Pregnancy Outcomes among Adolescents and Young Adults with Diabetes in Kumasi, Ghana

Effects of Low-Molecular-Weight Heparin on Pregnancy Outcomes in Protein S Deficiency: A Prospective, Randomized Controlled Phase II Clinical

The objective of the study was to assess adolescent’s attitudes towards premarital sex in Senior and Junior High Schools in the New Juaben Municipality in Ghana. A descriptive survey design was chosen for the study. The population of the study consisted of five thousand, one hundred forty-one (5,141) in-school adolescents in Junior and Senior High Schools in New Juaben Municipality. Convenient and random sampling techniques were used to select the study area, schools and respondents for the study. A convenient sampling technique was used to select the New Juaben Municipality. A random sampling method was used to select 250 respondents (students) from two Junior High Schools and two Senior High Schools in New Juaben Municipality. The main instrument used for data collection was a questionnaire. The data collected were statistically analysed using Statistical Package for the Social Sciences (SPSS). Both and descriptive statistics and the Analysis of Variance (ANOVA) test were used in the data analysis. Descriptive statistics such as frequency distribution in tabular form in graphical forms, and measures of central tendencies were used to analyse the data. The study concluded that the positive sexual behaviours of adolescents in Junior and Senior High Schools are evident in their attitude towards premarital sex. Adolescents in Senior High and Junior High Schools in the New Juaben Municipality exhibit a positive attitude towards premarital sex as the majority of them do not see that abstaining from sex would make them sick or look odd in society, neither would it give them problems during intercourse when they finally marry.

Penelitian ini bertujuan untuk melakukan eksplorasi mengenai kontribusi dukungan sosial terhadap prestasi dan faktor penyebab kegagalan yang berkontribusi terhadap kegagalan siswa SMP dan siswa SMA. Penelitian ini dilakukan dengan metode survey kualitatif dengan teknik pengambilan data open ended questionnaire, adaptasi dari kuesioner Achievement yang dikembangkan oleh Kim (Kim dkk, 2006). Pengambilan data tambahan dilakukan dengan wawancara personal (Shaughnessy dkk, 2007) secara terbuka. Total responden 725 partisipan yang terdiri dari 248 pelajar SMP dan 473 SMA, ditambah 2 pelajar SMP dan 2 Pelajar SMA hasil wawancara personal. Data hasil penelitian tersebut diolah dengan proses kategorisasi dengan teknik Content Analysis data. Berdasarkan data yang diperoleh bahwa kontribusi dukungan sosial secara langsung dari keluarga lebih berperan terhadap pencapaian prestasi pada subjek SMP (86,0%) maupun SMA (81,6%), dibandingkan kontribusi dukungan sosial yang diterima dari teman (SMP 8,0% & SMA 11,6%) dan guru (SMP 6,0% & SMA 6,8%). Besarnya kontribusi dukungan sosial secara langsung terhadap pencapaian prestasi tidak terlepas dari bentuk dukungan yang diterima oleh subjek. bentuk dukungan emosional (SMP 47,7% & SMA 54,0%) merupakan frekuensi bentuk dukungan sosial yang paling tinggi diterima subjek pelajar SMP dan SMA dari sumber dukungan sosial yang mereka miliki yang diikuti bentuk dukungan relasional (SMP 14,0% & SMA 7,6%), dukungan spiritual (SMP 13,4% & SMA 9,9%), dukungan material (SMP 12,6% & SMA 14,3%), dukungan informasional (SMP 11,2% & SMA 13,9%) dan dukungan temporal (SMP 1,2% & SMA 0,2%). Namun, kontribusi dukungan sosial secara langsung cenderung menurun pada kelompok siswa SMA. Selanjutnya, kegagalan seseorang dipengaruhi oleh dua faktor yaitu faktor internal dan faktor eksternal. Frekuensi tertinggi adalah faktor internal yang berkontribusi pada kegagalan baik pada kelompok SMP (79,0%) maupun pada kelompok SMA (87,1%). Faktor eksternal yang berkontribusi terhadap kegagalan pada pelajar SMP sebesar 21,0% dan pada SMA sebesar 12,9%.

AimsTo review the glycaemic control of type 1 diabetic patients attending the paediatric and transition adolescent diabetes clinic within NHS Lanarkshire during the coronavirus pandemic.MethodsA quantitative analysis of 348 patients...

Objective: Psychosocial concerns are common among youth with Type I diabetes; psychosocial screening and integrated care models can address these concerns. Medical providers are key stakeholders, but their perspectives on the role of mental health within pediatric diabetes care represent a gap in the literature. This study aimed to describe pediatric diabetes care providers’ views on the relationship between psychosocial stress and diabetes, their experiences with psychosocial screening and psychological consultation within their clinic, and their suggestions for mental health professionals working with youth who have diabetes. Method: All endocrinologists, fellows, and diabetes educators involved with psychosocial screening and psychology consultations ( N = 7; 71.4% female, 42.9% Hispanic/Latinx White, 28.6% Non-Hispanic/Latinx White, 28.6% Asian) at a single outpatient pediatric diabetes clinic participated in semistructured interviews. Qualitative data were analyzed via thematic content analysis. Results: Providers described a bidirectional relationship between psychosocial stress and diabetes management. They expressed positive views of psychosocial screening and the clinic’s integrated psychology team, which allow them to focus on the medical aspect of care and gain comfort with mental health. Providers offered suggestions to improve coordination and communication with mental health professionals. Conclusions: Pediatric diabetes care providers valued psychosocial screening and benefited from collaboration with the clinic psychology team. Clinics without access to mental health professionals may struggle to sustain screening practices. Eliciting medical providers’ opinions and using other implementation science strategies are important for incorporating psychosocial screening and intervention within pediatric diabetes clinics, especially for clinics with unique models for psychological services. Implications for Impact Statement Medical providers in a pediatric diabetes clinic reported positive views of psychosocial screening and psychology consultations. Interdisciplinary collaboration with mental health professionals may promote medical providers’ comfort, confidence, and competence navigating their patients’ mental health concerns and ultimately improve care for youth with Type I diabetes mellitus. Obtaining medical providers’ perspectives is important for effective implementation of psychosocial screening procedures in diabetes clinics with varying models for access to mental health services.

Children, adolescents and young adults with Type 1 diabetes mellitus need to be screened for chronic complications and associated (autoimmune) diseases. There are no Dutch national guidelines for screening available but the International Society for Pediatric and Adolescent Diabetes (ISPAD) gives recommendations in its guidelines. The ISPAD guidelines from 2014 were updated in 2018. The adherence of the Dutch pediatric diabetes clinics to the international guidelines as stated by the ISPAD. A questionnaire about screening method and frequency was send to all members of the Dutch national committee for pediatric diabetes. The screening policies of the pediatric diabetes clinics were compared to the ISPAD guidelines of 2014 and 2018. Sixty-two percent of all diabetes clinics filled out the questionnaire. None of the diabetes clinics followed all recommendations of the ISPAD. The majority of the clinics had a higher frequency of screening, performed extra blood tests and did not personalize their policy to the individual patient. Approximately one third of the diabetes clinics still commenced screening for chronic complications at the age of 10 years, as recommended in the previous version of the ISPAD guideline. Dutch pediatric diabetes clinics screen their patients on chronic complications and associated conditions very differently and not according to the international (and most recent) guidelines. A more individualized approach with respect to the newest ISPAD guidelines will diminish the burden for the patient and medical costs as well.

A Longitudinal Study of Learning Engagement of Math and Science Gifted Students in Junior and Senior High School

To describe the population of women having bariatric surgery and compare the pregnancy outcomes for women having bariatric surgery with a non-bariatric surgery population having a first and second pregnancy. Population-based record linkage study. New South Wales (NSW), Australia. All women aged 15-45years with a hospital record in NSW (2002-2014) and all women giving birth in NSW (1994-2015; n=1606737 women). Pregnancy and birth outcomes were compared between first and second pregnancies using repeated-measures logistic regression and paired Student's t-tests. Bariatric and non-bariatric groups were also compared. Maternal diabetes, preterm birth (<37weeks of gestation) and large for gestational age. There was a 13-fold increase in hospitalisations for primary bariatric surgery during 2002-2014. Compared with the general birthing population, women who had bariatric surgery experienced higher rates of hypertension, diabetes, and preterm birth. Among women who had bariatric surgery between a first and second pregnancy, there were reduced rates of hypertension (OR 0.39, 95%CI 0.29-0.53), spontaneous preterm birth (OR 0.37, 95%CI 0.16-0.86), infants that were large for gestational age (OR 0.63, 95%CI 0.44-0.88), and the admission of infants to a special care nursery or neonatal intensive care (OR 0.64, 95%CI 0.46-0.90) in the second pregnancy. Rates for small-for-gestational age and gestational diabetes following surgery were 8.3 and 11.4%, respectively CONCLUSIONS: Bariatric surgery between a first and second pregnancy was associated with reductions in obesity-related adverse pregnancy outcomes. Bariatric surgery performed for the management of obesity in accordance with current clinical criteria is associated with improved pregnancy outcomes in a subsequent pregnancy. Bariatric surgery for obesity may improve pregnancy and birth outcomes in a subsequent pregnancy.

The purpose of this study was to assess the influence of sex education on the sexual behaviour of adolescents in Senior and Junior High Schools in the New Juaben Municipality. A cross-sectional research design was adopted for the study. The population of the study are adolescents in Junior and Senior High Schools in New Juaben Municipality. A random sampling technique was used to select two-hundred and fifty (250) respondents from two Junior High Schools and two Senior High Schools in New Juaben Municipality. The main instrument used for data collection was a questionnaire. Both inferential and descriptive statistics were used to analyse the data. The study indicated that sex education (in terms of HIV/AIDS education) has had a significant influence (impact) on sexual behaviours. The positive sexual behaviours of adolescent in Junior and Senior High Schools is evident in their attitude toward premarital sex. The study also revealed that adolescents exhibited a positive attitude toward premarital sex and abstaining from sex that will make them sick or look odd in society, neither would it give them problems during intercourse when they finally marry. It is recommended that Parents should ensure that their children receive more sex education to offset the negative influences of the media. It is also recommended that Government may also consider replicating the popular nationwide Science and Mathematics quiz in the area of adolescent sexual behaviour and reproductive health in SHS and JHS to increase the awareness of students about appropriate adolescents’ sexual behaviours and reproductive health issues.

We investigated the heterogeneous developmental trajectories of depressive symptoms in junior and senior high school, the transitions to different trajectories after entering senior high school, and the linkages to the development of depressive symptoms in early adulthood among Taiwanese adolescents. An eight-wave longitudinal data set was analyzed, including 2687 Taiwanese adolescents (51.2% boys, M age = 14.3 at first wave). Using a manual three-step latent transition growth mixture model, we found that a three-class solution fit the data for both junior high school (termed high-improving, cumulative, and JS-low-stable) and senior high school period (termed heightening, moderate-stable, and HS-low-stable). The depressive symptoms of most individuals maintained at a low level (i.e., low-stable) from adolescence to early adulthood; however, nearly a quarter of the adolescents reported depressive symptoms that were moderately or highly severe in senior high school and beyond. More than 30% of the participants experienced transitioning into a different developmental trajectory between junior and senior high school. When perceiving a higher level of paternal behavioral control, adolescents categorized in the high-improving class in junior high school would have a higher chance to transition to the moderate-stable class than to HS-low-stable class in senior high school. Adolescent boys and girls did not differ in the probability of transitioning between trajectories across junior and senior high school. However, a clear and consistent pattern of symptoms between late adolescence and early adulthood was not observed. These results help elucidate the heterogeneity and fluidity associated with the development of depressive symptoms between early adolescence and early adulthood in light of school transition among youths in Taiwan.

Safety of influenza vaccines in pregnant women

Aims/hypothesisCurrent clinical guidelines for childhood-onset monogenic diabetes outside infancy are mainly focused on identifying and testing for dominantly inherited, predominantly MODY genes. There are no systematic studies of the recessively inherited causes of monogenic diabetes that are likely to be more common in populations with high rates of consanguinity. We aimed to determine the contribution of recessive causes of monogenic diabetes in paediatric diabetes clinics and to identify clinical criteria by which to select individuals for recessive monogenic diabetes testing.MethodsWe conducted a cross-sectional study of 1093 children from seven paediatric diabetes clinics across Turkey (a population with high rates of consanguinity). We undertook genetic testing of 50 known dominant and recessive causes of monogenic diabetes for 236 children at low risk of type 1 diabetes. As a comparison, we used monogenic diabetes cases from UK paediatric diabetes clinics (a population with low rates of consanguinity).ResultsThirty-four children in the Turkish cohort had monogenic diabetes, equating to a minimal prevalence of 3.1%, similar to that in the UK cohort (p = 0.40). Forty-one per cent (14/34) had autosomal recessive causes in contrast to 1.6% (2/122) in the UK monogenic diabetes cohort (p < 0.0001). All conventional criteria for identifying monogenic diabetes (parental diabetes, not requiring insulin treatment, HbA1c ≤ 58 mmol/mol [≤7.5%] and a composite clinical probability of MODY >10%) assisted the identification of the dominant (all p ≤ 0.0003) but not recessive cases (all p ≥ 0.2) in Turkey. The presence of certain non-autoimmune extra-pancreatic features greatly assisted the identification of recessive (p < 0.0001, OR 66.9) but not dominant cases.Conclusions/interpretationRecessively inherited mutations are a common cause of monogenic diabetes in populations with high rates of consanguinity. Present MODY-focused genetic testing strategies do not identify affected individuals. To detect all cases of monogenic paediatric diabetes, it is crucial that recessive genes are included in genetic panels and that children are selected for testing if they have certain non-autoimmune extra-pancreatic features in addition to current criteria.Graphical abstract

Where is the “W”oman in MCH?

Transabdominal uterine arteries doppler between 11-14 weeks of gestation for prediction of outcome in high risk pregnancies

Introduction: Acute complications of diabetes, particularly diabetic ketoacidosis (DKA) and hypoglycemia, can be fatal if misdiagnosed and hence not appropriately managed. This study was a 10-year mortality audit in children, adolescents, and young adults with T1DM attending the Pediatric and Adolescent Diabetes Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods: A mortality audit consisting of a review of the medical records of participants and verbal interviews with caregivers and physicians in other hospitals who also attended to some participants just before death. The period spanned from January 2012 to December 2021. Results: A total of 14 patients out of 355 died within the 10 years giving a mortality rate of 3.9%. Seventy-one percent (71.4%) were females. The mean age at diagnosis was 12.9 5.2 years (Range: 8-14 years). The mean duration of diabetes before mortality was 7.4 2.7 years (Range: 2-13 years). The mean age at death was 19.7 3.8 years (Range: 15-28 years). Up to 50% of the participants died in district and teaching hospitals while the other 50% died at home. The identified causes of death included DKA, chronic renal failure, and osteosarcoma for those who died in hospitals. Conclusion: Mortality among children and young adults with T1DM occurred at all levels of health care with misdiagnosis of DKA as a significant cause. Most of the children and young adults with diabetes died at home and specific causes of death could not be found.