Search

Information is scarce on Early Childhood Caries (ECC) in Mexican preschool children and its impact on quality of life.To evaluate the ECC prevalence and its impact on OHRQoL in 3-5 years-old Mexican children according to disease severity.Caries was determined at two thresholds: (1) children with at least one caries lesion (ICDAS-1-6) and (2) children with at least one lesion in dentin (ICDAS-3-6). OHRQoL was assessed through the Mexican Early Childhood Oral Health Impact Scale (M-ECOHIS). Associations among caries severity, M-ECOHIS, and other variables were assessed by ordinal logistic regression.A total of 409 children participated (53.8% girls, 46.2% boys). Caries prevalence was 82.2% considering all lesions, and 45.0% for dentinal lesions. Significant linear trends (p .05) among caries levels and categories of exposure were found for socioeconomic variables, dietary habits, and toothbrushing habits. Attending rural private schools (OR = 1.39, 95%CI = 1.11-1.72; p .01), two main meals/day (OR = 2.75, 95%CI = 1.26-6.03; p = .01) and unsupervised toothbrushing (OR = 3.20, 95%CI = 1.96-5.24; p .01) increased the risk to have high caries severity levels. M-ECOHIS scores were statistically significant associated with caries levels (χM-ECOHIS was significantly associated with caries severity. Type of school, age groups, parents' educational level, family income, and living conditions were correlated with caries, showing how distinctive risk indicators were associated with different caries stages.

Objectives To examine whether oral health-related quality of life (OHRQoL) explained the negative associations between dental caries and anthropometric measures of child growth among a sample of 5- to 9-year-old children in Dhaka, Bangladesh, while taking potential confounding factors (maternal education, family income, study setting, child's birth weight and childhood diseases) into account. In addition, to test whether specific oral impacts had a role in explaining these associations. Methods Data collection was conducted via a cross-sectional survey among children and their parents from both hospital and school settings in Dhaka. Dental caries and severe consequences of dental caries (defined here as dental sepsis) were the exposure variables, and age- and sex-adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ) were the outcome variables. OHRQoL was measured using the Bengali version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). First, associations between oral impacts (prevalence of overall impacts and specific items of the SOHO-5) and outcome measures were assessed. Multiple linear regression was used to assess associations between caries and anthropometric measures, adjusted for potential confounders. Oral impacts were then added to test whether their inclusion attenuated the associations between exposures and outcomes. To further investigate potential mediating role of oral impacts, structural equation modelling (SEM) was used to test the hypothesis that dental caries and sepsis were associated with the outcomes directly and also indirectly via oral impacts in general. A similar approach was used to investigate mediation by specific SOHO-5 items. Results The sample consisted of 715 children, 73.1% of whom had dental caries, 37.5% presented with sepsis, and 57.3% reported at least one oral impact (SOHO-5 score ≥1). Prevalence of overall oral impacts and also the impact on 'eating difficulty' (a specific item of SOHO-5) were negatively associated with all three outcomes. Dental caries and sepsis was associated with lower HAZ, WAZ and BAZ, and adjustment for overall oral impacts considerably attenuated the associations between 'severe dental caries' and outcomes, and dental sepsis and outcomes. Using SEM, we found significant indirect associations between caries and sepsis and anthropometric measures via oral impacts (except for dental caries and HAZ). Considering specific oral impacts, eating difficulties explained about 44% and 65% of the associations between caries and anthropometric outcomes, and dental sepsis and anthropometric outcomes, respectively. Conclusions Oral impacts, in particular eating difficulties, appear to mediate associations between caries and markers of child growth among this population.

Experimental research demonstrates sustained high-quality early care and education (ECE) can mitigate the consequences of poverty into adulthood. However, the long-term effects of community-based ECE are less known. Using the 1991 NICHD Study of Early Child Care and Youth Development (n = 994; 49.7% female; 73.6% White, 10.6% African American, 5.6% Latino, 10.2% Other), results show that ECE was associated with reduced disparities between low- and higher-income children's educational attainment and wages at age 26. Disparities in college graduation were reduced the more months that low-income children spent in ECE (d = .19). For wages, disparities were reduced when children from low-income families attended sustained high-quality ECE (d = .19). Findings suggest that community-based ECE is linked to meaningful educational and life outcomes, and sustained high-quality ECE is particularly important for children from lower-income backgrounds.

We review the empirical literature on the causal effects of welfare-to-work policies on the employment of low-income parents and the intergenerational impacts on their children. We focus on welfare policies that change benefit levels, activity requirements, time limits, and in-work benefits. These policies may affect children through several mechanisms, including changes in family income, time spent with parents, and attitudes towards work or welfare. To unpack these mechanisms and understand the net effects of these policies, we assess how the impact on children varies across outcomes, home environments and institutional settings. Overall, the literature shows that income tax credits are an attractive policy, simultaneously increasing employment and improving child development outcomes. In contrast, other policies that boost employment either have no or negative impacts on child development.

BACKGROUND Improved knowledge of causal and protective factors is crucial for Postpartum depression (PPD) prevention and management. AIMS To investigate the relationship between adverse childhood experience (ACE), perceived social support and PPD in a middle-income non-Western country, and to investigate which type of ACE and which sources of social support were associated with PPD. METHODS The study was cross-sectional study and conducted in a one center from Turkey during March-June 2019. Women up to 1-week postpartum were included in the study. The Edinburgh Postpartum Depression Scale (EPDS), a validated ACE questionnaire, and the Multidimensional Scale of Perceived Social Support were completed. RESULTS Nine hundred women took part in the study. The proportion identified with PPD and ACE were 10% and 8.8%, respectively. In bivariate analysis, having previous PPD, unwanted pregnancy, insufficient antenatal care, low family income, history of ACE, and perception of low social support were associated with PPD (p

Introduction Childhood conduct problems (CP) are characterized by maladaptive externalizing behaviors and are linked with poor sleep. CP are highly comorbid with other psychological problems, including attention deficit/hyperactivity disorder and depression, which are also associated with disturbed sleep. The present study examined if childhood CP and comorbid depressive and/or attentional-hyperactivity problems were prospectively associated with parent and self-reported sleep difficulties in adolescence. Methods Participants (N = 744; 53% boys) from an ongoing longitudinal study in Quebec, Canada were assessed for CP and comorbidities when they were between 6 and 9 years old. Participants were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms, and attention-hyperactivity problems. Regressions were conducted to examine the associations between comorbidity groups, parent, and self-reported sleep problems 7 years later (Median age = 15.33 years), controlling for sex, age, family income, primary caregiver education and medication. Results Adolescents in all CP groups had higher self and parent-reported sleep problems compared to adolescents without histories of CP. Adolescents with histories of CP, depressive symptoms and attention-hyperactivity problems had more sleep problems than all other groups according to self-reports, but not parent-reports. Conclusion Childhood CP was prospectively linked to sleep problems in adolescence, and comorbid conditions exacerbated these problems, according to youth but not parents.

BACKGROUND Possession of private health insurance has been associated with personal and socioeconomic characteristics, such as income and age. The objective of the present study is to assess the individuals' personal characteristics associated with private health insurance possession in Greece. METHODS The data used in the present analysis derived from the 'Health and Welfare' survey conducted by the Hellenic National School of Public Health in Greece and refer to year 2017. The sample of the analysis consisted of 1,932 adults aged 18 years or older. Α binary logistic regression model was conducted, in order to investigate the factors associated with private health insurance possession. RESULTS The factors that were found to be associated with private health insurance possession were: area of residence; Attica, family income level; 1,501€-2,000€, 2,001€+, absence of chronic condition, occupation; employer/self-employed, absence of public insurance, time since last health check-up; less than or equal to 5 and more than 1 years ago, more than 5 years or never and level of education; secondary, tertiary. CONCLUSIONS Private health insurance covers a low percent of the Greek population and has a low contribution to private health spending, compared with other countries. The personal characteristics that were found to be associated with private health insurance possession in Greece by the present study are in line with previous studies in other countries. These results are expected to provide policy advice on how to enhance coverage in order to reduce out-of-pocket expenditure, which is considered high in Greece.

Aims and objectives To find out the adherence to lifestyle modifications and its associated factors in hypertensive patients. Background Low adherence to lifestyle modifications leads to poor therapeutic effectiveness, decreased quality of life, poor health outcomes and increased health care costs. Various factors play an important role in determining the adherence level varying among the different cultural, social and national contexts. Design A cross-sectional analytical research design was carried out. Methods Information from 264 patients with hypertension was collected at the Outpatient Department of Manmohan Cardiothoracic, Vascular and Transplant Center, Kathmandu. A standard tool of WHO Steps Survey Questionnaire and Hypertension Fact Questionnaire was used for data collection. Chi-square test and binary logistic regression were used for analysis using SPSS 16. Result The overall adherence to lifestyle modifications was determined as 20.8% with the adherence rate being lowest up to 30.3% for adequate intake of fruits and vegetables. Likewise, 52.5% of patients had average knowledge of hypertension management. Age (p = .021), education (p = .001), occupation(p = .026), household income (p = .007) and family history(p = .011) had statistically significant association with the level of adherence. Younger age (AOR = 1.85 CI = 0.79-4.33) remained as the independent predictor of high adherence to lifestyle modifications. The study followed the STROBE checklist for reporting cross-sectional study. Conclusion This study identified that adherence to lifestyle modification is low in older patients. More effective lifestyle modification counselling and educational approaches focusing on the older age groups as well as considering educational level, occupation, family income and family history of hypertension are required to improve their level of adherence. Relevance to clinical practice Nurses are frequently acquainted with the hypertensive patients in hospitals where they need to provide health teaching on lifestyle modifications. This study identifies the factors that need to be considered while counselling the hypertensive patients.

This paper studies the impact of household income redistribution on income inequality among the elderly from 2002 to 2018. It defines shared income and measures how each family member's contributions affect income inequality among the elderly. The study has three major findings. First, from 2013 to 2018, the role of household shared income in reducing income inequality among the elderly increased. Second, the proportion of shared income contributed by children was the highest overall, reaching 11.0 percent nationwide and even 17.9 percent in rural areas in 2018. The contribution of shared income to inequality was also higher among the rural elderly. Grandchildren under 16 largely received shared income from the elderly, and the income transferred by the male elderly to their wives was obvious. Third, changes in family structure narrowed the inequality gap among the elderly in the periods 2002–2013 and 2013–2018.

AIM Female pattern hair loss (FPHL) is a common condition that is influenced by many external and internal factors. We aimed to identify the prevalence of FPHL among secondary school girls and identify possible associated factors. METHODS FPHL among 3405 adolescent females was identified using detailed history, physical examination, and dermoscopy in this cross-sectional study. RESULTS Among the 3405 included students, 2430 (71.4%) had no FPHL and 975 (28.6%) were diagnosed with FPHL (p = 0.001). The mean age of girls with FPHL was 16.43 ± 1.10 and ranged between 15 and 18 years. Among those with FPHL, 427 (43.8%) attended urban schools while 548 (56.2%) attended rural schools. No significant differences regarding paternal and maternal education, family income, or parental degree of education were observed among those with FPHL and those without (p = 0.230; p = 0.063; p = 0.276, respectively). CONCLUSION FPHL had an overall prevalence of 28.6% among secondary school girls with a significant predominance in rural over urban areas and with a significantly associated family history. Irregular menses, history of thyroid disease, and hirsutism were significant predictors for FPHL.

Objective Background Method Results Conclusion Implications The current study aimed to examine the economic impact of COVID‐19 virus on family dynamics and college‐age children's mental health in China and to identity personal and social or relational resilience factors that could buffer the negative consequences of COVID‐19.Since an outbreak of COVID‐19 was first reported in China in December 2019, it has profoundly changed the lives of families and children of all ages. In particular, it has created challenges among families with college‐age young adult children.Using a sample of 484 college students from 21 universities in China, an online survey design was utilized to obtain information from these students on their family demographics and economic situation, parent–child interactions, and individual well‐being during COVID‐19.Results from structural equation modeling suggested that family income loss due to COVID‐19 was related to economic pressure. Economic pressure was associated with negative interactions between parents and young adult children, which were associated with problems in young adult children's mental health (i.e., anxiety and depressive symptoms). Further, self‐control was found to buffer the association between family income loss and economic pressure, and respect for family was found to weaken the association between economic pressure and negative parent–child interactions.Findings supported the hypotheses of the negative impacts of COVID‐19 on young adult children's mental health and the resilience factors that buffered the negative impacts.Implications to family researchers, family life educators, practitioners, and policymakers were discussed. [ABSTRACT FROM AUTHOR] Copyright of Family Relations is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children with autism spectrum disorder (ASD) are at elevated risk for psychiatric problems in response to the COVID‐19 pandemic. This risk is due to their high rates of pre‐pandemic psychiatric comorbidities and the pandemic's disruption to routines and access to necessary supports. Prior research has indicated that children with ASD may experience a worsening of specific psychiatric symptoms in response to COVID‐19, though this body of work is limited in scope. The present study expands this literature by examining specific types of psychiatric problems that emerged about 2 months after the onset of the pandemic, and risk factors predicting changes in these psychiatric symptoms. Parents of children with a confirmed ASD diagnosis (N = 257), who enrolled in a clinic registry at an outpatient specialty autism center, were included in this study. All data were gathered online via customized and standardized questionnaires. Results showed that 59% of children experienced either a worsening of their pre‐pandemic psychiatric diagnoses and/or the development of new psychiatric symptoms during the pandemic. Multivariable regression models indicated that risk factors for increased psychiatric problems included child understanding of COVID‐19, COVID‐19 illness in the family, low family income, and elevated parental depression and anxiety symptoms (all p

Background Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors AIM: The aim of this study was to investigate associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8-10 years of age. Design A school-based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples. Results Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self-reported PAB. Conclusions Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self-reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB.

AIM To investigate the quality of life in patients with endometrial carcinoma and provide theoretical basis for nursing care. DESIGN In this study, 69 patients diagnosed with endometrial carcinoma from 2016-2018 were included in the cohort. METHODS Sixty-nine patients from our hospital who underwent endometrial cancer surgeries were selected. The SF-36 was used to investigate and analyse the patients' quality of life in the first, second and third months after their operations. Questionnaires were administered to analyse the factors affecting postoperative quality of life. RESULTS Quality of life for the second and third months was obviously better than that for the first month after the operation (p

Aims To investigate the status and influencing factors of illness uncertainty among patients with coronavirus disease 2019 (COVID‐19) in the mobile cabin hospital. Design A cross‐sectional study. Methods 114 patients with COVID‐19 admitted to a mobile cabin hospital in Wuhan, Hubei Province, in February 2020 were enrolled by a convenience sampling method. The Chinese version of the Mishel Illness Uncertainty Scale (MUIS) was used to assess patients’ degree of illness uncertainty, and multiple regression analysis was used to explore the influencing factors. Results The average total score of MUIS (Chinese version) was 52.22 ± 12.51, indicating a moderate level of illness uncertainty. The dimension unpredictability turned out to have the highest mean score: 2.88 ± 0.90. The multiple stepwise regression analysis showed that female (t = 2.462, p = .015), monthly family income not less than RMB 10,000 (t = −2.095, p = .039), and disease duration of 28 days or more (t = 2.249, p = .027) were independent influencing factors of illness uncertainty. Conclusion Patients with COVID‐19 are at a moderate level of illness uncertainty. Medical staffs should pay more attention to female patients, patients with lower monthly family income, patients with the prolonged disease, and take targeted interventions to help them reduce illness uncertainty. Impact Facing the brand new and unknown infectious disease, patients confirmed of COVID‐19 suffer from immense physical and psychological stress, where illness uncertainty is a major stressor that troubles patients. The present study surveys illness uncertainty among patients with COVID‐19 in the mobile cabin hospital with results revealing a moderate level. Study results will benefit nurses in any setting where care for patients with COVID‐19 is provided, public policymakers and future researchers.

I show that serious, yet common, parental health events in childhood have immediate and lasting effects on mental health and educational outcomes for children. Following a parental health event, the children are more likely to receive therapy and consume anti-depressant (AD) medication. More so, the children achieve lower test scores and have lower school enrollment rates. The effect immediately occurs following the event and persists at least into early adulthood. I find that the effect on test scores doesn't differ significantly across family income, but that children from low-income families are more likely to be prescribed ADs following the event, while children from high-income families are more likely to receive therapy. Exploiting differences in general practitioners' behavior in prescribing AD and referring children to therapy, I find suggestive evidence that children who are more exposed to medical treatment of mental health issues have lower educational attainments in early adulthood.

To quantify the impact of the COVID-19 pandemic and public health interventions on parent and child mental health and family relationships, we examined change in individual and family functioning in a sample of parents enrolled in a prevention trial; we examined change before the pandemic (2017-2019) when children were an average of 7 years old to the first months after the imposition of widespread public health interventions in the United States (2020) with paired t tests and HLM models. We examined moderation by parent gender, education, family income, and coparenting conflict. We found large deteriorations from before the pandemic to the first months of the pandemic in child internalizing and externalizing problems and parent depression, and a moderate decline in coparenting quality. Smaller changes were found for parent anxiety and parenting quality. Mothers and families with lower levels of income were at particular risk for deterioration in well-being. Results indicate a need for widespread family support and intervention to prevent potential family "scarring," that is, prolonged, intertwined individual mental health and family relationship problems.Para cuantificar el efecto de la pandemia de la COVID-19 y de las intervenciones de salud pública en la salud mental de los padres y los niños y en las relaciones familiares, analizamos los cambios en el funcionamiento individual y familiar en una muestra de padres inscriptos en un ensayo de prevención; estudiamos el cambio antes de la pandemia (2017-2019) cuando los niños tenían un promedio de 7 años hasta los primeros meses después de la imposición de las intervenciones generalizadas de salud pública en los Estados Unidos (2020) con pruebas t apareadas y modelos lineales jerárquicos. Analizamos la moderación por género, educación, ingresos familiares y conflicto de cocrianza de los padres. Hallamos grandes deterioros desde antes de la pandemia hasta los primeros meses de la pandemia en problemas de interiorización y exteriorización de los niños y depresión de los padres, y una disminución moderada de la calidad de la cocrianza. También encontramos cambios más pequeños en la ansiedad de los padres y la calidad de la crianza. Las madres y las familias con niveles más bajos de ingresos estuvieron en riesgo particular de deterioro del bienestar. Los resultados indican la necesidad de apoyo familiar generalizado y de intervenciones para prevenir posibles «secuelas» familiares, p. ej.: salud mental individual interconectada y prolongada y problemas en las relaciones familiares.本文把COVID-19和公共健康干预措施对父母和儿童的心理健康以及对家庭关系的影响进行量化，对参加一项预防试验的人群样本进行了研究，主要关于这些受试父母的个体功能和家庭功能产生了哪些变化; 我们采用配对t检验和HLM模型，研究了新冠肺炎(2017-2019年)前的变化，即平均年龄为7岁的儿童至美国实施广泛公共健康干预措施(2020年)后的第一个月。我们通过父母性别、教育程度、家庭收入和养育子女的冲突来考察这些因素的调适作用。我们发现，儿童对很多问题以及父母的抑郁表现都进行内化和外化，从新冠肺炎流行发生前到新冠大流行的头几个月出现了严重恶化倾向，亲子教育的质量略有下降。父母的焦虑和培养孩子方面的质量也有较小的变化。收入水平较低的母亲和家庭的福祉尤其有恶化的风险。结果表明，需要给予广泛的家庭支持和干预，以防止潜在的家庭"伤疤"，即长期错综搅合在一起的个人心理健康和家庭关系问题。.

Background and aims Cannabis use among parents may be increasing with legalization, but perception of associated risk has declined. The study investigated the association between cannabis legalization and cannabis use among adults with children in the home over time in the United States (US). Design A difference-in-difference approach was applied to public and restricted-use data from the 2004-2017 National Survey on Drug Use and Health (NSDUH), an annual cross-sectional survey. Setting A representative sample of the United States. Participants/cases Respondents ages 18+ with children living in the home drawn from the NSDUH (n = 287,624), which is administered to non-institutionalized civilians in the 50 states and District of Columbia. Measurements Exposures were year and state-level cannabis policy in state of residence annually. Outcomes were past-30-day cannabis use and daily cannabis use. Sociodemographic variables included age, gender, marital status, annual family income, race/ethnicity, educational attainment, and strength of state-level tobacco control. Findings In 2017, past-month cannabis use (11.9%, 9.3%, and 6.1%) and daily cannabis use (4.2%, 3.2%, and 2.3%) were more common in states with recreational marijuana laws (RML), followed by states with medical marijuana laws (MML) and without legal cannabis use, respectively. RML and MML were associated with significantly higher prevalence of past-month cannabis use (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.12-1.46; AOR = 1.12, 95% CI = 1.03-1.22) and daily cannabis use (AOR = 1.25, 95% CI = 1.03-1.51; AOR = 1.16, 95% CI = 1.02-1.32), respectively. The impact of MML was particularly salient among adults ages 50+ and the highest income and education subgroups. Conclusions Among adults with children living in the home, cannabis use appears to be more common in US states with legalized cannabis use compared with states with no legal cannabis use. Recreational legalization appears to increase use among adults with children in the home broadly across nearly all sociodemographic groups, whereas the effect of legalization for medical use is heterogeneous by age and socioeconomic status.

Research focussing on individual biopsychosocial processes leading to physical pain as a health condition is rare. The present study investigated sense of control as a mechanism linking early midlife stress to later-life physical pain for husbands and wives in long-term marriages. Using data from 508 rural husbands and wives over 27 years (1991–2017) with respondents in their early middle years (67 years on average) in 2017, this study utilized a comprehensive analytical model in an structural equation modelling framework. Family financial stress (FFS) trajectories in early middle years were associated with depleted sense of control, which was related to increased physical pain in later years after controlling for concurrent physical illness, family income and age. In cross-lagged analyses FFS influenced physical pain over mid-later years. Physical pain also influenced FFS, suggesting a bi-directional association between FFS and physical pain. Findings elucidate how early midlife FFS influences the progression of physical pain over mid-later years through sense of control. Findings suggest effective intervention and prevention programs should focus on FFS in early years of adulthood as well as the maintenance and development of adults’ sense of control.

Aim The aim of this study was to explore surgery decision conflict and its related factors among newly diagnosed early breast cancer patients in China. Design A cross‐sectional survey study was conducted. Methods A total of 262 patients confronted with surgery decision‐making were enrolled. The related factors were assessed with a demographic questionnaire, the Chinese version of the Decision Conflict Scale (DCS‐C‐16) and the Patient Participation Competence Scale (PPCS). Results Patients had a high level of decision conflict that was negatively correlated with the PPCS score. Age, marital status, living environment, education level, family income, cancer stage and the PPCS score were independent factors influencing decision conflict. Marital status, education level, cancer stage and participation competence were significant predictors of decision conflict. Patients who had higher participation competence were married, were well educated and had a lower cancer stage were likely to experience lower decision conflict.

Estimates of intergenerational mobility in lifetime income derived from incomplete income histories routinely incorporate in the estimation process, necessary life‐cycle adjustments to annual income data. The two‐stage method presented here first estimates proxies for fathers’ and sons’ lifetime family incomes from annual income observations, schooling and race; and then uses these income proxies to derive mobility measures. Applying this to United States PSID data for sons born between 1952 and 1981, we find a decline in intergenerational mobility in lifetime family income, as measured by the intergenerational elasticity of income, the rank‐rank correlation, absolute upward mobility, and other indicators.

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

BACKGROUND To evaluate mental development index (MDI) and psychomotor development index (PDI) scores of HIV-exposed uninfected (HEU) children by timing of in utero antiretroviral treatment (ART) initiation (Option B+) and sociodemographic characteristics compared with HIV-unexposed uninfected (HUU) children in Mzuzu, Malawi. METHODS One hundred HEU children and 100 HUU children aged 2-30 months were recruited. The differences in MDI and PDI scores between HEU and HUU children were tested by Student's t test, analysis of variance, Mann-Whitney U test, and logistic regression analysis. RESULTS The differences in MDI and PDI scores might be related to number of children in the family, delivery, place of residence, family income, complementary feeding, father's or mother's occupation, and degree of education. No significant difference in MDI and PDI scores between HEU and HUU children (P = 0.076 and P = 0.407) was found. Among HEU children, ART in the third trimester and beyond produced a lower PDI score compared with ART before pregnancy and in the first or second trimester (P = 0.027). CONCLUSION The MDI and PDI scores of HEU subgroups with different timing of ART (Option B+) initiation were comparable to those of the HUU group. Early in utero ART initiation was associated with better neurodevelopmental outcomes than ART initiation in the third trimester and beyond.

OBJECTIVE College attainment is one of the few phenotypes to have substantial variance accounted for by environmental factors shared by reared-together relatives. The shared environment is implicated by the consistently strong parent-to-offspring transmission of college attainment. The mechanisms underlying this relationship remain unclear. We use genetically informative methods with a longitudinal, adoption sample to identify possible environmental mechanisms underlying parent-offspring college transmission. METHOD Data were drawn from the Sibling Interaction and Behavior Study (SIBS), which includes 409 adoptive and 208 nonadoptive families, consisting of two offspring followed from adolescence into young adulthood and their rearing parents. Four domains of environmental mechanisms were examined: (a) skill enhancement; (b) academic support; (c) material advantage; and (d) supportive family environment. RESULTS Both shared environmental and genetic factors contributed to the parent-offspring transmission of college attainment. However, highly educated parents did not appear to be increasing their adopted offspring's attainment through skill development. The environmental factors that were associated with increased odds of offspring college attainment were mother's academic expectations and family income. CONCLUSIONS While complete mediation of the parent-offspring transmission of college attainment was not identified, the results shed light on some of the mechanisms associated with the common environment variance in the college attainment phenotype.

Aim This study examined the prevalence and risk factors of fine motor delay in Australian pre-school children from low-income communities. Methods Children from the Early Start Baseline Study completed the Ages and Stages Questionnaire (3rd edn.). Age, sex, executive function and family characteristics were assessed and associations with fine motor skills analysed. Results Data were available for 700 children (Mage 54.0 ± 8.6 months, 53.1% boys) of which 77.4% were typically developing, 12.1% at risk and 10.4% delayed for fine motor skill. Children had higher odds of being delayed if they were male (odds ratio (OR) 3.30, 95% confidence interval (CI) 2.22-4.90) or indigenous (OR 3.31, 95% CI 2.12-5.16) and had lower self-regulatory (OR 2.17, 95% CI 1.31-3.58). Higher vocabulary (OR 0.92, 95% CI 0.89-0.94), higher family income (OR 0.22, 95% CI 0.05-0.90) and family education (OR 0.25, 95% CI 0.08-0.74) were associated with lower odds of delay. Conclusion Almost one in four children from vulnerable communities experience fine motor difficulties, highlighting the importance of early screening and targeting key child and environmental risk factors.

BACKGROUND Treating patients with anorexia nervosa (AN) remains a major challenge. The choice between an inpatient or an outpatient care setting is an essential issue for the patients and for their relatives with major health economic implications. However, health services-related studies are lacking. The present study was a descriptive exploration of time-trends in treatment modes of patients with free and equal access to health services. METHODS The study was based on a nationwide cohort of patients diagnosed for the first time with AN, each followed for 5 years in the registers covering the years 1994-2018. The per patient number of hospital admissions, cumulated number of days of hospitalization and number of outpatient visits during the first 5 years after initial diagnosis were considered. RESULTS The cohort of patients with AN with at least 5 years of follow-up amounted to N = 7,505. A clear trend was observed in the per patient five-year cumulated number of inpatient days, decreasing by 6% per year after adjustment for age at diagnosis, parental mental diagnosis, and family income. The five-year number of hospital admissions after initial diagnosis decreased by 2% per year, while no trend was observed for outpatient visits. CONCLUSIONS The per patient number of hospitalizations and cumulated days of hospitalization during 5 years after diagnosis were reduced for patients initially diagnosed with AN while there was no change in the number of outpatient visits. The factors contributing to these changes of treatment modes over time are in need of further study.

High graduation of nurses and limited job opportunities in Indonesia may lead to the emigration of nurses particularly through facilitated migration. This study aimed at identifying the prevalence of Indonesian nursing students with intention to work in Japan and predictors of their intention to migrate as well as having a definite plan to work in Japan. The study adopted cross-sectional design with a sample of 1,407 Indonesian nursing students. Factors associated with having migration intention, as well as a definite plan to work in Japan, were age, residence, and overseas experience. Other factors related to a definite plan to work abroad were family income, mastering a foreign language, knowledge about the nurse migration related to Indonesia-Japan cooperation, and their motivations to migrate to Japan. Sustainability of this international recruitment of nurses is possible by understanding the context of both source and destination countries. Maximizing benefits of migration of nurses for Indonesia and Japan requires structured policies targeting the educational sector and addressing the sustainability issues.

As the economy diversifies and stratifies, more mothers of young children experience job instability. To advance understanding of the implications of this trend, this study examines the role of job instability in maternal sensitivity, an important component of child development, during their children's first 3 years of life. Structural equation models with longitudinal multimethod data from the NICHD Study of Early Child Care and Youth Development (n = 1,211; 1991-1994) revealed that mothers' involuntary job loss, but not other job transitions, was negatively associated with sensitivity. This association was most pronounced among mothers with less education. Mediation analyses found that the association was explained by changes in family income and maternal depression, pointing to policy-relevant mechanisms for reducing inequalities among children.

We estimate a dynamic model of schooling on two cohorts of the National Longitudinal Survey of Youth and find that, contrary to conventional wisdom, the effects of real (as opposed to relative) family income on education have practically vanished between the early 1980s and the early 2000s. After conditioning on a cognitive ability measure (AFQT), family background variables and unobserved heterogeneity (allowed to be correlated with observed characteristics), income effects vary substantially with age and have lost between 30% and 80% of their importance on age‐specific grade progression probabilities. After conditioning on observed and unobserved characteristics, a $300,000 differential in family income generated more than 2 years of education in the early 1980s, but only 1 year in the early 2000s. Put differently, a $70,000 differential raised college participation by 10 percentage points in the early 1980s. In the early 2000s, a $330,000 income differential had the same impact. The effects of AFQT scores have lost about 50% of their magnitude but did not vanish. Over the same period, the relative importance of unobserved heterogeneity has expanded significantly, thereby pointing toward the emergence of a new form of educational selectivity reserving an increasing role to noncognitive abilities and/or preferences and a lesser role to cognitive ability and family income.

Background Turkey is the country hosting the largest number of refugees from Syria, with currently 3 571 175 million persons. The general health needs of the refugees are being addressed; however, people with intellectual disabilities (IDs), particularly children, are relatively missed. The aim of this study was to identify medical, psychological and social needs of children with ID and their families, among the Syrian refugee population in Turkey, and to define psychosocial and cultural needs for planning of future services. Methods One hundred forty-two children (67.6% men; mean age 90.5 months) diagnosed with intellectual disorders were included in the study. Family Needs Survey, with additional open-ended and close-ended questions, was used to evaluate family needs. Items from Developmental Disabilities Profile-2 were used to evaluate and screen cognitive, motor and language development as well as medical concerns and behavioural problems. Data on sociodemographic characteristics were also collected. Results The highest needs were identified in information and financial needs domains. Other indicated needs were on child care and community services domains. The least indicated items were on family and social support and explaining to others domains. An average of 63.5% of the respondents definitely agreed with the Family Needs Survey items. The overall level of identification of need items was higher than that in some previous studies, indicating the level of unmet needs of the studied population. Family income, parents' employment and parents' education were not significantly associated with unmet family needs. Special education services were unreachable for most of the families in the study. Conclusions Families reported the highest needs in information and financial needs domains. The overall level of identification of needs was higher than that in some previous studies, indicating the level of unmet needs of the studied population. The majority of the parents reported that they had sufficient family and social support, which might be a protective factor for parental mental health. Parents' Turkish fluency was very significantly associated with every domain of unmet needs. Language barriers and translation problems had significant negative effects on families, as confirmed by the answers to open-ended questions. Another important factor identified was access to service professionals. Special education services, sorely needed for most of the families, could not always be reached. Although the progress of children who had received special education was not very encouraging, it was better than those who did not receive it. The first implication of the study is that increasing Turkish proficiency or providing high-quality and consistent translation services is vital for this category of children with ID. The second implication is that information and financial needs must be met with priority. Information must be tailored for each child's needs and developmental level. Special education and physical therapy must be more accessible and at higher quality.

Previous studies investigating the association between dysmorphology and cognitive, behavioral, and developmental outcomes among individuals with autism spectrum disorder (ASD) have been limited by the binary classification of dysmorphology and lack of comparison groups. We assessed the association using a continuous measure of dysmorphology severity (DS) in preschool children aged 2-5 years (322 with ASD and intellectual disability [ID], 188 with ASD without ID, and 371 without ASD from the general population [POP]). In bivariate analyses, an inverse association between DS and expressive language, receptive language, fine motor, and visual reception skills was observed in children with ASD and ID. An inverse association of DS with fine motor and visual reception skills, but not expressive language and receptive language, was found in children with ASD without ID. No associations were observed in POP children. These results persisted after exclusion of children with known genetic syndromes or major morphologic anomalies. Quantile regression models showed that the inverse relationships remained significant after adjustment for sex, race/ethnicity, maternal education, family income, study site, and preterm birth. DS was not associated with autistic traits or autism symptom severity, behaviors, or regression among children with ASD with or without ID. Thus, DS was associated with a global impairment of cognitive functioning in children with ASD and ID, but only with fine motor and visual reception deficits in children with ASD without ID. A better understanding is needed for mechanisms that explain the association between DS and cognitive impairment in children with different disorders. Autism Res 2020, 13: 1227-1238. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We examined whether having more dysmorphic features (DFs) was related to developmental problems among children with autism spectrum disorder (ASD) with or without intellectual disability (ID), and children without ASD from the general population (POP). Children with ASD and ID had more language, movement, and learning issues as the number of DFs increased. Children with ASD without ID had more movement and learning issues as the number of DFs increased. These relationships were not observed in the POP group. Implications are discussed.

Rationale, aims, and objectives It is estimated that 25% of pregnancies worldwide end in induced abortion. In Romania, the abortion situation shows a specific pattern. Following the fall of the communist regime, first-trimester abortions were legalized, and between 1990 and 1992, the country's abortion rate was the highest in the world, with 182 abortions per 1000 women of reproductive age. However, there are currently no statistically reliable data, as some abortions are not reported. The purpose of this study was to identify the main circumstances that determine the choice to undergo abortion with all related potential risks, rather than using contraception. Method We conducted a prospective type 1 cohort study based on a Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement that included women who presented at Bucur Maternity, Saint John Hospital, Bucharest, for abortion during the first trimester, between July and December 2018. The patients were asked to complete a 21-item questionnaire based on psychosocial data. Results The study included 119 patients, with a mean age of 29.57 years. Their educational level was average (ie, 51.3%, 4.2%, and 8.4% had completed high school, elementary school, and college or university, respectively). Most women were married (46.2%), and 47.9% were unemployed. The main reason for deciding to undergo an abortion was poverty (P = .014), and guilt was correlated with this decision (P = .004). Conclusion The profiles of the women who chose to undergo an abortion as a family planning method were as follows: in the third decade of life, resident of urban areas, married, unemployed, and with a low family income. The main reasons for abortion were financial status, advanced maternal age, incompatibility of pregnancy with future plans, and the desire to postpone conception.

Objectives To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics. Methods A total of 6196 adults aged 35-44 years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self-reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self-reported need for treatment, dental pain in the last 6 months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate. Results Pardos and Blacks were 1.25 (95% CI 1.10-1.42) and 1.73 (95% CI 1.41-2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics. Conclusions Racial differences in dental service utilization were evident for middle-aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites.

Children exposed to multiple risk factors early in life are increasingly more likely to suffer from a host of cognitive impairments across development. However, little work has identified the neurobiological mechanisms linking early cumulative risk and cognitive functioning. The current study examined the impact of cumulative risk assessed during early childhood on neural and cognitive outcomes measured 3 years later when children were school-aged. Participants included 63 children assessed during preschool (age: M = 4.23 years, SD = 0.84) and 3 years later (age: M = 7.19 years, SD = 0.89). Early cumulative risk was defined by the presence of low family income, a single parent household, low parental education, child exposure to parental depression, child exposure to high parental hostility, and high levels of stressful life events. Children's exposure to stressors in the past year, cognitive abilities, and brain structure were assessed at follow-up. Early cumulative risk was prospectively associated with reduced total gray matter volume, cortex volume, right superior parietal and inferior parietal thickness, and poorer attention shifting and memory. Right superior parietal thickness mediated associations between early risk and recall memory. Results highlight neural variations associated with early cumulative risk and suggest potential neural pathways from early risk to later childhood cognitive impairments.

This study investigates whether children's preschool experiences are associated with later achievement via enhanced learning behaviors using data from a German longitudinal study following children (N = 554) from age 3 in preschool to age 8 in second grade. There were two main findings. First, results suggest that more positive learning behaviors at school entry mediate effects of teacher-child interactions in preschool on second-grade achievement. Second, these effects varied by parental socioeconomic status (SES) indicating that low-SES children benefited the most. The findings highlight the role of preschool classroom environments in shaping the school readiness of children with socioeconomic risk factors.

Background Several factors can influence the oral health. Aim To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). Design This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. Results For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (β = 0.382, β = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (β=-0.201). The higher the age of the C/A, the lower the NDT (β=-0.235), and the higher the family income the lower, the need for social benefit (β = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. Conclusions Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.

A vast literature has examined the impact of family income on the health and development outcomes of children. Income may improve child outcomes through two mechanisms. First, income may improve development outcomes if it improves a family’s ability to purchase direct inputs into child education and health production such as reading material, educational equipment, and health care. Second, by reducing stress and conflict, additional income helps to foster an environment more conducive to healthy child development, regardless of the nature of specific expenditures. In this paper, we exploit changes in refundable tax benefit income in Canada to study these questions. Importantly, our approach allows us to make stronger causal inferences than has been possible in existing studies. Using variation in child benefits across province, time, and family type, we study expenditure patterns of families receiving child benefits. Our findings suggest that additional income may improve outcomes through both mechanisms: some benefit income is spent on direct education and health inputs, while some is spent on everyday items likely to improve the general conditions children face. Additionally, some families reduce spending on risky behavior items. Spending responses to benefit generosity appear to vary by income.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Background Evidence on the possible influence of social and psychosocial factors on gingival status in socially disadvantaged children is scarce. The aim of this study is to assess the relationships among socioeconomic status, pattern of dental visits, self-esteem, oral health beliefs, toothbrushing frequency, oral hygiene effectiveness, and gingivitis in low social status adolescents. Methods A cross-sectional study was performed involving 406 12-year-old students recruited in Manaus, Brazil. Socioeconomic status (family income, parent's schooling, number of goods, and household crowding), self-esteem, oral health beliefs, and frequency of toothbrushing were collected through self-completed questionnaires. Gingival status (bleeding on probing) and oral hygiene effectiveness (dental calculus) were evaluated by calibrated dentists through oral examinations. Structural equation modeling assessed the direct and indirect relationships between variables guided by a theoretical model. Results The prevalence of gingivitis was 77.6%. Worse socioeconomic status and poor oral hygiene effectiveness directly predicted gingival bleeding. Socioeconomic status was also linked to toothbrushing frequency. Positive oral health beliefs and higher self-esteem predicted higher frequency of toothbrushing. The latter was directly linked to greater oral hygiene effectiveness. Oral health beliefs and self-esteem indirectly predicted gingival bleeding via toothbrushing frequency and oral hygiene effectiveness. Conclusion The present findings suggest the importance of socioeconomic status and psychosocial factors on gingival status in underprivileged adolescents. Poor oral hygiene mediated the associations between psychosocial factors and gingival status.

This study examined the association between grandparental co-residence and child academic and behavioral outcomes using a sample from Shanghai, China (n = 1,763), and was built on two theoretical perspectives: intergenerational solidarity theory and the contextual model of family stress. These models integrate the impact of residential and relational proximity to grandparents on child well-being and underscore the importance of family context. This study also explored the moderating effects of family resources using proxies that prior theoretical and empirical studies have found to be important to such associations: family income, parental education, hukou status, and subjective social status. Results indicated that among families without co-residing grandparents, rural and low-income parents reported their children to have more externalizing behavioral issues than their respective urban and non-low-income counterparts. In addition, children who resided in poorly resourced families (i.e., low family income, low parental education, low subjective social status, or rural hukou status) tended to benefit from living with grandparents compared to their well-resourced counterparts in terms of lower externalizing and internalizing behaviors reported by teachers. These results do not negate the potential beneficial effects of living with grandparents for children in well-resourced environments. Implications for practice and policy, as well as future research directions, are discussed.Este estudio analizó la asociación entre la convivencia con los abuelos y los resultados académicos y conductuales de los niños utilizando una muestra de Shanghái, China (n = 1,763) y se basó en dos perspectivas teóricas: la teoría de la solidaridad intergeneracional y el modelo contextual de estrés familiar. Estos modelos integran el efecto que tiene la proximidad residencial y relacional a los abuelos en el bienestar de los niños y subrayan la importancia del contexto familiar. Este estudio también analizó los efectos moderadores de los recursos familiares usando variables cuya importancia para dichas asociaciones ha sido comprobada por estudios teóricos y empíricos previos: ingresos familiares, educación de los padres, estado en el sistema de registro de hogares (hukou) y estatus social subjetivo. Los resultados indicaron que entre las familias sin abuelos convivientes, los padres de bajos recursos y de áreas rurales informaron que sus hijos tenían más problemas de conducta externalizante que sus respectivos pares de zonas urbanas que no eran de bajos recursos. Además, los niños que vivían en familias de escasos recursos (p. ej.: bajos ingresos familiares, bajo nivel educativo de los padres, bajo estatus social subjetivo, o estado en el sistema de registro de hogares rurales) tendieron a beneficiarse de vivir con los abuelos en comparación con sus pares de altos recursos en cuanto a menos comportamientos externalizantes e internalizantes informados por los maestros. Estos resultados no niegan los posibles efectos beneficiosos de vivir con los abuelos en el caso de los niños de entornos de altos recursos. Se debatieron las implicancias para la práctica y las políticas así como las futuras direcciones de las investigaciones.本文研究的是儿童在和祖辈共同生活情境下的学术成就和行为结果,样本来自中国上海 (n = 1,763)。本研究基于两个主要的理论视角即代际团结理论和家庭压力的结构模式。这些模式融合了祖辈在居住距离和人际关系两方面的亲近对孩童福祉的影响,强调家庭环境的重要性。本文还探究了各种家庭资源的调节作用,这些相关资源的重要性在以前的理论和实证研究中已经得到过论证。它们包括如下方面:家庭收入,父母受教育程度,户口的情况,和主观的社会地位。结果表明在没有和祖辈同住的家庭里,来自农村和低收入家庭的家长报告说和生活在城镇的较高收入的同龄孩子相比,他们的孩子有更多的外部行为问题。另外,老师方面的报告也指出,如果孩子所在家庭资源匮乏(例如收入偏低,父母教育程度偏低,主观社会地位偏低,或者持有农村户口),和祖辈生活在一起会和家庭资源充足的同龄孩子比起来外在和内化的行为问题要少一些。这些结果并不否定在资源条件充裕的环境下,和祖辈在一起生活有诸多潜在益处。本研究还指出了实践和政策层面的建议,也探讨了未来研究方向。.

OBJECTIVE To compare the levels of social support, physical function, and social-emotional function between oral cavity cancer survivors who did or did not resume work 6 months or longer after treatment completion. METHODS This cross-sectional study examined survivors of oral cavity cancer who were treated at the outpatient radiation department of a medical center in Northern Taiwan. Questionnaires were used to collect data regarding perceived social support, physical function, social-emotional function, and return to work status after treatment. Logistic regression was conducted to determine factors related to returning to work. RESULTS We examined 174 survivors of oral cavity cancer, 55.2% of whom returned to work after treatment. Relative to survivors who returned to work, those who did not return to work reported needing greater tangible social support, having fewer positive social interactions, having poorer physical function, and having poorer social-emotional function. Multivariable analysis indicated that younger age (OR = 0.864, P < .05), higher family income (OR = 10.835, P < .05), sufficient tangible social support (OR = 0.943, P < .05), positive social interaction (OR = 1.025, P < .05), and better physical function (OR = 1.062, P < .05) were significantly associated with the return to work. CONCLUSIONS Survivors of oral cavity cancer who did not return to work had worse physical and social-emotional function and required more tangible social support and positive social interactions. Providing occupational rehabilitation and counseling for oral cavity cancer survivors may help them return to work.

Introduction The main leading cause of the upper respiratory tract infections (URTIs) is viral infection. However, parental attitudes often lead to inappropriate prescription of antibiotics contributing to development of antibiotic resistance. The aim of this study is to assess parental knowledge, attitude, and practice (KAP) towards the use of antibiotics in Dubai and to reveal the associated factors. Method Questionnaires were distributed to 500 parents of children who were visiting Al Jalila Children's Specialty Hospital in Dubai. Result A total of 467 subjects agreed to participate in the study. Family income, educational level, nationality, age of the respondents, and numbers of children were identified as factors that significantly associated with inadequate knowledge, negative attitude, or malpractice. Conclusion The study has identified key factors associated with misuse of URTI antibiotics and highlights the importance of targeting those groups with intervention programs and campaigns to increase awareness and decrease misconception of antibiotic use.

BACKGROUND China accounts for approximately 27% of global cancer deaths. However, to the authors' knowledge, the lasting effects of cancer and cancer treatments on patients have not been investigated in China. The authors developed a questionnaire, the China Survey of Experiences with Cancer, for Chinese cancer survivors. This article introduces the study design and domains covered in the questionnaire. METHODS The Cancer Survivorship Supplement of the Medical Expenditure Panel Survey (MEPS) was used as a reference to develop the questionnaire. The final in-person surveys were conducted in 2015 and 2016. Samples were chosen through multistage sampling. The authors described the characteristics of the study participants and their cancer experiences. RESULTS At the time of last follow-up, a total of 1166 patients had completed at least 1 component of the survey. Approximately 59% of the cancer survivors were aged ≥60 years. Greater than one-half of the participants had an elementary education level or less (51%) and a yearly family income of

Background/aims Traumatic dental injuries (TDIs) stand out as one of the major public health problems worldwide, characterized by a high prevalence in children and adolescents. However, their association with the 15-19 years age group has not been fully described. The aim of this study was to evaluate TDIs in a population of Brazilian adolescents. Methods An association study was performed with 5558 adolescents attending the Sao Paulo State Oral Health Survey (SBSP-15). Individual predisposing variables (gender, age, schooling, ethnic, overjet, and molar relationship); contextual predisposing (city size and Municipal Human Development Index); individual enabling (per capita income and type of service used); contextual enabling (number of dentists, family health team coverage, and family median income); individual need (satisfaction and perception regarding treatment) and contextual needs (average supervised brushing, number of visits, and dental extractions per city), as well as health behaviors were analyzed. Andersen's behavioral model was used for the data analysis. A multilevel logistic regression with fixed effects was performed to calculate the odds ratio (OR), with 95% confidence interval (CI). Results The prevalence of TDIs in adolescents was 1.42% (95% CI: 0.94-2.13). Individual and contextual factors of need, predisposing factors, facilitators, and health behaviors were associated with TDIs. In the adjusted analysis, gender (OR = 0.32, 95% CI: 0.18-0.53), mean family income (OR = 2.52, 95% CI: 1.35-4.69), number of dental visits (OR = 0.40, 95% CI: 0.19-0.84), and time of last visit (OR = 2.64, 95% CI: 1.46-4.77) remained significant concerning trauma. Conclusion At least one variable of the individual and contextual predisposing, enabling, and need factors (except for individual enabling variables) were associated with dental trauma in Brazilian adolescents aged 15-19 years. This information may help with the planning of preventive actions and dental treatment, especially in mid-sized and large cities.

A central theme of acculturative specificity is the heterogeneity of the immigrant experience. This study integrated this application of the Specificity Principle with intergenerational transmission models of self-regulation and identified both common and specific pathways in the self-regulatory development of Chinese American children in immigrant families (N = 169, Mage = 9.2 years). Consistent with intergenerational transmission models, results indicated associations between parents' and children's effortful control, with the mediation of these associations via authoritarian parenting. Parental education, family income, and children's bilingual proficiency were also uniquely associated with children's executive function and effortful control. Together, findings provide new directions for research with ethnic minority immigrant families, and underscore the utility of within-group approaches in advancing research on ethnic minority children's development.

The aim of this study was to investigate associations of sociodemographic, lifestyle, medical conditions, and caries experience with oral health-related quality of life (OHRQoL) in a large sample of adults with mental disorders. A sample of 753 adults diagnosed with schizophrenia or depression, who were users of 10 public mental health outpatient clinics located in the city of São Paulo, Brazil, participated in the study. Participants provided data on sociodemographic characteristics, psychiatric diagnosis, medication use, and health behaviors. Oral examinations to evaluate dental caries (using the decayed, missing, and filled teeth ([DMFT] index) and dental plaque (using the Silness-Löe plaque index) were conducted. Oral health-related quality of life was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire. Log-Poisson regression was used to evaluate associations between the outcome and independent variables. The prevalence of one or more OHIP-14 impacts occurring fairly often/often was 72.3%. Physical pain was the OHIP domain with the highest prevalence, followed by psychological discomfort. Multivariable analysis showed that higher prevalence of the reponses 'fairly often/often' in the OHIP-14 was associated with being female, aged 35 to 54 years, having a low family income, a diagnosis of depression, a smoking habit, and fewer than 20 teeth. Adults with mental disorders had a high prevalence of impacts on their OHRQoL, which were associated with caries experience, sociodemographic characteristics, type of psychiatric diagnosis, and behavioral risk indicators.

Natural disasters have detrimental effects not only on local infrastructure in an affected population but may also have an impact on the human biological condition, particularly during critical periods of life. This study aimed to assess the nutritional and weight status of women and their children who had experienced cyclone Aila prenatally and postnatally in comparison with a non‐affected neighbouring group. The study sample involved N = 597 dyads consisting of mothers and their prepubertal children prenatally or postnatally (during infancy) exposed to a natural disaster and a control group from a neighbouring region (West Bengal, India). The analysed anthropometric indices involved body mass index (BMI) and mid‐upper arm circumference (MUAC). Moreover, several socioeconomic characteristics were collected (mother's and father's education, family size and family income). Analyses revealed that the group factor (Aila‐exposed or non‐exposed groups) had the highest impact on both children's and their mothers' BMI and MUAC (p

This study examines whether associations between enrollment in public and non-public PreK and children's (N = 508; Mage = 5.60 years in fall of kindergarten) math and language and literacy outcomes were more likely to be sustained through the spring of kindergarten for unconstrained versus constrained skills. Associations between public PreK and language, literacy, and math outcomes were more strongly sustained through the spring of kindergarten for unconstrained skills, relative to constrained skills. Only associations between non-public PreK and unconstrained language skills were sustained through the spring of kindergarten. Associations in the fall of kindergarten differed by family income and dual language learner (DLL) status but there was no subgroup variation by the spring of kindergarten. Implications for policy and practice are discussed.