Background: EQ-5D is generic measure of health-related quality of life. Studies using EQ-5D generate ordinal data that are interpreted as categories ordered by severity. New analytic approaches taking into account the ordinal nature of the health dimension severity and leading to a better interpretation of EQ-5D data are needed to better elucidate differences in health-related quality of life. We propose utilizing the Improved RIDIT statistical method to analyze EQ-5D outcomes. Methods: 556 Moroccan participants aged over 18 years representing four chronic diseases: back pain (n = 158), renal insufficiency (n = 56), diabetes (n = 82) or hypertension (n = 80) and healthy subjects (n = 180). All participants received the two EQ-5D versions. Two other published data sets were included. The first was extracted from a diabetic Spain study and the second was extracted from a clinical trial study. The Improved RIDIT analyses were carried out using an R statistic program we developed. Results: Applying the Improved RIDIT on the EQ-5D data allowed estimating for the first time the ordinal odds, the Absolute Risk Reduction (ARR) or the Absolute Risk Increase (ARI) and the Number Needed to Treat. The ARI values estimated for Moroccan patients showed that (i) hypertension increased anxiety/depression by 66% and reduced mobility by 65%; (ii) back pain increased pain/discomfort by 69%; (iii) renal insufficiency impacts mobility (ARI = 57%, odds_ordinal = 9.95) and usual activities (ARI = 44%, odds_ordinal = 6.41) and (iv) diabetes acts only on anxiety/depression (ARI = 50%, odds_ordinal = 4.8). Also, we demonstrated that the approach works well in clinical trials. Conclusions: Improved RIDIT provides more intuitive and informative interpretation of the EQ-5D data by (1) taking into account the level severity; estimating (2) the odds ordinal, (3) the ARR/ARI and the NNT; (4) analyzing the five dimensions of the EQ-5D separately, which gives clinical teams more precision in understanding the treatment/pathology impacts on the health status and completes the EQ-5D data analysis based on score utilities.

The cultural context influences women’s antenatal care and postpartum knowledge. This study aims to determine the traditional practices related to maternal health in Morocco. We conducted in-depth qualitative interviews with 37 women from three different Moroccan regions on the first postpartum day. We used thematic content to analyze data, and an a priori coding framework was created utilizing the pertinent literature. Beliefs regarding pregnancy and postpartum positively affect maternal health, such as family support, prolonged rest for health recovery, and specific dietary precautions according to the mode of delivery of the new mother. However, some practices may negatively affect maternal health, such as cold postpartum treatment through traditional medicine and not seeking prenatal care after the first pregnancy experience. Such practices include painting newborns with henna, using kohl and oil to hasten the umbilical cord’s descent, and producing solutions based on chicken throat to cure respiratory ailments in newborns that might harm their health.

In the United States, Indiana ranks 43rdfor its infant mortality rate. Twenty-nine (of the 988) Indiana zip codes account for 27% of infant deaths. There is a need to train and mentor community members to lead local maternal and child health (MCH) efforts that address the priorities of community members as related to poor birth outcomes and facilitate the community’s solution strategies to this important public health problem. This community-centered approach coupled with local healthcare delivery helps thoroughly address local adverse birth outcomes. A comprehensive grassroots MCH leadership curriculum is needed for this training process. To meet this need we developed and solicited feedback on a curriculum designed to train community members situated in Indiana’s high-risk zip codes to be grassroots maternal child health leader (GMCHLs). The curriculum teaches GMCHLs the knowledge and skills to become self-reflective leaders who understand the causes and effects of adverse and inequitable birth outcomes, the negative health effects of chronic stress, and the protective power of the community. These GMCHLs will become skilled in the use of storytelling, Photovoice, policy development/advocacy and EvaluLead to build the capacity of their local community to support positive maternal and child health (MCH) outcomes.

Krox-20, a C2H2-type zinc-finger transcription factor, plays an important role in rhombomere development. This study reveals that the Krox-20 null mutation impacts the development of mesencephalic trigeminal (Me5) neurons, a cell group traditionally thought to emerge from the mesencephalon. Based on cell counting studies, we show that Krox-20 null mutants have twice as many Me5 neurons relative to wildtypes at E15, but by birth have half the number of Me5 cells as wildtypes. TUNEL studies reveal a period of increased apoptosis from E17-P0 in mutants. The mutation does not result in differences in Me5 cell size, morphology, gene expression or peripheral projection patterns between genotypes, as demonstrated by retrograde tracing and Brn3a immunohistochemistry. The data suggest that Krox-20 regulates the period and extent of Me5 apoptosis, impacting the final number of Me5 neurons. The loss of Me5 in Krox-20–/– mice may highlight species-specific differences in the origin of these cells.