid diabetes and identify factors associated with symptoms of distress in this population. Methods: Data from two studies (conducted between 2010 and 2014) were pooled. A total of 526 patients on hemodialysis (68.8% with diabetes) completed the Hospital Anxiety and Depression Scale (HADS). Elevated symptoms were defined as HADS-Anxiety or HADS-Depression ≥ 8. Univariate and multivariate logistic regressions were used to estimate associations between diabetic status, and other socio-demographic and clinical factors with baseline clinical anxiety and depression. Results: A total of 233 (45.4%) reported elevated anxiety symptoms and 256 (49.9%) reported elevated depressive symptoms sufficient for caseness. Rates were not different between patients with and without diabetes. Risk for clinical depression was higher in patients who were single/unpartnered (OR = 1.828), Chinese vs. Malay (OR = 2.05), or had lower albumin levels (OR = 0.932). None of the parameters were associated with anxiety caseness. Conclusion: Sociocultural factors rather than comorbid burden may help identify patients at risk for depression. The high rates of anxiety and depression underlie the importance for monitoring and intervention in dialysis care

Long‐term microbial community dynamics at two full‐scale biotrickling filters treating pig house exhaust air

In this study, the microbial community structure of two full-scale biotrickling filters treating exhaust air from a pig housing facility were evaluated using 16S metabarcoding. The effect of inoculation with activated sludge of a nearby domestic waste water treatment plant was investigated, which is a cheap procedure and easy to apply in practice. The study was performed at a three-stage and a two-stage full-scale biotrickling filter; of which, only the latter was inoculated. Both biotrickling filters evolved towards a rather similar community over time, which differed from the one in the activated sludge used for inoculation. However, the bacterial population at both biotrickling filters showed small differences on the family level. A large population of heterotrophic bacteria, including denitrifying bacteria, was present in both biotrickling filters. In the non-inoculated biotrickling filter, nitrite-oxidizing bacteria (NOB) could not be detected, which corresponded with the incomplete nitrification leading to high nitrite accumulation observed in this system. Inoculation with the wide spectrum inoculum activated sludge had in this study a positive effect on the biotrickling filter performance (higher ammonia removal and lower nitrous oxide production). It could thus be beneficial to inoculate biotrickling filters in order to enrich NOB at the start-up, making it easier to keep the free nitrous acid concentration low enough to not be inhibited by it

Predictors of anxiety after stroke: a systematic review of observational studies

Background: Anxiety disorders or symptoms are relatively common following stroke. A better understanding of the predictors of anxiety in stroke patients may improve the management of these disorders. The current review was conducted to determine the predictors of anxiety following stroke. Methods: Relevant articles concerning population, hospital or rehabilitation-based studies were identified by searching 10 electronic databases up to May 2014. Methodological quality appraisal, including the validity of prognostic models and data extraction were conducted by three reviewers. Results: A total of 18 studies were identified. Data from three population-based studies including 8130 patients, 8 hospital-based studies including 1199 patients, and 7 rehabilitation-based studies including 1103 patients was evaluated. Pre-stroke depression, stroke severity, early anxiety and dementia or cognitive impairment following stroke were the main predictors of post stroke anxiety. Older age, physical disability or impairment, and use of antidepressant drugs were not associated with presence of anxiety. Limitations of studies included wide variation in screening tools and cut-off scores, variability in the time frame of screening for anxiety, use of extensive exclusion criteria and questionable statistical internal and external validity of the models. Conclusions: Lack of methodological and statistical rigour affects the validity of proposed models to predict anxiety after stroke. Future research should focus on testing proposed models on both internal and external samples to ultimately inform future clinical practice

ADRIC: Adverse Drug Reactions In Children - a programme of research using mixed methods

Aims To comprehensively investigate the incidence, nature and risk factors of adverse drug reactions (ADRs) in a hospital-based population of children, with rigorous assessment of causality, severity and avoidability, and to assess the consequent impact on children and families. We aimed to improve the assessment of ADRs by development of new tools to assess causality and avoidability, and to minimise the impact on families by developing better strategies for communication. Review methods Two prospective observational studies, each over 1 year, were conducted to assess ADRs in children associated with admission to hospital, and those occurring in children who were in hospital for longer than 48 hours. We conducted a comprehensive systematic review of ADRs in children. We used the findings from these studies to develop and validate tools to assess causality and avoidability of ADRs, and conducted interviews with parents and children who had experienced ADRs, using these findings to develop a leaflet for parents to inform a communication strategy about ADRs. Results The estimated incidence of ADRs detected in children on admission to hospital was 2.9% [95% confidence interval (CI) 2.5% to 3.3%]. Of the reactions, 22.1% (95% CI 17% to 28%) were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44 out of 249 (17.7%) of ADRs, the remainder originating from hospital. A total of 120 out of 249 (48.2%) reactions resulted from treatment for malignancies. Off-label and/or unlicensed (OLUL) medicines were more likely to be implicated in an ADR than authorised medicines [relative risk (RR) 1.67, 95% CI 1.38 to 2.02; p  48 hours, the overall incidence of definite and probable ADRs based on all admissions was 15.9% (95% CI 15.0 to 16.8). Opiate analgesic drugs and drugs used in general anaesthesia (GA) accounted for > 50% of all drugs implicated in ADRs. The odds ratio of an OLUL drug being implicated in an ADR compared with an authorised drug was 2.25 (95% CI 1.95 to 2.59; p < 0.001). Risk factors identified were exposure to a GA, age, oncology treatment and number of medicines. The systematic review estimated that the incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children [pooled estimate of 2.9% (95% CI 2.6% to 3.1%)] and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. New tools to assess causality and avoidability of ADRs have been developed and validated. Many parents described being dissatisfied with clinician communication about ADRs, whereas parents of children with cancer emphasised confidence in clinician management of ADRs and the way clinicians communicated about medicines. The accounts of children and young people largely reflected parents’ accounts. Clinicians described using all of the features of communication that parents wanted to see, but made active decisions about when and what to communicate to families about suspected ADRs, which meant that communication may not always match families’ needs and expectations. We developed a leaflet to assist clinicians in communicating ADRs to parents. Conclusion The Adverse Drug Reactions In Children (ADRIC) programme has provided the most comprehensive assessment, to date, of the size and nature of ADRs in children presenting to, and cared for in, hospital, and the outputs that have resulted will improve the management and understanding of ADRs in children and adults within the NHS. Recommendations for future research: assess the values that parents and children place on the use of different medicines and the risks that they will find acceptable within these contexts; focusing on high-risk drugs identified in ADRIC, determine the optimum drug dose for children through the development of a gold standard practice for the extrapolation of adult drug doses, alongside targeted pharmacokinetic/pharmacodynamic studies; assess the research and clinical applications of the Liverpool Causality Assessment Tool and the Liverpool Avoidability Assessment Tool; evaluate, in more detail, morbidities associated with anaesthesia and surgery in children, including follow-up in the community and in the home setting and an assessment of the most appropriate treatment regimens to prevent pain, vomiting and other postoperative complications; further evaluate strategies for communication with families, children and young people about ADRs; and quantify ADRs in other settings, for example critical care and neonatology

Formation of machine groups and part families in cellular manufacturing systems using a correlation analysis approach

The important step in the design of a cellular manufacturing (CM) system is to identify the part families and machine groups and consequently to form manufacturing cells. The scope of this article is to formulate a multivariate approach based on a correlation analysis for solving cell formation problem. The proposed approach is carried out in three phases. In the first phase, the correlation matrix is used as similarity coefficient matrix. In the second phase, Principal Component Analysis (PCA) is applied to find the eigenvalues and eigenvectors on the correlation similarity matrix. A scatter plot analysis as a cluster analysis is applied to make simultaneously machine groups and part families while maximizing correlation between elements. In the third stage, an algorithm is improved to assign exceptional machines and exceptional parts using respectively angle measure and Euclidian distance. The proposed approach is also applied to the general Group Technology (GT) problem in which exceptional machines and part are considered. Furthermore, the proposed approach has the flexibility to consider the number of cells as a dependent or independent variable. Two numerical examples for the design of cell structures are provided in order to illustrate the three phases of proposed approach. The results of a comparative study based on multiple performance criteria show that the present approach is very effective, efficient and practical.cellular manufacturing; cell formation; correlation matrix; Principal Component Analysis; exceptional machines and parts