Mothers' education but not fathers' education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda

BACKGROUND: Health and nutrition inequality is a result of a complex web of factors that include socio-economic inequalities. Various socio-economic indicators exist however some do not accurately predict inequalities in children. Others are not intervention feasible. OBJECTIVE: To examine the association of four socio-economic indicators namely: mothers' education, fathers' education, household asset index, and land ownership with growth stunting, which is used as a proxy for health and nutrition inequalities among infants and young children. METHODS: This was a cross-sectional survey conducted in the rural district of Hoima, Uganda. Two-stage cluster sampling design was used to obtain 720 child/mother pairs. Information on indicators of household socio-economic status and child anthropometry was gathered by administering a structured questionnaire to mothers in their home settings. Regression modelling was used to determine the association of socio-economic indicators with stunting. RESULTS: One hundred seventy two (25%) of the studied children were stunted, of which 105 (61%) were boys (p < 0.001). Bivariate analysis indicated a higher prevalence of stunting among children of: non-educated mothers compared to mothers educated above primary school (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4–4.4); non-educated fathers compared to fathers educated above secondary school (OR 1.7, 95% CI 0.8–3.5); households belonging in the "poorest" quintile for the asset index compared to the "least poor" quintile (OR 2.1, 95% CI 1.2–3.7); Land ownership exhibited no differentials with stunting. Simultaneously adjusting all socio-economic indicators in conditional regression analysis left mothers' education as the only independent predictor of stunting with children of non-educated mothers significantly more likely to be stunted compared to those of mothers educated above primary school (OR 2.1, 95% CI 1.1–3.9). More boys than girls were significantly stunted in poorer than wealthier socio-economic strata. CONCLUSIONS: Of four socio-economic indicators, mothers' education is the best predictor for health and nutrition inequalities among infants and young children in rural Uganda. This suggests a need for appropriate formal education of the girl child aimed at promoting child health and nutrition. The finding that boys are adversely affected by poverty more than their female counterparts corroborates evidence from previous studies

100,000 Genomes Pilot on Rare-Disease Diagnosis in Health Care — Preliminary Report

BACKGROUND: The U.K. 100,000 Genomes Project is in the process of investigating the role of genome sequencing in patients with undiagnosed rare diseases after usual care and the alignment of this research with health care implementation in the U.K. National Health Service. Other parts of this project focus on patients with cancer and infection. METHODS: We conducted a pilot study involving 4660 participants from 2183 families, among whom 161 disorders covering a broad spectrum of rare diseases were present. We collected data on clinical features with the use of Human Phenotype Ontology terms, undertook genome sequencing, applied automated variant prioritization on the basis of applied virtual gene panels and phenotypes, and identified novel pathogenic variants through research analysis. RESULTS: Diagnostic yields varied among family structures and were highest in family trios (both parents and a proband) and families with larger pedigrees. Diagnostic yields were much higher for disorders likely to have a monogenic cause (35%) than for disorders likely to have a complex cause (11%). Diagnostic yields for intellectual disability, hearing disorders, and vision disorders ranged from 40 to 55%. We made genetic diagnoses in 25% of the probands. A total of 14% of the diagnoses were made by means of the combination of research and automated approaches, which was critical for cases in which we found etiologic noncoding, structural, and mitochondrial genome variants and coding variants poorly covered by exome sequencing. Cohortwide burden testing across 57,000 genomes enabled the discovery of three new disease genes and 19 new associations. Of the genetic diagnoses that we made, 25% had immediate ramifications for clinical decision making for the patients or their relatives. CONCLUSIONS: Our pilot study of genome sequencing in a national health care system showed an increase in diagnostic yield across a range of rare diseases. (Funded by the National Institute for Health Research and others.)

Modern temporal network theory: A colloquium

The power of any kind of network approach lies in the ability to simplify a complex system so that one can better understand its function as a whole. Sometimes it is beneficial, however, to include more information than in a simple graph of only nodes and links. Adding information about times of interactions can make predictions and mechanistic understanding more accurate. The drawback, however, is that there are not so many methods available, partly because temporal networks is a relatively young field, partly because it more difficult to develop such methods compared to for static networks. In this colloquium, we review the methods to analyze and model temporal networks and processes taking place on them, focusing mainly on the last three years. This includes the spreading of infectious disease, opinions, rumors, in social networks; information packets in computer networks; various types of signaling in biology, and more. We also discuss future directions.Comment: Final accepted versio

Moraxella catarrhalis bacteraemia. A report on 3 cases and a review of the literature

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOver the last decade, an increase in invasive infections due to Moraxella catarrhalis has been reported. We have analysed 58 cases of bacteraemia due to M. catarrhalis reported in the literature and 3 cases found in Iceland, a total of 61 cases. Patients with bacteraemia could be divided into 3 groups on the basis of host factors. They were either immunocompromised, had underlying respiratory disorders. or were normal hosts. The clinical manifestation of M. catarrhalis bacteraemic infection ranged from a mild febrile illness to a fatal disease. The severity of the clinical picture did not reflect the patients' condition at the time of bacteraemia. The port of entry of the bacteraemia was frequently not elucidated in immunocompromised patients. Patients with a contributory respiratory tract disorder were more likely to develop bacteraemia as a result of a lower respiratory tract infection, whereas bacteraemia in a normal host was more frequently due to an upper respiratory tract infection. The overall prognosis of M. catarrhalis bacteraemia was good, the exception being when it caused endocarditis (5 cases), where mortality rates as high as 80% have been reported

Working from home: the experience of records management professionals during the COVID-19 pandemic

Purpose: The purpose of this paper was to investigate how recordkeepers in Canada, Finland, the Netherlands, New Zealand, Iceland and Italy experienced accomplishing their tasks from home over varying lengths of time during the COVID-19 pandemic. Design/methodology/approach: A multilingual survey including 44 questions was designed and administered to the six countries identified above in 2022. This research was preceded by an environmental scan looking at existing studies considering archival and records management responses to the pandemic. Findings: The impact of working from home on recordkeeping and, more generally, work performance was perceived differently by the survey respondents depending on various factors. The study also identified a number of similarities across countries, such as an increased awareness of the importance of records management shared by organizational actors. Surprisingly, the pandemic did not appear to have a great impact on the perceived quality of records management. Originality/value: To the best of the authors’ knowledge, this is the first study aiming to capture records professionals’ perceptions of their role while working from home during the pandemic.Peer reviewe

Clinical Implications for Supporting Caregivers at the End-of-Life: Findings and from a Qualitative Study

Despite families providing considerable care at end of life, there are substantial gaps in the provision of supportive care. A qualitative interview study was conducted with 17 caregivers of people supported by an adult hospice to explore the support needs of families. Family members readily identified the ways in which the diagnosis of a life-limiting illness impacted on them and the family as a whole, not just the patient. Implications for practice demonstrate the need to intervene at a family and relational level prior to bereavement, in order to mitigate complicated grief for the surviving family members. Such an approach offers a fruitful prospective alternative to supporting caregivers post-bereavement