What inequality means for children: evidence from young lives. Background paper for the Global Thematic Consultation “Addressing Inequalities” in the post-2015 Development Agenda

Understanding how poverty and inequalities impact on children is the major goal of Young Lives, a unique longitudinal, mixed-methods research and policy study. We are tracking two cohorts of 12,000 children growing-up in Ethiopia, the state of Andhra Pradesh (AP) India, Peru and Vietnam. In this paper we offer eight key research messages, focusing on: 1. How inequalities interact in their impact on children’s development, and the vulnerability of the most disadvantaged households. 2. The ways inequalities rapidly undermine the development of human potential. 3. How gender differences interconnect with other inequalities, but do not always advantage boys in Young Lives countries. 4. The links between poverty, early ‘stunting’, and later outcomes, including psycho-social functioning, as well as emerging evidence that some children may recover. 5. Inequalities that open up during the later years of childhood, linked to transitions around leaving school, working, and anticipating marriage etc. 6. Children’s own perceptions of poverty and inequality, as these shape their well-­being and long-­term prospects. 7. Evidence of the growing significance of education, including the ways school systems can increase as well as reduce inequalities. 8. The potential of social protection programmes in poverty alleviation. We conclude that since inequalities are multidimensional, so too must be the response. Equitable growth policies, education and health services, underpinned by effective social protection, all have a role to play

What inequality means for children: evidence from Young Lives

Understanding how poverty and inequalities impact on children is the major goal of Young Lives, a unique longitudinal, mixed-methods research and policy study. We are tracking two cohorts of 12,000 children growing-up in Ethiopia, the state of Andhra Pradesh (AP) India, Peru and Vietnam. In this expanded version of the paper prepared for UN Global Consultatation on Inequalities we offer eight key research messages, focusing on: 1. How inequalities interact in their impact on children’s development, and the vulnerability of the most disadvantaged households. 2. The ways inequalities rapidly undermine the development of human potential. 3. How gender differences interconnect with other inequalities, but do not always advantage boys in Young Lives countries. 4. The links between poverty, early stunting, and later outcomes, including psychosocial functioning, as well as emerging evidence that some children may recover. 5. Inequalities that open up during the later years of childhood, linked to transitions around leaving school, working, and anticipating marriage etc. 6. Children’s own perceptions of poverty and inequality, as these shape their well-being and long-term prospects. 7. Evidence of the growing significance of education, including the ways school systems can increase as well as reduce inequalities. 8. The potential of social protection programmes in poverty alleviation. We conclude that since inequalities are multidimensional, so too must be the response. Equitable growth policies, education and health services, underpinned by effective social protection, all have a role to play

From Infancy to Adolescence : Growing Up in Poverty

The analysis takes account of initial household circumstances and characteristics (such as being in the poorest or least-poor tercile in terms of household wealth) recorded in the first survey round, when Younger Cohort children were aged 1 and the Older Cohort children were aged 8. The authors explore how children and young people’s trajectories diverge over time; and we provide preliminary findings on education, nutrition and youth transitions to higher education, work and marriage and parenthood, from the latest survey round. The researchers find that the poorest children, those in rural areas and/or from marginalised social groups, are consistently being ‘left behind’ in terms of nutritional status, learning and opportunities to continue in education. We conclude by considering how policy interventions at different stages of the early life course can mitigate the development of such inequalities

How Inequalities Develop through Childhood: Life-course Evidence from Young Lives Cohort Study

This paper contributes longitudinal research evidence on the impact of structural inequalities on children’s development within households and communities; the ways access to health, education and other key services may reduce or amplify inequalities; and especially evidence on the ways that children’s developmental trajectories diverge from early in life, through to early adulthood. The paper is based primarily on findings from Young Lives, an ongoing four country, two cohort, fifteen- year longitudinal study of 12,000 children growing up in poverty, in diverse sites in Ethiopia, India (in the State of Andhra Pradesh1), Peru and Vietnam (see www.younglives.org.uk

The Effects of a Scenario Based GPS Training Program on Pilot Proficiency in the General Aviation Pilot

Currently, General Aviation (GA) pilots working toward their instrument rating (IFR) in aircraft equipped with Global Positioning System (GPS) technology receive little, if any, formal flight instruction on GPS technology. Therefore, the hypothesis examined in this study was that instrument rated pilots already certificated to fly IFR / GPS have insufficient knowledge of the GPS technology to use it effectively. Our goal was to develop a single pilot crew, scenario-based training program to increase the knowledge and safety of pilots using this technology by focusing on GPS mode awareness, situational assessment, risk and time management, and situational awareness.. The study included thirty-four pilots who had completed their instrument rating in a GPS-equipped aircraft within the last 12 months. All participants were given Pre-experiment GPS screening tests to assess overall GPS knowledge and, more specifically, knowledge regarding the Garmin 430. Each participant underwent simulator familiarization sessions in a Frasca 142 flight simulator equipped with a panel mounted IFR approved GPS. After the familiarization sessions, participants were randomly assigned to one of two groups: 1) Experimental or 2) Control. All groups then flew IFR-generated flight scenarios designed to assess their aircraft system monitoring skills (situational assessment), GPS mode awareness, situational awareness, and understanding of the Garmin 430 IFR programming. Each scenario lasted approximately 60 minutes. Following the first session, the experimental group received training sessions concentrating on mode awareness, situational awareness, time management, and situational assessment using computer based training (CBT) with a Garmin 430 simulation software program. The control group received sessions that covered basic IFR flying skills. Following the training sessions both groups flew another scenario in the Frasca 142 simulator. Each subject was video-taped to assess eye fixation in three areas of interest: 1) out the window, 2) aircraft instruments, and 3), GPS display. The results of this study revealed that a GPS scenario-based training program significantly reduced omission errors and incorrect or inappropriate use of the GPS when compared to controls. In addition, a significant effect of training versus eye gaze was observed. Pilots in the experimental group spent significantly less time gazing at the GPS following the training sessions and more time gazing at the instruments compared to controls

Tracing the consequences of child poverty

Available Open Access under CC-BY-NC licence. Using life course analysis from the Young Lives study of 12,000 children growing up in Ethiopia, India, Peru and Vietnam over the past 15 years, this book draws on evidence on two cohorts of children, aged from 1 to 15 and from 8 to 22. It examines how poverty affects children’s development in low and middle income countries, and how policy has been used to improve their lives, then goes on to show when key developmental differences occur. It uses new evidence to develop a framework of what matters most and when and outlines effective policy approaches to inform the no-one left behind Sustainable Development Goal agenda

Tracing the consequences of child poverty

Available Open Access under CC-BY-NC licence. Using life course analysis from the Young Lives study of 12,000 children growing up in Ethiopia, India, Peru and Vietnam over the past 15 years, this book draws on evidence on two cohorts of children, aged from 1 to 15 and from 8 to 22. It examines how poverty affects children’s development in low and middle income countries, and how policy has been used to improve their lives, then goes on to show when key developmental differences occur. It uses new evidence to develop a framework of what matters most and when and outlines effective policy approaches to inform the no-one left behind Sustainable Development Goal agenda

A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results: Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it

Peptidyl-prolyl cis-trans isomerases (immunophilins) and their roles in parasite biochemistry, host-parasite interaction and antiparasitic drug action.

Immunophilin is the collective name given to the cyclophilin and FK506-binding protein (FKBP) families. As the name suggests, these include the major binding proteins of certain immunosuppressive drugs: cyclophilins for the cyclic peptide cyclosporin A and FKBPs for the macrolactones FK506 and rapamycin. Both families, although dissimilar in sequence, possess peptidyl-prolyl <i>cis-trans</i> isomerase activity in vitro and can play roles in protein folding and transport, RNA splicing and the regulation of multiprotein complexes in cells. In addition to enzymic activity, many immunophilins act as molecular chaperones. This property may be conferred by the isomerase domain and/or by additional domains. Recent years have seen a great increase in the number of known immunophilin genes in parasitic protozoa and helminths and in many cases their products have been characterized biochemically and their temporal and spatial expression patterns have been examined. Some of these genes represent novel types: one example is a <i>Toxoplasma gondii</i> gene encoding a protein with both cyclophilin and FKBP domains. Likely roles in protein folding and oligomerisation, RNA splicing and sexual differentiation have been suggested for parasite immunophilins. In addition, unexpected roles in parasite virulence (Mip FKBP of <i>Trypanosoma cruzi</i>) and host immuno-modulation (e.g. 18-kDa cyclophilin of <i>Toxoplasma gondii</i>) have been established. Furthermore, in view of the potent antiparasitic activities of cyclosporins, macrolactones and nonimmunosuppressive derivatives of these compounds, immunophilins may mediate drug action and/or may themselves represent potential drug targets. Investigation of the mechanisms of action of these agents may lead to the design of potent and selective antimalarial and other antiparasitic drugs. This review discusses the properties of immunophilins in parasites and the 'animal model' <i>Caenorhabditis elegans</i> and relates these to our understanding of the roles of these proteins in cellular biochemistry, host-parasite interaction and the antiparasitic mechanisms of the drugs that bind to them