Is Volunteering During Adolescence Associated with a Delay in Pregnancy Until Adulthood?

Purpose: The objective of this study was to determine if regular volunteering during adolescence was associated with a delay in first pregnancy until adulthood. Method: Data for this analysis were drawn from Wave III of the National Longitudinal Study of Adolescent Health (Add Health). Logistic regression was used, controlling for demographic characteristics and pregnancy intention, to estimate the independent contribution of volunteering during adolescence to a delay in first pregnancy until after age 18. Results: One-third of respondents reported regularly volunteering during adolescence. Volunteering significantly differed among those who had a teen pregnancy compared to those who delayed pregnancy until adulthood (chi-square 6.52, p-value 0.012). In the adjusted analysis, respondents who reported regularly volunteering during adolescence were nearly 60% more likely to delay their first pregnancy until adulthood compared to those who did not volunteer. Conclusions: This analysis is the only one known to have examined volunteering alone, not as part of a multiple component prevention program. Its findings suggest that incorporating volunteering opportunities may make pregnancy prevention programs more successful. In addition, increasing the number of the kinds of volunteering opportunities that are already available may confer some protection against adolescent pregnancy

Immunologic Risk Prediction Model for Kidney Graft Function

Clinicians lack appropriate non-invasive methods to be able to predict, diagnose, and reduce the risk of rejection in the years following kidney transplantation. Protocol biopsies and monitoring of serum creatinine levels are the most common methods of monitoring graft function after transplant; however, they have several negative aspects. Use of traditional factors regarding donors and recipients such as Human Leukocyte Antigen (HLA) DNA typing, pre-transplant anti-HLA antibody levels, and basic demographics (age, ethnicity/race, gender), has proved inadequate for post-transplant graft monitoring past the first few years. We propose that by utilizing immunologic factors available to clinicians across the United States, development of a non-invasive model for predicting renal graft outcome will provide a useful tool for post-transplant patient monitoring. We advocate an expanded model which incorporates both the traditional factors, as well as new factors, which have shown promise in predicting kidney outcome and are widely available for testing using commercial kits. These additional factors include major histocompatibility complex class I chain-related gene A (MICA) typing of donor and recipient, degree of matching for killer cell immunoglobulin-like receptors (KIRs) between donor and recipient, detection of MICA antibodies, and soluble CD30 level (sCD30). This proposed graft-function prediction model is the first to include all of these factors. Using multi-center data from adult recipients of standard-criteria deceased-donor (SCD) kidneys, we were able to construct models, containing the traditional factors only, for prediction of outcome at 1 year and 3 years post-transplant. Using single-center data from adult recipients of standard-criteria deceased-donor kidneys, we developed comparison models containing traditional factors only, as well as, expanded models containing the new suggested variables for prediction of outcome post-transplant. These additional variables, when incorporated into the expanded models provided greater positive predictive values, greater negative predictive values, and lower false negative rates for graft outcome at 1 year and at 3 years post-transplant than the models utilizing traditional factors only. Our results indicate that evaluation of sCD30, MICA and KIR as part of routine protocol testing, is helpful to clinicians for predicting risk of kidney graft rejection

Scoundrels Day: Promoting Active Learning in Nursing Research through Librarian-Presented Case-Based Problem-Solving Challenges

Highlighting a teaching collaboration between Nursing and Library. Using health/research cases, this team classroom activity and “lightning presentation” allows students to engage and appraise unfamiliar research papers, using research resources, skills, and concepts encountered throughout the semester. Using web-based library resources, each team ultimately discovers how a research study, author or concept has been a “scoundrel.

Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth?

Background Obesity in pregnant women is a major problem affecting both the mother and her offspring. Literature on the effect of obesity on preterm birth is inconsistent and few studies have investigated the influence of weight gain during pregnancy. This study examined the effect of maternal pre-pregnancy BMI and weight gain during pregnancy on preterm birth. Methods Data from the Collaborative Perinatal Project (CPP) on 45,824 pregnant women with singleton, live-born infants with no severe congenital anomalies was analyzed. Primary outcome variables included preterm (\u3c 37 weeks of gestation), categorized into spontaneous preterm with and without premature rupture of membrane (PROM) and indicated preterm. Maternal BMI was categorized into underweight (BMI \u3c 18.50), normal weight (BMI =1 8.50 – 24.99), overweight (BMI = 25.00 – 29.99), and obese (BMI ≥ 30.00). Multinomial regression analysis was conducted and OR and 95% CI were calculated. Results The rate of spontaneous preterm birth with PROM among overweight women decreased with increasing weight gain but increased among women who had excessive weight gain. Similarly, a U-shaped rate of spontaneous preterm birth with and without PROM was observed in obese women. Gaining less weight was protective of spontaneous preterm with and without PROM among overweight and obese women compared to normal weight women. Among underweight women, gaining \u3c 7 kg or 9.5-12.7 kg was associated with increased odds of indicated preterm birth. Appreciable differences were also observed in the association between pre-pregnancy BMI, gestational weight gain and the subtypes of preterm births among African Americans and Caucasian Americans. Conclusion Reduced weight gain during pregnancy among overweight and obese women is associated with reduced spontaneous preterm birth with and without PROM. Health care professionals and public health workers should be aware of this risk and adhere to the 2009 IOM guideline that recommended reduced weight gain during pregnancy for obese and overweight women

Using Surveillance Data to Inform Community Action: The Effect of Alcohol Sale Restrictions on Intentional Injury-related Ambulance Pickups

Youth violence disproportionately affects inner city, urban minority communities in the USA. This article illustrates the use of surveillance data to inform and evaluate community action directed at this serious problem. Community efforts in response to surveillance data indicating high rates of violence surrounding convenience stores with unrestricted alcohol beverage licenses provided a natural experiment to examine the impact of imposing licensing restrictions on intentional injury rates. Rates of ambulance pickups for intentional injuries in the 15- to 24-year-old population in five census tracts where alcoholic beverage sales were restricted were compared to five census tracts with similar demographic characteristics near stores where restrictions were not instituted. Time periods included an 18-month baseline period, a 6-month period during which restrictions were in effect in the intervention communities, and an 18-month period following lifting of this restriction resulting from legal action by store owners. The monthly average rate of ambulance pickups for violent injuries showed a significantly greater baseline-to-intervention phase decrease in the intervention communities (i.e., from 19.6 to 0 per 1,000) than in the control communities (i.e., 7.4 to 3.3 per 1,000). This rate subsequently increased to 11.4 in the intervention communities after the restriction was removed. This study illustrates the potential value of surveillance data for guiding community mobilization efforts and for evaluating the impact of such efforts. It also demonstrates the potential impact of restricting inexpensive, single-serve alcoholic beverages on rates of violence

Surgical Management of Benign Adnexal Masses in the Pediatric/Adolescent Population: An 11-Year Review

Study Objective The purpose of this study was to compare ovarian conservation rates and surgical approach in benign adnexal surgeries performed by surgeons vs gynecologists at a tertiary care institution. Design A retrospective cohort review. Setting Children's and adult tertiary care university-based hospital. Participants Patients 21 years of age and younger who underwent surgery for an adnexal mass from January 2003 through December 2013. Interventions Patient age, demographic characteristics, menarchal status, clinical symptoms, radiologic imaging, timing of surgery, surgeon specialty, mode of surgery, rate of ovarian conservation, and pathology were recorded. Patients were excluded if they had a uterine anomaly or pathology-proven malignancy. Main Outcome Measures The primary outcome was the rate of ovarian conservation relative to surgical specialty; secondary outcome was surgical approach relative to surgical specialty. Results Of 310 potential cases, 194 met inclusion criteria. Gynecologists were more likely than surgeons to conserve the ovary (80% vs 63%; odds ratio, 2.28; 95% confidence interval, 1.16-4.48). After adjusting for age, body mass index, mass size, and urgency of surgery, the difference was attenuated (adjusted odds ratio, 1.84; 95% confidence interval, 0.88-3.84). Surgeons and gynecologists performed minimally invasive surgery at similar rates (62% vs 50%; P = .11). A patient was more likely to receive surgery by a gynecologist if she was older (P < .001) and postmenarchal (P = .005). Conclusion Results of our study suggest that gynecologists are more likely to perform ovarian-conserving surgery. However, our sample size precluded precise estimates in our multivariable model. Educational efforts among all pediatric and gynecologic surgeons should emphasize ovarian conservation and fertility preservation whenever possible

Prospectus, December 16, 1982

CHRISTMAS GREETINGS; News Digest; Work, study can lead to burnout; Economy causes legendary benefactor to cut spending; Choral festival set; Season\u27s Greetings; Computer gift may affect family; Skylines; Christmas questions bring varied responses; Observance of Christmas has survived; Yule log symbol of holiday warmth; Will the real Kris Kringle please step forward; Victorian halls decked with garlands, mistletoe; Festive coffees lift spirits; Comic books aren\u27t just kid stuff anymore; Ryder rides into comeback trail; \u27Bah, humbug\u27 attitude can be changed; Buzz Galaxy saves Santa in the nick of time; \u27Rat\u27 release in time for holidays; Winter brings world-wide holiday celebrations; Begin looking for summer job now; Season for giving is also season for taking; Shoppers hunt for bargains; No matter how you say it, Happy Holidays; WILL planning holiday specials; Tree traditions of German origin; Create a tree of memories: Tradition is growing; Nativity source of art inspiration; Christmas Trees; Classified; Thanksgiving at Washington School; holiday season brings new movie blitz; It\u27s \u27Showtime!\u27; Holiday Trivia Quiz; Club Notes; Final Exam Schedule -- Fall \u2782; Christmas for the young at hearthttps://spark.parkland.edu/prospectus_1982/1000/thumbnail.jp

Prion infectivity in the spleen of a <em>PRNP</em> heterozygous individual with subclinical variant Creutzfeldt-Jakob disease

Blood transfusion has been identified as a source of human-to-human transmission of variant Creutzfeldt–Jakob disease. Three cases of variant Creutzfeldt–Jakob disease have been identified following red cell transfusions from donors who subsequently developed variant Creutzfeldt–Jakob disease and an asymptomatic red cell transfusion recipient, who did not die of variant Creutzfeldt–Jakob disease, has been identified with prion protein deposition in the spleen and a lymph node, but not the brain. This individual was heterozygous (MV) at codon 129 of the prion protein gene (PRNP), whereas all previous definite and probable cases of variant Creutzfeldt–Jakob disease have been methionine homozygotes (MM). A critical question for public health is whether the prion protein deposition reported in peripheral tissues from this MV individual correlates with infectivity. Additionally it is important to establish whether the PRNP codon 129 genotype has influenced the transmission characteristics of the infectious agent. Brain and spleen from the MV blood recipient were inoculated into murine strains that have consistently demonstrated transmission of the variant Creutzfeldt–Jakob disease agent. Mice were assessed for clinical and pathological signs of disease and transmission data were compared with other transmission studies in variant Creutzfeldt–Jakob disease, including those on the spleen and brain of the donor to the index case. Transmission of variant Creutzfeldt–Jakob disease was observed from the MV blood recipient spleen, but not from the brain, whereas there was transmission from both spleen and brain tissues from the red blood cell donor. Longer incubation times were observed for the blood donor spleen inoculum compared with the blood donor brain inoculum, suggesting lower titres of infectivity in the spleen. The distribution of vacuolar pathology and abnormal prion protein in infected mice were similar following inoculation with both donor and recipient spleen homogenates, providing initial evidence of similar transmission properties after propagation in PRNP codon 129 MV and MM individuals. These studies demonstrate that spleen tissue from a PRNP MV genotype individual can propagate the variant Creutzfeldt–Jakob disease agent and that the infectious agent can be present in the spleen without CNS involvement

Effect of vaccination on transmission of SARS-CoV-2

No abstract available