IMPORTANCE Although antibiotics are associated with obesity in animal models, the evidence in humans is conflicting. OBJECTIVE To assess whether antibiotic exposure during pregnancy and/or early childhood is associated with the development of childhood obesity, focusing particularly on siblings and twins. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional national study included 284 211 participants (132 852 mothers and 151 359 children) in New Zealand. Data analyses were performed for 150 699 children for whom data were available, 30 696 siblings, and 4188 twins using covariateadjusted analyses, and for 6249 siblings and 522 twins with discordant outcomes using fixedeffects analyses. Data analysis was performed November 2017 to March 2019. EXPOSURE Exposure to antibiotics during pregnancy and/or early childhood. MAIN OUTCOMES AND MEASURES The main outcome is odds of obesity at age 4 years. Anthropometric data from children born between July 2008 and June 2011 were obtained from the B4 School Check, a national health screening program that records the height and weight of 4-year-old children in New Zealand. These data were linked to antibiotics (pharmaceutical records) dispensed to women before conception and during all 3 trimesters of pregnancy and to their children from birth until age 2 years. RESULTS The overall study population consisted of 132 852 mothers and 151 359 children (77 610 [51.3%] boys) who were aged 4 to 5 years when their anthropometrical measurements were assessed. Antibiotic exposure was common, with at least 1 course dispensed to 35.7% of mothers during pregnancy and 82.3% of children during the first 2 years of life. Results from covariateadjusted analyses showed that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years, in a dose-dependent manner. Every additional course of antibiotics dispensed to the mothers yielded an adjusted odds ratio (aOR) of obesity in their children (siblings) of 1.02 (95% CI, 0.99-1.06), which was similar to the odds across pregnancy for the whole population (aOR, 1.06; 95% CI, 1.04-1.07). For the child's exposure, the aOR for the association between antibiotic exposure and obesity was 1.04 (95% CI, 1.03-1.05) among siblings and 1.05 (95% CI, 1.02-1.09) among twins. However, fixed-effects analyses of siblings and twins showed no associations between antibiotic exposure and obesity, with aORs of 0.95 (95% CI, 0.90-1.00) for maternal exposure, 1.02 (95% CI, 0.99-1.04) for child's exposure, and 0.91 (95% CI, 0.81-1.02) for twins' exposure. CONCLUSIONS AND RELEVANCE Although covariate-adjusted analyses demonstrated an association between antibiotic exposure and odds of obesity, further analyses of siblings and twins (continued) Key Points Question Is antibiotic exposure during pregnancy and/or during early childhood associated with the development of childhood obesity? Findings This cross-sectional national study of 284 211 participants (132 852 mothers and 151 359 children) in New Zealand found that...

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We have developed a software-based tool to support a dynamic micro-simulation model of life-course development (to age 13) as an aid to policy makers assessing the impact of policies affecting children. We demonstrate how this approach bridges the research-policy gap by creating: (1) an easy transfer of evidence in a form that policymakers can use (for example, ‘What is the policy influence of X on Y?’); and (2) a ‘pull’ system of knowledge transfer by which policy makers control the knowledge they access. The advantage of close collaboration with policy makers in the development and implementation phases is also discussed.

The aim of this study is to compare the risk of treatment-related toxicities and long-term survival between obese and nonobese patients with non-Hodgkin lymphoma when treated with full uncapped doses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. A total of 133 patients and 733 cycles of chemotherapy were analyzed. Obese patients did not experience an increased risk of acute treatment-related toxicities (adjusted odds ratio 0.825, p = 0.197), or delayed toxicities (adjusted odds ratio 0.819, p = 0.779). In the subgroup of diffuse large B-cell lymphoma patients (n = 109), treatment response rate was similar between the two body mass index (BMI) groups, and obese patients tended to have superior overall and progression-free survivals, albeit not statistically significant. Full uncapped doses of R-CHOP chemotherapy administered to obese patients with non-Hodgkin lymphoma (NHL) are safe, well tolerated, and do not lead to inferior treatment response or long-term outcomes.

The high level of academic, public and policy attention paid to the deservingness of the poor and (especially) of welfare recipients contrasts with the scant attention paid to the deservingness – or otherwise – of the rich. This discrepancy reflects socially dominant – but contestable – ideas about equality of opportunity and the role of individual merit within market systems. In this journal, Karen Rowlingson, Stewart Connor and Michael Orton have noted that wealth and riches have remained invisible as policy ‘problems’. This invisibility is socially important, in that policy efforts to address current, socially damaging, levels of economic inequality require attention to the deservingness of the rich, as well as of the poor. This article draws on recent survey data from New Zealand to provide new insights into public attitudes to the rich. It finds that the New Zealand public view the rich as more individually deserving of their outcomes than the poor are deserving of social assistance, and that attitudes towards the rich are related to redistributive sentiments at least as strongly as attitudes towards the poor. In concluding, the article reflects on the limitations of existing data sources and makes suggestions for future research.