Risk factors for strong regret and subsequent IVF request after tubal sterilisation

A case control study was done to examine presterilisation characteristics most consistently associated with strong poststerilisation regret and subsequent request for IVF. The case group was made up of 97 previously sterilised women evaluated for IVF treatment at the Fertility Clinic or Royal North Shore Hospital in Sydney during the period 1980-1992. A Control group of 101 women apparently satisfied with their tuballigation was found from the medical records of one gynaecologist at Royal North Shore Hospital. Of the characteristics that could be objectively determined preoperatively only age, number of living children, timing of sterilisation and marital status were significantly associated with IVF request in the univariate analysis. These characteristics were, then, examined multivariately by means of logistic regression. Age at the time of sterilisation had the most pronounced effect on strong regret. Women who were younger than 30 years old at the time of sterilisation had up to 8.7 times the risk of request for IVF treatment as women 30 to 34 years old. A concurrent caesarean section was associated with a threefold risk relative to an interval procedure, but there was no significant effect associated with sterilisation performed after vaginal delivery or abortion. A strong protective effect (OR=0.07) was found for women with more than 2 children compared to childless women. There was no longer a significant effect of marital status in the multivariate analysis. Other factors not significantly associated with the request for IVF included history of abortion, education, race, the principal method of contraception used before sterilisation, and medical indications for sterilisation. The overwhelming reasons stated by women for requesting IVF were change in marital status, either remarriage or the establishment of a new de facto relationship, and the desire to have a child with the new partner

Risk factors for strong regret and subsequent IVF request after tubal sterilisation

A case control study was done to examine presterilisation characteristics most consistently associated with strong poststerilisation regret and subsequent request for IVF. The case group was made up of 97 previously sterilised women evaluated for IVF treatment at the Fertility Clinic or Royal North Shore Hospital in Sydney during the period 1980-1992. A Control group of 101 women apparently satisfied with their tuballigation was found from the medical records of one gynaecologist at Royal North Shore Hospital. Of the characteristics that could be objectively determined preoperatively only age, number of living children, timing of sterilisation and marital status were significantly associated with IVF request in the univariate analysis. These characteristics were, then, examined multivariately by means of logistic regression. Age at the time of sterilisation had the most pronounced effect on strong regret. Women who were younger than 30 years old at the time of sterilisation had up to 8.7 times the risk of request for IVF treatment as women 30 to 34 years old. A concurrent caesarean section was associated with a threefold risk relative to an interval procedure, but there was no significant effect associated with sterilisation performed after vaginal delivery or abortion. A strong protective effect (OR=0.07) was found for women with more than 2 children compared to childless women. There was no longer a significant effect of marital status in the multivariate analysis. Other factors not significantly associated with the request for IVF included history of abortion, education, race, the principal method of contraception used before sterilisation, and medical indications for sterilisation. The overwhelming reasons stated by women for requesting IVF were change in marital status, either remarriage or the establishment of a new de facto relationship, and the desire to have a child with the new partner

Effect of Galleries on Thermal Conditions of Urban Open Areas

 Computer simulations were performed by ENVI-met model along with physical measurements in two urban squares under hot summer conditions in Isfahan, central Iran. Each scenario concentrated on adding or extending galleries in each square. The results confirmed the role of galleries on thermal conditions; however, it was found that the effectiveness of this strategy depends on the square geometry. It presented higher efficiency for the small square with higher H/W ratio. This solution is advisable for smaller squares and when the peripheral parts are frequently used compared to the middle areas. Galleries are most efficient when allowing enough natural ventilation© 2016. The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.

Microclimatic Conditions of an Urban Square: Role of Built Environment and Geometry

AbstractGeometry plays a dominant role in thermal situations within city structures. This study aims to seek how this role affects thermal comfort of the visitors in an urban square. Computer simulations were performed along with physical measurements in an urban square during peak hot conditions of summer in Isfahan, Iran. In addition to the influence of built environment inside the square, the results confirmed the role of geometry on thermal conditions. The amelioration effect for the aspect ratio was higher than that of the orientation. Findings are useful for urban design strategies dealing with thermal comfort

Drugs-related death soon after hospital discharge among drug treatment clients in Scotland:record linkage, validation and investigation of risk factors.

We validate that the 28 days after hospital-discharge are high-risk for drugs-related death (DRD) among drug users in Scotland and investigate key risk-factors for DRDs soon after hospital-discharge. Using data from an anonymous linkage of hospitalisation and death records to the Scottish Drugs Misuse Database (SDMD), including over 98,000 individuals registered for drug treatment during 1 April 1996 to 31 March 2010 with 705,538 person-years, 173,107 hospital-stays, and 2,523 DRDs. Time-at-risk of DRD was categorised as: during hospitalization, within 28 days, 29-90 days, 91 days-1 year, >1 year since most recent hospital discharge versus 'never admitted'. Factors of interest were: having ever injected, misuse of alcohol, length of hospital-stay (0-1 versus 2+ days), and main discharge-diagnosis. We confirm SDMD clients' high DRD-rate soon after hospital-discharge in 2006-2010. DRD-rate in the 28 days after hospital-discharge did not vary by length of hospital-stay but was significantly higher for clients who had ever-injected versus otherwise. Three leading discharge-diagnoses accounted for only 150/290 DRDs in the 28 days after hospital-discharge, but ever-injectors for 222/290. Hospital-discharge remains a period of increased DRD-vulnerability in 2006-2010, as in 1996-2006, especially for those with a history of injecting

Selective Expression of the Vβ14 T Cell Receptor on Leishmania guyanensis-Specific CD8+ T Cells during Human Infection

Peripheral blood mononuclear cells from subjects never exposed to Leishmania were stimulated with Leishmania guyanensis. We demonstrated that L. guyanensis-stimulated CD8+ T cells produced interferon (IFN)-γ and preferentially expressed the Vb14 T cell receptor (TCR) gene family. In addition, these cells expressed cutaneous lymphocyte antigen and CCR4 surface molecules, suggesting that they could migrate to the skin. Results obtained from the lesions of patients with localized cutaneous leishmaniaisis (LCL) showed that Vβ14 TCR expression was increased in most lesions (63.5%) and that expression of only a small number of Vb gene families (Vβ1, Vβ6, Vβ9, Vβ14, and Vβ24) was increased. The presence of Vβ14 T cells in tissue confirmed the migration of these cells to the lesion site. Thus, we propose the following sequence of events during infection with L. guyanensis. After initial exposure to L. guyanensis, CD8+ T cells preferentially expressing the Vb14 TCR and secreting IFN-γ develop and circulate in the periphery. During the infection, these cells migrate to the skin at the site of the parasitic infection. The role of these Vβ14 CD8+ T cells in resistance to infection remains to be determined conclusivel

Alteration of Peripheral Blood T-Reg Cells and Cytokines Production in Angiography Personnel Exposed to Scattered X-Rays

Angiocardiography is an X-ray examination of the blood vessels or chambers of the heart. Cardiologists and staff members applying this procedure are exposed to high levels of scattered radiation. In our previous study the incidence of unstable chromosomal aberrations and cytokinesis-blocked micronuclei were found to be significantly higher in exposed individuals than the age and sex matched controls. In the present study we assessed cytokine production by peripheral blood mononuclear cells of the above cases and the percentage of Treg cells. According to film dosimeter analysis, personnels received 0.25-15 mSv during the previous year (average of 3 mSv/y). Isolated PBMCs from the test and control groups were stimulated with Phorbol Myristate Acetate/ Ionomycin (PMA/I). Cytokine production was measured in the supernatants of cultured lymphocytes. The percentage of Treg cells was studied by flow cytometry. The production of IL-10 and IL-5 was significantly down-regulated in the test group compared to the control group. In contrast, IL-12 was up-regulated. Yet, no statistically significant difference was found for IFN- γ between two groups. In addition, we found higher percentage of CD4+CD25+bright Treg cells in the study group compared to the controls. Taken together, it was shown that low doses of scattered X-rays could skew cytokine profile of peripheral blood mononuclear cells in favour of inflammatory response causing the increase of Treg cells

Sensitivity of a national coronial database for monitoring unnatural deaths among ex-prisoners in Australia

<p>Abstract</p> <p>Background</p> <p>The period immediately after release from custody is a time of marked vulnerability and increased risk of death for ex-prisoners. Despite this, there is currently no routine, national system for monitoring ex-prisoner mortality in Australia. This study subsequently aimed to evaluate the sensitivity of Australia's National Coroners Information System (NCIS) for identifying reportable deaths among prisoners and ex-prisoners.</p> <p>Findings</p> <p>Prisoner and ex-prisoner deaths identified through an independent search of the NCIS were compared with 'gold standard' records of prisoner and ex-prisoner deaths, generated from a national monitoring system and a state-based record linkage study, respectively. Of 294 known deaths in custody from 2001-2007, an independent search of the NCIS identified 229, giving a sensitivity of 77.9% (72.8%-82.3%). Of 677 known deaths among ex-prisoners from 2001-2007, an independent search of the NCIS identified 37, giving a sensitivity of 5.5% (4.0-7.4%). Ex-prisoner deaths that were detected were disproportionately drug-related, occurring within the first four weeks post-release, among younger prisoners and among those with more than two prior prison admissions.</p> <p>Conclusions</p> <p>Although a search of the NCIS detected the majority of reportable deaths among prisoners, it was only able to detect a small minority of reportable deaths among ex-prisoners. This suggests that the NCIS is not effective for monitoring mortality among ex-prisoners in Australia. Given the elevated rates of mortality among ex-prisoners in Australia and elsewhere, there remains an urgent need to establish a process for routine monitoring of ex-prisoner mortality, preferably through record linkage.</p

Reducing Viral Load Measurements to Once a Year in Patients on Stable, Virologically Suppressive Cart Regimen: Findings from the Australian HIV Observational Database.

Reducing viral-load measurements to annual testing in virologically suppressed patients increases the estimated mean time those patients remain on a failing regimen by 6 months. This translates to an increase in the proportion of patients with at least one Thymidine Analogue Mutation from 10% to 32% over one year

Counting the cost: estimating the number of deaths among recently released prisoners in Australia

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007–08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and characteristics of people released from prison in 2007–08. Main outcome measures: Estimated number of deaths among adults released from Australian prisons in 2007–08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. Results: It was estimated that among people released from prison in 2007–08, between 449 (95% CI, 380–527) and 472 (95% CI, 438–507) died within 1 year of release. Of these, between 68 (95% CI, 56–82) and 138 (95% CI, 101–183) died within 4 weeks of release. Most of these deaths were not drug-related. Conclusion: The estimated annual number of deaths among recently released prisoners in Australia is considerably greater than the annual number of deaths in custody, highlighting the extreme vulnerability of this population on return to the community. There is an urgent need to establish a national system for routine monitoring of ex-prisoner mortality and to continue the duty of care beyond the prison walls