Impacts of caring for a child with the CDKL5 disorder on parental wellbeing and family quality of life

Background: Although research in this area remains sparse, raising a child with some genetic disorders has been shown to adversely impact maternal health and family quality of life. The aim of this study was to investigate such impacts in families with a child with the CDKL5 disorder, a newly recognised genetic disorder causing severe neurodevelopmental impairments and refractory epilepsy. Methods: Data were sourced from the International CDKL5 Disorder Database to which 192 families with a child with a pathogenic CDKL5 mutation had provided data by January 2016. The Short Form 12 Health Survey Version 2, yielding a Physical Component Summary and a Mental Component Summary score, was used to measure primary caregiver's wellbeing. The Beach Center Family Quality of Life Scale was used to measure family quality of life. Linear regression analyses were used to investigate relationships between child and family factors and the various subscale scores. Results: The median (range) age of the primary caregivers was 37.0 (24.6-63.7) years and of the children was 5.2 (0.2-34.1) years. The mean (SD) physical and mental component scores were 53.7 (8.6) and 41.9 (11.6), respectively. In mothers aged 25-54 years the mean mental but not the physical component score was lower than population norms. After covariate adjustment, caregivers with a tube-fed child had lower mean physical but higher mean mental component scores than those whose child fed orally (coefficient = -4.80 and 6.79; p = 0.009 and 0.012, respectively). Child sleep disturbances and financial hardship were negatively associated with the mental component score. The mean (SD) Beach Center Family Quality of Life score was 4.06 (0.66) and those who had used respite services had lower scores than those who had not across the subscales. Conclusions: Emotional wellbeing was considerably impaired in this caregiver population, and was particularly associated with increased severity of child sleep problems and family financial difficulties. Family quality of life was generally rated lowest in those using respite care extensively, suggesting that these families may be more burdened by daily caregiving

A hot mini-Neptune in the radius valley orbiting solar analogue HD 110113

We report the discovery of HD 110113 b (TESS object of interest-755.01), a transiting mini-Neptune exoplanet on a 2.5-d orbit around the solar-analogue HD 110113 (Teff = 5730 K). Using TESS photometry and High Accuracy Radial velocity Planet Searcher (HARPS) radial velocities gathered by the NCORES program, we find that HD 110113 b has a radius of 2.05 ± 0.12 R⊕ and a mass of 4.55 ± 0.62 M⊕. The resulting density of $2.90^{+0.75}_{-0.59}$ g cm-3 is significantly lower than would be expected from a pure-rock world; therefore HD 110113 b must be a mini-Neptune with a significant volatile atmosphere. The high incident flux places it within the so-called radius valley; however, HD 110113 b was able to hold on to a substantial (0.1-1 per cent) H-He atmosphere over its ∼4 Gyr lifetime. Through a novel simultaneous Gaussian process fit to multiple activity indicators, we were also able to fit for the strong stellar rotation signal with period 20.8 ± 1.2 d from the RVs and confirm an additional non-transiting planet, HD 110113 c, which has a mass of 10.5 ± 1.2 M⊕ and a period of $6.744^{+0.008}_{-0.009}$ d.Fil: Osborn, H. P.. University of Bern; Suiza. Massachusetts Institute of Technology; Estados UnidosFil: Armstrong, D. J.. University of Warwick; Reino UnidoFil: Adibekyan, V.. Universidad de Porto; PortugalFil: Collins, K. A.. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Delgado Mena, E.. Universidad de Porto; PortugalFil: Howell, S. B.. National Aeronautics and Space Administration; Estados UnidosFil: Hellier, C.. Keele University. Faculty Of Humanities And Social Sciences.; Reino UnidoFil: King, G. W.. University of Warwick; Reino UnidoFil: Lillo Box, J.. Consejo Superior de Investigaciones Cientificas. Centro de Astrobiologia.; EspañaFil: Nielsen, Louise D.. Universidad de Ginebra; SuizaFil: Otegi, J. F.. Universidad de Ginebra; SuizaFil: Santos, N. C.. Universidad de Porto; PortugalFil: Ziegler, C.. University of Toronto; CanadáFil: Anderson, D. R.. University of Warwick; Reino UnidoFil: Briceno, C.. Cerro Tololo Inter American Observatory; ChileFil: Burke, C.. Massachusetts Institute of Technology; Estados UnidosFil: Bayliss, D.. University of Warwick; Reino UnidoFil: Barrado, D.. Consejo Superior de Investigaciones Cientificas. Centro de Astrobiologia.; EspañaFil: Bryant, E. M.. University of Warwick; Reino UnidoFil: Brown, D. J. A.. University of Warwick; Reino UnidoFil: Barros, S. C. C.. Universidad de Porto; PortugalFil: Bouchy, F.. Universidad de Ginebra; SuizaFil: Caldwell, D. A.. SETI Institute; Estados UnidosFil: Conti, D. M.. American Association of Variable Star Observers; Estados UnidosFil: Diaz, Rodrigo Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Ciencias Físicas. - Universidad Nacional de San Martín. Instituto de Ciencias Físicas; Argentina. International Center for Advanced Studies; Argentina. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología. Centro Internacional de Estudios Avanzados; ArgentinaFil: Dragomir, D.. University of New Mexico; Estados UnidosFil: Deleuil, M.. Universidad de Aix-Marsella; Francia. Centre National de la Recherche Scientifique; FranciaFil: Demangeon, O. D. S.. Universidad de Porto; PortugalFil: Dorn, C.. Universitat Zurich; SuizaFil: Daylan, T.. Massachusetts Institute of Technology; Estados Unido

Internationalisation and migrant academics: the hidden narratives of mobility

Internationalisation is a dominant policy discourse in higher education today. It is invariably presented as an ideologically neutral, coherent, disembodied, knowledgedriven policy intervention - an unconditional good. Yet it is a complex assemblage of values linked not only to economic growth and prosperity, but also to global citizenship, transnational identity capital, social cohesion, intercultural competencies and soft power (Clifford and Montgomery 2014; De Wit et al. 2015; Kim 2017; Lomer 2016; Stier 2004). Mobility is the sine qua non of the global academy (Sheller 2014). International movements, flows and networks are perceived as valuable transnational and transferable identity capital and as counterpoints to intellectual parochialism. Fluidity metaphors abound as an antidote to stasis e.g. flows, flux and circulations (Urry 2007). For some, internationalisation is conceptually linked to the political economy of neoliberalism and the spatial extension of the market, risking commodification and commercialisation (Matus and Talburt 2009). Others raise questions about what/whose knowledge is circulating and whether internationalisation is a form of re-colonisation and convergence that seeks to homogenise higher education systems (Stromquist 2007). Internationalisation policies and practices, it seems, are complex entanglements of economic, political, social and affective domains. They are mechanisms for driving the global knowledge 2 economy and the fulfilment of personal aspirations (Hoffman 2009). Academic geographical mobility is often conflated with social mobility and career advancement (Leung 2017). However, Robertson (2010: 646) suggested that ‘the romance of movement and mobility ought to be the first clue that this is something we ought to be particularly curious about.

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London