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Contraceptive use before first pregnancy by women in India (2005–2006): determinants and differentials

This study attempts to identify the socio demographic determinants and differentials of contraceptive use or non use by a woman in India, before she proceeds to have her first child. The analysis was done using data from the third National Family Health Survey (2005–2006), India.

The Early Childhood Obesity Prevention Program (ECHO): an ecologically-based intervention delivered by home visitors for newborns and their mothers

The goals of the Early Childhood Obesity Prevention Program (ECHO) are to examine the 12-month efficacy of a primary obesity prevention program targeting the first year of life that is delivered by home visitors and that engages mothers as agents of change to modify their own behavior and their infant’s behavior through education and skill-building around nutrition, physical activity, and wellness, and then “echoes” her training with linkages to neighborhood programs and resources. ECHO will provide important information about whether an enhanced behavior change curriculum integrated into an existing home visitation program, focused on the mother as the agent of change and linked to neighborhood resources is effective in changing energy balance behaviors in the infant and in the mother. If effective, the intervention could be widely disseminated to prevent obesity in young children.        

Mechanisms of clonal evolution in childhood acute lymphoblastic leukemia

Childhood acute lymphoblastic leukemia (ALL) can often be traced to a pre-leukemic clone carrying a prenatal genetic lesion. Postnatally acquired mutations then drive clonal evolution toward overt leukemia. The enzymes RAG1-RAG2 and AID, which diversify immunoglobulin-encoding genes, are strictly segregated in developing cells during B lymphopoiesis and peripheral mature B cells, respectively. Here we identified small pre-BII cells as a natural subset with increased genetic vulnerability owing to concurrent activation of these enzymes. Consistent with epidemiological findings on childhood ALL etiology, susceptibility to genetic lesions during B lymphopoiesis at the transition from the large pre-BII cell stage to the small pre-BII cell stage was exacerbated by abnormal cytokine signaling and repetitive inflammatory stimuli. We demonstrated that AID and RAG1-RAG2 drove leukemic clonal evolution with repeated exposure to inflammatory stimuli, paralleling chronic infections in childhood.      

Scale-up plan for essential medicines for child health: Diarrhea, Pneumonia and Malaria in Pakistan

With an under-five mortality rate of 89 per 1000 live births, Pakistan is lagging behind the desired MDG 4. There is still a need to reduce the under-five mortality rate by 45 percentage points in order to achieve the MDG target by 2015. Each year around 91,000 and 53,300 children die from pneumonia and diarrhea respectively, in Pakistan. Diarrhea, pneumonia and malaria collectively contribute to around 50% of deaths in children. These three diseases, thus, represent a challenging but surmountable obstacle towards achieving the MDG 4 target. Implementation of large-scale interventions and scale-up plan focusing on these three major killers of children in Pakistan is essential. This report identifies the major barriers towards accessing essential medicines by care givers.