Low Paternal Education Research Articles

Adherence to Mediterranean diet in Moroccan school-age adolescents: sociodemographic, socioeconomic and lifestyle determinants

BackgroundDespite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries.ObjectiveThe aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents.Material and methodsA cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waist�to-height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student’s t-test for independent samples, <i>Chi</i><sup>2</sup> test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample.ResultsAdherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p<0.001) and a better socio-professional class of the father (p<0.001).ConclusionsThis study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.

Medication Adherence of Children with Congenital Hypothyroidism in Iran: A National Cross-Sectional Study

Background: Congenital hypothyroidism is the most common preventable and treatable cause of intellectual disability in children. A key component of the surveillance system for congenital hypothyroidism is ensuring a regular treatment program for affected children. Despite nearly 20 years since the successful implementation of the newborn screening program for hypothyroidism in Iran, a comprehensive evaluation of patients' adherence to treatment has not been conducted. Objectives: The aim of this study was to investigate the adherence to treatment among patients with congenital hypothyroidism in Iran. Methods: In this national cross-sectional study conducted in 2024, the adherence to treatment of 400 children with congenital hypothyroidism born between 2019 and 2023 in Iran was examined using the Morisky Medication Adherence Scale. The patients were randomly selected from national registry data. Data were analyzed using chi-squared tests, Fisher's exact test, and logistic regression in Stata software version 16. Results: The mean and standard deviation of medication adherence was 6.35 ± 1.41. Overall, adherence was good (≥ 6) in 284 (71.0%) of the study participants. In the univariate analysis, the most significant factors influencing adherence were place of residence, higher maternal education, lower paternal education, and type of congenital hypothyroidism (CH). In the multivariate analysis, children with permanent CH had good adherence, and parental education was not statistically significant (P > 0.05). Conclusions: The results of this study showed that medication compliance in more than two-thirds of hypothyroid children diagnosed by national newborn screening is good. Given the importance of treatment in these patients, it is recommended that intervention plans be implemented, including educational programs and active follow-up of patients to increase compliance.

Microcephaly in Infants: A Retrospective Cohort Study from Turkey

Microcephaly (MC) is a clinical finding mostly reflecting deficiency of brain growth. The aim of this retrospective cohort study was to assess risk factors and follow-up features of children with MC. Children’s personal health records (n=7580) followed between 2002 and 2020 in the Unit of a Well Child Clinic were assessed retrospectively. The case group comprised children with MC. MC was defined as head circumference (HC) standard deviation score (SDS) value ≤-2 SDS. Age and sex-matched children with normal HC were selected as the control group. Children with MC (n=49) had more disadvantaged sociodemographic characteristics, such as young maternal and paternal age and low maternal and paternal education. Breastfeeding was more common among controls (n=98). Resolution of MC was observed in 26 (53.1%) children with MC, whether it was mild (HC SDS between -2 and -2.9) or severe (HC SDS ≤3). Children with persistent MC had poorer developmental milestones than controls and cases with resolution. Sociodemographic features or developmental milestones in mild and severe MC did not differ. These results suggest that the use of a definition of MC of ≤-2 SDS would be appropriate in order not to miss cases on follow-up. Greater sociodemographic equality may prevent some cases of MC. Further studies are needed evaluating socioeconomic factors on MC.

Malnutrition in children under five years in a squatter settlement of Karachi: a case-control study

BackgroundMultidimensional factors such as socioeconomic or environmental factors influence malnutrition. Several studies have strongly linked malnutrition to poverty. Some international studies point to the worse nutritional status of urban slum children than rural children. Limited data is available regarding the nutritional status of slum children in Karachi. This study aimed to determine characteristics of malnourished children in an urban squatter settlement in Karachi, Pakistan.MethodsA case- control study was carried out at the primary healthcare center of a squatter settlement in Karachi, Pakistan. All children under five years of age visiting the primary healthcare center were recruited consecutively. Cases were defined as children with z scores < -2 SD of WHO reference measurements of WFA, HFA, WFH and OFC. The controls were similar in terms of age group but had z scores between − 2SD and + 2SD. A self- structured risk factor questionnaire that included information about sociodemographic, economic and environmental factors as well as child- related characteristics was researcher administered via face-to-face interviews with the mothers of children. Univariate and multivariate logistic regression analyses were conducted. Crude and adjusted odds ratios were calculated with 95% confidence interval.ResultsA total of 280 participants including 140 cases and 140 controls participated in the study. A larger proportion of the sample originated from individuals with low household income. After adjusting for the confounders, childhood malnutrition was significantly associated with a low education level of father (aOR 4.86, 95% CI 2.23–10.60), a monthly income less than 25,000 PKR (89 USD) per month (aOR 7.13, 95% CI 1.67–30.54), pour pit latrine type of toilet (aOR 4.41, 95% CI 2.67–7.3), less than six months of exclusive breast feeding (aOR 3.578, CI 1.58–8.08), inappropriate weaning age (aOR 3.71, 95% CI 1.53-9).ConclusionMalnutrition in children under five years of age in the community is associated with low family income, low paternal education, poor toilet facilities, lack of exclusive breastfeeding and inappropriate weaning age. The implementation of poverty reduction programs, sanitation provision at affordable rates, community-based breast feeding and weaning education intervention are urgently required to efficiently improve children’s nutritional status.

The association between marital satisfaction and coparenting quality: A meta-analysis.

Coparenting refers to the way parents or caregivers relate to each other as parents. Marital satisfaction (MS) is the subjective evaluation of the overall quality of one's relationship, including the extent to which needs, expectations, and desires are met. The coparenting relationship is distinct from, yet intimately connected to, the marital relationship. The objective of this study was to summarize and analyze current evidence regarding the association between MS and coparenting quality (CQ). Meta-analyses of 108 published and unpublished articles were conducted to evaluate the association between MS and CQ. In the meta-analysis of samples including both mothers and fathers, a medium association was found between MS and CQ, r = .41; 95% CI [.37, .44]; Q(88) = 1253.42. Separate meta-analyses of samples including only mothers and only fathers and an analog analysis of variance examining the moderating effect of parent gender found larger effects for mothers (r = .48) than fathers (r = .42). Maternal age, paternal education level, relationship length, and number of children were also significant moderators, with larger effects being found with families with more advanced maternal age, lower paternal education, longer relationships, and more children. The country, person reporting on CQ, and measure of CQ were also found to be statistically significant moderators. This research has implications that may inform the work of parent and family support services and contribute to positive family functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Oral and Inactivated Polio Vaccine Coverage and Determinants of Coverage Inequality Among the Most At-Risk Populations in Ethiopia.

Combining oral (OPV) and inactivated (IPV) poliovirus vaccines prevents importation of poliovirus and emergence of circulating vaccine-derived poliovirus. We measured the coverage with IPV and third dose of OPV (OPV-3) and identified determinants of coverage inequality in the most at-risk populations in Ethiopia. A national survey representing 10 partly overlapping underserved populations-pastoralists, conflict-affected areas, urban slums, hard-to-reach settings, developing regions, newly formed regions, internally displaced people (IDPs), refugees, and districts neighboring international and interregional boundaries-was conducted among children 12 to 35 months old (N = 3,646). Socioeconomic inequality was measured using the concentration index (CIX) and decomposed using a regression-based approach. One-third (95% CI: 31.5-34.0%) of the children received OPV-3 and IPV. The dual coverage was below 50% in developing regions (19.2%), pastoralists (22.0%), IDPs (22.3%), districts neighboring international (24.1%) and interregional (33.3%) boundaries, refugees (27.0%), conflict-affected areas (29.3%), newly formed regions (33.5%), and hard-to-reach areas (38.9%). Conversely, coverage was better in urban slums (78%). Children from poorest households, living in villages that do not have health posts, and having limited health facility access had increased odds of not receiving the vaccines. Low paternal education, dissatisfaction with vaccination service, fear of vaccine side effects, living in female-headed households, having employed and less empowered mothers were also risk factors. IPV-OPV3 coverage favored the rich (CIX = -0.161, P < 0.001), and causes of inequality were: inaccessibility of health facilities (13.3%), dissatisfaction with vaccination service (12.8%), and maternal (4.9%) and paternal (4.9%) illiteracy. Polio vaccination coverage in the most at-risk populations in Ethiopia is suboptimal, threatening the polio eradication initiative.

An Epidemiological study on Depression among Rural &amp; Urban Adolescent of Moradabad District, Uttar Pradesh

Introduction: Adolescence is a stressful period due to physical, psychological, sexual changes, and presence of disorder such as depression is a matter of concern. Objectives: To study the prevalence of depression among adolescents in urban and rural areas and its socio-demographic correlates. Materials and methods: The PSU consisted all villages (n=29) and mohallas (n=23) in field-practice area. The required number of villages and mohallas, i.e., 10 each, were chosen using the basic random procedure, wherein each village and Mohalla has been assigned a unique serial number. Results: Overall, depression was observed in 110 participants (27.5%) with similar distribution in urban and rural areas. Low maternal and paternal education was a significant risk factor. Adolescents from the upper middle socioeconomic class (42.9%) and those from the lower middle socioeconomic class (33.3%) experienced the most depression. Burden was more among adolescents with low physical activity. Conclusion: This community based study of 400 adolescents residing in the urban and rural areas of Moradabad observed significant burden of depression in adolescent with poor maternal education, living in nuclear families, leading poor lifestyle and affected by any chronic illness at the time of the interview. Positive family history of mental illness was also an important risk factor.

Behavior problems of preschoolers with Developmental Language Disorder

Objective: Children with developmental language disorder (DLD) are prone to numerous adverse outcomes throughout their lives. The aim of the study was to investigate risk factors and behavior problems in children aged 1.5 to 5 years with DLD in a low/middle-income country. Material and Methods: This case-control study included 101 preschoolers (54 children with DLD and 47 children with typical development (TD)). A developmental pediatrician evaluated each child’s development using the Ages and Stages Questionnaire. Children Behavior Checklist and Beck Depression Inventory were completed by mothers. Socio-demographic information and screen parameters were obtained using a researcher-developed form. Results: Risk factors for DLD were identified as less frequent reading books with parents, consanguineous marriage, and having a family member with language disorders. Preschoolers with DLD had more behavior problems (except sleep and somatic problems) than preschoolers with TD (p&amp;lt;0.050). The risk factors for behavior problems of preschooler with DLD in the multivariable regression model included: ages of parents and children, paternal education, lack of having their own room, and maternal depressive symptoms. Conclusion: Consistent with the findings of this study, consanguineous marriage, family history of language disorders, and infrequent reading of books with parents were associated with the development of DLD. Attention should be given to behavioral problems in preschool children with DLD. Maternal depressive symptoms, lower paternal education, younger father, and lack of having their own room can be highlighted factors for behavior problems of children with DLD. Parents play a crucial role in shaping behavior and language development during the preschool period.

Socioeconomic differences in children's victimization to maternal and paternal violence: a register-based study.

To explore the potential of administrative data in assessment of the association between parental socioeconomic position (SEP) and children's violent victimization by biological parents. A longitudinal register-linkage study based on child-mother and child-father data, including all children born in Finland between 1991 and 2017. The data included 1,535,428 children, 796,335 biological mothers, and 775,966 fathers. We used logistic regression with person-years as observations and cluster-robust standard errors to predict children's violent victimization in 2009-2018 and assessed effect modification by child's age and gender. For the SEP indicators, lower maternal education (adjusted odds ratio (OR) 2.90, secondary education OR 1.99) and lower paternal education (OR 2.24, secondary education OR 1.59) were risk factors for violent victimization. Parental social assistance receipt (OR 2.4) and non-employment (OR 1.8-1.9) increased the risk of victimization to maternal and paternal violence. Income was associated with victimization in a gradient-like manner, with ORs ranging from 1.14 to 1.98 among mothers and from 1.29 to 2.56 among fathers. Children with low parental SEP were at the highest risk of parental violence, particularly paternal violence, at ages 3-8 years. All indicators of low SEP increased the risk of children experiencing both maternal and paternal physical violence, especially at ages 3-8 years. Longitudinal register data-because of large samples, no nonresponse or self-report bias, and the possibility to analyze violence committed by mother and father and age-groups separately-have great potential for comprehensive research on the risk factors of parental violence that are difficult to reliably assess with other types of data.

Socio-demographic and antenatal risk factors of brain tumor in children and young people: A matched case-control study from Karachi, Pakistan.

Brain tumors are a common cause of morbidity, disability, cognitive deterioration and mortality in children, even after treatment. Little is know about the specific causes. The study aimed to assess potential socio-demographic and antenatal factors in primary brain tumor (PBTs) in children and young people (CYP) in Karachi, Pakistan. A single center hospital based matched case control study in Karachi, Pakistan. Cases were defined as CYP aged between 5 and 21 years with any histological type and grade of primary brain tumor of any histology, stage or grade. Data were collected from parents of 244 patients at the selected center between 2017 and 2021 via telephonic interview. Controls were 5-21 years old CYP admitted with non-oncological diagnoses matched on age and sex. Matched Odds Ratios for predictors of brain tumor in children were derived. Those of statistical significance were included in a multivariable logistic regression model. In the adjusted model, lower paternal education (matched adjusted odds ratio (maOR) 2.46; 95% CI 1.09-5.55), higher household monthly income (maOR 3.4; 95% CI 1.1-10.2), antenatal paternal use of addictive substances (maOR 19.5; 95% CI 2.1-179.8), and antenatal maternal use of analgesics during pregnancy (maOR 3.0; 95% CI 1.2-7.9) were all independently predictive of brain tumors. This matched case-control study found novel associations between maternal use of analgesics, paternal use of addictive substances, higher household income, and lower paternal education and Primary Brain Tumors in Children and Young People. Longitudinal multicenter studies will be required to test these associations prospectively.

Cognitive performance of 4-6-year-old children: a longitudinal study

Background Many children in low and middle-income countries (LMIC) have reduced cognitive abilities, but few studies have explored the influencing factors.&#x0D; Objective To determine the determinants of children's low cognitive development at 4 to 6-year-old.&#x0D; Methods This is a retrospective cohort study in year 2021. The data was obtained from Bogor Longitudinal Study of Child Growth and Development (BLSCGD) that started from year 2012. For this analysis, we considered 165 of children aged 4-6 years. The dependent variable in this analysis was cognitive development as measured by the Indonesian Wechsler Preschool and Primary Scale of Intelligence (WPPSI) with the indicators of full-scale IQ (FSIQ), verbal IQ (VIQ) and performance IQ (PIQ). The independent variables were determinants of children’s cognitive development at 4-6 years, consisted of socio-demographic factors, determinants from early life (0-23 months), as well as determinants from current conditions. Multivariate analysis done with the logistic regression test.&#x0D; Results Bivariate analysis revealed that paternal education level was significantly associated with FSIQ and inadequate calorie intake in infancy and poor child stimulation were significantly associated with VIQ. In the final model of multivariate analysis, low paternal education level retained a significant association with FSIQ. Psychosocial stimulation was significantly associated with VIQ and inadequate calorie intake during infancy was significantly associated with PIQ.&#x0D; Conclusion Low paternal education level and inadequate psychosocial stimulation are risk factors for reduced child cognitive development in 4-6-year-olds. Inadequate calorie intake in infancy even though not statistically significant it has high OR values for low VIQ and PIQ, thus the results showed the importance of calory intake in infancy.

Parental exposure to famine in early life and child overweight in offspring in Chinese populations

Little is known about the transgenerational effect of nutrition deficiency in early life. This study aimed to evaluate the associations of fetal and childhood exposure to famine of parents with their offspring's risk of overweight during childhood. This analysis included a total of 3734 participants of the China Health and Nutrition Survey aged 1-17 years whose fathers and/or mothers were born in 1955-1966. These children were classified into subgroups according to parental famine exposure status (unexposed and exposed) and timing (fetal-exposed and childhood-exposed). Random effects models were applied to evaluate the associations of parental famine exposure with body mass index (BMI) and overweight of offspring. Fractional polynomial functions were adopted to describe trajectories of BMI against age. Compared with children of unexposed parents, there was a lower risk of overweight among offspring of childhood-exposed fathers [OR (95%CI): 0.80 (0.61, 1.04)] or exposed parents [0.84 (0.68, 1.04)], particularly among male offspring, but not among those with exposed mothers only [0.98 (0.65, 1.47)]. For BMI, children with exposed mothers only had a slightly higher BMI [β(95%CI): 0.17 (-0.15, 0.49)], while those with exposed fathers only had no difference [-0.02 (-0.23, 0.19)] or exposed parents had a slightly lower BMI [-0.17 (-0.33, 0.00)] (p<0.05 for interaction between maternal and paternal exposures). Stratified analysis showed little heterogeneity between male and female offspring, but the association between paternal childhood exposure to famine and lower overweight risk in offspring was more evident in high (vs low) paternal education group (p for interaction< 0.05). The transgenerational associations of early-life exposure to famine with lower risks of child overweight may be via the paternal line and differ by the educational levels of parents. Further studies are warranted to confirm the results and reveal the biological mechanisms underlying.

Linked labor force trajectories: Empirical evidence from dual-parent families in the United States and Australia

To what extent are parents’ and children’s labor force trajectories associated and what factors shape these intergenerational labor force trajectories? We address these questions by proposing a linked labor force trajectory approach that compares monthly labor market attachment sequences over a 2.5 year period, first for parents, and for their children 12 years later when they reach young adulthood in their 20 s. Using triadic sequences from the U.S. Panel Study of Income Dynamics (PSID) ( N = 488) and the Household, Income and Labour Dynamics in Australia (HILDA) Survey ( N = 693), we show that children’s labor force trajectories in young adulthood are strongly associated with the labor force trajectories of their parents. Intergenerational associations of labor force trajectory are strongest in “Job-rich” households where at least one parent is employed and weaker in “Job-poor” households, particularly in Australia. Low educational attainment, low maternal education (in Australia) and low paternal education (in the U.S.), family size, and family structure (in the U.S.), are among the most consistent factors generating associative patterns of “Job-poor” labor force trajectories between parents and children. Our findings suggest that parents’ joint workforce engagement improves children’s future labor force outcomes.

Inequalities in adverse birth outcomes and survival in early childhood: birth cohort in South Korea

Abstract Background Adverse birth outcomes (ABOs) are considered the most common factor of deaths in early childhood. Inequalities in child mortality occur due to interactions between intrinsic and socio-environmental factors related to socioeconomic disadvantage. There are, however, few studies investigating the impact of ABOs on mortality in terms of parental SEP. Methods Using the Under-5 Infant Birth-Death Cohort Data in Korea, a pooled retrospective birth cohort of all children born in 2012-2014 was built (N = 1,356,584). We analyzed neonatal, post-neonatal, and childhood mortality by ABOs and with the interaction of parental SEP using the Cox proportional hazard regression model for survival analyses. We further stratified the analysis both by parental SEP and child age. Multiple logistic regression was performed to confirm the social inequalities in ABO itself. Results After adjusting for covariates, children born with ABOs presented higher risk of mortality for all periods. For post-neonatal period, lower maternal education showed significant interaction effect with LBW (HR = 0.57; 95% CI = [0.39-0.85]), PTB (HR = 0.53; 95% CI = [0.33-0.86]), LBW &amp; PTB ([HR = 0.67; 95% CI = [0.54-0.83]) while lower paternal education (HR = 0.67; 95% CI = [0.54-0.82]) and maternal unemployment (HR = 0.80; 95% CI = [0.63-0.99]) showed significance for babies with LBW &amp; PTB. However, stratification analyses suggested that the impact of ABOs on mortality was greater for children born to lower parental SEP in neonatal period. Meanwhile apparent social inequalities in ABOs were suggested from regression analyses. Conclusions We confirmed social inequalities in the incidence of ABOs as well as mortalities from ABOs. However, the difference in mortality between babies with and without ABOs was greater for advantaged children. Policies to reduce the mortality of children with ABOs as well as those of healthy children among socioeconomically disadvantaged families are required. Key messages • Social inequalities in mortality from ABOs were apparent especially in the neonatal period while the incidence of ABOs itself was greater among children from disadvantaged families. • Disadvantaged children are more likely to die not only from ABOs but also from other socio-environmental determinants, especially in the post-neonatal period than their counterparts.

Examination of risk exposure models during COVID-19 in relation to youth life satisfaction and internalizing symptoms

This study examined mediation of a negative COVID-impact on the relationship between risk exposure, and life satisfaction and internalizing symptoms in youth (aged 9–18). Four operationalizations of risk exposure were applied; an Additive versus a Cumulative Risk Model (ARM and CRM), risk clusters and the most salient risk factors. Results showed that a stronger negative COVID-impact is related to lower life satisfaction, more internalizing symptoms and higher additive and cumulative risk. ARM and CRM’s effect on lower life satisfaction is mediated through negative COVID-impact, though not for internalizing symptoms. Clusters of risk factors and risk factors within clusters significantly related to a stronger negative COVID-impact are the clusters ‘Individual factors’ (low self-control), ‘Parenting’ (negative mother–child interaction and low parental responsiveness), ‘Maternal mental health’ and ‘Demographic factors’ (low SES and high paternal education). From all significant risk factors, low self-control, low parental responsiveness, negative mother–child interaction and low SES were most salient.

Associations between low parental education, childhood adversities and sickness absence in midlife public sector employees.

Parental education and childhood adversities are associated with long-term work disability but their contribution to sickness absence is largely unknown. We aimed to examine the associations between parental education, childhood adversities and self-certified and medically-certified sickness absence among midlife employees. The Helsinki Health Study baseline survey data (2000-2002) of 40-to-60-year-old municipal employees were linked with sickness absence data from the employer's register. Self-certified (1-3 days) and medically-certified (>3 days) sickness absence spells were followed from 2003 until the end of 2008. The study included 5728 employees. The analyses were made by Poisson regression and the results are presented as rate ratios (RRs) and their 95% confidence intervals (CIs). Low maternal education was associated with self-certified sickness absence (RR 1.32, 95% CI 1.13-1.55) among women only whereas both low maternal (1.49, 1.26-1.77) and low paternal education (1.48, 1.32-1.67) were associated with medically-certified sickness absence. Adjustment for own occupational class mainly abolished these associations. Having experienced any childhood adversity was associated with self-certified (1.18, 1.12-1.25) and medically-certified (1.22, 1.15-1.30) sickness absence. In addition, childhood economic difficulties, childhood illness, parental divorce, parental mental illness, parental alcohol problems and bullying were each associated both with self-certified and with medically-certified sickness absence. The associations mainly remained after adjustments for occupational class, marital status, working condition, body mass index and health behaviours. Low parental education and childhood adversities contributed to midlife sickness absence. Promoting well-being of families with children might help sustain adult work ability and prevent sickness absence still in midlife.

THE EFFECT OF SOCIOECONOMIC FACTORS ON THE FIRST VISIT OF A CLUBFOOT TO A HEALTH FACILITY

Background: Clubfoot, also known as CTEV (Congenital Talipes Equinovarus), is a foot deformity characterized by varus of the hindfoot, adductus of the forefoot (metatarsus), arched middle leg (cavus), and equinus. Untreated CTEV causes physical, social, psychological, and financial burdens that worsen the patient's condition, family, and community around the patient. Methods: This research is an observational analytic study in which data was collected in the city of Medan in December 2021 and the number of samples in this study was 38. Results: Patients with low paternal education had a 3.5 times risk of having a first visit time of > 1 year compared to those with high paternal education. Patients with low maternal education had a risk of 3,212 times having a first visit time of > 1 year compared to those with high maternal education. Patients with low paternal income are 3,261 times more likely to have a first visit time of > 1 year than those with high paternal income. Conclusion: Socioeconomic factors such as father's education, mother's education, and father's income were significantly related to the first visit of pediatric patients with clubfoot to health facilities.

The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians-The RODAM Study.

Background: Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. Methods: Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. Results: Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54–0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50–3.74). No associations were found among rural Ghanaians. Conclusion: The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.

Biosocial life-course factors associated with women's early marriage in rural India: The prospective longitudinal Pune Maternal Nutrition Study.

By convention, women's early marriage is considered a sociocultural decision sensitive to factors acting during adolescence such as poverty, early menarche, and less education. Few studies have examined broader risk factors in the natal household prior to marriage. We investigated whether biosocial markers of parental investment through the daughters' life-course were associated with early marriage risk in rural India. We used an evolutionary perspective to interpret our findings. A prospective cohort recruited mothers at preconception. Children were followed from birth to age 21 years. Multivariable logistic regression models estimated odds ratios of marrying early (<19 years) associated first with wealth, age at menarche and education, and then with broader markers of maternal phenotype, natal household characteristics, and girls' growth trajectories. Models adjusted for confounders. Of 305 girls, 71 (23%) had married early. Early married girls showed different patterns of growth compared to unmarried girls. Neither poverty nor early menarche predicted early marriage. Girls' non-completion of lower secondary school predicted early marriage, explaining 19% of the variance. Independent of girls' lower schooling, nuclear household, low paternal education, shorter gestation, and girls' poor infant weight gain were associated with marrying early, explaining in combination 35% of the variance. Early marriage reflects "future discounting," where reduced parental investment in daughters' somatic and educational capital from early in her life favors an earlier transition to the life-course stage when reproduction can occur. Interventions initiated in adolescence may occur too late in the life-course to effectively delay women's marriage.

Screen Time and Autism: Current Situation and Risk Factors for Screen Time Among Pre-school Children With ASD.

Objective: To investigate the current status of screen time in children with ASD, its correlation with autistic symptoms and developmental quotient (DQ), and the factors affecting screen time.Method: One hundred ninety-three Chinese children with ASD were recruited. We collected the demographic and screen time data using a questionnaire. The ASD core symptoms and developmental quotient (DQ) were measured by the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Griffiths Development Scales-Chinese Language Edition (GDS-C), and Chinese Children's Parent-Child Relationship Questionnaire (CPCIS). Then, we analyzed the correlations between the screen time of children with ASD and the ABC, CARS, ADOS, GDS-C DQs, and CPCIS scores. Linear regression was used to analyze the risk factors that affect screen time.Results: The children's average daily screen time was 2.64 ± 2.24 h. Forty eight percent children were exposed to two or more types of electronic devices. Their favorite activity of screen time was watching cartoons. Only 34% children spent screen time accompanied by parents and with communication. 50.26% children had no screen time before sleeping. The screen time of children with ASD had a negative correlation with the GDS-C CQ (r = −0.234, P = 0.001) and the CPCIS score (r = −0.180, P = 0.012) and a positive correlation with the CARS score (r = 0.192, P = 0.009). A low father's education level (P = 0.010), less restriction of the child's screen time by the guardian (P = 0.001), greater caregiver screen time (P < 0.001), the use of the screen as a tool for child rearing (P = 0.001), and the child's ownership of independent electronic equipment (P = 0.027) are risk factors for long screen time in children with ASD.Conclusion: The screen time of children with ASD in China is higher than the recommended standard, and the current situation is serious. The screen time of ASD children is related to their autism symptoms, DQ and parent-child interaction. Low paternal education levels, less restriction of children's screen time by guardians, greater guardian screen time, the use of screens in child rearing, and children's ownership of independent electronic equipment can lead to an increase in children's screen time. These findings may have implications for family intervention strategies.