Social inequality in pre-pregnancy BMI and gestational weight gain in the first and second pregnancy among women in Sweden.

BACKGROUND: High pre-pregnancy body mass index (BMI) and inappropriate gestational weight gain (GWG) are associated with adverse short and long-term maternal and neonatal outcomes and may act as modifiable risk factors on the path to overweight/obesity, but their social patterning is not well established. This study investigates the association of education with BMI and GWG across two consecutive pregnancies. METHODS: The study includes 163,352 Swedish women, having their first and second singleton birth in 1982-2010. In both pregnancies, we investigated the association of women's education with (1) pre-pregnancy weight status and (2) adequacy of GWG. We used multinomial logistic regression, adjusting for child's birth year, mother's age and smoking status. RESULTS: Overall, the odds of starting either pregnancy at an unhealthy BMI were higher among women with a low education compared to more highly-educated women. Lower education also predicted a greater increase in BMI between pregnancies, with this effect greatest among women with excessive GWG in the first pregnancy (p<0.0001 for interaction). Education was also inversely associated with odds of excessive GWG in both pregnancies among healthy weight status women, but this association was absent or even weakly reversed among overweight and obese women. CONCLUSIONS: Lower educated women had the largest BMI increase between pregnancies, and these inequalities were greatest among women with excessive GWG in the first pregnancy. The importance of a healthy pre-pregnancy BMI, appropriate GWG and a healthy postpartum weight should be communicated to all women, which may assist in reducing existing social inequalities in body weight

Heritability of mammographic breast density, density change, microcalcifications, and masses

Background: Mammographic features influence breast cancer risk and are used in risk prediction models. Understanding how genetics influence mammographic features is important since the mechanisms through which they are associated with breast cancer are not well known. Methods: Mammographic screening history and detailed questionnaire data for 56,820 women from the KARMA prospective cohort study were used. The heritability of mammographic features such as dense area (MD), microcalcifications, masses, and density change (MDC – cm2/year) were estimated using 1,940 sister pairs. We investigated the association between a genetic predisposition to breast cancer and mammographic features, among women with family history of breast cancer information (N=49,674) and a polygenic risk score (PRS, N=9,365). Results: Heritability was estimated at 58% (95% CI: 48%, 67%) for MD, 23% (2%, 45%) for microcalcifications, and 13% (1%, 25%) for masses. The estimated heritability for MDC was essentially null (2%, 95% CI: -8%, 12%). The association between a genetic predisposition to breast cancer (using PRS) and MD and microcalcifications was positive, while for masses this was borderline significant. In addition, for MDC, having a family history of breast cancer was associated with slightly greater MD reduction. Conclusions: We confirmed previous findings of heritability in MD, and also found heritability of the number of microcalcifications and masses at baseline. Since these features are associated with breast cancer risk, and can improve detecting women at short-term risk of breast cancer, further investigation of common loci associated with mammographic features is warranted to better understand the etiology of breast cancer.Swedish Research Council, 2018-02547Swedish Cancer Society, CAN 19 0266Stockholm County Council, LS 1211-1594Swedish Research Council, 70867902Accepte

Evaluating Equity and Inclusion in Access to Water and Sanitation for Persons Living with HIV/AIDS in Wukro, Ethiopia

[EN] For more than a decade, foreign aid-supported water interventions focusing on an increase in household private connections have been implemented in the small urban center of Wukro. However, little has been investigated about the effectiveness of these interventions in achieving equitable and inclusive access to water and sanitation for all, including the most vulnerable. With this purpose, a cross-sectional comparative analysis of service provision between the HIV-infected population (n = 199) and non-infected population (n = 199) was undertaken. Findings suggest significant inequalities regarding the primary water source, monthly expenditure in water, water consumption, and time employed to fetch water, as well as the type of toilet facility, number of users, and the time employed to access it. Results also show a reported feeling of discrimination with regard to service provision within the HIV-positive population. This study provides evidence on local-scale interventions increasing the number of household water connections but overlooking the pursuit of equity and inclusion for the most vulnerable. The study also presents recommendations on how to specifically target the needs of persons living with HIV/AIDS in order to achieve equitable and inclusive access to water and sanitation for all.This research was funded by ICLI and the University of the Basque Country.Jimenez-Redal, R.; Holowko, N.; Almandoz Berrondo, J.; Soriano Olivares, J.; Arregui De La Cruz, F.; Magrinya, F. (2018). Evaluating Equity and Inclusion in Access to Water and Sanitation for Persons Living with HIV/AIDS in Wukro, Ethiopia. Water. 10(9). https://doi.org/10.3390/w10091237S10

Building a global alliance of biofoundries (vol 10, 2040, 2019)

The original version of this Comment contained errors in the legend of Figure 2, in which the locations of the fifteenth and sixteenth GBA members were incorrectly given as '(15) Australian Genome Foundry, Macquarie University; (16) Australian Foundry for Advanced Biomanufacturing, University of Queensland.'. The correct version replaces this with '(15) Australian Foundry for Advanced Biomanufacturing (AusFAB), University of Queensland and (16) Australian Genome Foundry, Macquarie University'. This has been corrected in both the PDF and HTML versions of the Comment

High education and increased parity are associated with breast-feeding initiation and duration among Australian women

Objective Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months. Design Prospective cohort study. Setting Australia. Subjects Parous women from the Australian Longitudinal Study on Women's Health (born 1973-78), with self-reported reproductive and breast-feeding history (N 4777). Results While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months. Conclusions A greater understanding of barriers to initiating and sustaining breast-feeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding

Evaluating equity and inclusion in access to water and sanitation for persons living with HIV/AIDS in Wukro, Ethiopia

For more than a decade, foreign aid-supported water interventions focusing on an increase in household private connections have been implemented in the small urban center of Wukro. However, little has been investigated about the effectiveness of these interventions in achieving equitable and inclusive access to water and sanitation for all, including the most vulnerable. With this purpose, a cross-sectional comparative analysis of service provision between the HIV-infected population (n = 199) and non-infected population (n = 199) was undertaken. Findings suggest significant inequalities regarding the primary water source, monthly expenditure in water, water consumption, and time employed to fetch water, as well as the type of toilet facility, number of users, and the time employed to access it. Results also show a reported feeling of discrimination with regard to service provision within the HIV-positive population. This study provides evidence on local-scale interventions increasing the number of household water connections but overlooking the pursuit of equity and inclusion for the most vulnerable. The study also presents recommendations on how to specifically target the needs of persons living with HIV/AIDS in order to achieve equitable and inclusive access to water and sanitation for all.Peer Reviewe

Assessing sustainability of rural gravity-fed water schemes on Idjwi Island, D.R. Congo

[EN] To assess the sustainability of rural gravity-fed water schemes on Idjwi Island, the association between four hypothesized drivers of sustainability ¿ perceived sense of ownership, willingness to pay for maintenance, trust in the water committee, and household involvement in the project ¿ and service reliability, the main outcome variable, was analyzed. Primary data were gathered through in-person surveys of 1253 user households. The results provide two significant insights. First, during the 5¿10 years after implementation, in the presence of an external intervention, a lower perceived sense of ownership for the water system was associated with higher service reliability. This stands in contrast with much of the existing literature, which outlines a consistent positive association between sense of ownership and sustainability of rural water systems. Second, despite 77% of beneficiaries stating that they were willing to pay for maintenance service, such contributions were not forthcoming, due to lack of trust in the water committee. In this scenario, almost 42% of the water points are reported as non-functional, 5¿10 years after completion.Jimenez-Redal, R.; Soriano Olivares, J.; Holowko, N.; Almandoz Berrondo, J.; Arregui De La Cruz, F. (2017). Assessing sustainability of rural gravity-fed water schemes on Idjwi Island, D.R. Congo. International Journal of Water Resources Development. 1-14. doi:10.1080/07900627.2017.1347086S11