Middle-sized City Research Articles

Central America and the Caribbean: Dengue and P.Vivax malaria

In recent decades, the incidence, distribution and clinical severity of dengue have increased dramatically in most tropical and subtropical areas worldwide. As a consequence, and due to the expanding international tourism, health care providers in travel clinics of developed countries are increasingly confronted with dengue, reflecting its global impact. No specific prophylactic or therapeutic agents exist for dengue infections. All four serotypes of dengue viruses are widespread in Central America and the Caribbean basin. Dengue is most common in cities but can be found in rural areas. It is rarely found in mountainous areas above 4,000 feet. Dengue fever is the most common cause of fever in travelers returning to the USA from the Caribbean and Central America. In some case studies, dengue has been the second most common cause of hospitalization (malaria is the most common) among travelers returning from the tropics. Infection rates (based on anti-dengue serology) among febrile travelers returning from those areas may range from 2.9% to 8.0%. Similar results have been reported in travelers returning to Europe. Persons travelling to areas where dengue is endemic should avoid exposure to mosquitoes, and health care providers should consider dengue as a differential diagnosis in febrile travelers returning from the tropics after discounting malaria. Surveillance of imported dengue is crucial to monitor the risk of infection for travelers and to strengthen clinical awareness of the disease. The risk for a traveler acquiring malaria differs substantially from different areas within the region and from traveler to traveler, even within a single country. In a large series of 10,745 cases of malaria among U.S. residents reported to CDC from 1997 through 2006, 1,427 (13.3%) were acquired in the Caribbean and Centra/South America. Malaria has been reported in about 1 per 100,000 European travelers to Central America and the Caribbean. The risk of vivax malaria may be relatively high in some Central American countries, including several large or middle size cities. Travelers to malaria-risk areas, including infants, children, and former residents of Mexico and Central America, should take an antimalarial drug. There is no chloroquine resistance in Central America, so this drug can still be recommended for travelers to these countries. Malaria is not a risk in most of the Caribbean islands, but P. falciparum is endemic to most of Haiti and some areas of the Dominican Republic, where there is variable to low risk. Malaria in these areas is still sensitive to chloroquine, which is therefore recommended for prevention. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive

Gender-specific Problem Behaviors of School-aged Children according to Parenting Characteristics in Poverty

Purpose:The purpose of this study was to examine the association between the parenting characteristics and problem behaviors of school-aged children living in poverty. Methods:With a cross-sectional study design, the ChildBehaviorChecklist (CBCL) was utilizedtocollectdatafrom190primarycaregiversof childreninlow income families in one middle-size city in South Korea. Results: Among the children's characteristics, only school performance showed significant association with problem behaviors and children's age and gender were not associated with problem behaviors. Among the primary caregivers' parenting characteristics, discipline style, rearingconfidence,andconcernsfor their childrenshowedsignificant associationwithproblembehaviorsfor girls, but not for boys. Parenting attitude was not related to problem behaviors with either girls or boys. Conclusion: Thefindingsofthisstudyindicatethat theparentingcharacteristicsof low incomeprimarycaregiversareimportant in children's problem behaviors, especially for girls and parent education programs for child rearing, including methods of discipline for both boys and girls, are effective nursing interventions.

Rede social das cuidadoras de familiares com doença crônica incapacitante no domicílio: implicações para a enfermagem

At the moment a person presents an impairing illness in his home, the care given, is usually under the responsibility of a family member. This member, in general, does not possess the proper preparation to care for the other, without interfering in his own health condition. The social networks may have an essential role in the aid of the caregivers of such people. This is a qualitative, exploratory-descriptive research, which aimed at knowing how the social networks are formed on the family caregivers of individuals with chronically impairing illnesses, home care, in the region comprehending a family care unit, of a middle-size city in the south of Brazil. Ten caregivers were interviewed, most of them over 50 years old, and children of the cared individual. The caring time ranged from seven months to five years. It was noticed that the networks of these caregivers was composed by relatives, neighbors, friends, members of religious congregations and health professionals. It was evidenced the importance of the social networks in the lives of the caregivers, providing them the necessary support, especially in the cases of illness. Thus, it is suggested to the nurses, new studies and activities in the health units aiming at means to strengthen these social networks, which will aid the caregiver in the care taken.

Associated factors in high blood pressure among schoolchildren in a middle size city, southern Brazil

To establish the prevalence of high blood pressure and associated factors among schoolchildren from Caxias do Sul, state of Rio Grande do Sul, Brazil. This school-based cross-sectional study assessed boys and girls aged 7 to 12 years from private and public schools. Three measurements of the children's blood pressure were taken during one visit to the schools. Weight, height, and waist circumference were measured. We also assessed the children's aerobic capacity (9-minute running test) and socioeconomic status. Statistical analysis was carried out using the chi-square test and logistic regression in order to control for confounding factors. The sample included 1,413 children. Prevalence of schoolchildren with high blood pressure was 13.8% (systolic, diastolic, systolic/diastolic), and the proportion was higher (double) for obese and/or overweight children in comparison to normal-weight children. Children with increased waist circumference had 2.8 times greater chance of having high blood pressure levels than those with appropriate waist circumference (95% confidence interval 2.513-3.186 and p = 0.000). Individuals belonging to a high social class, defined according to the Brazilian National Economic Index, had 2.6 times greater chance of having high blood pressure. In the present study, schoolchildren aged 7 to 12 years from Caxias do Sul had high prevalence of high blood pressure levels; increased waist circumference, high socioeconomic status, and low physical capacity were associated with this condition. We suggest that measures be taken to promote the practice of physical activity and dietary control to improve blood pressure levels and thus reduce risk factors.

Eco-service enhancement in peri-urban area of coal mining city of Huaibei in East China

After 50 years of coal mining, Huaibei Mine, located at 50 km southeast of Xuzhou City in East China, has grown to a middle-size city of 600,000 people from a small village of 2000 farmers. The Zhahe Valley, with 400 km 2 of a built-up area and more than 100 km 2 of subsided peri-urban wetland at the city center, is surrounded by eight exhausted old mines and communities. In cooperation with the local city government, an ecological landuse change assessment and eco-city planning project has been carried out with a focus on the assessment, restoration and enhancement of the wetland as an eco-service to the community. The assessment includes relationships to Green House Gas emissions and heat island effects, as well as measures for a livable, workable, affordable and sustainable human settlement development through industrial transition, landscape design and capacity building. This paper will briefly introduce the main ecological approaches and results of the assessment, including measures such as changing the car-dominated transportation network to a rail-dominated network, transforming the coal-oriented high-carbon industry to a service-oriented low-carbon industry, the C-shape urban form to an O-shape with a green–blue core at the center, and the fragmentized collapsed land to integrative eco-service land.

Development of Composite Deprivation Index for Korea: The Correlation with Standardized Mortality Ratio

The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

Trends and issues in municipal twinnings from the Netherlands

The Netherlands is a decentralised unitary state. From a legal perspective, central government clearly dominates, but on the other hand ‘a certain autonomy’ of the municipal/provincial level is guaranteed. The Dutch politico-administrative culture, however, has a strong preference for consultation and consensus, and, therefore, municipalities have considerable room for their international contacts. Defining municipal twinnings as the organized contacts with municipalities abroad, based on a decision of the municipal council, one can distinguish six waves since World War Two. First, there was the wave driven by the desire for peace in Europe. Second, there was a wave of socially/politically driven idealism to fight injustice in the Third World. Third, the wave of humanitarian involvement with Central and Eastern Europe after the fall of the Berlin Wall, followed by a fourth wave driven by EU-membership for the former communist countries. Fifth, since the 1990s, a ‘Diaspora-related’ wave developed, driven by immigrant minority problems in the Netherlands. Sixth, there is the recent UN- and Millennium-driven wave. In most Dutch municipalities, one finds several/all waves co-existing, in harmony and/or tension. A fourfold typology of twinnings is proposed: the four big cities, the middle-sized cities, the small municipalities, and the municipalities in the border regions. Five issues have an impact on twinnings: municipal mergers and increase in scale, public versus private responsibility and involvement, volunteers versus professionals, the impact of EU, and the low political profile of most twinnings. Strategies to deal with these issues are presented and discussed. For the development of a theoretical framework for twinnings, the concepts of success–failure (evaluation), life cycles and the co-existence of continuity and change look most promising.

Why Does Zipf's Law Break Down in Rank-Size Distribution of Cities?

We study the rank-size distribution of cities in Japan by data analysis and computer simulation. From the census data after World War II, we find that the rank-size distribution of cities is composed of two parts, each of which has an independent power exponent. In addition, the power exponent of the head part of the distribution changes with time and Zipf's law holds only for a restricted period. We show that Zipf's law broke down owing to the great Showa and Heisei mergers and recovered owing to population growth in middle-sized cities after the great Showa merger.

Depression among elderly people with and without heart failure, managed in a primary healthcare setting

Depression is common among patients with heart failure (HF) and among elderly in general. Problems in diagnosing and care planning can arise as symptoms of HF, dyspnoea and especially fatigue, are nonspecific and also overlap with symptoms of depression. The objective of this study was to describe the prevalence and compare degrees of depression among patients with confirmed HF, patients with symptoms similar to HF (no heart failure, NHF) and a reference group in one primary healthcare centre (PHC), after adjusting for background characteristics and fatigue. A descriptive case-reference study was conducted in one PHC in a middle-sized city. Participants were 49 patients with confirmed HF, 59 patients with symptoms similar to HF (NHF) and 40 people in a reference group. After informed consent data were collected by structured interviews using the Geriatric Depression Scale and the Multidimensional Fatigue Inventory-20. Odds ratios for the outcomes HF vs. NHF, HF vs. reference group, and NHF vs. reference group were calculated. The HF and NHF groups had similar degrees of depression which were significantly higher than for the reference group. This difference between the groups did not remain significant when adjusting for physical fatigue. More patients in the NHF than in the HF group were living alone and there were more women in the NHF than in the reference group. Prevalence of depression and degrees of fatigue were higher among elderly from a PHC who experienced HF symptoms, independent of objectively measured heart function, compared with elderly without such symptoms. When comparing degrees of depression between the three groups and adjusting for fatigue, the physical dimension of fatigue was of greater importance in explaining group differences.

Use of Pit-and-Fissure Sealants by Dentists from a Middle-Sized City

Objetivo: Avaliar a utilizacao de selantes de fissuras por cirurgioes-dentistas (CDs) do municipio de Piracicaba, SP. Metodo: Foram selecionados aleatoriamente 115 CDs que trabalhavam em consultorio particular e 44 CDs que trabalhavam em Unidades Basicas de Saude (UBSs). Foi aplicado um questionario abrangendo dados pessoais e profissionais e a frequencia de uso dos selantes na pratica clinica. Para avaliar alguma associacao entre as variaveis, utilizaram-se os testes estatisticos de Qui-quadrado e Exato de Fisher. Resultados: Verificou-se que os CDs que trabalhavam em consultorio utilizavam selantes com mais frequencia do que os que trabalhavam nas UBSs (p<0,05). Dos CDs da rede privada, os que prestavam servicos para algum convenio odontologico utilizavam selantes com mais frequencia em comparacao com aqueles nao conveniados (p<0,05). O criterio mais utilizado para indicacao de selantes por profissionais das UBSs foi a presenca de molares higidos, porem em pacientes com experiencia anterior de carie e higiene bucal deficiente, enquanto que a maioria dos CDs da rede privada costumavam aplica-lo em dentes com atividade de carie em esmalte. Conclusao: Grande parte dos CDs entrevistados utiliza selantes como metodo preventivo, entretanto, verificou-se que o uso e influenciado pelo local de trabalho e, no caso dos CDs que trabalham em consultorio particular, vinculo do profissional com algum tipo de convenio.

On the urban-rural differences in classroom environment in compulsory education in the Eastern coastal developed areas of China

Totally 789 students from 18 schools (9 primary schools and 9 junior high schools) at a medium managed level from Shanghai, Wenzhou, and Aojiang, which are located in the Eastern coastal developed areas of China were investigated with the questionnaire of Hong Kong Classroom Environment Scale in this study. The result indicates that the actual classroom environment in the Eastern coastal developed areas at the present stage of curriculum reform is as follows. (1) The satisfaction of the students is above the average. Teachers’ involvement and support are higher than collaboration, classroom order and the student involvement. (2) There are significant differences between urban and rural areas. The big cities are better than the middle-sized cities, while the latter are better than the counties in the aspects of collaboration, teacher involvement and support. The big cities are better than counties, but the counties are better than the middle-sized cities in the aspects of classroom order and student involvement. (3) The three main types of the actual classroom environment are high, middle and low ones, which distribute in a descending way in big cities, middle-sized cities and counties. (4) Per capita GDP of a region is a main factor affecting classroom environment.

Sociodemographic Groups and Mode Choice in a Middle-Sized European City

This paper studies the transportation mode choice and the travel behaviors of different sociodemographic groups in a middle-sized European city. Data were extracted from an extensive origin–destination survey (10,092 individuals and 28,225 trips) conducted in Trieste, Italy, in 2002 and 2003. Gender, age, employment, and vehicle availability are important variables influencing transportation mode choice. These variables were explicitly introduced in the utility function of a random utility model, the multinomial logit model. The proposed model allows the effects of the different transportation planning initiatives on different socio-demographic groups to be evaluated. The effects of any transportation initiative may not affect the population as a whole and can be quite different for each sociodemographic group. These differences should be considered in assessments of any transportation planning process for two reasons: they improve the performance of the policy design phase and they increase the predictability of the effects caused by the transportation scenario chosen. Hence, the introduction of sociodemographic variables within a transportation mode choice model should be aimed not only at improving the statistical evaluation of the model but also at increasing its descriptive potential.

The impact of a forced reduction in traffic volumes on urban air pollution

The Middle East military conflict of summer 2006 resulted in a few weeks in which the city of Haifa, Israel, and its environs experienced very profound variations in the commercial and personal activities. Large industrial plants continued almost normal operations but activities of small scale industry, shopping, and personal commuting were drastically reduced, leading to a dramatic decrease in the commercial and personal traffic volumes. This period of reduced activity serves as a real life experiment for assessment and demonstration of the impact that human activity, and mainly road traffic, may have on the air pollution levels in a bustling middle-sized city. The analysis is made especially sharp and reliable due to the abruptness of the beginning and the end of the reduced activity period, its length, and the stable summer meteorological conditions in the eastern Mediterranean region. The reduced traffic volumes resulted in lowered levels of NO 2, hydrocarbons and particulate matter. The decrease in these pollutants’ mean concentration was significantly larger than the reduction in the mean traffic volume. Slightly higher mean O 3 concentrations were observed during the reduced traffic period.

Determinants of Childrenʼs Academic Achievements in Primary Education

The measurement of children’s academic achievements and the explanation of differences between social classes should not be dismissed by sociologists of education. Although inequality is a major theme of the field, the sociology of education has lacked empirical evidence on the structure of disparities in academic achievements. This is partly due to the difficulties involved in collecting sufficient data on academic achievement through schools.In and after 2002, studies were begun on the relationship between academic achievement and social class in Japan. At the time, schools were being heavily criticized within the context of the debate over falling children’s academic achievements. Some significant surveys were administered at that time, though they were small in number. However, they left some important issue to be solved. The first is that analyses of the determinants of academic achievement are inadequate for clarifying what factors will diminish class differences in achievement. The second concerns the reliability and validity of the variables collected. In particular, variables on the economic conditions of households are lacking. Finally, the surveys were conducted only in large cities.This paper examines the factors that affect children’s academic achievements, and the extent of the effect of such factors, through an analysis of the data of the Japan Education Longitudinal Study 2003 (JELS2003). JELS2003 was conducted in two areas: one a middle-sized city within the capital metropolitan areas, and the other a small local city. It also contains variables about the economic conditions of households.The major findings of the paper are as follows.1. In the small local city, the differences of academic achievement between social classes were relatively small.2. In the middle-sized city within the metropolitan area, children’s academic achievements were affected by the level of monthly educational expenses, level of educational expectations of the child, and income level of the family.Inequalities in children’s academic achievements in our society should be grasped in the context of the substitution of “parentocracy” for meritocracy.

Increase of visceral fat area in Indonesians and Japanese with normal BMI

We compared the visceral fat accumulation between Indonesians and Japanese. Non-obese (25 > BMI ≥ 18.5) men aged between their 20s and 50s were collected in Toban including moderately populated middle-sized cities of Hyogo Prefecture in Japan, and Sangsit town and Pedawa village in Indonesia. Their visceral fat accumulation was assessed by determination of visceral fat area (VFA) that was measured through bio-electrical impedance analysis. VFA as well as VFA per body weight in those aged in their 20s did not vary significantly among Toban, Sangsit and Pedawa. In these three districts, they increased with age. Compared with VFA as well as VFA per body weight among those aged in their 20s, they increased in their 30s and over in the urban area of both Japan and Indonesia, whereas it did in their 40s and over in Pedawa, economically poor district. The inhabitants in their 40s and over in Sangsit and those in their 30s and over in Pedawa had less VFA than those with the corresponding age in Toban, while those in the 30s and 40s in Pedawa and those in their 40s in Sangsit had less VFA per body weight than those with corresponding age in Toban. In conclusion, the visceral fat appears to accumulate progressively with aging and urbanization of lifestyle even in those with normal body mass index. It is recommended that some preventive measures against visceral fat accumulation should be taken in their 20s or under for urban dwellers and in their 30s or under for rural inhabitants.

Tourism Potentials in American Middle-Sized Cities: The Case of Wilmington, Delaware, and Albany, New York

Tourism in small American cities is often problematic. Many do not have the images and attractions to lure tourists. This is particularly true for cities with myopic local politics, crumbling infrastructures and unstable demographics. Lacking an alternative economic development plan, tourism has become a possibility if not an imperative. Often such cities are slow to realize the possibilities of a tourist-oriented future. This paper analyses the tourism potential of two relatively small cities, Willington, Delaware, and Albany, New York. Using interviews of city leaders we assessed the readiness of these two cities for a tourism-based economy.

Thyroid Function Is Associated with Components of the Metabolic Syndrome in Euthyroid Subjects

Thyroid disease and the metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to explore the hypothesis that thyroid function, in euthyroid subjects, is associated with components of the metabolic syndrome, including serum lipid concentrations and insulin resistance. A total of 2703 adult inhabitants of a middle-sized city in The Netherlands participated in this cross-sectional study. Subjects who were not euthyroid were excluded, as were subjects taking thyroid medication, medication for diabetes, and subjects for whom medication data were not available (n = 1122). Homeostasis model assessment for insulin resistance (HOMA-IR) (mU*mmol/liter2) was calculated as fasting insulin (mU/liter) times fasting glucose (mmol/liter) divided by 22.5. The metabolic syndrome was defined according to National Cholesterol Education Program's Adult Treatment Panel III criteria. After adjustment for age and sex, free T4 (FT4) was significantly associated with total cholesterol [standardized beta (beta) = -0.059; P = 0.014], low-density lipoprotein cholesterol (beta = -0.068; P = 0.004), high-density lipoprotein cholesterol (beta = 0.100; P < 0.001), and triglycerides (beta = -0.102; P < 0.001). Both FT4 and TSH were significantly associated with HOMA-IR (beta = -0.133; P < 0.001 and beta = 0.055; P = 0.024, respectively). Median HOMA-IR increased from 1.42 in the highest tertile of FT4 to 1.66 in the lowest tertile of FT4. FT4 was significantly related to four of five components of the metabolic syndrome (abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and blood pressure), independent of insulin resistance. We have demonstrated an association between FT4 levels within the normal reference range and lipids, in accordance with the earlier observed association between (sub)clinical hypothyroidism and hyperlipidemia. Moreover, low normal FT4 levels were significantly associated with increased insulin resistance. These findings are consistent with an increased cardiovascular risk in subjects with low normal thyroid function.

Lead concentrations in feathers and blood of common blackbirds (Turdus merula) and in earthworms inhabiting unpolluted and moderately polluted urban areas

Despite the dramatic decrease of atmospheric lead (Pb) concentrations in urban areas of most industrialised countries, we hypothesised that urban common blackbirds (Turdus merula) may still be contaminated by Pb concentrations of toxicological concern due to transfer from soil through the food chain. We sampled blackbirds and earthworms, one of their main preys, in Besançon, a middle-size city of Eastern France (where atmospheric Pb concentrations decreased from 0.5 microg/m(3) in 1987 to nearly 0 in 2002) and in a rural reference site. Lead concentrations were determined in the tissues of the different functional groups of earthworms (anecic, epigeous and endogeous) and in blood, washed and unwashed outermost tail feathers and breast feathers of blackbirds. Fresh masses and an index of individual body condition were measured in the two blackbird populations as biomarkers of possible toxic effects. Lead concentrations in earthworms did not differ among functional groups but were significantly higher in urban individuals than in rural ones. Concentrations in outermost tail feathers, breast feathers and blood were significantly higher in urban blackbirds (7.75+/-4.50, 3.15+/-1.77 and 0.15+/-0.09 microg/g, respectively) than in rural individuals. In urban blackbirds, concentrations in washed and unwashed outermost tail feathers allowed estimating the external contamination (probably due to deposition of dusts and/or to excretion of the uropygial gland) at 37% of the total Pb concentration of the unwashed feathers. Remaining 63% should be linked to food chain transfer of persistent Pb from urban soils. Among the 23 sampled blackbirds, 4 of them (3 in the urban site and 1 in the rural site) exhibited blood Pb concentrations higher than the benchmark value (0.20 microg/g) related to subclinical and physiological effects in birds. Variations in body condition index were not correlated to Pb concentrations in blackbird tissues. Present results suggest that Pb may still be of environmental concern for blackbirds in urban areas because of the persistence of Pb in soils and its transfer through the food chain.

Var går gränsen?

This article introduces a study concerning parent s regulations regarding their child’s participating in social activities. The aim of the study is to examine how many pupils who are not allowed to participate in social activities and some educational elements at school, as for example sports and study tours. The ethnicity and gender perspectives are central for the questions. The implicit aim is to compare the situation among boys and girls with immigrant background in relation to boys and girls with Swedish background. The study contains a quantitative survey among 1193 children, 13 to 15 years old, living in a Swedish middle-sized city. The result from the analysis shows that most of the children are allowed to participate in the activities. However, regarding parental consent to participating in activities the results show that children with immigrant background experience restrictions to a larger extent than others. This result concerns in particular girls with immigrant background. Other significant findings in this study indicate that low-educated parents or/and religious parents have more restrictive norms considering pupils participating in social activities, especially for immigrant girls.

Vadr går gränsen?

This article introduces a study concerning parents regulations regarding their child’s participation in social activities. The aim of the study is to examine how many pupils who are not allowed to participate in social activities and some educational elements at school, as for example sports and study tours. The ethnicity and gender perspectives are central for the questions. The implicit aim is to compare the situation among boys and girls with immigrant background in relation to boys and girls with Swedish background. The study contains a quantitative survey among 1193 children, 13 to 15 years old, living in a Swedish middle-sized city. The result from the analysis shows that most of the children are allowed to participate in the activities. However, regarding parental consent to participating in activities the results show that children with immigrant background experience restrictions to a larger extent than others. This result concerns in particular girls with immigrant background. Other significant findings in this study indicate that low-educated parents or/and religious parents have more restrictive norms considering pupils participating in social activities, especially for immigrant girls.