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Trends in perinatal health after assisted reproduction: a Nordic study from the CoNARTaS group

January 23, 2015 Comments off

Trends in perinatal health after assisted reproduction: a Nordic study from the CoNARTaS group
Source: Human Reproduction

STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time?

SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births.

WHAT IS KNOWN AND WHAT THIS PAPER ADDS A Swedish study has shown a reduction in unwanted outcomes over time in children conceived after ART. Our analyses based on data from more than 92 000 ART children born in four Nordic countries confirm these findings.

STUDY DESIGN Nordic population-based matched cohort study with ART outcome and health data from Denmark, Finland, Norway and Sweden.

PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215 spontaneously conceived singletons. Twins conceived after ART were compared with all spontaneously conceived twins (n = 122 763) born in the Nordic countries during the study period. The rates of several adverse perinatal outcomes were stratified into the time periods: 1988–1992; 1993–1997; 1998–2002 and 2003–2007 and presented according to multiplicity.

MAIN RESULTS AND ROLE OF CHANCE For singletons conceived after ART, a remarkable decline in the risk of being born preterm and very preterm was observed. The proportion of ART singletons born with a low and very low birthweight also decreased. Finally, the stillbirth and infant death rates have declined among both ART singletons and twins. Throughout the 20 year period, fewer ART twins were stillborn or died during the first year of life compared with spontaneously conceived twins, presumably due to the lower proportion of monozygotic twins among the ART twins.

LIMITATIONS, REASONS FOR CAUTION We were not able to adjust for some potential confounders such as BMI, smoking, length or cause of infertility. The Nordic ART populations have changed over time, and in recent years, both less as well as severely reproductive ill couples are being treated. This may have affected the observed trends.

WIDER IMPLICATIONS OF THE FINDINGS It is assuring that data from four countries confirm an overall improvement over time in the perinatal outcomes of children conceived after ART. Furthermore, data show the beneficial effect of single embryo transfer, not only in regard to lowering the rate of multiples but also concerning the health of singletons.

See: Largest study of babies born after infertility treatment shows significant improvements in health over past 20 years (Science Daily)

On the Front Line of Child Protection

January 22, 2015 Comments off

On the Front Line of Child Protection
Source: Boston Consulting Group

  • An outstanding social worker can transform the lives of disadvantaged children and help them reach their full potential. But attracting high-caliber job candidates is not easy.
  • In a 2012 survey, 70 percent of 600 industry professionals reported that newly qualified social workers were entering the profession with insufficient skills and experience to begin practicing.
  • Frontline’s cost-effective program combines an innovative curriculum, a five-week summer institute, 12 months of supervised on-the-job training, and an ongoing leadership-development course.

Access to dependent care reimbursement accounts and workplace-funded childcare

January 21, 2015 Comments off

Access to dependent care reimbursement accounts and workplace-funded childcare
Source: Bureau of Labor Statistics

The U.S. labor force includes many working mothers and working fathers with dependents and children in their care. These families often enlist help, such as daycare or eldercare, to balance family and work responsibilities. But many families find it challenging to pay for the high costs of care for dependents and children. That’s where benefits such as dependent care reimbursement accounts and workplace-funded childcare can prove helpful to working families.

This issue of Beyond the Numbers takes a look at dependent care reimbursement accounts and workplace-funded childcare, and the rate of worker access to each of these benefits. The data show the employee access rates in 2014 for selected occupational and establishment characteristics for state and local government workers and for private industry workers.

Valuing All Our Families; Progressive Policies that Strengthen Family Commitments and Reduce Family Disparities

January 20, 2015 Comments off

Valuing All Our Families; Progressive Policies that Strengthen Family Commitments and Reduce Family Disparities
Source: Center for American Progress

Stable, healthy marriages and relationships can bolster the economic security and well-being of adults and children. Too often, however, national debates about the American family have been limited to arguing the merits of married versus single parenthood or “traditional” families versus “alternative” ones. An underlying assumption often seems to be that these are static types of families that children are born into and remain in until they leave home.

Reality is much more complex. Relatively few children—less than one in four—currently live in families with married parents in which only the father is employed, compared to the roughly two in three children who did in 1960. Families in the United States—including those headed by married parents—appear to be much more unstable than in most other wealthy nations. In fact, more than half of U.S. children today will spend at least part of their childhoods not living with two biological parents, even though the vast majority of children begin their lives living with both of them. A family headed by only one adult is typically not a permanent state; rather, it is more frequently a transitional situation. Moreover, grandparents, other kin, and parents living apart from their children often play major and supporting roles in their children’s upbringing.

This complex reality does not mean that policymakers should throw up their hands and conclude that public policy can do little to influence children’s or adults’ stability and well-being via family-related policies. As argued in this report, a clear-eyed approach that better aligns family policy with the lived experience of 21st century families could provide the necessary supports to improve American family life. Such an approach should eschew simple diagnoses and prescriptions, such as the idea held by some conservatives that only the decline in marriage needs to be reversed, primarily through cultural change, or the idea held by some progressives that only the economy needs to be fixed.

Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?

January 19, 2015 Comments off

Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?
Source: National Bureau of Economic Research

We examine the long-term impact of expansions to Medicaid and the State Children’s Health Insurance Program that occurred in the 1980’s and 1990’s. With administrative data from the IRS, we calculate longitudinal health insurance eligibility from birth to age 18 for children in cohorts affected by these expansions, and we observe their longitudinal outcomes as adults. Using a simulated instrument that relies on variation in eligibility by cohort and state, we find that children whose eligibility increased paid more in cumulative taxes by age 28. These children collected less in EITC payments, and the women had higher cumulative wages by age 28. Incorporating additional data from the Medicaid Statistical Information System (MSIS), we find that the government spent $872 in 2011 dollars for each additional year of Medicaid eligibility induced by the expansions. Putting this together with the estimated increase in tax payments discounted at a 3% rate, assuming that tax impacts are persistent in percentage terms, the government will recoup 56 cents of each dollar spent on childhood Medicaid by the time these children reach age 60. This return on investment does not take into account other benefits that accrue directly to the children, including estimated decreases in mortality and increases in college attendance. Moreover, using the MSIS data, we find that each additional year of Medicaid eligibility from birth to age 18 results in approximately 0.58 additional years of Medicaid receipt. Therefore, if we scale our results by the ratio of beneficiaries to eligibles, then all of our results are almost twice as large.

Undocumented migrant children in the EU

January 19, 2015 Comments off

Undocumented migrant children in the EU
Source: European Parliamentary Research Service

In its 2006 communication COM (2006) 0367, “Towards an EU strategy on the rights of the child”, relating to the rights of children “as immigrants, asylum seekers and refugees” , the Commission voiced its commitment to closing the gap between national or community migration laws and the children’s rights that the EU is committed to defending.

However the European reality is that undocumented migrants’ access to education, healthcare and housing is often restricted. The unwanted effects of migration laws are especially felt by undocumented migrant children who find themselves in a vulnerable situation rather than being protected by national, EU and international legislation.

This Keysource puts together legislative and practical experience in the European Union with reference to undocumented migrant children, including recommendations on how to improve the coherence between migration policies and moral issues.

A New Majority Research Bulletin: Low Income Students Now a Majority in the Nation’s Public Schools

January 17, 2015 Comments off

A New Majority Research Bulletin: Low Income Students Now a Majority in the Nation’s Public Schools
Source: Southern Education Foundation

Low income students are now a majority of the schoolchildren attending the nation’s public schools, according to this research bulletin. The latest data collected from the states by the National Center for Education Statistics (NCES), show that 51 percent of the students across the nation’s public schools were low income in 2013.

In 40 of the 50 states, low income students comprised no less than 40 percent of all public schoolchildren. In 21 states, children eligible for free or reduced-price lunches were a majority of the students in 2013.

Most of the states with a majority of low income students are found in the South and the West. Thirteen of the 21 states with a majority of low income students in 2013 were located in the South, and six of the other 21 states were in the West.

Mississippi led the nation with the highest rate: ­71 percent, almost three out of every four public school children in Mississippi, were low-income. The nation’s second highest rate was found in New Mexico, where 68 percent of all public school students were low income in 2013.

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