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A considerable body of sociological literature has examined the role that education plays in the ongoing reproduction of class-based inequalities. However, there is a relative lack of research that has focused on the reproduction of inequalities linked to the combined influences of disability and social class. Based on a qualitative study of 19 Australian families, this article examines how the strategies that mothers adopt to advocate for their dyslexic children are shaped by social class. We argue that the expectation by schools that mothers will advocate for their child reproduces inequality because advocacy hinges on mothers having access to specialised cultural capital and considerable financial capital. Our findings also indicate that there is a reliance on mothers to advocate for their child in order to get support. We argue that this reliance on advocacy shifts responsibility for inclusion from the state to mothers, further reproducing a system that is exclusionary of students with disabilities.

This patient's disease course was characterized by low-risk myelodysplastic syndrome, immunodeficiency with profound B and NK cell deficiency as well as demyelinating leukoencephalopathy. List of Abbreviations aHSCT allogeneic hematopoietic stem cell transplantation GVHD graft-vs-host disease MG Majocchi's granuloma MIC minimum inhibitory concentration To the Editor, Germline GATA2 mutations cause heterogeneous inherited disorders which can present with bone marrow failure syndrome, immunodeficiency, and other systemic manifestations.1 The only potentially curative therapy is allogeneic hematopoietic stem cell transplantation (aHSCT) which usually result in reversal of the hematological and infection susceptibility phenotypes.2,3 Here, we report the case of a 56-year-old patient with GATA2 haploinsufficiency disorder whose extensive and refractory dermatophytosis resolved after aHSCT. [Extracted from the article]

AbstractMyelodysplastic syndromes (MDSs) treatment focuses on improving quality of life (QOL), affected by anemia and transfusion dependence (TD). Using the MDS-CAN registry, we studied how changes in transfusion status – TD to transfusion independence (TI) (group A), or vice versa (group B), and maintaining TD (group C) or TI (group D) – affected OS and QOL in 1120 MDS patients. Analysis showed superior OS for those remaining TI, poorer for those remaining TD, and intermediate for those with changes. Among 656 treated patients, group A (n = 54) showed improved QOL, with trends toward improved physical and social function scores. Group B (n = 151) experienced declines in global QOL measures after switching to TD, particularly in fatigue and physical, role, and social functioning. Group C had notable fatigue worsening, while group D showed milder declines across multiple QOL aspects. Achieving TI in MDS correlates with improved QOL, whereas reverting to TD more significantly worsens overall QOL and function scores. [ABSTRACT FROM AUTHOR]

Introduction: Antithymocyte globulin (ATG) has been demonstrated to reduce the incidence of graft-versus-host disease (GVHD); however, it remains controversial whether these gains are offset by an increase in relapse. Methods: We conducted a retrospective historical control study consisting of patients (n = 210) who underwent myeloablative allogeneic hematopoietic stem-cell transplantation (HSCT) from 2014 to 2020. Results: The incidence of acute GVHD was lower in the ATG group (51.4%) than the non-ATG group (control) (70.0%, p = 0.010). The incidence of chronic GVHD was also lower in the ATG group at 1-year (36.4% vs. 62.9%, p < 0.001) and 2-year (40.0% vs. 65.7%, p < 0.001) post-HSCT. The mortality due to GVHD was higher in the control (18.5%) than the ATG group (4.3%; p = 0.024). The severe GVHD-relapse-free survival was higher in the ATG group (36.4%) than the control (12.9%; p < 0.001). Nevertheless, the 2-year overall survival was similar. Conclusion: Our results confirm the effectiveness of ATG in prevention of GVHD in the real-world setting and enhanced GVHD-free survival. An important result is the equalization of overall survival between the ATG and control groups at 1- and 2-year post-HSCT and implies that earlier GVHD-associated mortality may be offset by later relapse mortality producing similar overall survival over time. [ABSTRACT FROM AUTHOR]

Introduction: People with intellectual disability are at risk of poor physical and mental health. Risks to health are compounded by poor health literacy, that is, reduced capacity to access health services, respond quickly to changes in health status and navigate care pathways. Building health literacy skills is a strength-based way to increase health and optimise the use of healthcare services. The internet is a primary source of health information for many people, including people with intellectual disability and their families. This scoping review will aim to identify and collate online lay healthcare resources available to and developed for people with intellectual disability and their families and evaluate whether domains of health literacy are addressed., Methods and Analysis: This review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. The proposed search strategy has three components. Resources will be identified by (1) reviewing disability organisation websites, (2) searching key disability and health terms in the Google search engine and (3) snowball sampling to identify additional resources through links in identified websites and resources. Resources will be selected if they are freely available, presented in or translatable into English, provide health information and are directed to people with intellectual disability or their family members. Extracted data will include descriptors of the source, format, area of health and targeted age range. Content relevant to domains of health literacy will be documented and gaps in available health information will be identified. Study findings will be presented in narrative, tabular and visual forms., Ethics and Dissemination: Ethical approval will not be sought because primary data will not be collected. The results will be disseminated in peer-reviewed literature, as conference presentations, as a synthesised resource for people with intellectual disability and their families and in summary documents for health service managers and policymakers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Iron overload (IO) reflected by elevated ferritin is associated with increased mortality in myelodysplastic syndromes (MDS), however, ferritin is an imperfect metric. Elevated labile plasma iron correlates with clinical outcomes and transferrin saturation (TSAT) >80%, but is not readily measurable. The trajectory of TSAT, and its association with clinical outcomes remain undefined. Canadian MDS registry patients were evaluated. Mean TSAT, mean ferritin and transfusion dose density (TDD) were determined. Survival was evaluated by TSAT and ferritin (<50%, 50-80%, >80%), (≤500 μg/L, 501-800 μg/L, >800 μg/L). In 718 patients, median age was 74 years; 12%, 31%, 29%, 15% and 13% were IPSS-R very low, low, intermediate, high and very high. TSAT and ferritin were moderately correlated (r=0.63, P<0.0001). TSAT increased over time in transfusion- dependent patients (P=0.006). Higher TSAT and ferritin were associated with inferior 5-year overall (OS), progression- free (PFS), and leukemia-free survival (LFS) (P≤0.008) and higher TDD with inferior 5-year OS. TSAT >80% trended with inferior cardiac death-free survival (P=0.053). In univariate analysis, age, IPSS-R, blast percentage by Eastern Cooperative Oncology Group Performance Status, frailty, Charlson Comorbidity Index, iron chelation (Y/N), TDD, TSAT and ferritin were significantly associated with inferior OS. By multivariable analysis, TSAT >80% (P=0.007) remained significant for OS (R2 30.3%). In MDS, TSAT >80% and ferritin >800 μg/L portended inferior OS, PFS and LFS. TSAT may indicate the presence of oxidative stress, and is readily measurable in a clinical setting. The relationship between TSAT and cardiac death-free survival warrants further study.