Intimate Partner Violence and Pregnancy Termination in Armenia: Evidence from Nationally-Representative Survey Data

Intimate partner violence has been associated with numerous consequences for women, including pregnancy termination. This study examined the association between predictive capacity of intimate partner violence and pregnancy termination among women in Armenia. The study analyzed the 2015–16 Armenia Demographic and Health Survey (ADHS) data on women aged 15–49 (Mean: 31.49; Standard Deviation, SD: 9.51). Marital control exercised by husbands, ever experienced physical violence, sexual violence, and emotional violence by husbands were the four indicators of intimate partner violence used in this study. To assess the association between intimate partner violence and pregnancy termination, a binary logistic regression model was fitted. After controlling for confounders, we found that women whose husbands exercised marital control were 26% more likely to experience pregnancy termination, compared to women whose husbands did not exercise marital control (adjusted odds ratio (aOR): 1.26, 95% Confidence interval (CI): 1.03–1.53). Women who ever experienced sexual violence were about 10 times likely to experience pregnancy termination than women who did not experience sexual violence (aOR: 9.76, 95% CI: 1.91–49.96). Both ever experienced physical violence and emotional violence did not have any significant associations with pregnancy termination. Forms of intimate partner violence are associated with pregnancy termination. The findings of this study provide evidence for government and policymakers to formulate, modify, and implement policies and program that target both men and women regarding the prevailing intimate partner violence and its consequences. Strengthening the policy implementation will ensure that women are empowered to make decisions about their reproductive health. Making husbands and their family members aware of the basics and consequences of intimate partner violence and focusing on child cognitive development which can be hampered due to the prevalence violence in families are recommended

Prevalence and Factors Associated with Interpersonal Violence among In-School Adolescents in Ghana: Analysis of the Global School-Based Health Survey Data

Interpersonal violence is a critical public health concern that is linked with many negative consequences, including mortality. It is the second most predominant cause of death among male adolescents aged 15–19. This study used a nationally representative data from the recent Ghana Global School-based Health Survey to examine the prevalence and factors associated with interpersonal violence among Ghanaian in-school adolescents. A total of 2214 in-school adolescents were included in the final analysis. Multivariable binomial logistic regression analysis was performed to determine the factors assciated with interpersonal violence. The results of the regression analysis were presented as adjusted odds ratios (aOR) with 95% confidence level (CI) in all the analyses. Statistical significance was set at p &lt; 0.05. The overall prevalence of interpersonal violence was 55.7%, of which the prevalences of physical fighting and attack were 38.2% and 41.5%, respectively. In-school adolescents who had an injury were more likely to experience interpersonal violence (aOR = 2.29, 95% CI = 1.71–3.06) compared with those who did not have an injury. The odds of interpersonal violence were higher among in-school adolescents who were bullied (aOR = 2.48, 95% CI = 1.84–3.34) compared with those who were not bullied. In addition, in-school adolescents who attempted suicide (aOR = 1.56, 95% CI = 1.22–2.47), consumed alcohol at the time of the survey (aOR = 1.88, 95% CI = 1.15–3.06), and were truant (aOR = 1.58, 95% CI = 1.29–1.99) had higher odds of experiencing interpersonal violence. These factors provide education directors and school heads/teachers with the relevant information to guide them in designing specific interventions to prevent interpersonal violence, particularly physical fights and attacks in the school settings. School authorities should organize parent–teacher meetings or programs to help parents improve their relationships with in-school adolescents to prevent or minimize their risky behaviors, including physical fights.</jats:p

Determinants of Fruits and Vegetables Consumption among In-School Adolescents in Ghana

Background: Fruit and vegetable consumption is an important source of nutrients for healthy growth and development, as well as a protective factor against chronic non-communicable diseases. Paucity of data exists on adolescents’ fruit and vegetable consumption in Ghana. This study, therefore, sought to determine the prevalence and correlates of fruit and vegetable consumption among in-school adolescents in Ghana. Methods: Data for this study were extracted from the 2012 Global School-Based Health Survey. A cross-sectional analysis on 2786 in-school adolescents from junior and senior high schools was conducted. Descriptive analyses using frequencies and percentages were used to present the results on the prevalence of fruit and vegetable consumption. Multivariable binomial regression analysis was performed to determine the association between fruit and vegetable consumption and explanatory variables. The results of the regression analyses were presented using adjusted odds ratio (aOR) with their respective confidence intervals (CIs). Statistical significance was set at p &lt; 0.05. Results: The prevalence of adequate fruits, adequate vegetables, and adequate fruit and vegetable consumption were 35.7%, 26.8%, and 27.8%, respectively. In-school male adolescents had lower odds of adequate fruit and vegetable consumption compared to female adolescents (aOR = 0.64, 95%CI = 0.51–0.82). Adolescents in senior high schools (aOR = 0.36, 95%CI = 0.22–0.61) were less likely to consume adequate fruits and vegetables compared to those in junior high schools. The odds of adequate fruit and vegetable consumption were higher among adolescents who consumed soft drinks (aOR = 3.29, 95%CI = 2.42–4.46), fast foods (aOR = 1.42, 95%CI = 1.13–1.77), and those who had sedentary behavior (aOR = 1.38, 95%CI = 1.07–1.77). Conclusions: The findings revealed that fruit and vegetable consumption among Ghanaian adolescents is relatively low. Sex of adolescents, grade, soft drink intake, fast food consumption, and sedentary behavior were factors associated with adequate fruit and vegetable consumption. Health promotion interventions to scale up fruit and vegetable consumption should pay attention to the factors identified in this study.</jats:p

Efficacy and Safety of a New 20% Immunoglobulin Preparation for Subcutaneous Administration, IgPro20, in Patients With Primary Immunodeficiency

Subcutaneous human IgG (SCIG) therapy in primary immunodeficiency (PID) offers sustained IgG levels throughout the dosing cycle and fewer adverse events (AEs) compared to intravenous immunoglobulin (IVIG). A phase I study showed good local tolerability of IgPro20, a new 20% liquid SCIG stabilized with L-proline. A prospective, open-label, multicenter, single-arm, phase III study evaluated the efficacy and safety of IgPro20 in patients with PID over 15 months. Forty-nine patients (5–72 years) previously treated with IVIG received weekly subcutaneous infusions of IgPro20. The mean serum IgG level was 12.5 g/L. No serious bacterial infections were reported. There were 96 nonserious infections (rate 2.76/patient per year). The rate of days missed from work/school was 2.06/patient per year, and the rate of hospitalization was 0.2/patient per year. Ninety-nine percent of AEs were mild or moderate. No serious, IgPro20-related AEs were reported. IgPro20 effectively protected patients with PID against infections and maintained serum IgG levels without causing unexpected AEs

Efficacy and Safety of Hizentra®, a New 20% Immunoglobulin Preparation for Subcutaneous Administration, in Pediatric Patients with Primary Immunodeficiency

Subcutaneous IgG treatment for primary immunodeficiencies (PI) is particularly well suited for children because it does not require venous access and is mostly free of systemic adverse events (AEs). In a prospective, open-label, multicenter, single-arm, Phase III study, 18 children and five adolescents with PI were switched from previous intravenous (IVIG) or subcutaneous (SCIG) IgG treatment to receive dose-equivalent, weekly subcutaneous infusions of Hizentra® for 40 weeks. Mean IgG trough levels were maintained in patients previously on SCIG, or increased in those previously on IVIG, regardless of age. No serious bacterial infections were reported during the efficacy period of the study. The rates of non-serious infections were 4.77 (children) and 5.18 (adolescents) infections per patient per year. Related AEs were observed in seven children (38.9%) and two adolescents (40%). Three serious AEs and two AEs leading to discontinuation (all unrelated) were reported in children. Hizentra® is an effective and well-tolerated treatment for pediatric patients

Tear fluid biomarkers in ocular and systemic disease: potential use for predictive, preventive and personalised medicine

In the field of predictive, preventive and personalised medicine, researchers are keen to identify novel and reliable ways to predict and diagnose disease, as well as to monitor patient response to therapeutic agents. In the last decade alone, the sensitivity of profiling technologies has undergone huge improvements in detection sensitivity, thus allowing quantification of minute samples, for example body fluids that were previously difficult to assay. As a consequence, there has been a huge increase in tear fluid investigation, predominantly in the field of ocular surface disease. As tears are a more accessible and less complex body fluid (than serum or plasma) and sampling is much less invasive, research is starting to focus on how disease processes affect the proteomic, lipidomic and metabolomic composition of the tear film. By determining compositional changes to tear profiles, crucial pathways in disease progression may be identified, allowing for more predictive and personalised therapy of the individual. This article will provide an overview of the various putative tear fluid biomarkers that have been identified to date, ranging from ocular surface disease and retinopathies to cancer and multiple sclerosis. Putative tear fluid biomarkers of ocular disorders, as well as the more recent field of systemic disease biomarkers, will be shown

Higher Doses of Subcutaneous IgG Reduce Resource Utilization in Patients with Primary Immunodeficiency

The recommended dose of IgG in primary immunodeficiency (PID) has been increasing since its first use. This study aimed to determine if higher subcutaneous IgG doses resulted in improved patient outcomes by comparing results from two parallel clinical studies with similar design. One patient cohort received subcutaneous IgG doses that were 1.5 times higher than their previous intravenous doses (mean 213 mg/kg/week), whereas the other cohort received doses identical to previous subcutaneous or intravenous doses (mean 120 mg/kg/week). While neither cohort had any serious infections, the cohort maintained on higher mean IgG dose had significantly lower rates of non-serious infections (2.76 vs. 5.18 episodes/year, P < 0.0001), hospitalization (0.20 vs. 3.48 days/year, P < 0.0001), antibiotic use (48.50 vs. 72.75 days/year, P < 0.001), and missed work/school activity (2.10 vs. 8.00 days/year, P < 0.001). The higher-dose cohort had lower health care utilization and improved indices of well being compared to the cohort treated with traditional IgG doses

Proposed follow up programme after curative resection for lower third oesophageal cancer

The incidence of oesophageal adenocarcinoma has risen throughout the Western world over the last three decades. The prognosis remains poor as many patients are elderly and present with advanced disease. Those patients who are suitable for resection remain at high risk of disease recurrence. It is important that cancer patients take part in a follow up protocol to detect disease recurrence, offer psychological support, manage nutritional disorders and facilitate audit of surgical outcomes. Despite the recognition that regular postoperative follow up plays a key role in ongoing care of cancer patients, there is little consensus on the nature of the process. This paper reviews the published literature to determine the optimal timing and type of patient follow up for those after curative oesophageal resection

Social Networking Technology, Social Network Composition, and Reductions in Substance Use Among Homeless Adolescents

Peer-based prevention programs for homeless youth are complicated by the potential for reinforcing high-risk behaviors among participants. The goal of this study is to understand how homeless youth could be linked to positive peers in prevention programming by understanding where in social and physical space positive peers for homeless youth are located, how these ties are associated with substance use, and the role of social networking technologies (e.g., internet and cell phones) in this process. Personal social network data were collected from 136 homeless adolescents in Los Angeles, CA. Respondents reported on composition of their social networks with respect to: home-based peers and parents (accessed via social networking technology; e.g., the internet, cell phone, texting), homeless peers and agency staff (accessed face-to-face) and whether or not network members were substance-using or non-substance-using. Associations between respondent’s lifetime cocaine, heroin, and methamphetamine use and recent (previous 30 days) alcohol and marijuana use were assessed by the number of non-substance-using versus substance-using ties in multivariate linear regression models. 43% of adolescents reported a non-substance-using home-based tie. More of these ties were associated with less recent alcohol use. 62% of adolescents reported a substance-using homeless tie. More of these ties were associated with more recent marijuana use as well as more lifetime heroin and methamphetamine use. For homeless youth, who are physically disconnected from positive peers, social networking technologies can be used to facilitate the sorts of positive social ties that effective peer-based prevention programs require

Effects of chronic ascariasis and trichuriasis on cytokine production and gene expression in human blood: a cross-sectional study.

Background Chronic soil-transmitted helminth (STH) infections are associated with effects on systemic immune responses that could be caused by alterations in immune homeostasis. To investigate this, we measured the impact in children of STH infections on cytokine responses and gene expression in unstimulated blood. Methodology/Principal Findings Sixty children were classified as having chronic, light, or no STH infections. Peripheral blood mononuclear cells were cultured in medium for 5 days to measure cytokine accumulation. RNA was isolated from peripheral blood and gene expression analysed using microarrays. Different infection groups were compared for the purpose of analysis: STH infection (combined chronic and light vs. uninfected groups) and chronic STH infection (chronic vs. combined light and uninfected groups). The chronic STH infection effect was associated with elevated production of GM-CSF (P = 0.007), IL-2 (P = 0.03), IL-5 (P = 0.01), and IL-10 (P = 0.01). Data reduction suggested that chronic infections were primarily associated with an immune phenotype characterized by elevated IL-5 and IL-10, typical of a modified Th2-like response. Chronic STH infections were associated with the up-regulation of genes associated with immune homeostasis (IDO, P = 0.03; CCL23, P = 0.008, HRK, P = 0.005), down-regulation of microRNA hsa-let-7d (P = 0.01) and differential regulation of several genes associated with granulocyte-mediated inflammation (IL-8, down-regulated, P = 0.0002; RNASE2, up-regulated, P = 0.009; RNASE3, up-regulated, p = 0.03). Conclusions/Significance Chronic STH infections were associated with a cytokine response indicative of a modified Th2 response. There was evidence that STH infections were associated with a pattern of gene expression suggestive of the induction of homeostatic mechanisms, the differential expression of several inflammatory genes and the down-regulation of microRNA has-let-7d. Effects on immune homeostasis and the development of a modified Th2 immune response during chronic STH infections could explain the systemic immunologic effects that have been associated with these infections such as impaired immune responses to vaccines and the suppression of inflammatory diseases