Family Survey Research Articles

Early milk cereal drink consumption correlated with rapid weight gain but not with subsequent adiposity.

The role of infant nutrition in rapid weight gain (RWG) is not well understood. This study investigated associations between milk cereal drinks, early RWG, and later body mass index (BMI) and waist-to-height ratio (WHtR). In total, 1333 children, from three communities in Western Sweden constituted the combined IDEFICS-I. Family cohort. Data were obtained retrospectively from the National Medical Birth Register, child health centres and school health services. Anthropometric data and parental reported food habits were collected in the 2007-2008 IDEFICS baseline survey. Follow-up data for 656 children were collected in the 2013-2014 I. Family survey. Linear and logistic regressions were used. At baseline, 820 (62%) of the 658 boys and 675 girls, median age 6.0 years, interquartile range 4.0-7.5 years, consumed milk cereal drinks and 229 (18%) had early RWG. Milk cereal drinks were associated with early RWG without effects on later BMI or WHtR status 6 years later. Early RWG was predictive of higher anthropometric measures later in childhood, particularly abdominal adiposity. Despite early-life correlations between RWG and milk cereal drinks, this study could not demonstrate a long-term detrimental association between milk cereal drinks and BMI or WHtR.

Influenza knowledge and barriers to vaccination in immunosuppressed patients in the pediatric rheumatology clinic

BackgroundMost patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.MethodsPatients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020. Survey questions assessed demographics, rheumatology diagnosis, immunosuppressive medication(s), influenza vaccination recommendation, patient/parent influenza knowledge, and barriers to influenza vaccination. Influenza vaccination rates for immunosuppressed patients were acquired each influenza season from 2015–2020 and tracked on a control chart.ResultsOf the 226 completed surveys, 145 (64.2%) were completed by parents and 81 (35.8%) by patients. The majority (85%) reported the influenza vaccine was recommended. The most common reasons for not receiving the influenza vaccine included: worry about disease flare (25.6%), concern the vaccine will cause influenza (25.6%), and lack of vaccine effectiveness (20.5%). Parents (40.9%) were more worried about disease flare compared to patients (17%; p = 0.024). Most respondents were able to correctly answer fever, cough and/or congestion as the most common symptoms of influenza; however, 23% answered gastrointestinal symptoms and 10.2% joint swelling. Most respondents (95.1%) were aware that immunosuppressive medication increases risk of infection. The average weekly influenza vaccination rate for the 2019–2020 flu season was 85.5%, which increased from 72.0% the previous year. Parents with higher education status were more likely to have their child receive the influenza vaccine compared to parents with less education.ConclusionsThis survey indicates that respondents understand the potential severity of influenza and the increased risk of infection due to immunosuppressive medication use; however, many inaccurately identified the most common symptoms of influenza and also reported misconceptions of influenza vaccine risks. The barriers identified in this survey will help drive future improvement efforts to increase influenza vaccination rates in this high-risk population.

Pain Outcomes Among Medical Centers With High vs Low Specialist Palliative Care Reach Among People With Heart Failure.

Background: Pain affects more than 60% of people with heart failure (HF), with increasing frequency and severity towards the end of life (EOL). We examined if family-rated pain near EOL was associated with rates of specialist palliative care (SPC) among patients with HF. Methods: We conducted a retrospective cohort study among 1095 decedents with advanced HF (aHF = ≥2 hospitalizations) from 83 Veterans Affairs Medical Centers (VAMCs) between 2018-2020. We used multilevel logistic regression to derive facility rates of predicted SPC for each VAMC adjusting for demographic and clinical characteristics. We examined associations between VAMCs in the top 20% (vs bottom 80%) of SPC rates and family-reported pain at the EOL from the Bereaved Family Survey and the interaction between receiving SPC and VAMC-level SPC rates on study outcomes. Analyses were conducted using generalized linear models, adjusting for demographic, clinical, and facility covariates. Results: The sample was 98% male, 73% White, and 20% Black, with a mean age of 79.7+/-10.3years. Over 77% of the sample had uncontrolled pain at the EOL. In adjusted models, there was no association between family-reported pain and VAMC rates of SPC (Odds Ratio = 1.082, 95% Confidence Interval = 0.706-1.659). Receipt of SPC did not change this relationship (p-interaction = .405). Conclusion: Families of people with aHF cared for in VAMCs with high rates of SPC were as likely to report uncontrolled pain relative to people cared for in VAMCs with lower SPC rates. Research is needed to identify delivery and organizational features associated with improved pain control at the EOL among this symptomatic population.

The Association between Parenting Burden and Depression Symptoms Dual-earner Women: The Korean Longitudinal Survey of Women and Family 2019-2020

Objectives: The purpose of this study was to investigate the parenting burden and depression symptoms relationship between dual-earner women. Methods: A total of 1,023 dual-earner women were selected from the 8th Female Family Panel Longitudinal Survey (KLoWF) database. Parenting burden, depression symptoms characteristics were calculated based on responses from KLoWF. Univariate and multicariate analyses were performed to evaluate crude and coordinated associations using PASW 18.0. Results: There was an independently positive association between depression symptoms between parenting burden (b=0.40, <i>p</i>=0.002), spouse dgree of household-labor (2-3 days a week: b=0.91, <i>p</i>=0.036; 4-5 days a week b=1.76, <i>p</i>=0.010) and association between parenting burden and depression symptoms. And negative association between perceived health state (b=-0.80, <i>p</i>=0.001), the impact of work on family life (disagree: b=-0.27, <i>p</i>=0.008; agree: b=-1.54, <i>p</i>=0.004), marital satisfaction (b=-0.33, <i>p</i><0.001) and between parenting burden and depression symptoms. Conclusions: This study suggests parenting burdens and depressive symptoms in dual-income women. The findings of this study can help policymakers develop strategies to improve parenting and working conditions.

Caste disparities and affirmative action in India

Abstract This paper uses data from the National Family and Health Survey (NFHS) for India for 2019–21 to present estimates of contemporary caste gaps in education, occupational distribution, and wealth between three broad groups: Scheduled Castes–Scheduled Tribes (SC–ST), Other Backward Classes (OBCs), and Others, the latter being a proxy for higher-ranked castes and communities. We find the caste gaps continue to be significant, indicating the persistence of the traditional caste hierarchy. We then assess how these gaps have evolved since the previous round of NFHS (2015–16). We find convergence in asset ownership between OBCs and Others. Finally, using a difference-in-differences estimator, we identify the direct impact of the extension of reservations in the arena of tertiary education in 2006 to the OBCs. We find a positive impact on the probability of acquiring tertiary education in the treated cohorts of OBCs.

Better end-of-life care in surgical patients: Veterans Affairs Bereaved Family Survey – a qualitative analysis

BackgroundEnd-of-life care among surgical patients is largely understudied and far fewer studies examine such care from the family perspective. To identify potential opportunities for improvement, we explored responses of family...

Simulation-based survey of TMEM16 family reveals that robust lipid scrambling requires an open groove.

Biological membranes are complex and dynamic structures with different populations of lipids in their inner and outer leaflets. The Ca 2+ -activated TMEM16 family of membrane proteins plays an important role in collapsing this asymmetric lipid distribution by spontaneously, and bidirectionally, scrambling phospholipids between the two leaflets, which can initiate signaling and alter the physical properties of the membrane. While evidence shows that lipid scrambling can occur via an open hydrophilic pathway ("groove") that spans the membrane, it remains unclear if all family members facilitate lipid movement in this manner. Here we present a comprehensive computational study of lipid scrambling by all TMEM16 members with experimentally solved structures. We performed coarse-grained molecular dynamics (MD) simulations of 27 structures from five different family members solved under activating and non-activating conditions, and we captured over 700 scrambling events in aggregate. This enabled us to directly compare scrambling rates, mechanisms, and protein-lipid interactions for fungal and mammalian TMEM16s, in both open (Ca 2+ -bound) and closed (Ca 2+ -free) conformations with statistical rigor. We show that all TMEM16 structures thin the membrane and that the majority of (>90%) scrambling occurs at the groove only when TM4 and TM6 have sufficiently separated. Surprisingly, we also observed 60 scrambling events that occurred outside the canonical groove, over 90% of which took place at the dimer-dimer interface in mammalian TMEM16s. This new site suggests an alternative mechanism for lipid scrambling in the absence of an open groove.

Impact of an Inpatient Social Needs Screening Program: Did Our Referral Resolve Your Need?

To evaluate the effectiveness of social resource referrals after social needs screening among caregivers of pediatric inpatients by assessing (1) the rates of resource connection, (2) caregiver perception of resource helpfulness, (3) barriers to connection, and (4) resolution of needs. We conducted a cross-sectional survey of families discharged from our pediatric inpatient floor between October 2021 and June 2022 who had screened positive for unmet social needs and received a referral to at least 1 community resource during their hospitalization. We surveyed caregivers by telephone 1 month to 1 year post-intervention, inquiring about their perception of and experience with referrals. We compared responses across groups using χ2 tests. Multivariable logistic regression was used to predict the likelihood of resource connection based on race, ethnicity, language, and insurance type. Of 361 families that screened positive for social needs and received a referral, 219 (61%) completed surveys. A total of 50.2% (110/219) of caregivers connected to at least 1 community resource, and 30.6% (67/219) connected to all referrals. Of 515 referrals, 315 (61.2%) did not result in resource connection. The most frequent barrier was families not recalling receiving the referral (44.8%, 141/315). Of 200 referrals that resulted in resource connection, 152 (76%) were helpful and 120 (60%) resolved the need. Non-Hispanic or Latino ethnicity predicted connection to resources. Screening hospitalized children for social needs can result in meaningful resource connections. In our population, language, race, and insurance did not impact connection to resources. However, two-thirds of referrals did not result in resource connection.

Activating the resources of families raising children with autism spectrum disorders

Introduction. Modern family resources in terms of supporting children with autism spectrum disorders are increasingly becoming a subject of discourse at the level of interdepartmental and intersectoral cooperation. At the same time, a large-scale investigation of parental expertise and inclusiveness as basic family resources is required. Metaprofessional qualities of parents’ personality, being a backbone characteristic, are considered as a component of their expertise and inclusiveness. The aim of the article is the analysis of deficiencies and potentialities of families raising children with autism spectrum disorders in terms of personal metaprofessional competence. Materials and methods. The study covered 160 families raising children with autism spectrum disorders and 164 assisting experts. The diagnostic material was grounded on the basic data obtained through the results of parents’ completion of a special document “Personal Card” and following the survey of families and specialists entrusted with upbringing, education, psychological and pedagogical support of children with autism spectrum disorders (the section for assessing the educative competencies group in the structure of the author’s questionnaires: “Self-assessment of parental inclusiveness” and “Expert assessment of inclusive potential”). The significance of the obtained results was evaluated through the analysis of contingency tables based on Pearson’s chi-squared test. Results. The quantitative/qualitative characterisation of resources of families raising children with autism spectrum disorders was derived, demonstrating parental expertise and inclusiveness. The relationship between the category of children and the level of education was established, which level is higher in parents bringing up children with autism spectrum disorders (χ2 = 14.655; p=0.006); in addition, significant differences in professional employment of parents bringing up children with autism spectrum disorders, mental retardation and visual impairment were established. Some differences in the extent of satisfaction with the quality and nature of assistance received by the parents were identified (χ2 = 8.433; p<0.05). The parents of children with autism spectrum disorders, unlike control groups, preferred private educational centres as the main sources of help, support and assistance. The survey established a pronounced deficit of active and effective participation of the second parent, grandparents and people from the immediate environment in the upbringing of a child (more than 26% of the respondents). The shortcomings in the mastery of special methods and techniques of interaction with a child with autism spectrum disorders were highlighted, as well as the lack of a unified, effective and sustainable system of stimulating and encouraging a child within the family. Conclusion. The obtained results are significant for further comprehensive elaboration and comprehension of the inclusive potential of families raising children with autism spectrum disorders. The most important guideline is the adoption of metaprofessional solutions designed to significantly complement the existing applied methods within the framework of realising the strategy for comprehensive support of persons with autism spectrum disorders, their parents and the immediate environment.

Systematic Analysis of Cinnamyl Alcohol Dehydrogenase Family in Cassava and Validation of MeCAD13 and MeCAD28 in Lignin Synthesis and Postharvest Physiological Deterioration.

Cassava (Manihot esculenta Crantz) is used as a biomass energy material and an effective supplement for food and feed. Cinnamyl alcohol dehydrogenase (CAD) catalyzes the final step of lignin biosynthesis and is responsible for various stresses. However, systematic investigations of the CAD gene family in cassava have been poorly understood. In this study, a genome-wide survey and bioinformatics analysis of CAD gene family was performed, transcriptomics, qRT-PCR, gene silencing and stress of yeast cell were used for excavate and validate the candidate MeCADs gene. 36 MeCADs genes unevenly distributed across 12 chromosomes were identified. Through phylogenetic analyses alongside their Arabidopsis counterparts, these MeCADs were divided into four groups, each containing a similar structure and conserved motifs. Interestingly, transcriptome data analysis revealed that 32 MeCAD genes were involved in the postharvest physiological deterioration (PPD) process, whereas 27 MeCAD genes showed significant changes. Additionally, the relative quantitative analysis of 6 MeCAD genes demonstrated that they were sensitive to PPD, suggesting that they may be involved in the regulation of PPD. Silencing MeCAD13 and MeCAD28 further showed that lignin content significantly decreased in the leaves. The wound-stress tolerance of transgenic yeast cells was enhanced after transformation with MeCAD13 and MeCAD28. MeCAD13 and MeCAD28 may play positive roles in lignin biosynthesis and PPD response, respectively. These results provided a systematic functional analysis of MeCADs in cassava and paved a new way to genetically modify lignin biosynthesis and PPD tolerance.

Health disparities continue to report in DEIS schools: Irish COSI Round 6 study

Abstract Background Previous reports have identified clear differences in the prevalence of overweight and obesity among children living with disadvantaged compared to those living in advantaged circumstances. Childhood obesity is influenced by factors in the home environment, including lifestyle behaviours and socio-economic status. The Childhood Obesity Surveillance Initiative (COSI) family survey provides insights into these factors, particularly in children that attend disadvantaged (DEIS) and non-disadvantaged (non-DEIS) schools. Aim This study aims to compare various demographic and socioeconomic factors within the home environment of primary school children across DEIS and non-DEIS schools in Ireland, elucidating the differences in their performance with implications for health policy. Methods Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on demographics, diet, transportation, activities, and clinical characteristics of children in Ireland were collected, anonymised and analysed in SPSS, comparing children from DEIS (n = 147) and non-DEIS (n = 1014) schools. Results Around 88% of respondents of returned surveys included in the study (n = 1161) were mothers. Significant disparity in families with diabetes diagnosis or treatment observed between DEIS and non-DEIS schools (10.6% vs. 5.4%, p = 0.016). Breastfeeding rates were higher in non-DEIS schools (57.0% vs. 46.9%, p = 0.015). Children consuming at least 3 portions of fruits and vegetables daily were also higher in non-DEIS schools (58.9% vs. 46.0%, p < 0.001). More children in non-DEIS schools engaged in physical activities outside of school hours (93.7% vs. 74.5%, p < 0.001). Conclusions The findings underscore the significant socioeconomic disparities between families whose children attend DEIS and non-DEIS schools in Ireland. Key messages • Irish COSI R6 reveals disparities in health-related factors between disadvantaged and advantaged schools. • Targeted interventions and policies are necessary to address factors influencing child health.

Disparities in Breastfeeding Patterns Persist Despite Improved Rates: Findings from Irish COSI R6

Abstract Background Breastfeeding is crucial for reducing childhood obesity, recommended exclusively for 6 months by World Health Organisation (WHO). Previous reports have highlighted disparities in breastfeeding patterns between Irish and non-Irish mothers. The Irish Childhood Obesity Surveillance Initiative (COSI) family survey offers insights into breastfeeding rates and patterns in Ireland and their differences between Irish and non-Irish mothers. Aims This study aims to compare the breastfeeding rates in Ireland between COSI Round 6 (R6) and COSI R5, elucidating the differences between Irish and non-Irish mothers. Additionally, it aims to establish the association between breastfeeding pattern and socio-economic factors involved in the Irish households. Methods Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on breastfeeding rates and pattern were collected, anonymised, and analysed using SPSS version 29. Results Around 88% of respondents were mothers. The number of children breastfed for at least a month increased in R6 (55.7%) compared to R5 (45.6%). The mean duration of exclusive breastfeeding increased to 5.86 months in R6 from 4.91 months in R5, in line with WHO recommendations. Significant disparities were found in breastfeeding patterns, with higher rates among non-Irish mothers (67.8%) compared to Irish mothers (52.6%) (p < 0.001). Linear regression showed a significant association between breastfeeding duration and maternal birth country. Irish mothers exhibited a negative coefficient (b1=-2.442; 95% CI -4.1 to -0.8; p = 0.004), suggesting shorter breastfeeding durations compared to non-Irish mothers. Conclusions Breastfeeding rates improved in COSI R6 compared to R5. There are significant disparities in breastfeeding pattern between Irish and non-Irish mothers. Key messages • Improved breastfeeding rates indicate good feeding practices in Ireland. • Targeted interventions and policies are necessary to address the disparities between Irish and non-Irish mothers in breastfeeding patterns.

Influence of socio-economic factors on obstetric morbidity in Eastern India: A study based on NFHS 5

Abstract Background Obstetric morbidity encompasses health issues related to pregnancy or childbirth, excluding accidental causes. The whole process of childbearing is not just a biological phenomenon, rather it is governed by personal, social, cultural, and institutional factors. The entire eastern region of India including the four provinces of Bihar, Jharkhand, Odisha, and West Bengal is susceptible to high maternal mortality and morbidity. It presents a strong background to further envisage the factors responsible for such situation. Thus, the study aims to explore regional variations and socio-economic factors associated with obstetric morbidity among women in eastern India. Methods This study uses data from the 2019-2021 National Family and Health Survey (NFHS 5). The explanatory variable, obstetric morbidity, includes issues during pregnancy and delivery- vision difficulties, bleeding, swelling, convulsions, fever, breech presentation, and prolonged labor. Predictor variables include age, age at marriage and first birth, wealth index, residence, toilet facility, caste, working status, media exposure, religion, birth order, and education level. Bivariate and binary logistic regression analyses have been used as a methodological tool. Results In the eastern region, 53.76% women experience obstetric issues. Women belonging to 15-24 years with higher educational attainment increases the prevalence of obstetric morbidity. The probable reason is, with education, awareness about reproductive morbidity increases and in turn the reporting for morbidity increases. Therefore, the findings showed age, educational attainment, wealth quintile, media exposure, residence, work status, birth order and toilet facilities are highly associated with obstetric morbidity among women. Conclusions Implementing of targeted interventions, and awareness campaigns are crucial to reducing obstetric complications and maternal mortality in the eastern region of India Key messages • Socioeconomic correlates impact obstetric morbidity in eastern India in manifolds especially education, age, and wealth quintile of women in eastern India. • Obstetric morbidity is a growing concern in eastern India, thus implementing targeted interventions and awareness campaigns are much needed.

The impact of the COVID-19 pandemic on physical activity among primary school children in Ireland

Abstract Background The containment measures implemented during COVID-19 to curb the virus’s spread disrupted family life globally and profoundly impacted children’s daily behaviours. A decrease in children’s physical activity during COVID-19 is one such health behaviour change that was observed in many European countries. This study aimed to understand the pandemic’s impact on primary school children’s physical activity in Ireland which is important given the epidemic of childhood obesity and chronic diseases in the long term. Methods All Childhood Obesity Surveillance Initiative (COSI) participating countries (n = 45) could voluntarily implement the COVID study as part of their COSI Round 6 (R6) data collection or separately. The parents of First and Second-class primary school children (n = 2,784) who consented to participate in COSI-Ireland R6 were invited to complete the family survey which included the standardised COVID study. The COVID module assessed children’s lifestyles and health behaviours before and during the pandemic through 12 questions. Consenting parents supplied their email or postal address and completed the survey in hardcopy or electronically using LimeSurvey. Descriptive statistics were then calculated on the cleaned pseudonymised dataset (n = 1,060) using IBM SPSS Statistics 27. Results The time spent playing actively outside school hours remained the same for some children on both weekdays and weekends (24.2% and 37.1%, respectively). An increase rather than a decrease in the time spent in active play was also observed among almost twice as many children across Ireland on both weekdays (47.3% and 24.2% respectively), and weekends (40.10% and 21.80% respectively). Conclusions The positive findings show that the public health messaging from the Irish Government which emphasized the importance of staying active during COVID-19 may have been effective. Further research to assess children’s physical activity during COVID-19 is warranted to inform future pandemics. Key messages • In Ireland, unlike in many European countries, a substantial number of primary school children increased their time spent playing actively during the COVID-19 pandemic. • A unique trend in Irish children’s physical activity levels compared to their European counterparts.

Regional patterns in minimum diet diversity failure and associated factors among children aged 6-23 months in India.

Background About 35% of the global child deaths and 11% of the total disease burden are due to inadequate nutrition. While in India, 1 in 3 children are underweight and stunted, and 1 in 5 children are wasted. Methods Using multivariate and descriptive statistical analysis, we examined the prevalence, determinants of minimum diet diversity failure (MDDF) and trends of MDDF across different regions of India among children aged 6-23 months. Dietary pattern in 8 food groups was also examined using the National Family and Health Survey (NFHS) data from 2005-06 to 2019-21. Results Overall, MDDF in India has decreased from 87.4% (2005-06) to 77.1% (2019-21). The central region (84.6%) reported the highest prevalence of MDDF in 2019-21. Children of illiterate and rural residing mothers with no mass media exposure, children of the first birth order and children not exposed to counselling and health check-ups at Anganwadi/Integrated Child Development Services (ICDS) centres, children with low birth weight and anaemic, and who belonged to a large family had greater likelihood for MDDF. Conclusion To tackle the high prevalence of MDDF, a holistic action is needed from the government, i.e. improved public distribution system (PDS), intensified Integrated Child Development Scheme (ICDS) programme, use of social media, and nutrition counselling through local self-governance.

Genetic heterogeneity in autosomal recessive hearing loss: a survey of Brazilian families.

Hearing loss is a frequent sensory impairment type in humans, with about 50% of prelingual cases being attributed to genetic factors. Autosomal recessive hearing loss (ARHL) exhibits great locus heterogeneity and is responsible for 70%-80% of hereditary nonsyndromic cases. A total of 90 unrelated Brazilian individuals were selected for having hearing loss of presumably autosomal recessive inheritance, either born from consanguineous marriages or belonging to families with two or more affected individuals in the sibship and most cases were of normal hearing parents. In all cases, common pathogenic variants in GJB2 (c.35delG), GJB6 [del(GJB6-D13S1830) and del(GJB6-D13S1854)] and MT-RNR1 (m.1555A>G) were discarded and most were previously assessed by complete Sanger sequencing of GJB2. Their genetic material was analyzed through next-generation sequencing, targeting 99 hearing loss-related genes and/or whole exome sequencing. In 32 of the 90 probands (36,7%) causative variants were identified, with autosomal recessive inheritance confirmed in all, except for two cases due to dominant variants (SIX1 and P2RX2). Thirty-nine different causative variants were found in 24 different known hearing loss-associated genes, among which 10 variants are novel, indicating wide genetic heterogeneity in the sample, after exclusion of common pathogenic variants. Despite the genetic heterogeneity, some genes showed greater contribution: GJB2, CDH23, MYO15A, OTOF, and USH2A. The present results confirmed that next-generation sequencing is an effective tool for identifying causative variants in autosomal recessive hearing loss. To our knowledge, this is the first report of next-generation sequencing being applied to a large cohort of pedigrees with presumable autosomal recessive hearing loss in Brazil and South America.

Gender inequality in intergenerational contact after parental separation in the digital era

AbstractObjectiveThe goal of this brief report is to analyze parent‐adult child contact frequency in intact and non‐intact families by focusing on parent and child gender and the type of contact.BackgroundParental separation increases gender differences in parent–child relationships, with separated fathers having less frequent contact with their adult children compared to separated mothers. We investigate whether the father–mother gap in post‐separation contact varies according to parent–child gender mismatch and the type of contact, that is, face‐to‐face, phone, or digital (e.g., via video calls).MethodWe use data on Italian families from the Family and Social Subjects survey to examine parent–child contact frequency among 6770 adult children aged 30–55 (11,041 parent–child dyads). We estimate random and fixed effects models on the probability of having frequent contact with biological parents in intact and non‐intact families (parental separation before age 18).ResultsFathers' reduced contact frequency compared to mothers is particularly evident with daughters, more pronounced in face‐to‐face and phone contact than in digital contact, and greater among younger daughters at the time of separation. Gender differences in phone and digital contact are larger for fathers who have also less frequent face‐to‐face contact compared to mothers.ConclusionWe interpret these findings by focusing on the centrality of mother–daughter ties and the loyalty that children have with the same‐gender parent. We also suggest that different types of contact reinforce gender differences between parents and may lead to a polarization of older parents with “strong” and “weak” family ties.

Factors associated with under-five mortality in Scheduled Tribes in India: An analysis of national family health survey-5 (2019-2021).

Background & objectives Under-five mortality is high among the Scheduled Tribes (ST) in India compared with the general population. This study examined the association of different maternal, child, socio demographic, and household factors associated with under-five mortality among Scheduled Tribes in India. Methods Data from the National Family and Health Survey (NFHS)-5 (2019-2021) for the ST, across all Indian States and Union Territories were used for analyses. Binary and multivariate logistic regression were performed to identify the association of maternal, child, socio-demographic, and household factors with under-five mortality among the ST population. Results Different maternal, child, socio demographic, and household factors were significantly associated with under-five mortality. The odds of under-five mortality were highest among women who gave birth to their children at home [Adjusted odds ratio (AOR): 1.42; 95% confidence interval (CI): 1.268-1.59] as compared with women who gave birth at institution. Literate women have lesser odds of under-five mortality than women with no formal education (AOR: 0.666; 95% CI: 0.501-0.885). The risk of under-five mortality was higher among four or more birth order children (AOR: 1.422; 95% CI: 1.246-1.624) compared with the first to third birth order children. The odds of under-five mortality decreased among children with a rich wealth index (AOR: 0.742; 95% CI: 0.592-0.93) compared to children with a poor wealth index. Interpretation & conclusions Analyses of under-five mortality among ST in India showed a significant association between different maternal, child, sociodemographic, and household factors. Grass-roots-level interventions such as promoting female education, addressing vast wealth differentials, and providing family planning services with a focus on reducing under-five mortality are essential in improving the survival of under-five children among the ST population in India.

Barriers in Accessing Orthodontic Care for Patients with Orofacial Clefts: Insights from a Florida-Based Survey and National Database Analysis.

To assess the barriers to obtaining care for patients with orofacial clefts through a survey of Florida-based orthodontists and families and an analysis of the Pediatric Health Information System (PHIS) database. A cross-sectional study utilizing multiple-choice questionnaires completed by Florida orthodontists and caregivers of patients who attended a Florida-based cleft and craniofacial clinic. Additionally, data from the PHIS database were analyzed to investigate national factors affecting the age of alveolar bone grafting (ABG). Craniofacial team in Florida. The survey included 39 orthodontists (7.1% response rate) and 48 caregivers (41% response rate) The PHIS study included 1182 patients. Barrier to orthodontic care and age of ABG. Orthodontic Survey: Among the surveyed orthodontists, 71% treated cleft/craniofacial patients, 37% accepted Medicaid, and 55% provided pro-bono care. Poor reimbursement was identified as the most common barrier (58%). Caregiver Survey: Most patients were insured by Medicaid (67%), with 55% incurring out-of-pocket expenses. PHIS Database: The average age of ABG was 10.3 years (SD = 3.2). Government funding was associated with a 6.0-month delay in ABG (p = 0.047) and residing in non-Medicaid expanded states was linked to a 6.0-month delay (p = 0.023). Post-Medicaid expansion status was also associated with a delay (p = 0.004). Access to oral care is difficult for patients with OFC. Despite both federal and state mandates, many financial and non-financial barriers still exist in accessing orthodontic care and a majority of patients experience significant out-of-pocket expenses despite statutorily mandated insurance coverage.

Survey of families’ psychosocial needs in the context of pediatric cancer: a first step toward the participatory development of a group intervention

Background Pediatric cancer is associated with stressors that increase the risk for distress across family members. Psychosocial support varies and may not meet family needs and preferences. This study investigated family members’ points of view regarding psychosocial service needs, as a first step of a large participative research project aiming to develop interventions grounded in key stakeholders’ perspectives. Methods This study documented the perceptions of 370 parents, 11 siblings, and 60 individuals who themselves had received a cancer diagnosis as a child and employed a mixed-methods design through an online survey. Results Respondents indicated their key concerns were coping with intense emotions, accepting their feelings toward the diagnosis, and managing the psychological burden that accompanies cancer, its treatment, and associated life changes. Conclusion The results suggest that an intervention program should address emotion management as well as interventions focusing on the entire family system.