Education, gender and cohort fertility in the Nordic countries

Systematic comparisons of fertility developments based on education, gender and country context are rare. Using harmonized register data, we compare cohort total fertility and ultimate childlessness by gender and educational attainment for cohorts born beginning in 1940 in four Nordic countries. Cohort fertility (CTF) initially declined in all four countries, although for cohorts born in the 1950s and later, the CTF remained stable or declined only modestly. Childlessness, which had been increasing, has plateaued in Denmark, Norway and Sweden. Women’s negative educational gradient in relation to total fertility has vanished, except in Finland, while men’s positive gradient has persisted. The highest level of men’s childlessness appears among the least educated. In the oldest female cohorts, childlessness was highest among the highly educated, but these patterns have changed over the cohorts as childlessness has increased among the low educated and remained relatively stable among higher educated women. In Denmark, Norway and Sweden, childlessness is now highest among the least educated women. We witness both a new gender similarity and persistent (among men) and new (among women) educational disparities in childbearing outcomes in the Nordic region. Overall, the number of low educated has decreased remarkably over time. These population segments face increasing social and economic disadvantages that are reflected as well in their patterns of family formation.</p

Education, Gender, and Cohort Fertility in the Nordic Countries

Abstract: Systematic comparisons of fertility developments based on education, gender and country context are rare. Using harmonized register data, we compare cohort total fertility (CTF) and ultimate childlessness by gender and educational attainment for cohorts born beginning in 1940 in four Nordic countries. CTF has remained fairly stable in all countries. Childlessness, which had been increasing, has plateaued except in Finland. Women’s negative educational gradient has vanished, while men’s positive gradient has persisted. The highest level of men’s childlessness appears among the less educated, revealing striking educational differences. Childlessness has increased among low-educated women but not among highly educated women. The educational gradient in women’s childlessness has shifted from positive to negative. Thus, we witness both a new gender similarity and widening social inequalities in childbearing in the Nordic welfare states. Low-educated citizens of both sexes have apparently become an increasingly marginalized segment with regard to childbearing. </p

Exploring the host factors affecting asymptomatic Plasmodium falciparum infection: insights from a rural Burkina Faso study.

BACKGROUND Asymptomatic Plasmodium falciparum parasitaemia forms a reservoir for the transmission of malaria disease in West Africa. Certain haemoglobin variants are known to protect against severe malaria infection. However, data on the potential roles of haemoglobin variants and nongenetic factors in asymptomatic malaria infection is scarce and controversial. Therefore, this study investigated the associations of iron homeostasis, inflammation, nutrition, and haemoglobin mutations with parasitaemia in an asymptomatic cohort from a P. falciparum-endemic region during the high transmission season. METHODS A sub-study population of 688 asymptomatic individuals (predominantly children and adolescents under 15 years, n = 516) from rural Burkina Faso previously recruited by the NOVAC trial (NCT03176719) between June and October 2017 was analysed. Parasitaemia was quantified with conventional haemocytometry. The haemoglobin genotype was determined by reverse hybridization assays targeting a selection of 21 HBA and 22 HBB mutations. Demographics, inflammatory markers (interleukins 6 and 10, hepcidin), nutritional status (mid upper-arm circumference and body mass index), and anaemia (total haemoglobin, ferritin, soluble transferrin receptor) were assessed as potential predictors through logistic regression. RESULTS Malaria parasites were detected in 56% of subjects. Parasitaemia was associated most strongly with malnutrition. The effect size increased with malnutrition severity (OR = 6.26, CI95: 2.45-19.4, p < 0.001). Furthermore, statistically significant associations (p < 0.05) with age, cytokines, hepcidin and heterozygous haemoglobin S were observed. CONCLUSIONS According to these findings, asymptomatic parasitaemia is attenuated by haemoglobin S, but not by any of the other detected genotypes. Aside from evidence for slight iron imbalance, overall undernutrition was found to predict parasitaemia; thus, further investigations are required to elucidate causality and inform strategies for interventions

Beyond the Economic Gaze: Childbearing during and after recessions in the Nordic countries

Abstract: During the 2010s, fertility rates fell across the Nordic region. The onset of thesedeclines seems linked to the Great Recession of 2008–2009 but their continuation cannot easilybe linked to subsequent economic change. The 1990s, too, brought episodes of economic crisesto the Nordic region that were followed by different degrees of fertility decline. In this study,we provide an empirical overview of parity-, age- and education-specific fertility developmentsin the five Nordic countries in the wake of the economic recessions in 2008 and the early 1990s,respectively. We demonstrate a high degree of heterogeneity in fertility developments acrosscountries after 1990, whereas after 2008, the trends are much more similar across the fivecountries. Likewise, the educational differences in birth hazards that characterized thedevelopments after 1990 were much smaller in the initial years after 2008–2009. This reversalfrom heterogeneity to homogeneity in the fertility response to recessions calls for an expansionof theories on the cyclicality of fertility in relation to uncertainty and economic and socialchange. In our discussion, we consider the role of a set of factors that also incorporates the state,crisis management, and perceptions of economic and welfare uncertainty.</p

Effects of interleukin-1 antagonism on cortisol levels in individuals with obesity: a randomized clinical trial

Background: Anti-inflammatory treatment with interleukin-1 (IL-1) antagonism decreases both cortisol and adrenocorticotropin hormone (ACTH) levels in individuals with obesity in short term. However, it remains unknown whether these effects persist upon prolonged treatment. Methods: In this double-blind, parallel-group trial involving patients with features of the metabolic syndrome, 33 patients were randomly assigned to receive 100 mg of anakinra (recombinant human IL-1 receptor antagonist) subcutaneously twice-daily and 34 patients to receive placebo for 4 weeks. For this analysis, change in cortisol and ACTH levels from baseline to 4 weeks were predefined end points of the trial. Results: The mean age was 54 years, baseline cortisol levels were 314 nmol/L (IQR 241–385) and C-reactive protein (CRP) levels were 3.4 mg/L (IQR 1.7–4.8). Treatment with anakinra led to a significant decrease in cortisol levels a t day 1 when compared to placebo with an adjusted between-group difference of 28 nmol/L (95% CI, −7 to −43; P = 0.03). After 4 weeks, the cortisol-lowering effect of anakinra was attenuated and overall was statistically not significant (P = 0.72). Injection-site reactions occurred in 21 patients receiving anakinra and were associated with higher CRP and cortisol levels. Conclusions: IL-1 antagonism decreases cortisol levels in male patients with obesity and chronic low-grade inflammation on the short term. After prolonged treatment, this effect is attenuated, probably due to injection-site reactions (ClinicalTrials.gov, NCT02672592)

Beyond the Economic Gaze: Childbearing during and after recessions in the Nordic countries

During the 2010s, fertility rates fell across the Nordic region. The onset of these declines seems linked to the Great Recession of 2008–2009, but their continuation cannot easily be linked to subsequent economic change. The 1990s, too, brought episodes of economic crises to the Nordic region that were followed by different degrees of fertility decline. In this study, we provide an empirical overview of parity-, age- and education-specific fertility developments in the five Nordic countries in the wake of the economic recessions in 2008 and the early 1990s, respectively. We demonstrate a high degree of heterogeneity in fertility developments across countries after 1990, whereas after 2008, the trends are much more similar across the five countries. Likewise, the educational differences in birth hazards that characterized the developments after 1990 were much smaller in the initial years after 2008–2009. This reversal from heterogeneity to homogeneity in the fertility response to recessions calls for an expansion of theories on the cyclicality of fertility in relation to uncertainty and economic and social change. In our discussion, we consider the role of a set of factors that also incorporates the state, crisis management, and perceptions of economic and welfare uncertainty.</p

Metabolomics for Prediction of Relapse in Graves' Disease: Observational Pilot Study

Background: There is a lack of biochemical markers for early prediction of relapse in patients with Graves' disease [GD], which may help to direct treatment decisions. We assessed the prognostic ability of a high-throughput proton NMR metabolomic profile to predict relapse in a well characterized cohort of GD patients.Methods: Observational study investigating patients presenting with GD at a Swiss hospital endocrine referral center and an associated endocrine outpatient clinic. We measured 227 metabolic markers in the blood of patients before treatment initiation. Main outcome was relapse of hyperthyroidism within 18 months of stopping anti-thyroid drugs. We used ROC analysis with AUC to assess discrimination.Results: Of 69 included patients 18 (26%) patients had a relapse of disease. The clinical GREAT score had an AUC of 0.68 (95% CI 0.63–0.70) to predict relapse. When looking at the metabolomic markers, univariate analysis revealed pyruvate and triglycerides in medium VLDL as predictors with AUCs of 0.73 (95% CI 0.58–0.84) and 0.67 (95% CI 0.53–0.80), respectively. All other metabolomic markers had lower AUCs.Conclusion: Overall, metabolomic markers in our pilot study had low to moderate prognostic potential for prediction of relapse of GD, with pyruvate and triglycerides being candidates with acceptable discriminatory abilities. Our data need validation in future larger trials