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Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.

The paper provides a detailed historical account of Douglass C. North's early intellectual contributions and analytical developments in pursuing a Grand Theory for why some countries are rich and others poor.

The author approaches the discussion using a theoretical and historical reconstruction based on published and unpublished materials.

The systematic, continuous and profound attempt to answer the Smithian social coordination problem shaped North's journey from being a young serious Marxist to becoming one of the founders of New Institutional Economics. In the process, he was converted in the early 1950s into a rigid neoclassical economist, being one of the leaders in promoting New Economic History. The success of the cliometric revolution exposed the frailties of the movement itself, namely, the limitations of neoclassical economic theory to explain economic growth and social change. Incorporating transaction costs, the institutional framework in which property rights and contracts are measured, defined and enforced assumes a prominent role in explaining economic performance.

In the early 1970s, North adopted a naive theory of institutions and property rights still grounded in neoclassical assumptions. Institutional and organizational analysis is modeled as a social maximizing efficient equilibrium outcome. However, the increasing tension between the neoclassical theoretical apparatus and its failure to account for contrasting political and institutional structures, diverging economic paths and social change propelled the modification of its assumptions and progressive conceptual innovation. In the later 1970s and early 1980s, North abandoned the efficiency view and gradually became more critical of the objective rationality postulate. In this intellectual movement, North's avant-garde research program contributed significantly to the creation of New Institutional Economics.

Constructive deviance has received increasing attention across the last 20 years. However, because the distinction between constructive and traditional forms of deviance (i.e., destructive) is based on the intent behind the behaviors, it can be difficult to determine which acts are constructive. As an umbrella construct consisting of several forms of deviant acts (e.g., whistle-blowing, employee voice, necessary evils), research into constructive deviance has largely remained focused on the individual behaviors to date. While advancements have been made, this focus has limited the consideration of an overarching understanding of constructive deviance in the workplace. Further, constructs like constructive deviance that straddle the bounds between beneficial and detrimental necessitate the exploration into their antecedents as determined by the employees (i.e., apples), their environments (e.g., barrels), or some combination of the two. The author seeks to advance the research in constructive deviance by proposing a testable model. In which, the author develops an interactionist perspective of the antecedents to reposition constructive deviance as the acts of good employees in restrictive or negative environments. In doing so, the author considers how various aspects of individuals, their organizational environments, and the influence of their leaders interact. The author then develops a multi-stakeholder approach to the outcomes of constructive deviance to consider how the various parties (i.e., organization, coworkers, customers) are expected to respond and how these responses impact the more distal outcomes as well as the likelihood of engaging in future constructive deviance.