Partial D variant with demonstrated risk of D alloimmunization in the Australian Indigenous population.

Australian Red Cross Lifeblood (Lifeblood) performs human erythrocyte antigen (HEA) genotyping for a subset of repeat whole-blood donors through preferential selection which aims to maximise variation of results and possibility of identifying donors lacking high frequency red cell antigens. The HEA Molecular Bead chip™ assay is used by Lifeblood for donor genotyping. A review of all donor HEA genotype data from March 2019 to May 2022 (3 years) was conducted. HEA genotyping was performed for 20,185donors. Due to selective genotyping of donors, a higher frequency of R1R1 predicted phenotype was identified. However, frequencies of other red cell phenotypes were relatively similar to previous reported in the Australian population. A small number of donors with rare red cell phenotypes was identified. Genotyping of blood donors provides an available pool of extended matched red blood cell products for matching to recipients. Additionally genotyping can improve the identification of donors with rare phenotypes. Whilst limitations exist, genotyping may reduce the need for labour intensive serotyping, improve blood inventory management, and may be useful in donor recruitment and retention.

The Family Planning Program (KB) is one of the strategies carried out by the government to suppress the increase in the rate of population growth. The Family Planning Program (KB) will not run well if there is a family planning dropout. Women of childbearing age (WUS) who experience discontinuation of family planning will increase the risk of conception. This study uses secondary data from the 2017 IDHS for 945 women of childbearing age who have used modern family planning. This study uses secondary data from the 2017 IDHS for Women of Childbearing Age (WUS). This study uses cross-tabulation to determine the distribution of husbands' approval regarding family planning devices, wanting more children, side effects of family planning, the role of family planning service providers, and the incidence of dropping out of family planning use in North Sumatra Province. The results of this study indicate that there are 238 women of childbearing age (25.8%) who drop out of family planning use and 707 women of childbearing age (74.8%). The incidence of dropping out of family planning in North Sumatra Province mostly occurs to women of childbearing age who experience side effects of family planning as many as 238 women of childbearing age and women of childbearing age who still want more children many as 67 women of childbearing age. The BKKBN of North Sumatra Province must provide training to field worker family planning on side effects of family planning to improve the skills of PLKB in providing counselling about side effects of family planning in women of childbearing age. Fieldwork family planning North Sumatra Province must provide health counselling to women of childbearing age before deciding to use contraceptive methods to minimize the side effects of family planning in women of childbearing age.

Obstructive sleep apnoea (OSA) is highly prevalent among the Australian Indigenous population. In this setting, alongside a high prevalence of chronic medical comorbidities, OSA may further perpetuate adverse health outcomes. Though CPAP is a well-established, proven therapeutic modality, acceptability, and adherence have not been examined among the Australian Indigenous population. 730 Indigenous Australian patients with a diagnostic sleep study recorded between 2011 and 2020 were included. CPAP therapy was assessed as Accepting (any recorded use), Adapting (≥30 days use) and Adhering (≥30 days with ≥4 hours use on ≥70% of nights). 649 (89%) Indigenous patients had OSA (25% mild, 25% moderate & 50% severe). The majority of patients were male (53%), aged a median 47 years and were obese (72%), with 44% residing in remote locations. 309 (48%) Accepted CPAP, 197 (30%) Adapted to CPAP and 67 (10%) Adhered to CPAP. Acceptance, Adaptation and Adherence were higher in patients with Severe vs. Mild OSA (63, 44 & 16% vs. 23, 10 & 3%). OSA severity was associated with Acceptance and Adaptation to CPAP therapy but was not associated with Adherence. Remote residence was significantly and negatively associated with Adaptation and Adherence to therapy.Remote location was found to be the major factor defining whether patients continued therapy for ≥30 days and adhered to therapeutic guidelines. Given that 80% of Indigenous Australians in the NT reside in remote communities significant work needs to be done to promote adaptation and adherence to therapy in order to reduce morbidity associated with sleep disorders.

Ischaemic strokes lead to significant morbidity and mortality within the Australian Indigenous population, with known variances in the management of strokes between indigenous and non-indigenous populations. To compare investigations and management of indigenous and non-indigenous patients presenting to a New South Wales rural referral hospital with an ischaemic stroke to the national stroke standards across inpatient and outpatient settings. Historical cohort study of 43 indigenous and 167 non-indigenous patients admitted to Tamworth Rural Referral Hospital with an ischaemic cerebrovascular accident. Indigenous patients were significantly less likely to have investigations completed, including carotid imaging (93.8% vs 100%, P = 0.012) and echocardiography (73.3% vs 97.7%, P = 0.004). Discharge follow up was significantly lower for the indigenous population (74.4% vs 87.4%, P = 0.034). Indigenous stroke patients were 15.8 years younger than non-indigenous subjects (56.8 vs 72.6 years old; P < 0.001). Indigenous patients were more likely to have stroke risk factors, including smoking (51.2% vs 15.0%; P < 0.001), diabetes mellitus (37.2% vs 16.8%, P = 0.003) and past history of cerebrovascular accident or transient ischaemic attack (50.2% vs 31.1%, P = 0.032). The investigation and post-discharge care of indigenous ischaemic stroke patients is inferior to non-indigenous patients. Indigenous patients within rural NSW have a higher prevalence of preventable disease, including those that confer a higher stroke risk. Further research is needed to investigate the cause of these discrepancies and to improving indigenous stroke care between hospitals and primary care providers.

To investigate the prevalence and impact of severe mental illness (SMI) within the Australian Indigenous population. A systematic search of existing literature and data sources was conducted, using PubMed, Web of Science, EMBASE, MEDLINE, PsycINFO, and SCOPUS, to collect and analyse information on the prevalence of SMI among Indigenous Australians. Screening, data extraction and risk of bias assessments were performed independently by three co-authors. Of the 3372 studies identified by the search strategy, 16 studies met the eligibility criteria and were reviewed in detail. Results indicated that the pooled prevalence of all SMI in health centre or community settings was 2.58% (95% CI 1.37–4.85), bipolar disorder was 0.32% (95% CI 0.01–17.48), schizophrenia was 1.39% (95% CI 0.86–2.25). The pooled prevalence of SMI in incarceration is 12.26% (95% CI 4.29–35.02). Indigenous Australians reported a higher prevalence of SMI than non-Indigenous Australians. Besides, one study showed that the incidence of metabolic syndrome (MetS) in Indigenous Australians with SMI (66%), higher than in non-Indigenous Australians (55%). There is an urgent need to address mental health inequality among the Indigenous Australians and conduct further research in the areas of standardized diagnostic methods, the relationship between SMI and incarceration, and the incidence of MetS.

Reproductive tract diseases have become a serious public health problem threatening women's health. Vaginal microecological balance in women of childbearing age is essential for the maintenance of reproductive health, and different environmental conditions may have an impact on the composition of the vaginal microbial community and its metabolites. This is particularly true at different altitudes. Changes in environmental factors with increasing altitude may lead to vaginal microecological imbalances that increase the risk of reproductive tract infections and other gynecological diseases. Therefore, it is important to study vaginal microbial communities and metabolites in women of reproductive age at different altitudes. In this study, 16S rDNA sequencing and non-targeted metabolomics of vaginal secretions from healthy women of childbearing age at different altitudes were performed to analyze the composition of vaginal flora and metabolites of normal women of childbearing age at different altitudes, with the aim of providing new ideas for the prevention, diagnosis and treatment of diseases caused by vaginal microecological imbalance in women of childbearing age. General clinical data and vaginal secretions of a total of 60 healthy women of childbearing age were collected from four regions, namely, the low altitude group (8m above sea level), the middle altitude group (2,000m above sea level), the middle-high altitude group (2,800m above sea level), and the same as the high altitude group (4,000m above sea level), and were analyzed by sequencing of the V3-V4 region of the 16S rDNA and untargeted metabolomics sequencing. 16S rDNA sequencing can be used to comprehensively analyze the reproductive tract flora of women of childbearing age at different altitudes; the vaginal flora of normal women of childbearing age is dominated by the phylum Thick-walled Bacteria and Lactobacillus spp. The α-diversity of the vaginal flora increases with the elevation of altitude but there is no statistically significant difference; with the elevation of altitude, the percentage of the specialized anaerobic flora in the vagina is higher among the genera of Porphyromonas, Anaerobic Coccidia, and Peptostreptococcus. anaerobic increased in the vagina. Non-targeted metabolomics analysis revealed that there were differences in vaginal metabolites among women of childbearing age at different altitudes, with energy metabolism and nutrient metabolism being the main ones. Analysis of the four groups of differential metabolites showed that Ectoine, Thiamine, Taurine, D-glucono-1,5-lactone, 2-oxoadipic acid and N-Acetylserotonin differed significantly in the distribution of the four groups and were significantly elevated in the vaginas of women at high altitude. With the increase of altitude, the diversity of vaginal flora of women of childbearing age increased, and at the same time, there were differences in vaginal metabolites at different altitudes, which were hypothesized to be related to factors such as hypoxia, high altitude, and differences in hygiene habits in the plateau. The relationship between this and high altitude and reproductive tract diseases will be further explored in the future to provide theoretical guidance for improving the reproductive health of women of childbearing age in highland areas.

To analyze the relationship between vitamin D(VitD)-related single nucleotide polymorphism(SNP) and 25-hydroxyvitamin D(25(OH) D) levels and VitD nutritional status. A total of 1507 women of childbearing age aged 18-45 were selected from the sample bank of "2015 Chinese adult chronic disease and nutrition monitoring". Basic information(including region, season, age, height, weight, etc. ) of the subjects was collected. The SNPs related to VitD metabolism were screened, and the improved multiple ligase detection reaction was used for SNP testing. Liquid chromatography tandem mass spectrometry was used to determine the serum 25(OH)D concentration. The effects of genotypes on 25(OH)D level and VitD deficiency were analyzed by generalized linear model and binary logistic regression model, respectively. After adjusting for latitude, region, region type, season and age, CYP2R1 rs12794714, GC rs2282679, GC rs7041 and VDR rs2228570 were associated with serum 25(OH)D levels in women of childbearing age. The risk of VitD deficiency in individuals carrying GG genotype at rs2282679 was significantly higher than that in individuals carrying TT genotype(OR=2.466, 95%CI 1.690-3.598, P&lt;0.001), and the risk of VitD deficiency in individuals carrying A allele at rs2228570 was lower than that in individuals carrying G allele(OR_(AA)=0.625, 95%CI 0.446-0.876, P_(AA)=0.006;OR_(GA)=0.661, 95%CI 0.502-0.869, P_(GA)=0.003). The genotype distribution of CYP2R1 rs12794714, GC rs2282679, GC rs7041 and VDR rs2228570 may be related to serum 25(OH)D level or VitD nutritional status of Chinese women of childbearing age.

BackgroundApproximately 1 in 5 to 1 in 6 Indigenous Australian males are currently imprisoned or have previously been imprisoned. Recent work has also pointed to a widening socio-economic gap within the Indigenous population. Given the myriad social, wellbeing and environmental risk factors associated with justice-involvement, it is conceivable that incarceration may contribute to the increasing disparities found within the Indigenous population. This study aimed to explore the presence and extent of an ‘incarceration gap’ within the Indigenous population and to uncover which social factors characterise the disparity.MethodsThe study utilised data from the 2014–5 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). A number of socio-economic, environmental and clinical factors were compared by life-time incarceration status. Chi-square tests were used to examine the association between incarceration status and each of the comparison variables.ResultsDisparities were observed within the Indigenous Australian population across a number of important health and socio-economic markers by incarceration status - the most pronounced being for educational obtainment – year 10 completion (Never incarcerated 73%, Ever incarcerated 50%), labour force participation (Never incarcerated 56%, Ever incarcerated 26%) and drug/alcohol problems (Never incarcerated 7%, Ever incarcerated 29%). Never-incarcerated Indigenous males yielded aggregate proportions across numerous variables that approximated or matched general Australian population estimates.ConclusionsThere appears to be evidence for a substantial ‘incarceration gap’ within the Indigenous Australian population.

The common occurrence of renal disease in Australian Aboriginal populations such as Tiwi Islanders may be determined by environmental and genetic factors. To explore genetic contributions, we performed a genome-wide association study (GWAS) of urinary albumin creatinine ratio (ACR) in a sample of 249 Tiwi individuals with genotype data from a 370K Affymetrix single nucleotide polymorphism (SNP) array. A principal component analysis (PCA) of the 249 individual Tiwi cohort and samples from 11 populations included in phase III of the HapMap Project indicated that Tiwi Islanders are a relatively distinct and unique population with no close genetic relationships to the other ethnic groups. After adjusting for age and sex, the proportion of ACR variance explained by the 370K SNPs was estimated to be 37% (using the software GCTA.31; likelihood ratio = 8.06, p-value = 0.002). The GWAS identified eight SNPs that were nominally significantly associated with ACR (p < 0.0005). A replication study of these SNPs was performed in an independent cohort of 497 individuals on the eight SNPs. Four of these SNPs were significantly associated with ACR in the replication sample (p < 0.05), rs4016189 located near the CRIM1 gene (p = 0.000751), rs443816 located in the gene encoding UGT2B11 (p = 0.022), rs6461901 located near the NFE2L3 gene, and rs1535656 located in the RAB14 gene. The SNP rs4016189 was still significant after adjusting for multiple testing. A structural equation model (SEM) demonstrated that the rs4016189 SNP was not associated with other phenotypes such as estimated glomerular filtration rate (eGFR), diabetes, and blood pressure.

The purpose of the study to fnd out the infuence of factors of education, interest and motivation towards the behavior of early detection of ca cervix in the women of childbearing age in the health Kembangbahu Lamongan design research using observational analytic with cross design sectional. The entire population is women of childbearing age was 9476 in UPT Kembangbahu Lamongan with 369 samples of respondents taken with engineering proportional cluster random sampling. Data analyzed with logistic regression test. There are educational factors infuence behavior towards early detection of ca cervix in the women of childbearing age (p-value 0.000), there is interest in behavioral factors infuence early detection of ca cervix in the women of childbearing age (p-value 0.000), there is the infuence of motivation factors against the behavior of early detection of ca cervix in the women of childbearing age (p-value 0.05) and there the infuence factors of education, interest and motivation towards the behavior of early detection of ca cervix in the women of childbearing age (p-value 0.000). to make the behavior is indeed needed a variety of factors as predisposing factors include education, interest, and motivation. It was concluded that educational factors, interest, and motivation being the dominant factor against the behavior of early detection of ca cervix in women of fertile age. It is recommended that place research improve outreach regarding early detection of ca cervix in the women of childbearing age.

BackgroundMigraine is a primary headache, which has been producing heavy disease burden globally. There is no data on the incidence of migraine among women of childbearing age worldwide, including China. This study aimed to investigate the time trend in incidence rate of migraine among women of childbearing age in China from 1999 to 2019, and to make a prediction for 2030.MethodsData on migraine incidence and population among women of childbearing age in China were derived from the Global Burden of Diseases Study 2019. Crude and age-standardized incidence rates of migraine (CIR, ASIR) were presented. The trend in migraine during 1990–2019 was examined using annual percent change and average annual percent change based on Joinpoint regression models. Age-period-cohort model was introduced to estimate the independent effect of age, period and cohort on migraine incidence rate among participants over the three decades. Bayesian age-period-cohort analysis was conducted to predict migraine incidence rate for 2030 among women of childbearing age in China.ResultsFor women of childbearing age in China, the case number, CIR and ASIR of migraine kept rising, with a cumulative percentage increase of 10.87%, 2.01% and 5.65%, respectively, from 1990 to 2019. An annual percent increase of 0.18% in the ASIR was observed over the three decades. As for the age, period and cohort effects, the adjusted cohort-specific relative risks constantly increased from 0.91 (95% CI: 0.90, 0.93) in the 1940–1949 cohort to 1.04 (95% CI: 1.03, 1.05) in the 1995–2004 cohort, while the period-specific relative risks initially declined from 1.00 (95% CI: 0.99, 1.00) in 1990–1994 cohort to 0.99 (95% CI: 0.98, 0.99) in 1995–1999 cohort, and then increased to 1.04 (95% CI: 1.03, 1.04) in 2015–2019 cohort. Moreover, the age-specific relative risks of migraine followed a bimodal pattern with peaks at the age-group of 25–29 years (CIR = 1718.27/100000) and 35–39 years (CIR = 1635.18/100000). Projection modeling showed that the CIR and ASIR of migraine will continue to significantly increase from 2020 to 2030.ConclusionMigraine incidence remained an increasing trend from 1990 to 2019 and is projected to continually increase till 2030 among women of childbearing age in China. This study has important public health implication for population-level migraine prevention in China. Precision intervention strategies and approaches shall be considered in campaigns initiated for migraine prevention among Chinese women of childbearing age.

Age-standardized incidence, prevalence, and mortality rates of autoimmune diseases in women of childbearing age from 1990 to 2019

Obesity in women of childbearing age: risks, prevention, and treatment

IntroductionExposure to potentially teratogenic medications during pregnancy is underinvestigated in Switzerland. We aimed to assess exposure to potential teratogens preconceptionally, during the first trimester, and in women of childbearing age, and specifically explore the effectiveness of the valproate pregnancy prevention program (2018).Material and MethodsRetrospective study using the Swiss Helsana claims database. In a pregnancy cohort (2015–2021) and a cohort of women of childbearing age (2021 and 2018), we defined three 90‐day time periods: (1) first trimester, (2) preconceptional period (days 180–90 before pregnancy), and (3) January 01, 2021, and March 31, 2021 (women of childbearing age). During all periods, we quantified the exposure prevalence to at least one dispensed weak, proven, and unequivocally potent teratogen overall and by age strata. We quantified the exposure prevalence to each individual teratogen, and to valproate during pregnancy by calendar year to compare its use before and after the introduction of a pregnancy prevention program (2018). We investigated the use of systemic retinoids particularly isotretinoin in women of childbearing age.ResultsOf 34 584 pregnant women, 1.4% were exposed to potential teratogens during the first trimester (weak: 1.3%, proven: 0.06%, unequivocally potent: 0.04%). During the preconceptional period, 2.9% were exposed to any teratogen compared to 4.7% of women of childbearing age (Ntotal = 95 059). Systemic glucocorticoids were the most prevalent weak teratogens during all time periods (75% of all claimed teratogens during the first trimester). In the first trimester, the antibiotic cotrimoxazole and the thyreostatic thiamazole (weak teratogens), ranked second and third, followed by the antiseizure medications carbamazepine and topiramate (proven teratogens). Among women of childbearing age, exposure to weak and proven teratogens increased with age, whereas exposure to unequivocally potent teratogens decreased with age. This was due to 2.3% of women <26 years who claimed systemic isotretinoin. Valproate use during pregnancy decreased after the introduction of a pregnancy prevention program (2.39/10 000 pregnancies [2015–2018] vs. 0.93/10 000 pregnancies [2019–2021]).ConclusionsMost medications with potential teratogenic effects dispensed to women of childbearing age and pregnant women were in the group of weak teratogenicity level, and many women discontinued treatment before pregnancy. Preliminary evidence suggests the valproate pregnancy prevention program in Switzerland may be beneficial.

Prevention of pregnancy by various contraceptive methods remains an important part of medical practice and can occur during any reproductive cycle. The more types of contraceptive methods available, the more choices of contraceptive methods available for people. Many determinant factors cause women of childbearing age to choose contraceptives that suit their needs. This study aims to determine the determinants affecting women of childbearing age using contraceptives in West Nusa Tenggara Province. The design of this study is an analytical study (descriptive analysis) with a cross-sectional approach using secondary data from the 2019 SKAP Family Planning and Family Development Population Accountability Performance Survey (KKBPK) in the Province of West Nusa Tenggara (NTB). Data were analyzed using bivariate analysis using Chi-Square and multivariate with logistic regression. The results showed that the determinants that affect women of childbearing age in using contraceptive methods include: unmet need, age, parity, previous family planning experience, decision-making, knowledge, and visits to health facilities. The results of multivariate analysis of the most dominant decision-making factors influencing the use of contraceptive methods in women of childbearing age with an OR value of 174,666. It can be interpreted that the decision-making ability of women of childbearing age is 174,666 times more influencing the use of contraceptive methods compared to other variables. This study recommends empowering women of childbearing age through increasing knowledge by maximizing the individual counseling process so that women of childbearing age can choose contraceptive methods according to their needs.