Breastfeeding,schooling, and income: Insights from the Indonesian Family Life Survey

Recent research has highlighted associations of breastfeeding with IQ, schooling, and income, but uncertainty about such links remains. The Indonesian Family Life Survey, representative of 83% of the Indonesian population, provides data on breastfeeding, parents' years of schooling, wealth, and other family characteristics in 1993–1994, as well as schooling and income in 2014–2015 for 5,421 children of those families. Using linear regressions and controlling for village or neighbourhood, as well as propensity score matching, we analysed breastfeeding associations for boys and girls separately, when regularly fed foods/beverages other than breast milk is significantly associated with years of schooling in 2014–2015 for girls, but not for boys, after controlling for the village or neighbourhood of residence in 1993–1994. For girls, ages 1 to 1.9, 2 to 2.9, 3 to 3.9, and >4 months, relative to ages <1 month, are associated with an additional 0.41 to 0.46 years of schooling, with p values of 0.086, 0.071, 0.043, and 0.026, respectively. No comparable estimate for boys attains statistical significance. Using propensity score matching yields similar results. Associations with annual income in 2014–2015 are not statistically significant, either for all children, or for either sex. Our finding suggests that delaying regular feeding of foods/beverages other than breast milk beyond 1 month may help girls' schooling but has no observable association with annual income, perhaps because of lower labour force participation by women. Also, the inclusion of controls for village or neighbourhood of residence reduces confounding.     

PexLoc—Parallel excitation using local encoding magnetic fields with nonlinear and nonbijective spatial profiles

With the recent proposal of using magnetic fields that are nonlinear by design for spatial encoding, new flexibility has been introduced to MR imaging. The new degrees of freedom in shaping the spatially encoding magnetic fields (SEMs) can be used to locally adapt the imaging resolution to features of the imaged object, e.g., anatomical structures, to reduce peripheral nerve stimulation during in vivo experiments or to increase the gradient switching speed by reducing the inductance of the coils producing the SEMs and thus accelerate the imaging process. In this work, the potential of nonlinear and nonbijective SEMs for spatial encoding during transmission in multidimensional spatially selective excitation is explored. Methods for multidimensional spatially selective excitation radiofrequency pulse design based on nonlinear encoding fields are introduced, and it is shown how encoding ambiguities can be resolved using parallel transmission. In simulations and phantom experiments, the feasibility of selective excitation using nonlinear, nonbijective SEMs is demonstrated, and it is shown that the spatial resolution with which the target distribution of the transverse magnetization can be realized varies locally. Thus, the resolution of the target pattern can be increased in some regions compared with conventional linear encoding. Furthermore, experimental proof of principle of accelerated two‐dimensional spatially selective excitation using nonlinear SEMs is provided in this study. Magn Reson Med 70:1220–1228, 2013. © 2012 Wiley Periodicals, Inc.     

Differences in gambling problem severity and gambling and health/functioning characteristics among Asian-American and Caucasian high-school students

Studies of Asian-American adults have found high estimates of problematic gambling. However, little is known about gambling behaviors and associated measures among Asian-American adolescents. This study examined gambling perceptions and behaviors and health/functioning characteristics stratified by problem-gambling severity and Asian-American and Caucasian race using cross-sectional survey data of 121 Asian-American and 1659 Caucasian high-school students. Asian-American and Caucasian adolescents significantly differed on problem-gambling severity, with Asian-American adolescents more often reporting not gambling (24.8% vs. 16.4%), but when they did report gambling, they showed higher levels of at-risk/problem gambling (30.6% vs. 26.4%). Parental approval or disapproval of adolescent gambling also significantly differed between races, with Asian-American adolescents more likely to perceive both parental disapproval (50.0% vs. 38.2%) and approval (19.3% vs. 9.6%) of gambling. Asian-American adolescents were also more likely to express concern about gambling among close family members (25.2% vs. 11.6%). Among Asian-American adolescents, stronger associations were observed between at-risk/problem gambling and smoking cigarettes (interaction odds ratio=12.6). In summary, differences in problem-gambling severity and gambling perceptions indicate possible cultural differences in familial attitudes towards gambling. Stronger links between cigarette smoking and risky/problematic gambling amongst Asian-American adolescents suggest that prevention and treatment efforts targeting youth addictions consider cultural differences.     

Parental leave and child health

This study investigates whether rights to parental leave improve pediatric health. Aggregate data are used for 16 European countries over the 1969 through 1994 period. More generous paid leave is found to reduce deaths of infants and young children. The magnitudes of the estimated effects are substantial, especially where a causal effect of leave is most plausible. In particular, there is a much stronger negative relationship between leave durations and post-neonatal or child fatalities than for perinatal mortality, neonatal deaths, or low birth weight. The evidence further suggests that parental leave may be a cost-effective method of bettering child health.     

A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections.

OBJECTIVE: We evaluated 4 important outcomes associated with postoperative nosocomial infection: costs, mortality, excess length of stay, and utilization of healthcare resources. DESIGN: The outcomes for patients who underwent general, cardiothoracic, and neurosurgical operations were recorded during a previous clinical trial. Multivariable analyses including significant covariates were conducted to determine whether nosocomial infection significantly affected the outcomes. SETTING: A large tertiary care medical center and an affiliated Veterans Affairs Medical Center. PATIENTS: A total of 3,864 surgical patients. RESULTS: The overall nosocomial infection rate was 11.3%. Important covariates included age, Karnofsky score, McCabe and Jackson classification of the severity of underlying disease, National Nosocomial Infection Surveillance system risk index, and number of comorbidities. After accounting for covariates, nosocomial infection was associated with increased postoperative length of stay, increased costs, increased hospital readmission rate, and increased use of antimicrobial agents in the outpatient setting. Nosocomial infection was not associated independently with a significantly increased risk of death in this surgical population. CONCLUSION: Postoperative nosocomial infection was associated with increased costs of care and with increased utilization of medical resources. To accurately assess the effects of nosocomial infections, one must take into account important covariates. Surgeons seeking to decrease the cost of care and resource utilization must identify ways to decrease the rate of postoperative nosocomial infection.