Within-Family Inequalities in Human Capital Accumulation in India: Birth Order and Gender Effects

In this paper we investigate birth order and gender effects on the development of children’s human capital in India. We investigate both indicators of the child’s current stock of human capital and of investment into their continued human capital accumulation, distinguishing between time investments and pecuniary investment into school quality. Our results show that in India, birth order effects are mostly negative. More specifically, birth order effects are negative for indicators of children's accumulated human capital stock and for indicators of pecuniary investments into school quality. These results are more in line with previous results from developed countries than from developing countries. However, for time investments, which are influenced by the opportunity cost of child time, birth order effects are positive. Gender aspects are also important. Girls are disadvantaged within families, and oldest son preferences can explain much of the within-household inequalities which we observe.JEL:D13, I20, J16, O15A later version of this report was published December 2018: http://hdl.handle.net/2077/5846

Son Preferences and Education Inequalities in India

We investigate the impact of son preferences in India on gender inequalities in education. We distinguish the impact of preferential treatment of boys from the impact of gender-biased fertility strategies (gender-specific fertility stopping rules and sex-selective abortions). Results show strong impacts of gender-biased fertility strategies on education differences between girls and boys. Preferential treatment of boys has a more limited impact on gender differences. Further, results suggest that gender-biased fertility strategies create gender inequalities in education both because girls and boys end up in systematically different families and because of gender-inequalities in pecuniary investment within families. The extra advantage of the eldest son within the family is small.D13, I20, J16, O1

När användaren kom bort

Today's technological development means that organizations are constantly evolving. This means that the market, which the organizations operate in, is constantly changing and becoming more complex to interpret. This development increases the demand to forecast possible outcomes and receive real-time information from the operations – i.e., obtain the most accurate data for decision-support. To make this possible, organizations need so-called ‘decision support systems’; IT-tools that rapidly provide decision makers with information based on relevant data. To obtain the highest possible value from the systems, they must seamlessly integrate and interact with the organization. This study examines how decision support systems, organizations and users relate to each other in an organizational context. The aim is to provide an insight into the limitations and possibilities of human behaviour, technological development and organizational structure to create and enable relevant and effective decision support systems. The paper’s theoretical framework is based on Orlikowski’s (1992) structurational model. The empirical material consists of semi-structured interviews, which are analysed based on Orlikowski’s model. The results show that although there is a common understanding on how the different factors should interact in order for the decision support systems to function the respondents neglected their own influence as users of the systems. Dagens teknikutveckling medför att organisationer hela tiden utvecklas och förändras. Det i sin tur medför att den marknad organisationer agerar på förändras och blir alltmer komplex att tolka. Denna utveckling ökar efterfrågan att förutspå sannolika utfall, få information om verksamheten i realtid, kort sagt få ett korrekt beslutsunderlag. För att detta ska vara möjligt behövs IT-verktyg som snabbt kan förse beslutsfattare med underlag som grundar sig på relevanta data, så kallade beslutsstödsystem. För att få ut mesta möjliga värde från beslutsstödsystemen ställs höga krav på att de integreras och samverkar med organisationen. I studien undersöks hur beslutsstödsystem, organisationer och användare förhåller sig till varandra i en organisatorisk kontext. Målet är att ge en inblick i de begränsningar och möjligheter människors agerande, teknikens utveckling och organisationens struktur skapar för att möjliggöra relevanta och effektiva system för beslutsstöd. Studiens teoretiska ramverk tar sin utgångspunkt i Orlikowskis (1992) struktureringsmodell. Det empiriska materialet utgörs av semistrukturerade intervjuer som analyseras med utgångspunkt från Orlikowskis modell. Resultatet visar att även om det överlag finns en förståelse för hur olika faktorer bör samspela för att beslutsstödsystemen ska fungera, tonar respondenterna ner sin egen betydelse som användare av systemen.

Theatre nurses experiences of incident reporting

Bakgrund: Varje år drabbas nästan var tionde patient av skador under vårdtiden, skador som hade kunnat undvikas. Detta leder till ett onödigt lidande för dessa patienter och deras närstående. Vårdskadorna beräknas enligt Socialstyrelsen (2008) kosta samhället sex miljarder kronor per år. Operationssjuksköterskor liksom all vårdpersonal har skyldighet att avvikelserapportera händelser som kunnat leda till eller lett till vårdskada. Syftet med att rapportera avvikelser är att dra lärdom och att med riskförebyggande insatser förhindra att händelserna uppstår igen. Syfte: Att studera vilken erfarenhet operationssjuksköterskor har av avvikelserapportering. Metod: Studien utfördes som en tvärsnittsstudie med kvantitativ ansats. Ett studiespecifikt frågeformulär innehållande tio strukturerade frågor med möjlighet till egna kommentarer användes. Formulärets frågor behandlade erfarenheter kring avvikelserapportering. Resultat: En stor majoritet av deltagarna (85 %) hade någon gång avstått från att skriva avvikelserapport. Slutsatser: Bland annat var tidsbrist en avgörande faktor varför operationssjuksköterskorna inte dokumenterade en avvikelserapport. Background: Each year, nearly every tenth patient suffers of injuries during hospitalization, which could have been avoidable. This leads to unnecessary suffering for the patients and their families. Health damage according to the National Board (the Swedish Socialstyrelsen) (2008) costs the society six billion Swedish kronor (SEK) every year. It is mandatory for theatre nurses to report incidents that could have coast injuries to the patient during hospitalization. The purpose with incident reports is to learn from mistakes and with preventive measurements make the healthcare safer for the patients. Aim: To evaluate theatre nurses experience with reporting incidents. Method: The study was conducted as a cross-sectional design with quantitative data. A study- specific questionnaire comprising ten structured questions with the possibility of their comments was used. The form´s questions dealt with experiences about incident reporting. Result: A large majority of respondents (85 %) had at some point refrained from writing incident reports. Conclusions: Among other things, lack of time was the decisive factor why theatre nurses were not documented an incident report

Land Certification and Schooling in Rural Ethiopia

This paper investigates the impact of a rural land certification program on schooling in two zones of the Amhara region of Ethiopia. Using the variation in the timing of the arrival of the program at the local level, we investigate the link between land tenure security, schooling and child labor. The results show a positive effect of improved land rights on school enrollment for all children in one of the zones studied, and for oldest sons in the other. Grade progress of oldest sons, who are most likely to inherit the land, worsens

A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome : No Evidence of Benefit, Supported by Epidemiology and In Vitro Data

Background: Men are more severely affected by COVID-19. Testosterone may influence SARS-CoV-2 infection and the immune response. Objective: To clinically, epidemiologically, and experimentally evaluate the effect of antiandrogens on SARS-CoV-2 infection. Designs, settings, and participants: A randomized phase 2 clinical trial (COVIDENZA) enrolled 42 hospitalized COVID-19 patients before safety evaluation. We also conducted a population-based retrospective study of 7894 SARS-CoV-2–positive prostate cancer patients and an experimental study using an air-liquid interface three-dimensional culture model of primary lung cells. Intervention: In COVIDENZA, patients were randomized 2:1 to 5 d of enzalutamide or standard of care. Outcome measurements: The primary outcomes in COVIDENZA were the time to mechanical ventilation or discharge from hospital. The population-based study investigated risk of hospitalization, intensive care, and death from COVID-19 after androgen inhibition. Results and limitations: Enzalutamide-treated patients required longer hospitalization (hazard ratio [HR] for discharge from hospital 0.43, 95% confidence interval [CI] 0.20–0.93) and the trial was terminated early. In the epidemiological study, no preventive effects were observed. The frail population of patients treated with androgen deprivation therapy (ADT) in combination with abiraterone acetate or enzalutamide had a higher risk of dying from COVID-19 (HR 2.51, 95% CI 1.52–4.16). In vitro data showed no effect of enzalutamide on virus replication. The epidemiological study has limitations that include residual confounders. Conclusions: The results do not support a therapeutic effect of enzalutamide or preventive effects of bicalutamide or ADT in COVID-19. Thus, these antiandrogens should not be used for hospitalized COVID-19 patients or as prevention for COVID-19. Further research on these therapeutics in this setting are not warranted. Patient summary: We studied whether inhibition of testosterone could diminish COVID-19 symptoms. We found no evidence of an effect in a clinical study or in epidemiological or experimental investigations. We conclude that androgen inhibition should not be used for prevention or treatment of COVID-19

Metabolite-related dietary patterns and the development of islet autoimmunity

The role of diet in type 1 diabetes development is poorly understood. Metabolites, which reflect dietary response, may help elucidate this role. We explored metabolomics and lipidomics differences between 352 cases of islet autoimmunity (IA) and controls in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. We created dietary patterns reflecting pre-IA metabolite differences between groups and examined their association with IA. Secondary outcomes included IA cases positive for multiple autoantibodies (mAb+). The association of 853 plasma metabolites with outcomes was tested at seroconversion to IA, just prior to seroconversion, and during infancy. Key compounds in enriched metabolite sets were used to create dietary patterns reflecting metabolite composition, which were then tested for association with outcomes in the nested case-control subset and the full TEDDY cohort. Unsaturated phosphatidylcholines, sphingomyelins, phosphatidylethanolamines, glucosylceramides, and phospholipid ethers in infancy were inversely associated with mAb+ risk, while dicarboxylic acids were associated with an increased risk. An infancy dietary pattern representing higher levels of unsaturated phosphatidylcholines and phospholipid ethers, and lower sphingomyelins was protective for mAb+ in the nested case-control study only. Characterization of this high-risk infant metabolomics profile may help shape the future of early diagnosis or prevention efforts. © 2019, The Author(s)

Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results

Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Skåne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.status: publishe

Early probiotic supplementation and the risk of celiac disease in children at genetic risk

Abstract Probiotics are linked to positive regulatory effects on the immune system. The aim of the study was to examine the association between the exposure of probiotics via dietary supplements or via infant formula by the age of 1 year and the development of celiac disease autoimmunity (CDA) and celiac disease among a cohort of 6520 genetically susceptible children. Use of probiotics during the first year of life was reported by 1460 children. Time-to-event analysis was used to examine the associations. Overall exposure of probiotics during the first year of life was not associated with either CDA (n = 1212) (HR 1.15; 95%CI 0.99, 1.35; p = 0.07) or celiac disease (n = 455) (HR 1.11; 95%CI 0.86, 1.43; p = 0.43) when adjusting for known risk factors. Intake of probiotic dietary supplements, however, was associated with a slightly increased risk of CDA (HR 1.18; 95%CI 1.00, 1.40; p = 0.043) compared to children who did not get probiotics. It was concluded that the overall exposure of probiotics during the first year of life was not associated with CDA or celiac disease in children at genetic risk