Abstractobjectives To evaluate how an intervention, which combined hand washing promotion aimed at 5-year-olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism.methods We monitored illnesses, including diarrhoea and acute respiratory infections (ARIs), school absences and soap consumption for 41 weeks in 70 low-income communities in Mumbai, India (35 communities per arm).results Outcomes from 847 intervention households (containing 847 5-year-olds and 4863 subjects in total) and 833 control households (containing 833 5-year-olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5-year-olds had fewer episodes of diarrhoea (À25%, 95% confidence intervals [CI] = À37%, À2%), ARIs (À15%, 95% CI = À30%, À8%), school absences due to illnesses (À27%, 95% CI = À41%, À18%) and eye infections (À46%, 95% CI = À58%, À31%). Further, there were fewer episodes of diarrhoea and ARIs in the intervention group for 'whole families' (À31%, 95% CI = À37%, À5%; and À14%, 95% CI = À23%, À6%, respectively), 6-to 15-year-olds (À30%, 95% CI = À39%, À7%; and À15%, 95% CI = À24%, À6%) and under 5 s (À32%, 95% CI = À41%, À4%; and À20%, 95% CI = À29%, À8%).conclusions Direct-contact hand washing interventions aimed at younger school-aged children can affect the health of the whole family. These may be scalable through public-private partnerships and classroom-based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.keywords hand washing with soap, diarrhoea, acute respiratory infection, hygiene, school absence

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Despite prominent and compelling theoretical arguments linking manufacturing imports from the global South to rising income inequality in the global North, the literature has produced decidedly mixed support for such arguments. We explain this mixed support by introducing intervening processes at the global and national levels. At the global level, evolving characteristics of global production networks (GPNs) amplify the effect of Southern imports. At the national level, wage-coordination and welfare state generosity counteract the mechanisms by which Southern imports increase inequality, and thereby mitigate their effects. We conduct a time-series cross-section regression analyses of income inequality among 18 advanced capitalist countries to these propositions. Our analysis addresses alternative explanations, as well as validity threats related to model specification, sample composition and measurement. We find substantial variation in the effect of Southern imports across global and national contexts. Southern imports have no systematic effect on income inequality until the magnitude of GPN activity surpasses its world-historical average, or in states with above average levels of wagecoordination and welfare state generosity. With counterfactual analyses, we show that Southern imports would have led to much different inequality trajectories in the North if there were fewer GPNs, and the prevailing degrees of wage-coordination and welfare state generosity were higher. The countervailing effects of GPNs and institutional context call for theories of inequality at the intersection of the global and the national, and raise important questions about distributional politics in the years to come.

Individual tooth surfaces have vastly different susceptibilities to caries and this susceptibility also varies over time. The aim of this study was to develop a method of grouping tooth surfaces into a caries susceptibility classification based on their survival experience. The data used in the study were from a 3–year caries clinical trial. The definition of survival time was taken to be the time from the start of the trial to when a surface is recorded as decayed or filled. Cluster analysis was used to divide the tooth surfaces into groups in such a way that surfaces in the same group have similar survival time distributions. The 13 groups identified were ordered from 1 to 13 starting with the group with the shortest survival time, i.e. the occlusal surfaces of the four first molars. Approximately 80% of symmetrical pairs of tooth surfaces were in the same group. The groups obtained using cluster analysis were compared to groups defined using dental/anatomical criteria. It is concluded that the cluster analysis method developed for grouping the tooth surfaces cn provide a useful descriptive measure of caries susceptibility which can be applied to data from any longitudinal study of caries.

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