Can mothers judge the size of their newborn? Assessing the determinants of a mother's perception of a baby's size at birth

Birth weight is known to be closely related to child health, although as many infants in developing countries are not weighed at birth and thus will not have a recorded birth weight it is difficult to use birth weight when analysing child illness. It is common to use a proxy for birth weight instead, namely the mother’s perception of the baby’s size at birth. Using DHS surveys in Cambodia, Kazakhstan and Malawi the responses to this question were assessed to indicate the relationship between birth weight and mother’s perception. The determinants of perception were investigated using multilevel ordinal regression to gauge if they are different for infants with and without a recorded birth weight, and to consider if there are societal or community influences on perception of size. The results indicate that mother’s perception is closely linked to birth weight, although there are other influences on the classification of infants into size groups. On average, a girl of the same birth weight as a boy will be classified into a smaller size category. Likewise, infants who died by the time of the survey will be classified as smaller than similarly heavy infants who are still alive. There are significant variations in size perception between sampling districts and clusters, indicating that mothers mainly judge their child for size against a national norm. However, there is also evidence that the size of infants in the community around the newborn also has an effect on the final size perception classification. Overall the results indicate that mother’s perception of size is a good proxy for birth weight in large nationally representative surveys, although care should be taken to control for societal influences on perception

Gender Disparity in HIV Prevalence: A National-Level Analysis of the Association between Gender Inequality and the Feminisation of HIV/AIDS in sub-Saharan Africa

The HIV pandemic in sub-Saharan Africa is often described as undergoing a ‘feminisation’ in which female HIV prevalence exceeds that of male in most age groups and countries. However, much of the variation between countries in the female-to-male (FTM) ratio of HIV prevalence remains unexplained. This paper uses information from DHS, World Bank, UNDP and UNAIDS to identify correlates of the FTM ratio at the country level, with a focus on gender inequality. The FTM ratio is investigated overall and for two age groups. Divergent results by age suggest that the influence of particular mechanisms depend on the age group in question, with epidemiological and demographic variables in particular demonstrating strong associations with the FTM ratio for 25-49 year olds. The mechanisms influencing gender disparity in HIV prevalence between younger adults remain unclear, with few significant correlates observed for the 15-24 age group.

Universal health care and equity: evidence of maternal health based on an analysis of demographic and household survey data

INTRODUCTION: The drive toward universal health coverage (UHC) is central to the post 2015 agenda, and is incorporated as a target in the new Sustainable Development Goals. However, it is recognised that an equity dimension needs to be included when progress to this goal is monitored. WHO have developed a monitoring framework which proposes a target of 80 % coverage for all populations regardless of income and place of residence by 2030, and this paper examines the feasibility of this target in relation to antenatal care and skilled care at delivery.METHODOLOGY: We analyse the coverage gap between the poorest and richest groups within the population for antenatal care and presence of a skilled attendant at birth for countries grouped by overall coverage of each maternal health service. Average annual rates of improvement needed for each grouping (disaggregated by wealth quintile and urban/rural residence) to reach the goal are also calculated, alongside rates of progress over the past decades for comparative purposes.FINDINGS: Marked inequities are seen in all groups except in countries where overall coverage is high. As the monitoring framework has an absolute target countries with currently very low coverage are required to make rapid and sustained progress, in particular for the poorest and those living in rural areas. The rate of past progress will need to be accelerated markedly in most countries if the target is to be achieved, although several countries have demonstrated the rate of progress required is feasible both for the population as a whole and for the poorest.CONCLUSIONS: For countries with currently low coverage the target of 80 % essential coverage for all populations will be challenging. Lessons should be drawn from countries who have achieved rapid and equitable progress in the past.<br/

Improving the Efficiency of Starch Digestion in Beef Cattle

The efficiency of feedlot cattle production largely depends on the utilisation of starch. Current grain selection and processing practices can achieve whole tract starch digestibility levels of greater than 95% but gross inefficiencies in feed utilisation can still occur. The aim of this thesis was to examine opportuinities for improving the efficiency of starch digestion in beef cattle

Resurrecting the interval of need concept to improve dialogue between researchers, policymakers, and social care practitioners

Academics, social care practitioners, and policymakers speak different languages. If academic research is to have an impact on society, it must be understandable and convincing to the end users. We argue that the conceptualisation of social care ‘need’ is different among these stakeholders, leading to poor communication between them. Academics should use concepts that have more meaning to practitioners. We propose resurrecting a little-used concept from the 1970s, ‘interval of need’, to help to bridge this gap. The interval of need concept identifies how often people require help, supplementing the usual data about types of tasks where assistance is needed. The history of the concept is described, followed by a test of its usefulness for today’s researchers by applying it to data from the English Longitudinal Study of Ageing. An updated version of interval of need is proposed. Validation checks were conducted against mortality data, and through conceptual validation from a social work practitioner. The nature of the dataset limited comparability with previous studies. However, we conclude that the interval of need concept has promising scope to enhance communication of research findings, potentially leading to improved outcomes for service users. This paper strives to mark a turning point in the language and analysis of social care, ensuring that academic investigation in this field is convincing and clear to practitioners and policymakers

The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter?

Background: Alongside the global population ageing phenomenon, there has been a rise in the number of individuals who suffer from multiple chronic conditions. Taking the case of South Africa, this study aims, first, to investigate the association between multi-morbidity and disability among older adults; and second, to examine whether hypertension (both diagnosed and undiagnosed) mediates this relationship. Lastly, we consider whether the impact of the multi-morbidity on disability varies by socio-demographic characteristics. Methods: Data were drawn from Wave 1 (2007-08) of the South African Study on Global Ageing and Adult Health. Disability was measured using the 12-item World Health Organisation Disability Assessment Schedule (WHODAS) 2.0. Scores were transformed into a binary variable whereby those over the 90th percentile were classified as having a severe disability. The measure of multi-morbidity was based on a simple count of self-reported diagnosis of selected chronic conditions. Self-reports of diagnosed hypertension, in addition to blood pressure measurements at the time of interview, were used to create a three category hypertension variable: no hypertension (diagnosed or measured), diagnosed hypertension, hypertension not diagnosed but hypertensive measured blood pressure. Interactions between the number of chronic diseases with sex, ethnicity and wealth were tested. Logistic regression was used to analyze the relationships. Results: 25.4% of the final sample had one and 13.2% two or more chronic diseases. Nearly half of the respondents had a hypertensive blood pressure when measured during the interview, but had not been previously diagnosed. A further third self-reported they had been told by a health professional they had hypertension. The logistic regression showed in comparison to those with no chronic conditions, those with one or two or more had significantly higher odds of severe disability. Hypertension was insignificant and did not change the direction or size of the effect of the multi-morbidity measure substantially. The interactions between number of chronic conditions with wealth were significant at the 5% level. Conclusions: The diagnosis of multiple chronic conditions, can be used to identify those most at risk of severe disability. Limited resources should be prioritized for such individuals in terms of preventative, rehabilitative and palliative care

Reducing in-stent restenosis therapeutic manipulation of miRNA in vascular remodeling and inflammation

Background: Drug-eluting stents reduce the incidence of in-stent restenosis, but they result in delayed arterial healing and are associated with a chronic inflammatory response and hypersensitivity reactions. Identifying novel interventions to enhance wound healing and reduce the inflammatory response may improve long-term clinical outcomes. Micro–ribonucleic acids (miRNAs) are noncoding small ribonucleic acids that play a prominent role in the initiation and resolution of inflammation after vascular injury.&lt;p&gt;&lt;/p&gt; Objectives: This study sought to identify miRNA regulation and function after implantation of bare-metal and drug-eluting stents.&lt;p&gt;&lt;/p&gt; Methods: Pig, mouse, and in vitro models were used to investigate the role of miRNA in in-stent restenosis.&lt;p&gt;&lt;/p&gt; Results: We documented a subset of inflammatory miRNAs activated after stenting in pigs, including the miR-21 stem loop miRNAs. Genetic ablation of the miR-21 stem loop attenuated neointimal formation in mice post-stenting. This occurred via enhanced levels of anti-inflammatory M2 macrophages coupled with an impaired sensitivity of smooth muscle cells to respond to vascular activation.&lt;p&gt;&lt;/p&gt; Conclusions: MiR-21 plays a prominent role in promoting vascular inflammation and remodeling after stent injury. MiRNA-mediated modulation of the inflammatory response post-stenting may have therapeutic potential to accelerate wound healing and enhance the clinical efficacy of stenting

Imaging Cool Giant Planets in Reflected Light: Science Investigations and Synergy with Habitable Planets

Planned astronomical observatories of the 2020s will be capable of obtaining reflected light photometry and spectroscopy of cool extrasolar giant planets. Here we explain that such data are valuable both for understanding the origin and evolution of giant planets as a whole and for preparing for the interpretation of similar datasets from potentially habitable extrasolar terrestrial planets in the decades to follow.Comment: Science white paper submitted to the Astro 2020 Decadal Survey on Astronomy and Astrophysics. Replace version to fix typo in co-signer name and add figure credit