Low Parental Education Level Research Articles

The link between social risks factors with insufficient metabolic control and onset of T1D in children and adolescents in Russia

Despite significant progress in the treatment of T1DM in children, achieving target levels of carbohydrate metabolism in children remains one of the most difficult tasks. The influence of the psychosocial state of the family on the ability to achieve metabolic compensation is becoming increasingly clear. However, the study of social risk factors in families with children with T1DM and their impact on metabolic control remains clearly insufficient.The purpose of the study is to determine social risk factors (SR) that are most typical for families of children with type 1 diabetes mellitus (T1DM) in our country and to analyze their relationship with compensation for T1DM based on a survey of parents.MATERIALS AND METHODS: The study was conducted in endocrinology departments of children’s hospitals and departments of medical and social care of children’s clinics in 4 regions - Vologda, Tyumen, Chelyabinsk regions and Khanty-Mansi Autonomous Okrug.A total of 325 respondents took part in the study. 1 group — experience of T1DM in children >1 year and poor metabolic control (level of glycated hemoglobin ((HbA1c) >7.5%) — 195 hours; 2 gr. — experience of T1DM in children >1 year and good metabolic control (HbA1c <7.5%) — 60 people. An additional group consisted of 73 patients with <1 year of experience of T1DM in children, regardless of metabolic control, in order to analyze the prevalence of social risk factors already in the 1st year of diabetes.RESULTS: In the overall group, HbA1c was 9.1% (4.9–17%). The five most common SR factors were a low level of parental education (lack of higher or secondary education), lack of a permanent job, raising a child alone, lack of support from loved ones, and income below the subsistence level.1 group (192 people). Average HbA1c level 9.8% (7.5–17%). Among the HR factors that significantly influence HbA1c levels, the level of education of parents, single parenting of a child, low family income and the number of children in the family were identified. The number of influencing social risk factors also has a negative impact on metabolic control.2nd group. (60 people). HbA1с — 6.6% (5.3%–7.3%). The prevalence of SR factors was significantly lower than in the previous group. The differences were significant for lack of higher education, single parenting, and low family income.3 gr. (73 people). HbA1c — 9.3% (4.9–15.1%, which may be due to the duration of diabetes less than 3 months in some children. After 3 months, the HbA1c level was 7.9% (4.8–13.4%). The list of SR factors practically coincides in composition and frequency with those in families of group 1. Thus, social difficulties that are not resolved in a timely manner aggravate the situation of the family and negatively affect the compensation of carbohydrate metabolism.CONCLUSION. We have identified the most significant factors of SR in families with children with T1DM in the Russian Federation. The deterioration of social conditions in the family is a factor that negatively affects the level of control of T1DM and the development of complications in the future. As a result, families with children with T1DM, especially with chronic decompensation, need assessment of SD factors and support from social services.

Type of Cleft and Socioeconomic Determinants for Increased Caries Risk Among Young Patients With Cleft Lip and/or Palate

This study aimed to identify the predictive role of cleft type, ethnicity, adoption status, spoken language at home and parental education level on the caries risk in the primary dentition of patients with cleft lip and/or palate (CL/P). This knowledge is used to make an estimate on increased caries risk in young patients with CL/P. A retrospective analysis of data concerning dental caries and basic characteristics of patients with CL/P was done. Patients were born and registered in 2016, 2017, or 2018 at the cleft team of the Erasmus Medical Center, Rotterdam, the Netherlands. After Chi-square tests, the cleft type ( P = .02), country of birth father ( P < .001), country of birth mother ( P = .002), parental educational level ( P = .006), and spoken language at home ( P = .002) were significantly different between 144 patients with CL/P with and without caries. Items were used in binary logistic regressions and after stepwise backward elimination resulting in most important determinants for caries in the primary dentition in patients with CL/P being: father born in another country than the Netherlands (odds ratio [OR] = 4.87, P = .001), a cleft lip alveolus and palate phenotype (OR = 3.54, P = .002), and a lower parental educational level (OR = 2.30, P = .04). The recommendation for the dental care professional will be to use these 3 determinants as a first prediction on future dental caries. This helps the dental professional in clinical decisions as recall intervals, referral to specialized dental care and extensiveness of caries prevention strategies and thereby improves oral health of patients born with CL/P.

Screen exposure status and related factors in children with epilepsy

To understand the status of screen exposure in children with epilepsy and analyze the influencing factors for screen exposure time, providing a scientific basis for managing screen exposure in these children. A convenience sampling method was used to select 275 children with epilepsy from outpatient clinics or those undergoing 24-hour electroencephalogram monitoring at two tertiary hospitals in Jinan from March to June 2023. Their parents (fathers or mothers) completed a questionnaire to collect data on screen exposure, parental screen regulation behaviors, and related information about the children and their families. The Wilcoxon rank-sum test or the Kruskal-Wallis H test was used to conduct a univariate analysis of the average screen exposure time of children on school days and weekends, as well as the daily average screen exposure time. A multivariate logistic regression analysis was used to identify the risk factors for children whose screen exposure time exceeded the recommended guidelines (average screen exposure time on school days >1 hour or average on weekends >2 hours). The median screen exposure duration on school days was 40 minutes, while on weekends it was 120 minutes. Among the children studied, 23.1% (63/273) had average screen exposure time exceeding 1 hour on school days, and 42.5% (117/275) had average screen exposure time exceeding 2 hours on weekends. Four children experienced seizures while using screen devices. Multivariate logistic regression analysis indicated that using screen devices shortly before sleep, lower educational levels of parents, caregivers discussing screen content with children, and longer seizure durations in children were risk factors for exceeding recommended guidelines (P<0.05). Some children with epilepsy have a screen exposure time exceeding the recommended guidelines. A longer seizure duration, lower parental education levels, and permissive digital parenting are closely associated with children's screen exposure time exceeding the recommended guidelines. Families and children exhibiting these characteristics should be prioritized for attention and health education.

Prevalence and lifestyle determinants of depressive symptoms among Chinese children and adolescents

Based on Chinese Students’ Fitness Health Examination, this study sought to investigate the relationships between depressive symptoms and family environment, physical activity, dietary habits, sleep and sedentary behavior among children and adolescents. A cross-sectional study was carried out to estimate the prevalence of depressive symptoms in 32,389 participants (grades 4–12) using the CES-D. Logistic regression was used to evaluate the relationships between lifestyle determinants and depressive symptoms, and a random forest model was used to rank the importance of those determinants. The overall prevalence of depressive symptoms was 39.93%. Students with depressive symptoms had higher grades, lower parental educational levels and unhealthy lifestyles (P < 0.05). The top ten most important determinants of depressive symptoms were grade, egg intake, milk/soy product intake, frequency of muscle strength training, screen time, sleep duration, parental educational level, sugar beverage intake and total physical activity. Socioeconomic status, physical activity, sleep and screen time, and diet habits are determinants of depressive symptoms, and surveillance of lifestyles may be an effective way to detect students with depressive symptoms early.

Classroom Toileting: A Collaborative Effort.

Developmental norms suggest that children are ready for toilet training between the ages of 18 and 24 months; however, many children now enter school without this self-care skill. Many factors can contribute to delayed toilet training including child readiness, developmental disabilities, poverty, lower parental education levels, and higher rates of single and teen-aged parents who may lack parenting skills including toilet training. Most children enroll in a kindergarten program at 5 years of age. Because children will be accepted to kindergarten regardless of toilet training status, schools need to be ready for children who lack this self-care skill. Although school staff are willing to support these children, the main purpose of school is education. The school nurse can take an active role in classroom toileting programs by collaborating with school administrators, teachers, staff, and parents to promote successful toilet training and fostering a healthy learning environment.

Socioeconomic Factors and Physical Activity Levels Among Badminton Players in Selected Middle Schools in Guangdong Province

The relationship between socioeconomic factors and physical activity levels in badminton player is a critical area of study, given the long-term implications for health and well-being. Various socioeconomic determinants, including family income, parental education, and neighborhood environment, significantly influence badminton player' engagement in physical activities (Sharma &amp; Gupta, 2021). Family income plays a pivotal role in determining the availability of resources necessary for physical activity. Badminton player from higher-income families often have access to sports equipment, private coaching, and safe recreational facilities, which promote regular physical activity (Patel et al., 2022). Conversely, those from lower-income backgrounds may face financial barriers that limit their participation in organized sports or access to quality facilities, leading to reduced physical activity levels (Rahman &amp; Khan, 2023). Parental education is another significant factor influencing badminton player' physical activity. Educated parents are more likely to recognize the importance of physical activity for their children's health and development (Basu &amp; Das, 2021). They may also have better knowledge and resources to support their children’s involvement in sports and physical activities. In contrast, lower parental education levels are often associated with less awareness and fewer opportunities for badminton player to engage in physical activity (Singh et al., 2020). The neighborhood environment significantly impacts badminton player' physical activity levels. Safe, well-maintained neighborhoods with parks, playgrounds, and sports facilities encourage outdoor activities (Hassan &amp; Rafiq, 2021). However, badminton player living in neighborhoods with high crime rates, poor infrastructure, or limited recreational spaces may be less likely to engage in physical activities due to safety concerns and lack of accessible facilities (Chowdhury et al., 2023). Cultural factors also influence physical activity levels among badminton player. In many societies, cultural norms and expectations can either promote or hinder physical activity (Kumar &amp; Jain, 2022). For instance, traditional gender roles may restrict girls’ participation in sports, while boys might be encouraged to engage in physical activities. Understanding these cultural dynamics is essential for developing effective interventions to promote physical activity among all badminton player. The impact of socioeconomic status (SES) on physical activity is further compounded by educational institutions. Schools in higher SES areas often have better sports facilities, more extracurricular activities, and programs promoting physical education (Sharma &amp; Gupta, 2021). Conversely, schools in lower SES areas may lack these resources, limiting students' opportunities to engage in regular physical activity. This disparity highlights the need for policies to ensure equitable access to physical activity opportunities across different socioeconomic strata. Peer influence is another crucial factor in badminton player' physical activity levels. Badminton player are more likely to engage in physical activities if their peers also participate (Basu &amp; Das, 2021). However, socioeconomic factors can affect the peer group's overall activity levels. Badminton player from higher SES backgrounds might have more active peer groups due to greater access to recreational activities, whereas those from lower SES backgrounds might face peer pressure to engage in sedentary behaviors. Government policies and community programs play a vital role in addressing the socioeconomic disparities in physical activity levels among badminton player. Policies that provide subsidies for sports programs, build recreational facilities in underprivileged areas, and promote safe neighborhood environments can help mitigate the impact of socioeconomic factors (Patel et al., 2022). Effective community programs that target low-income families and educate parents about the benefits of physical activity are also crucial for promoting equitable physical activity levels. Technological advancements and their accessibility also influence physical activity levels. Badminton player from higher SES backgrounds might have access to technology that encourages physical activity, such as fitness trackers and online workout programs (Kumar &amp; Jain, 2022). In contrast, those from lower SES backgrounds may lack access to such technology, further widening the gap in physical activity levels. Socioeconomic factors significantly influence physical activity levels among badminton player. Family income, parental education, neighborhood environment, cultural norms, school resources, peer influence, government policies, and technological accessibility all play crucial roles. Addressing these factors through targeted interventions and policies is essential for promoting equitable physical activity levels and ensuring the long-term health and well-being of all badminton player. Recent research highlights the importance of understanding and addressing these socioeconomic determinants to foster a more active and healthy youth population.

Cumulative risk predicting differential effectiveness of the incredible years parent-training

The evidence on whether socioeconomic status moderates the effectiveness of parent-training programs for disruptive child behaviors is inconclusive. These varied results may stem from differences in the programs or the studies themselves. We applied an equivalence test paradigm to test the hypothesis of equal benefit from the Incredible Years Parent-Training (IYPT) across family risk on disruptive child behaviors. During the Danish roll-out of the IYPT, 1203 families were recruited across 20 different municipalities. The isolated and cumulative effect of five markers of low socioeconomic status, specifically single parent household, parental unemployment, low family income, low parental educational level, and teen parenthood, were analyzed as predictors of pre-to-post treatment response. Results showed equal benefit among families experiencing from zero to four accumulated socioeconomic risks (99 % of our sample). Our findings suggest that the IYPT brings equal benefit across socioeconomic backgrounds and risk levels in Danish community settings.

Refractive errors in Tianjin youth aged 6-18 years: exploring urban-rural variations and contributing factors.

Refractive errors, particularly myopia, constitute a significant global public health concern, contributing to morbidity and disability. A more comprehensive understanding of the determinants of refractive errors and the differences between urban and rural areas is essential to develop effective preventive measures for youth. This study aimed to compare the prevalence and risk factors of refractive errors among youth in urban and rural Tianjin, China. This school-based cross-sectional study was conducted in 2022. Elementary, middle, and high school students aged 6-18 years from both urban and rural areas of Tianjin were included. All participants underwent visual acuity testing and refractive measurement and completed comprehensive questionnaires. A total of 346,146 participants (176,628 boys) were included in this investigation (50.36% for urban and 49.64% for rural, respectively). Myopia, hyperopia, astigmatism, and anisometropia were present in 56.8, 9.7, 56.64, and 21.3% of urban students, respectively. Similarly, rural students had a prevalence of 57.6, 11.5, 56.48, and 22.0% for the respective conditions. Compared to rural students, after adjusting for age, sex, and other significant variables, urban students were 1.05 times more likely to have myopia (95% CI: 1.03-1.07, p < 0.0001), 0.71 times less likely to have hyperopia (95% CI: 0.69-0.73, p < 0.0001), and 1.02 times more likely to have astigmatism (95% CI: 0.69-0.73, p < 0.0001). There was no significant association between anisometropia and residence (OR: 1.00, 95% CI: 0.98-1.02, p = 0.9850). Sociodemographic and physiological factors contribute to the disparities in the prevalence of refractive errors between urban and rural areas. Age, increased near-work activities, and Decreased outdoor time were identified as risk factors for myopia, astigmatism, and anisometropia. Conversely, the absence of a parental history of refractive errors emerged as a protective factor for myopia and astigmatism among students. Lower parental education levels were negatively correlated with the risk of myopia and anisometropia in their children. Specifically, the lower the parental education, the greater the risk of myopia in their offspring. For urban students only, lower parental education was associated with an increased risk of astigmatism. Crude prevalence estimates May not accurately reflect the true burden of refractive error due to confounding factors such as age and sex. Accounting for these factors revealed that urban students were more likely to have myopia and astigmatism but less likely to have hyperopia compared to their rural counterparts. These disparities highlight the importance of considering geographical variations when implementing strategies for myopia control and prevention.

Carotid Artery Wall Echogenicity Measured by Gray Scale Median of the Intima-Media Complex From Childhood to Young Adulthood.

Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media complex (IM-GSM), is a novel subclinical atherosclerosis marker with lower values indicating greater lipid deposition. Our longitudinal study investigated IM-GSM from childhood to adulthood and its associated risk factors. A total of 240 participants from the Southern California CHS (Children's Health Study) underwent carotid artery ultrasounds in 2008 (mean age±SD): (11.2±0.6 years), and again around 2022 (24.2±1.6 years) to assess IM-GSM, carotid artery intima-media thickness, and carotid artery distensibility. Questionnaires and anthropometric and blood pressure measurements were completed by participants at both times. Mean and SD of IM-GSM were 108.2±24.6 in childhood and 75.6±15.8 in adulthood. Each 1-year increase in age was associated with -2.52 change in IM-GSM (95% CI, -2.76 to -2.27). Childhood and adulthood IM-GSMs were highly correlated (β=0.13 [95% CI, 0.05-0.22]). In childhood, Hispanic ethnicity, lower parental education levels and prenatal father smoking were significantly associated with lower IM-GSM. In adulthood, higher systolic blood pressure, carotid artery intima-media thickness, hypertension, and lower distensibility were significantly associated with lower IM-GSM. Weight status exhibited a consistent association with both childhood and adulthood IM-GSM. During the transition from childhood to adulthood, individuals who shifted from normal weight to overweight/obese or normal blood pressure to hypertension or experienced an increase in carotid artery intima-media thickness displayed lower levels of IM-GSM in adulthood. IM-GSM decreases with age. Maintaining healthy weight and blood pressure levels in children could potentially aid in preventing subclinical atherosclerosis.

Stigma perception and health fatalism in parents of children with epilepsy: A cross-sectional study

AimThe aim of this study was to examine the factors that affect stigma perceptions and health fatalism of parents of children with epilepsy in eastern Turkey, the relationship between these and the impact of these on their social lives. MethodThis descriptive and cross-sectional study was conducted between August 2022 and January 2023 with the parents of children under the age of 18 who had been diagnosed with epilepsy for at least 1 year and who were followed up in the only hospital with a paediatric neurology outpatient clinic in Van province of Turkey. No sample selection was made in the study. Healthy parents (n = 123) who presented to the outpatient clinic within the specified time period and who agreed to participate in the study after being explained the purpose of the study participated in the study. ResultsIn this study, parental age was found to have a statistically weak positive correlation with Health Fatalism Scale (HFS) (r = 0.251; p = 0.005). A weak positive correlation was also found between the years patients had epilepsy and Parent Stigma Scale (PSS) (r = 0.275; p = 0.002). In addition, a statistically positive and weak relationship was found between Parent Stigma Scale scores and Health Fatalism Scale scores (r = 0.212; p = 0.018). This study found significant relationships between stigma perception and health fatalism in parents of epileptic children. Stigma perception increased with disease duration and lower parental education levels. ConclusionWhile providing an important basis for understanding the difficulties experienced by parents and developing support mechanisms, the present study can contribute to more informed support for parents of patients with epilepsy in the community. Nurses can contribute to ending stigma and discrimination by identifying patients' and parents’ perceptions of epilepsy, focusing on addressing gaps in knowledge and raising awareness in the community.

Epigenetic Aging and Racialized, Economic, and Environmental Injustice

Epigenetic age acceleration is associated with exposure to social and economic adversity and may increase the risk of premature morbidity and mortality. However, no studies have included measures of structural racism, and few have compared estimates within or across the first and second generation of epigenetic clocks. To determine whether epigenetic age acceleration is positively associated with exposures to diverse measures of racialized, economic, and environmental injustice measured at different levels and time periods. This cross-sectional study used data from the My Body My Story (MBMS) study between August 8, 2008, and December 31, 2010, and examination 5 of the Multi-Ethnic Atherosclerosis Study (MESA) from April 1, 2010, to February 29, 2012. In the MBMS, DNA extraction was performed in 2021; linkage of structural measures to the MBMS and MESA, in 2022. US-born individuals were randomly selected from 4 community health centers in Boston, Massachusetts (MBMS), and 4 field sites in Baltimore, Maryland; Forsyth County, North Carolina; New York City, New York; and St Paul, Minnesota (MESA). Data were analyzed from November 13, 2021, to August 31, 2023. Ten epigenetic clocks (6 first-generation and 4 second-generation), computed using DNA methylation data (DNAm) from blood spots (MBMS) and purified monocytes (MESA). The US-born study population included 293 MBMS participants (109 men [37.2%], 184 women [62.8%]; mean [SD] age, 49.0 [8.0] years) with 224 Black non-Hispanic and 69 White non-Hispanic participants and 975 MESA participants (492 men [50.5%], 483 women [49.5%]; mean [SD] age, 70.0 [9.3] years) with 229 Black non-Hispanic, 191 Hispanic, and 555 White non-Hispanic participants. Of these, 140 (11.0%) exhibited accelerated aging for all 5 clocks whose estimates are interpretable on the age (years) scale. Among Black non-Hispanic MBMS participants, epigenetic age acceleration was associated with being born in a Jim Crow state by 0.14 (95% CI, 0.003-0.27) SDs and with birth state conservatism by 0.06 (95% CI, 0.01-0.12) SDs, pooling across all clocks. Low parental educational level was associated with epigenetic age acceleration, pooling across all clocks, for both Black non-Hispanic (0.24 [95% CI, 0.08-0.39] SDs) and White non-Hispanic (0.27 [95% CI, 0.03-0.51] SDs) MBMS participants. Adult impoverishment was positively associated with the pooled second-generation clocks among the MESA participants (Black non-Hispanic, 0.06 [95% CI, 0.01-0.12] SDs; Hispanic, 0.07 [95% CI, 0.01-0.14] SDs; White non-Hispanic, 0.05 [95% CI, 0.01-0.08] SDs). The findings of this cross-sectional study of MBMS and MESA participants suggest that epigenetic age acceleration was associated with racialized and economic injustice, potentially contributing to well-documented inequities in premature mortality. Future research should test the hypothesis that epigenetic accelerated aging may be one of the biological mechanisms underlying the well-documented elevated risk of premature morbidity and mortality among social groups subjected to racialized and economic injustice.

Assessment of depression in children and adolescents with Type 1 diabetes mellitus: Impact and intervention strategies.

Depression is a common comorbidity in children and adolescents with type 1 diabetes mellitus (T1DM), yet its prevalence, impact, and intervention strategies remain underexplored. This study aims to assess the prevalence of depression among children and adolescents with T1DM, investigate its impact on health outcomes, and explore potential intervention strategies. A convenient sampling method was employed to recruit 229 participants aged 6 to 18 years from a single center. Data collection involved validated assessments, demographic surveys, and diabetes-related factor examinations during routine clinic visits. The patient health questionnaire-9 was utilized to evaluate the severity of depressive symptoms. Associations between depression and sociodemographic variables, diabetes management factors, and health behaviors were analyzed using chi-squared tests and logistic regression analysis. The prevalence of depression among participants was 43.23%. Older age, lower parental education levels, lower household income, smoking, and comorbidities were identified as significant risk factors for depression. Associations were found between depression and diabetes management factors, including glycemic control and frequency of glucose monitoring. Depression is highly prevalent among children and adolescents with T1DM and is associated with sociodemographic factors, health behaviors, and diabetes management. Integrated approaches to care that address both physical and mental health aspects are crucial for improving outcomes in this population.

Association of household food insecurity with sociodemographic factors and obesity in US youth: findings from the National Health and Nutrition Examination Survey 2017-2018.

The objective is to determine the prevalence of household food insecurity (HFI) based on sociodemographic factors and their relationship to obesity in youth. The study included a sample of 1,962 youth (aged 6-18) from the National Health and Nutrition Examination Survey (NHANES). The US Household Food Security Survey Module is used to measure food security over the past 12 months. Logistic regression models were used to estimate adjusted odds ratios (ORs) while controlling for covariates. In total, 27.4% of the individuals surveyed experienced HFI. Youth from food insecure households were more likely to be obese (adjusted odds ratio [aOR]: 1.59 [95% confidence interval: 1.19-2.13]) and also having abdominal obesity (aOR: 1.56 [95% CI: 1.19-2.03]). however, factors such as non-Hispanic ethnicity, having a Head of household with a college degree, and households with an income exceeding 350% of the poverty line were associated with a reduced risk of facing HFI. Hispanic individuals, households with lower parental education levels, and lower family incomes, are disproportionately affected by food insecurity. Furthermore, HFI has been associated with an increased risk of overweight and abdominal obesity among youth. Addressing FI requires targeted policies and interventions that prioritize vulnerable groups.

Patterns and socioeconomic differences in secondhand exposure to cigarettes, e-cigarettes, and heated tobacco products at home in Hong Kong adolescents.

Smoke or aerosols from cigarettes, e-cigarettes (ECs), or heated tobacco products (HTPs) are harmful. Yet, there is little knowledge about the specific patterns of secondhand tobacco exposure by source within household settings and the socioeconomic status (SES) differences in adolescents. We used territory-representative student data from a cross-sectional school-based survey in 2020-2021 to calculate the weighted prevalence of secondhand exposure to cigarettes, e-cigarettes, and HTPs in the past seven days. Parental education and perceived family affluence were used as indicators of socioeconomic status. Generalized linear mixed models were used to analyze associations. Among 22039 participants, 29.8% reported any secondhand tobacco exposure (SH-Any) at home, primarily from cigarettes (27.4%), followed by e-cigarettes (4.0%) and HTPs (0.9%). Tertiary parental education level was associated with lower SH-Any exposure (Adjusted odds ratio, AOR=0.49; 95% CI: 0.45-0.53, p<0.001), fewer exposure days (β= -0.685, p<0.001), lower exposure to cigarettes (SH-CC) (AOR=0.49; 95% CI: 0.45-0.54, p<0.001) and to e-cigarettes or HTPs (SH-EC/HTP) (AOR=0.57; 95% CI: 0.45-0.71, p<0.001). 'Poor' family affluence was associated with higher exposures [AOR(SH-Any) =1.14; 95% CI: 1.06-1.22, p=0.001; β(days)=0.160, p<0.001; AOR(SH-CC) =1.15; 95% CI: 1.07-1.24, p<0.001], except for SH-EC/HTP exposure, which was higher in students in an affluent family (AOR =1.66; 95% CI: 1.25-2.21, p<0.001). Significant SES differences in SH-EC/HTP exposure were found only in groups with low parental education level. Dose-response relationships were found between lower SH-Any and SH-CC and higher SES categories (p for trend<0.001). Adolescents experienced a high prevalence of tobacco smoke exposure at home, primarily from cigarettes. Higher SES was associated with lower tobacco exposure, except for SH-EC/HTP, which was higher among adolescents from affluent families. Additionally, high parental education level was protective against exposure to SH-EC/HTP. Comprehensive control measures to reduce the use of these tobacco products are needed to protect adolescents of diverse socioeconomic backgrounds.

Research on the trajectory and influential factors of poly-victimization: A longitudinal study of Chinese adolescents

BackgroundPoly-victimization is more detrimental to adolescents' physical and mental health than is a single type of victimization. However, there has been limited research on the trajectory of poly-victimization among Chinese adolescents. ObjectiveIdentify the different developmental trajectories of poly-victimization among Chinese adolescents over time and examine the influencing factors of poly-victimization trajectories. MethodsData from four surveys conducted between 2020 and 2022, encompassing a cohort of 319 adolescents who had experienced poly-victimization, were utilized to identify their developmental trajectories via group-based trajectory modeling. Potential influencing factors were screened and compared using ANOVA or chi-square tests, while factors affecting the developmental trajectories of poly-victimization were analyzed through multinomial logistic regression. ResultsWe identified three poly-victimization trajectories among adolescents: increasing poly-victimization (n = 39, 12.2 %), relieved poly-victimization (n = 228, 71.5 %), and fluctuating poly-victimization (n = 52, 16.3 %). Our findings indicate that boys, and those with poor class grade ranking, a lower level of parental education, lower household economy, smoking, drinking, suicide attempts, and suicide ideation, constitute the primary focus for the prevention and treatment of poly-victimization. ConclusionWe identified three poly-victimization trajectories, highlighting a significant heterogeneity in poly-victimization development. Understanding the characteristics of these developmental trajectories is crucial for realizing the dynamics of different poly-victimization subgroups and informing effective interventions.

Maternal folic acid supplementation during pregnancy in association with childhood overweight or obesity.

This study aimed to examine associations of maternal folic acid supplementation (FAS) during pregnancy with childhood overweight or obesity (OWO) or adiposity. In a population-based cohort of 1479 children, maternal FAS during pregnancy was assessed retrospectively by questionnaires. BMIand body fat percentages were measured at a mean age of 6.4 years. Pertinent factors were accounted for in data analyses. Maternal FAS during pregnancy was negatively associated with OWO (adjusted odds ratio: 0.70; 95% CI: 0.50 to 0.99). There were inverse associations of maternal FAS during pregnancy with BMI z score (β: -0.22; 95% CI: -0.39 to -0.05), whole body fat percentage (β: -1.28; 95% CI: -2.27 to -0.30), trunk fat percentage (β: -1.41; 95% CI: -2.78 to -0.04), and limb fat percentage (β: -1.31; 95% CI: -2.32 to -0.30). Stratified analyses found inverse associations of FAS during pregnancy with OWO, BMI z score, and body fat percentages predominantly among children without breastfeeding and whose parents had a below-tertiary educational level. This study provides novel evidence that maternal FAS during pregnancy was significantly associated with a decreased risk of childhood OWO and adiposity, particularly among children with no breastfeeding and lower parental educational level.

Racial/ethnic disparities in sleep health among adolescents in South Korea: The role of substance use behaviours.

To examine the relationship between racial/ethnic disparities and substance use behaviours (alcohol and tobacco use) and their impact on the sleep health of South Korean adolescents. Secondary analysis of cross-sectional study data from the 2021 Korea Youth Risk Behaviour Web-based Survey dataset. Given that Korean society has historically linked its racial/ethnic identity to a shared bloodline, we categorized 2644 adolescents from the Korea Youth Risk Behaviour Web-based Survey based on their racial/ethnic status, determined by their parents' birthplaces. Using multiple linear regression, we investigated whether the impact of racial/ethnic disparities on sleep health (sleep duration, debt, and timing) varies depending on substance use behaviours (alcohol and tobacco use) after controlling for age, sex, household economic status, depressed mood, suicidal ideation, perceived excessive stress, and anxiety level. Despite no statistical differences in sleep health and the prevalence of substance use between racial/ethnic groups, racial/ethnic minority adolescents experienced greater sleep debt than racial/ethnic majority adolescents when consuming alcohol. Moreover, racial/ethnic minority adolescents were more likely to report psychosocial distress and had lower parental education level. Racial/ethnic minority adolescents were more vulnerable to the detrimental effects of alcohol use on sleep health compared to racial/ethnic majority adolescents. This heightened vulnerability may be attributed to the more pronounced psychosocial challenges and the lower socioeconomic status of parents in the racial/ethnic minority group. Racial/ethnic disparities are concerning in South Korea, particularly since the negative effects of substance use on sleep health are intensified among racial/ethnic minority adolescents. Nurses and other healthcare providers should recognize the importance of addressing the social disadvantages linked to racial/ethnic disparities. Beyond just advocating for the cessation of substance use, it is crucial to address these underlying issues to reduce sleep disparities among South Korean adolescents. No patient or public contribution.

Abstract 64: Risk Factors for Carotid Artery Lipid Deposition Measured by Gray Scale Median of the Intima-Media in Children and Young Adults Over the Life Course

Introduction: Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media (GSM-IM), is a unitless measure that reflects lipid deposition in the arterial wall, with lower values indicating greater lipid deposition and atherosclerosis. Due to the relative novelty of GSM-IM, its progression and associated risk factors are incompletely understood. This study investigated the GSM profile in childhood and young adulthood using a longitudinal cohort of individuals followed over time, and conducted a priori analysis on the behavioral, psychosocial, and health risk factors for GSM. Methods: Data were collected as part of the Meta-Air2 follow-up study of participants enrolled in the Southern California Children’s Health Study. A total of 240 study participants underwent a carotid artery ultrasound examination in 2008 (mean age±standard deviation [ SD] : 11.2±0.6 years), and again between 2018 and 2023 (24.2±1.6 years) to assess changes in carotid artery health, including GSM-IM, carotid artery intima-media thickness (CIMT), and carotid artery distensibility. Participants self-reported lifestyle behaviors, psychosocial health, and underwent anthropometric and blood pressure measures at both time points. Mixed effects models were used to predict GSM-IM changes with repeated measurements of lifestyle behaviors, perceived stress, BMI, and blood pressure. Results: Means and SDs of GSM-IM were 110.0±27.4 in childhood, and 75.6±15.8 in adulthood, with an annual change rate of -2.6 per year. Individuals of Hispanic ethnicity, and those with lower parental education levels had significantly lower GSM-IM in both childhood and adulthood. GSM-IM was significantly correlated with other measures of carotid artery atherosclerosis, including CIMT (r=0.28; p &lt;0.001) and carotid artery distensibility (r=0.36; p &lt;0.001). Results of mixed effects models adjusting for covariates, indicated that higher BMI (β=-1.35; 95% confidence interval [CI], -1.70, -0.99; p &lt;0.001) and systolic blood pressure (β=-0.32, 95% CI, -0.55, -0.09; p=0.007) were significantly associated with lower GSM-IM. A significant interaction between BMI and age (β difference=0.14; 95% CI, 0.09, 0.20; p &lt;0.001) suggested that a per-unit change in BMI has a greater effect on GSM-IM among adolescents compared to young adults. Health compromising behaviors, including less sleeping time, smoking, drug use, and higher perceived stress were significantly associated with lower GSM-IM in unadjusted models. However, these associations were attenuated after adjustment for covariates. Conclusion: Our study highlights the influence of BMI, particularly during childhood, blood pressure and lifestyle behaviors on adverse changes in GSM-IM, indicative of greater lipid deposition. These risk factors may be key targets for early prevention for atherosclerosis.

Developmental trajectories of conduct problems and time-varying peer problems: the Bergen child study

BackgroundWhile it is increasingly acknowledged that conduct problems and peer problems often co-occur in development, less is known about the ways in which peer problems may alter the developmental course of conduct problems for distinct subgroups.MethodsUsing data from a large population-based study in Norway (the Bergen Child Study/youth@hordaland; 47.4% males), we estimated group-based trajectories of conduct problems and the presence of time-varying peer problems on the developmental progression of conduct problems between seven and 19 years of age. Risk factors for group membership were also examined.ResultsA 3-group model of conduct problems best fit the data (non-engagers, low-engagers, moderate-stable). The presence of peer problems increased the estimated level of conduct problems for both the low-engagers and moderate-stable groups across adolescence. No differences in conduct problems were observed when peer problems were present in childhood or preadolescence for these two groups, nor for the non-engagers group at any point. Being male, having lower perceived economic wellbeing, and lower levels of parental education predicted group membership for the moderate-stable group, whilst lower paternal education predicted membership for the low-engagers group.ConclusionsSupport for developmental ‘turning points’ was found, suggesting that adolescence is a particularly salient time for those with conduct problems. In particular, the presence of peer problems can increase observed conduct problems at this stage in development.

Association between parental education level & outcomes for children with long-term ventilator dependence: Communication behaviors as moderating variables

PurposeThe purpose of this study was to examine the correlation between parental education level and outcomes for children with long-term ventilator dependence (LTVD) and their families and whether parent communication behaviors with hospital nurses moderated the relationship. Advances in medical technology and policy changes allow children with LTVD to be cared for at home. The child's diagnosis and disease severity affect their health outcomes, as do their family's social determinants of health (SDoH) such as parent education. Design and methodsThis secondary data analysis used chi-square tests to evaluate the correlation between parental education level and outcomes. Generalized linear mixed effect models were used to examine the moderation effect of parent communication behaviors. ResultsLower parental education level was associated with more child respiratory infections and more parental uncertainty within one month following hospital discharge. Lower parent education level was also associated with fewer unplanned contacts with providers within one week post-discharge. Additionally, parent use of Verifying Understanding communication behaviors moderated the relationship between parental education level and number of respiratory infections and amount of parental uncertainty. Finally, parent use of Negotiating Roles moderated the association between education level and number of unplanned visits. ConclusionsContradicting previous research, lower parental education level does not consistently correspond to adverse outcomes and may be explained by parents' determination to ensure optimal outcomes for their children with LTVD. Practice implicationsOverall, healthcare providers should not be concerned that children with LTVD will have different outcomes based on their parents' education level.