Low Socioeconomic Families Research Articles

Perceptions of preschoolers and parents on forest pollution

IntroductionAn examination of preschool children’s perceptions and attitudes towards the environment and forests has recently been conducted. However, little research has focused on preschool children’s and their parents’ perceptions of clean and dirty forests. Investigating these perceptions is essential to increase children’s interest in and sensitivity to the environment, thereby fostering their development as responsible individuals who protect the natural world.MethodsThis study aimed to address this knowledge gap by examining the perceptions of clean and dirty forests held by 40 5–6-year-old students and 40 parents, randomly selected from two preschools: one attended by children from high socioeconomic families and the other by children from low socioeconomic families, in a Mediterranean coastal city in southwestern Turkey. A semi-structured questionnaire was used to collect sociodemographic information and perceptions of clean and dirty forests. Additionally, drawing sheets were distributed to the students to illustrate their concepts of clean and dirty forests.ResultsThe results indicated that individuals with higher educational levels had more complex and conscious perceptions of clean forests. Children considered abstract concepts, such as supernatural forces and fossil fuels, while parents focused on awareness and conservation status. Conversely, parents and children with lower levels of education tended to concentrate on more concrete and everyday factors, such as litter and natural disasters. Individuals with higher socioeconomic status generally associated forest cleanliness with conscious behaviors and conservation, whereas those with lower socioeconomic status linked it more with polluting factors.DiscussionThis investigation provides valuable insights into the management and control of local forests by incorporating the perspectives of children and their parents, promoting responsible and sustainable tourism practices.

Obstetric Outcome and its Relationship with Mode of Delivery in Preterm Labour- A Study of 86 Patients in Combined Military Hospital, Dhaka

Background: Caesarean section in preterm pregnancy may add further pressure to the already existing poorly developed facilities for intensive perinatal care in low resource countries. The objective of the study was to determine the feto-maternal outcome and its relationship with mode of delivery in preterm labour. Methods: This was a descriptive type of cross-sectional study conducted at Department of Obstetrics and Gynecology, Combined Military Hospital (CMH), Dhaka, during March to August 20l8. The study population was total eighty-six patients having 28 to 36 weeks of gestation who were admitted in the above department and were in labour. Data were edited and analyzed by using computer-based software, statistical package for social sciences (SPSS) version 20.0. Results: Majority of the patients belonged to 26-30 years age group and were from low socioeconomic family (71.4 to 72.7) % and had below average nutritional status (88.1 to 93.2) %. The mean gestational age was 31 weeks and 35 weeks. Nulliparous (77.3 to 85.7) % and patients taking irregular antenatal check-up (69.0 to 72.8) % were predominant. About (59.1 to 66.7) % patients had vaginal delivery and (33.3 to 40.9) % patients had undergone caesarean section. Maternal morbidity was more in caesarean section (37.5%) than vaginal delivery (33.3%). Live birth babies were found 100% in caesarean section and 94.4% in vaginal delivery and among them 95.7% were from group I and 97.6% were from group ll. Perinatal mortality was higher in vaginal delivery than caesarean section (7.40% vs 2.7%) and also higher in group I than group ll (8.3% vs 2.3%). But late perinatal complications were more in caesarean section (47.2%) than vaginal delivery (45.1%) baby, and majority (60%) of them were from group l. Conclusion: Preterm pregnancy when leads to an early delivery, brings a grave consequence for both the mother and foetus. After birth, the premature newborn is at risk for complications related to incomplete development of its organ system. Caesarean section delivery in preterm labour improves foetal outcome to some extent, but not significantly, and leads the mother to more maternal morbidity. Perinatal mortality and morbidity is also inversely related to the gestational age at the time of delivery, in preterm labour - more the gestational age, less the perinatal mortality and morbidity. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 43-49

Zoom to the Virtual Room: The Shift to Remote Early Childhood Observational Assessments.

The COVID-19 pandemic has led prevention researchers to increasingly use remote observational procedures given social distancing directives associated with the pandemic. However, few studies have used remote observational procedures with children and their caregivers, with scant literature describing procedures with socioeconomically, racially, and ethnically diverse families. This manuscript describes processes to pivot to remote assessment of parent and child observations in the context of a longitudinal study examining the effects of a postpartum depression preventive intervention on responsive parenting and child self-regulation. We conducted remote assessments across three timepoints-42, 48, and 54 months-with 133 low-income and racially and ethnically diverse parent-child dyads. Details are provided on remote observation preparation and setup, as well as adaptation of observational assessments. Lessons learned are shared on the use of technology, scheduling considerations, parent's role as facilitator, maintaining child engagement, and cost considerations. We demonstrated excellent inter-rater reliability between independent coders on all assessments, suggesting the quality of remote assessments was conducive for analysis. Surveys with families completing a remote assessment found that most felt it was easy to participate in remote assessments and their child had a positive experience. Most parents preferred virtual visits if given an option for future assessments. Much prevention research utilizes observational measures that are less subject to bias. Our study demonstrated that research teams can effectively and reliably pivot to remote assessment with racially and ethnically diverse, low socioeconomic families, thereby providing guidance to other prevention researchers considering similar remote assessments with diverse samples.

Self-Esteem Among U.S. African American and Latinx Adolescents With Depressive Symptoms and Overweight and/or Obesity.

To examine the concept of self-esteem among African American and Latinx adolescents with overweight and/or obesity and depressive symptoms in the United States. Using key terms in CINAHL, PubMed, and PsycINFO databases, an initial search yielded 371 articles; after examining title, abstract, and full text, 33 articles remained. The concept of adolescent self-esteem was analyzed using Rodger's evolutionary method. Several antecedents of self-esteem in this context were identified, including bullying, negative portrayal in the media, stressors and hassles, low socioeconomic status, dieting, and family dietary influences. Attributes identified were body image and misperception, body image dissatisfaction, diminished social status, and isolation. Consequences included stigma, somatic complaints, decreased earnings over a lifetime, decreased quality of life, lower educational attainment over a lifetime, and increased substance use. Increased self-esteem, increased number of friends, and in-depth friendships were associated with a lower risk of being overweight or obese. Adolescent self-esteem varied based on gender, racial and ethnic group, and changed over time in the African American population but remained static in the Latinx population. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

The Family Characteristics, Eight Family Functions and Socio-Economic Class of Contribution Assistance Recipient Families in Indonesia

Efforts to realize quality human and family resources can be achieved through optimizing the implementation of the eight family functions. This research was conducted to analyze what kind of family characteristics and at what socio-economic level are the families receiving contribution assistance in Indonesia, as well as to examine the extent of knowledge about the eight functions of the family in families receiving contribution assistance. This study uses longitudinal secondary data from the 2015-2019 National Medium-Term Development Plan Performance Indicator Survey. Data processing and analysis were carried out descriptively and inferentially using cross tabulation and regression testing. The study included 943,004 individual respondents. The result show that the higher the socioeconomic class of the family, the higher the knowledge about the eight family functions, this is statistically very significant as evidenced by the P value below 0.05, with a coefficient of 0.676. It is surprising that this study states that family size has no significant effect on socioeconomic class. Study proves that when the PBI Contribution recipient family data is regressed with socioeconomic class, the low economic class is positively correlated with a coefficient value of 0.481 and is statistically significant with a 95 percent confidence level and below 0.05, which is 0.000, meaning that in low socioeconomic families, they are the largest recipients of PBI contributions.

Identifying and characterising digital behaviour change interventions to improve fruit and vegetable intake in low-socioeconomic status primary school children: a systematic review

BackgroundDigital behaviour change interventions aiming to improve dietary intakes; specifically fruit and vegetable intake, in low-socioeconomic children are being developed and tested. However there is currently no synthesis of the characteristics or reported effectiveness of these interventions. This systematic review aims to: (1) identify existing digital interventions targeting fruit and vegetable intake in low-socioeconomic status children, (2) identify and synthesise characteristics and reported effectiveness of these interventions using the Behaviour Change Intervention Ontology.MethodCINAHL, ERIC, PubMed, Cochrane Library, ACM Digital Library and Scopus were searched in December 2021 – February 2022 and in February–March 2024. Inclusion criteria for studies were: 1) children of low-SES families, aged between 5–11 years old; 2) Digital intervention to improve fruit and vegetable intake; 3) Comparison groups could be digital or non-digital; 4) Outcome measures were fruit and vegetable intake and antecedents to diet behaviours; 5) Randomised controlled trials (cluster and parallel designs). Characteristics of identified studies were coded using the Behaviour Change Techniques Taxonomy and Modes of Delivery, Setting and Source ontologies of the Behaviour Change Intervention Ontology.ResultsFive studies met all inclusion criteria, with majority reporting significant effects of interventions on improving fruit and vegetable intake. Most common Behaviour Change Techniques found were Goal Setting (k = 4), Problem Solving (k = 3), Instruction on how to perform a Behaviour (k = 3), and Prompts and Cues (k = 3). Characteristics relating to intervention source were unclear.ConclusionsDigital interventions had positive outcomes in fruit and vegetable intake in children; particularly more for fruit than vegetable intake. Characteristics in digital interventions which have direct effects on child fruit and vegetable intake in low-socioeconomic families should be further investigated. Furthermore, clearer reporting on intervention characteristics is needed.

Inequities in human papillomavirus vaccination among children aged 9–14 years old under constrained vaccine supply in China

BackgroundInequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China.MethodsA cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9–14. Mixed-effects logistic regression models with school units as random effects were used for analysis.ResultsFrom 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine.ConclusionsSustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother’s HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters.

The Description of Functional Disorders in Children with Stunting in Puskesmas Rowosari Semarang

Abstracts
 
 Introduction: The consequences of stunting in children are immediate and long-term including increased morbidity and mortality, poor child development, decreased productivity and economic capacity. Decreased functional status can occur because stunting can affect the structure and function of the brain.
 Method: This research was observational research with cross-sectional data collection. The data were collected with consecutive techniques. The research subjects were obtained from the toddler attending Posyandu at the Puskesmas Rowosari Semarang. The identity of the subjects like gender, age, parent’s social economy and type of functional disorder were measured by the modified WeeFIM. All data were analyzed with the computer using SPSS® software to determine the description of functional disorders.
 Results: Of the 14 children with stunting, 11 of them experienced functional disorders. Among the toddlers who experienced functional disorders were dominated by 7 male toddlers (63.6%) and aged more than 2 years (72.7%). All subjects came from low socioeconomic families. Six subjects (54.5%) experienced impaired control of defecation and urination. Only 1 subject had hearing loss (9.1%). Four subjects had eating disorders (36.4%). Grooming disorders were found in 9 toddlers (81.8%). About 7 toddlers (63.6%) experienced bathing disorders. Eight toddlers experienced dressing disorders (72.7%) and 4 toddlers experienced toileting disorders (36.4%). Ambulation disorder was found in 1 toddler (9.1%).
 Conclusion: Toddlers with stunting are at risk of experiencing functional disorders.
 Keywords: Toddlers, Stunting, Functional Disorders, Modified WeeFIM

Barriers to preschool aged children's participation in swimming lessons in New South Wales, Australia.

To understand barriers to uptake of subsidised swimming lessons by children aged 3-6 years old ('preschool aged children'), including from priority populations, in New South Wales (NSW). A thematic analysis of 4191 qualitative responses from parents/carers of preschool aged children describing barriers that resulted in their child's non-participation in subsidised swimming lessons in the past 12 months was conducted. Data, including parent/carer sociodemographic variables, were collected through registrations for the NSW Government's First Lap voucher program. Seven overarching barriers to participation were identified: (1) child's disability or health needs; (2) swimming lesson affordability; (3) family or personal circumstances; (4) lack of or poor availability of swimming lessons; (5) parent/carer availability, including to fulfil participation requirements; (6) COVID-19 and (7) deprioritisation of formal swimming lessons due to parent/carer perceptions relating to its importance. These may limit the uptake of swimming lessons in preschool aged children, particularly those who are Aboriginal and Torres Strait Islander, from culturally and linguistically diverse backgrounds, living with a disability, from low socioeconomic families and living in regional and remote areas. Structural barriers must be addressed to increase uptake of swimming lessons in preschool aged children, particularly in priority populations, to reduce drowning risk. SO WHAT?: Evidence-based policy initiatives, with robust evaluation, should seek to address the availability and flexibility of swimming lessons, including for priority populations; complexities associated with supervision requirements; poor awareness of parents/carers of the importance of swimming for preschool aged children and the lack of continuity of swimming for children in out of home care.

School Refusal Behavior: A Narrative Review

This narrative review aims to identify key concepts associated with school refusal, including various risk factors, and to discuss current practical assessment and treatment methods available or under trial. For this study, we searched MEDLINE and Scopus databases for articles containing keywords like “school refusal” and associated keywords such as “childhood,” “adolescence,” “risk factors,” “interventions,” and “assessment.” Thirty-eight original articles in English containing these keywords, published in the last 10 years on the above platforms, were included. We excluded studies focusing on school refusal solely in a subset of the population, such as autistic children or immigrant children. This review found that in India, school refusal is often ignored, especially in lower socioeconomic families, due to non-affordability and poor access to appropriate resources, and is sometimes also equated with truancy and bad behavior. Various risk factors at the parental and school level promote this behavior, and therefore, appropriate interventions at these levels are necessary. As per current evidence, psychoeducation and multidisciplinary treatments are the most effective in managing such children. Early detection of such cases and coordinated efforts by all stakeholders are crucial for effective intervention.

Autistic clinical profiles, age at first concern, and diagnosis among children with autism spectrum disorder.

To explore the relationship between autistic clinical profiles and age at first concern and diagnosis among children with autism spectrum disorder. The clinical profiles included the severity of autism, cognition, adaptability, language development, and regression. The multivariate linear regression model was used to examine the association of diagnostic age and first-concern age with autistic clinical profiles and with further stratification analysis. A total of 801 autistic children were included. Language delay and regression were associated with earlier diagnostic age (language delay: crudeβ: -0.80, 95%CI%: -0.92--0.68; regression: crudeβ: -0.21, 95%CI%: -0.43--0.00) and the age of first concern of autistic children (language delay: crudeβ: -0.55, 95%CI%: -0.65--0.45; regression: crudeβ: -0.17, 95%CI%: -0.34--0.00). After stratification by sex, language delay tended to be more associated with the earlier diagnostic age among boys (crudeβ: -0.85, 95%CI%: -0.98--0.72) than among girls (crudeβ: -0.46, 95%CI%: -0.77--0.16). After stratification by maternal education level or family income level, language delay was most associated with the earlier diagnostic age in autistic children from families with higher socioeconomic levels. Language delay, rather than other symptoms, promoted an earlier diagnostic age. Among male autistic children or children from families with higher socioeconomic levels, language delay was most significantly associated with an earlier age of diagnosis. Cognitive delay, or adaptive delay, was associated with a later age at diagnosis and presented only in autistic children from families with lower socioeconomic levels. There may be sex or socioeconomic inequality in the diagnostic age for autistic children. More publicity and public education about the diversity of autistic symptoms are urgently needed in the future, especially for low-socioeconomic families.

Socio-Demographic Correlates of Barriers to Access Healthcare Services among Children in Post-Communist Albania

Access to healthcare services is an essential component of promoting public health and sustainable development. Our aim was to assess socio-demographic correlates of barriers to accessing healthcare services among children in Albania, a post-communist country in Europe. An online survey was conducted in September 2022, including a nationwide representative sample of 7831 school children (≈54% girls) ranging from grades six to nine from all regions of Albania. A structured and anonymous questionnaire was administered to all children inquiring about a range of potential barriers to accessing healthcare services. Overall, about 42% of the children reported that they had barriers to accessing healthcare services. There were no gender differences, but there were significant ethnic differences (51% among Roma/Egyptian children vs. 42% among the general sample of the children); urban/rural differences (46% rural vs. 39% urban); and socio-economic differences (52% among children with a lower maternal education vs. 31% among children with a higher maternal education; 66% among children from poor families vs. 35% among children with a higher family income). In transitional Albania, children residing in rural areas, children from Roma and/or Egyptian communities, and especially those pertinent to low socio-economic families report considerably more barriers to accessing healthcare services, which is a cause of concern.

Barriers to Exclusive Breastfeeding in Mothers Belonging to Low, Middle, and High Socio-Economic Families in Pakistan

Introduction: Exclusive breastfeeding (EBF) for the first six months of life improves health and increases infant survival. In Asia, Pakistan ranks second in child mortality. Socioeconomic status (SES) is an important predictor of healthy behaviors. The study aims to understand the barriers to exclusive breastfeeding faced by mothers from different socioeconomic classes in Pakistan.
 Method: The cross-sectional study was done in the Pediatric outpatient department (OPD) of Shifa International hospital and community health center from November 2020 to 1 March 2021. Mothers and their children 1 to 3 years of age were included in the study.
 Results: A total of 175 mothers and their children were included. EBF for the first six months was done by 120 (68.6%). However, by one year of age, only 99 (56%) continued breastfeeding. Out of these 175 mothers, 79 (45%) were from the lower class, 69 (39.4%) were from the middle class, and 27 (15.4%) were from upper SES. Among the lower, middle, and high socioeconomic classes frequency of EBF practiced by mothers was 51, 54, and 15 (p 0.03), respectively. Pre-lacteals were given to 102 (58.2%). This practice was more frequent in lower SES families (0.03). The majority of working women belonged to upper SES (0.04). Mothers in the upper class are least likely to EBF their children (OR 0.5 CI 0.2-1.3). The adjusted odds ratio for EBF is highest for lower SES mothers, followed by the middle class.
 Conclusion: Support from family, place and mode of delivery, working mothers, and high socioeconomic class are important factors affecting exclusive breastfeeding in Pakistan.

Socioeconomic Burden of Critically Ill Patients: A Descriptive Study.

Background The cost of critical illness treatment is generally recognized as expensive and increasing in India. Critical illness of the individual will affect the socioeconomic status of the individual and the family. The direct and indirect costs of intensive care and its impact on the socioeconomic status of critically ill patients and their families need to be estimated. The present study was carried out to evaluate the socioeconomic burden of critically ill patients admitted to ICUs in Eastern India. Methods A descriptive survey was conducted to measure the socioeconomic burden. One hundred fifteen critically ill patients and their family members were conveniently selected for the study. Critically ill patients admitted to ICUs and those who were bedridden for more than seven days along with anyone the family member, i.e., spouse, father, or mother, were included in the study to estimate the impact of long-term illness on the care providers in the family. Socio-demographic and socioeconomic burdens were analyzed through the interview method. Results Half (49.6%) of the critically ill patients were heads of the family, and their employment is the primary source of income for the family members. Most (60.9%) of the patients belonged to lower socioeconomic status. Critically ill patients spend a maximum (38169.6±3996.2) amount for pharmaceutical expenses. Eventually, the family members accompanying patients lost maximum working days because of the long length of hospital stay. Below upper-lower (p=0.046) class socioeconomic family, age less than 40 (p=0.018) years, and those families depending (p=0.003) on patients' income significantly reported higher socioeconomic burden. Conclusions Critical care hospitalization of patients increases the socioeconomic burden on the whole family, especially in lower-middle-income countries like India. It soberly affects younger age group patients with low socioeconomic status and families depending on the patient's income during their man days.

Impact of COVID-19 on medical teaching and students

Impact of COVID-19 on medical teaching and students

Trends in prevalence of overweight and obesity among South African and European adolescents: a comparative outlook

BackgroundSouth Africa has several national surveys with body weight-related data, but they are not conducted regularly. Hence, data on longitudinal trends and the recent prevalence of adolescent obesity are not readily available for both national and international reporting and use. This study collectively analysed nationally representative surveys over nearly 2 decades to investigate trends in prevalence of adolescent obesity in South Africa. Furthermore, it compared these data with similar continental report for 45 countries across Europe and North America including United Kingdom, Norway, Netherland, Sweden, Azerbaijan, etc. to identify at-risk sub-population for overweight and obesity among adolescents. MethodsThe study included primary data of adolescents (15 – 19 years) from South African national surveys (N = 27, 884; girls = 51.42%) conducted between 1998 and 2016. Adolescents’ data extracted include measured weight, height, sex, parent employment status, monthly allowance received, and family socioeconomic-related variables. Data were statistically analysed and visualized using chi-square of trends, Wald statistics, odds ratio and trend plots, and compared to findings from European survey report (N = 71, 942; girls = 51.23%). South African adolescents’ obesity and overweight data were categorized based on World Health Organization (WHO)’s growth chart and compared by sex to European cohort and by family socioeconomic status.ResultsBy 2016, 21.56% of South African adolescents were either obese or overweight, similar to the 21% prevalence reported in 2018 among European adolescents. Girls in South Africa showed higher trends for obesity and overweight compared to boys, different from Europe where, higher trends were reported among boys. South African Adolescents from upper socioeconomic families showed greater trends in prevalence of overweight and obesity than adolescents from medium and lower socioeconomic families. Mothers’ employment status was significantly associated with adolescents' overweight and obesity.ConclusionsOur study shows that by 2016, the prevalence of adolescent obesity was high in South Africa – more than 1 in 5 adolescents – which is nearly similar to that in Europe, yet South African girls may be at a greater odd for overweight and obesity in contrast to Europe, as well as adolescents from high earning families. South African local and contextual factors may be driving higher prevalence in specific sub-population. Our study also shows the need for frequent health-related data collection and tracking of adolescents’ health in South Africa.

Animasyon Filmlerinin Çocuğun Epistemolojik Gelişimine Etkisi

This study aimed to explore the effects of information types in animated films on 6th-grade middle school students' learning skills. The study was carried out with 70 volunteer students who attended a public middle school in a village in Oğuzeli district of Gaziantep in the 2019-2020 academic year. The participant 6th-graders were from low socio-economic families. The study was designed in an embedded pattern, which was one of the mixed-method approaches. There were 24 students in the experimental group in which animated movies were watched, 23 students in the placebo group where children's films were watched, and 23 in the control group where Turkish lessons were taught without films. The qualitative data about student and researcher experiences were included in the experimental process. The quantitative data were analyzed using a pre-test, post-test, and follow-up test and case study methodologies. The study adopted a 3x3 quasi-experimental design, including experimental, control, and placebo groups. The quantitative data were collected with an Information Types Assessment Tool (ITAT), developed by the researcher and verified by expert opinion. The qualitative data were collected with The Assessment Form for the Information Types (AFIT), a semi-structured interview form, and student and researcher diary. The experimental process lasted for 12 weeks, including the pre-test and post-tests. The follow-up test was conducted at the end of the experimental process and six weeks after the post-test. The research results indicated a significant difference in post-test scores of those who watched the animated movie. There was also a statistically significant difference in favor of the experimental group in the post-tests. It was concluded that animated films had a meaningful and permanent effect on students' learning information types. Besides, following the data related to student diaries and interviews revealed that the experimental group students could permanently learn the types of information through animated films and enjoyed such lessons

Impact of socioeconomic position on childhood obesity in Finland based on register data from 2018

Abstract Background Obesity is a globally growing public health challenge among children. In developed countries, the risk of obesity is commonly higher among lower socioeconomic groups. Measuring socioeconomic position (SEP), especially income, is challenging in surveys as self-reported information may suffer from reporting, awareness, recall and non-response bias. Our aim is to utilize official register data on several SEP indicators and measured height and weight of children, to identify the strongest predictors of SEP of the parents on the risk of obesity among the whole 2-17-year-old child population in Finland. Methods Data for all children who had visited child health clinic or school health care in 2018 were extracted from the National Outpatient Register on Primary Health Care Services (n = 387623, coverage 40% in 2018). Obesity was defined according to the WHO criteria. SEP indicators were obtained from Statistics Finland for both parents living in the same household with a child. Boosted regression model was used to analyze the contribution of SEP to obesity using training dataset on 155479 non-related children. Results The area under the curve for the final model in training dataset was 0.736 and 0.718 in validation dataset. Mother's educational level (12.6% of the total explained variation) and household's disposable income (12.6%) were the SEP indicators that most strongly predicted childhood obesity, whereas the impact of educational level of the father was somewhat smaller (8.1%). The influence of the age of a child was even bigger (39.2%), the prevalence of obesity being highest at 11 and 9 years of age among boys and girls, respectively. Conclusions Our results based on official register data from Finland, a Nordic high-income country, endorse earlier findings on higher obesity risk among children with low socio-economic family background. Identification of the SEP related risk factors and support to families are essential in the prevention of childhood obesity. Key messages

Superficial Fungal Infections among School Age Children: Does Prevalence and Pattern Differ between Commercial and Agrarian Communities?

Background: Superficial fungal infections (SFIs) are common and have considerable negative impact on school children in tropics.
 Objectives: The study compared the prevalence and pattern of SFI among primary school pupils in an agrarian (Ukpor) and commercial (Nnewi) communities in Nnewi Area.
 Methodology: A cross-sectional study was conducted among primary school pupils in Nnewi Area. Subjects were selected using stratified random sampling technique. Data was analyzed using SPSS version 21.
 Results: Final analysis involved 773 and 789 pupils in the agrarian and commercial communities, respectively. Their mean age was 9.0 ±2.0 years and male: female ratio was 1:1. The agrarian community had a significantly higher proportion of children who were from low socio-economic class families, and had poorer hygiene practices (p=0.000). The overall prevalence of SFIs was 28.9%. Prevalence was significantly higher in the agrarian compared to commercial community (39.3% versus 18.6%; p = 0.000). Tinea capitis was the predominant form of SFIs accounting for 80.3% and 83.7% of SFIs cases in the agrarian and commercial communities, respectively. Black dot tinea capitis was the commonest variant of tinea capitis in both communities. Of the variants of tinea capitis, only the diffuse scale type differed in the rate of occurrence in the two communities (6.3% in agrarian versus 0.0% in commercial communities, p=0.023). The most prevalent organisms were T. tonsurans (37.9%), T. mentagrophytes (28.8%) and T. rubrum (18.7%) of which T. rubrum was significantly higher in the commercial community (27.6% versus 14.9%, p=0.036).
 Conclusion: The burden of SFI is high among primary school children in Nnewi area, especially among those in agrarian communities. More awareness should be created on the prevention, identification and treatment.

Speech and Reading Disorders Screening, and Problems in Structure and Function of Articulation Organs in Children in Mashhad City, Iran

Objectives: Investigating the prevalence of speech and language disorders and the contributing factors can help determine the best treatment options suited to the needs of these patients. So far, no comprehensive study has been conducted on screening speech and reading disorders and Problems in the Structure and Function of Articulation Organs (PSFAOs) in children in Mashhad City, Iran. This study aims to screen for these disorders and investigate the effects of demographic factors on such disorders. Methods: Via the stratified-cluster sampling method, 2770 native Persian-speaking children participated in this study, of whom 1381 were girls and 1389 were boys, ranging from preschool to the third grade (3 to 9 years old). After obtaining the demographic information, the PSFAOs screening was performed for all participants using a semi-structured questionnaire taken from Paul et al.’s report (2017). Screening for a grade of dysphonia was then carried out for children with suspected voice disorders using the grade, roughness, breathiness, asthenia, and strain test. Fluency of speech screening for children with suspected fluency disorders was performed using the stuttering severity instrument – fourth edition test, and screening of reading skills for school children was performed using the screening inventory reading test. Analytical analysis was performed via the Chi-square test between study variables, including disorders and other variables. Two types of logistic regression models were used. The data were analyzed using survey data analysis of the Stata software, version 14.1, and P<0.05 was considered significant. Results: The prevalence of articulation disorders, voice disorders, stuttering, PSFAOs, reading disorders, and multiple disorders (presence of two or more disorders per person) was 1.62%, 1.99%, 1.69%, 1.1%, 8.21%, and 14.89%, respectively. Descriptive analysis showed that the prevalence of articulation disorders, voice disorders, stuttering, and multiple disorders was higher in boys compared to girls (P=0.000), while the prevalence of reading disorders and PSFAOs was higher in girls (P=0.000). Furthermore, articulation disorders and reading disorders were more common in first-graders. The prevalence of voice disorders, stuttering, and PSFAOs were higher in the third graders. The logistic regression analysis showed that boys were more likely to develop speech and language disorders compared to girls (OR=1.3, P=0.01), and first-, second-, and third-graders were less likely to have such disorders when compared to preschoolers (OR=0.8, P=0.03). Discussion: Compared to previous studies, the different rates of prevalence of the disorders studied in this investigation are related to differences in their methodology, the number of samples, age, linguistic and cultural characteristics of the subjects, and individual factors. In this study, the prevalence of the studied disorders was higher in boys, first-graders, and children with families of 4 or more. The development of speech and language skills is different between genders; slower maturation of male brains seems to predispose them to slower development of speech skills. The lower prevalence in school-age children may be because these disorders gradually resolve during the early years of childhood. Moreover, low family socioeconomic status and family size may be the contributing factors to speech and language disorders.