Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS)

AIM: Education is one of the strongest social determinants of health, yet previous literature has focused on primary education. We examined whether there are additional benefits to completing upper secondary compared to lower secondary education in a middle-income country. METHODS: We performed a longitudinal analysis of the Cape Area Panel Study, a survey of adolescents living in South Africa. We undertook causal modeling using structural marginal models to examine the association between level of education and various health outcomes, using inverse probability weighting to control for sex, age, ethnicity, home language, income, whether employed in past year, region of birth, maternal educational status, marital status, whether currently pregnant and cognitive ability. Educational attainment was defined as primary (grades 1–7), lower secondary (grades 8–9) or upper secondary (grades 10–12). RESULTS: Of 3,432 participants, 165 (4.8%) had completed primary education, 646 (18.8%) lower secondary and 2,621 (76.3%) upper secondary. Compared to those completing lower secondary, males completing upper secondary education were less likely to have a health problem (OR 0.49; 95%CI 0.27–0.88; p = 0.02); describe their health as poor (0.52; 0.29–0.95; p = 0.03) or report that health interferes with daily life (0.54; 0.29–0.99; p = 0.047). Females were less likely to have been pregnant (0.45; 0.33–0.61; p<0.001) or pregnant under 18 (0.32; 0.22–0.46; p<0.001); and having had sex under 16 was also less likely (males 0.63; 0.44–0.91; p = 0.01; females 0.39; 0.26–0.58; p<0.001). Cigarette smoking was less likely (males 0.52; 0.38–0.70; p = <0.001; females 0.56; 0.41–0.76; p<0.001), as was taking illicit drugs in males (0.6; 0.38–0.96; p = 0.03). No associations were found between education and alcohol use, psychological distress, obesity, increased waist circumference or hypertension. CONCLUSION: Completing upper secondary education was associated with improved health outcomes compared with lower secondary education. Expanding upper secondary education offers middle-income countries an effective way of improving adolescent health

Portraits of people with dementia : three case studies of creating portraits

Peer reviewedPreprin

Cause-specific child and adolescent mortality in the UK and EU15+countries

Objective: To compare cause-specific UK mortality in children and young people (CYP) with EU15+ countries (European Union countries pre-2004, Australia, Canada and Norway). Design: Mortality estimates were coded from the WHO World Mortality Database. Causes of death were mapped using the Global Burden of Disease mortality hierarchy to 22 cause groups. We compared UK mortality by cause, age group and sex with EU15+ countries in 2015 (or latest available) using Poisson regression models. We then ranked the UK compared with the EU15+ for each cause. Setting: The UK and EU15+ countries. Participants CYP aged 1–19. Main outcome measure: Mortality rate per 100 000 and number of deaths. Results: UK mortality in 2015 was significantly higher than the EU15+ for common infections (both sexes aged 1–9, boys aged 10–14 and girls aged 15–19); chronic respiratory conditions (both sexes aged 5–14); and digestive, neurological and diabetes/urological/blood/endocrine conditions (girls aged 15–19). UK mortality was significantly lower for transport injuries (boys aged 15–19). The UK had the worst to third worst mortality rank for common infections in both sexes and all age groups, and in five out of eight non-communicable disease (NCD) causes in both sexes in at least one age group. UK mortality rank for injuries in 2015 was in the top half of countries for most causes. Conclusions UK CYP mortality is higher than a group of comparable countries for common infections and multiple NCD causes. Excess UK CYP mortality may be amenable to health system strengthening

ConSUS: A light-weight program conditioner

Program conditioning consists of identifying and removing a set of statements which cannot be executed when a condition of interest holds at some point in a program. It has been applied to problems in maintenance, testing, re-use and re-engineering. All current approaches to program conditioning rely upon both symbolic execution and reasoning about symbolic predicates. The reasoning can be performed by a ‘heavy duty’ theorem prover but this may impose unrealistic performance constraints. This paper reports on a lightweight approach to theorem proving using the FermaT Simplify decision procedure. This is used as a component to ConSUS, a program conditioning system for the Wide Spectrum Language WSL. The paper describes the symbolic execution algorithm used by ConSUS, which prunes as it conditions. The paper also provides empirical evidence that conditioning produces a significant reduction in program size and, although exponential in the worst case, the conditioning system has low degree polynomial behaviour in many cases, thereby making it scalable to unit level applications of program conditioning

Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine

Objectives: The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. Design: Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. Setting: The School of Medicine at the University of Leeds, UK. Participants: Fifty-five staff members were purposively sampled to represent gender and academic pay grade. Results: Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. Conclusions: The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term

Investigating equalisation of health inequalities during adolescence in four low-income and middle-income countries: an analysis of the Young Lives cohort study

OBJECTIVE: To investigate if socioeconomic gradients in health reduce during adolescence (the equalisation hypothesis) in four low-income and middle-income countries (LMIC). SETTING: Analysis of the Young Lives Study cohorts in Ethiopia, Peru, Vietnam and India. PARTICIPANTS: A total of 3395 participants (across the four cohorts) aged 6–10 years at enrolment and followed up for 11 years. OUTCOME MEASURED: Change in income-related health inequalities from mid-childhood to late adolescence. Socioeconomic status was determined by wealth index quartile. The health indicators included were self-reported health, injuries in the previous 4 years, presence of long-term health problems, low mood, alcohol use, overweight/obesity, thinness and stunting. The relative risk of each adverse health outcome between highest and lowest wealth index quartile were compared across four waves of the study within each country. RESULTS: We found steep socioeconomic gradients across multiple health indicators in all four countries. Socioeconomic gradients remained similar across all waves of the study, with no significant decrease during adolescence. CONCLUSION: We found no consistent evidence of equalisation for income-related health inequalities in youth in these LMIC. Socioeconomic gradients for health in these cohorts appear to persist and be equally damaging across the early life course and during adolescence

Submillimeter Studies of Prestellar Cores and Protostars: Probing the Initial Conditions for Protostellar Collapse

Improving our understanding of the initial conditions and earliest stages of protostellar collapse is crucial to gain insight into the origin of stellar masses, multiple systems, and protoplanetary disks. Observationally, there are two complementary approaches to this problem: (1) studying the structure and kinematics of prestellar cores observed prior to protostar formation, and (2) studying the structure of young (e.g. Class 0) accreting protostars observed soon after point mass formation. We discuss recent advances made in this area thanks to (sub)millimeter mapping observations with large single-dish telescopes and interferometers. In particular, we argue that the beginning of protostellar collapse is much more violent in cluster-forming clouds than in regions of distributed star formation. Major breakthroughs are expected in this field from future large submillimeter instruments such as Herschel and ALMA.Comment: 12 pages, 9 figures, to appear in the proceedings of the conference "Chemistry as a Diagnostic of Star Formation" (C.L. Curry & M. Fich eds.

Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents

OBJECTIVE: To undertake a systematic review of reviews of the prevalence of symptoms and signs of COVID-19 in those aged under 20 years. DESIGN: Narrative systematic review of reviews. PubMed, medRxiv, Europe PMC and COVID-19 Living Evidence Database were searched on 9 October 2020. SETTING: All settings, including hospitalised and community settings. PATIENTS: Children and young people (CYP) under age 20 years with laboratory-proven COVID-19. STUDY REVIEW, DATA EXTRACTION AND QUALITY: Potentially eligible articles were reviewed on title and abstract by one reviewer. Quality was assessed using the modified AMSTARS criteria and data were extracted from included studies by two reviewers. MAIN OUTCOME MEASURES: Prevalence of symptoms and signs of COVID-19. RESULTS: 1325 studies were identified and 18 reviews were included. Eight were high quality, 7 medium and 3 low quality. All reviews were dominated by studies of hospitalised children. The proportion of asymptomatic CYP ranged from 14.6% to 42%. Fever and cough were the the most common symptoms; proportions with fever ranged from 46% to 64.2% and with cough from 32% to 55.9%. All other symptoms or signs including rhinorrhoea, sore throat, headache, fatigue/myalgia and gastrointestinal symptoms including diarrhoea and vomiting were infrequent, occurring in less than 10%-20%. CONCLUSIONS: Fever and cough are the most common symptoms in CYP with COVID-19, with other symptoms infrequent. Further research on symptoms in community samples are needed to inform pragmatic identification and testing programmes for CYP

Quantum-Dot-Based Telecommunication-Wavelength Quantum Relay

The development of quantum relays for long-haul and attack-proof quantum communication networks operating with weak coherent laser pulses requires entangled photon sources at telecommunication wavelengths with intrinsic single-photon emission for most practical implementations. Using a semiconductor quantum dot emitting entangled photon pairs in the telecommunication O band, we demonstrate a quantum relay fulfilling both of these conditions. The system achieves a maximum fidelity of 94.5% for implementation of a standard four-state protocol with input states generated by a laser. We further investigate robustness against frequency detuning of the narrow-band input and perform process tomography of the teleporter, revealing operation for arbitrary pure input states, with an average gate fidelity of 83.6%. The results highlight the potential of semiconductor light sources for compact and robust quantum-relay technology that is compatible with existing communication infrastructures