Parentage Research Articles

Antibiotic Use for Patients with Inherited Metabolic Diseases in Outpatient Clinical Setting

Objective: In this study, we aimed to assess the the frequency and accuracy of antibiotic use for upper respiratory tract infection for children younger than 6 years of age with inherited metabolic diseases and also to identify possible associated factors in the outpatient clinic. Materials and Methods: This study was a prospective, randomized, single center study in which children with upper respiratory tract infections were enrolled. A 25-question questionnaire was prepared to ask the patients' families. These survey questions were included age, gender, weight, parental ages, education levels, type of antibiotics given, antibiotic dose and frequency. Results: Of the 415 individuals, 380 patients and caregivers agreed to participate in the study. The most prescribed antibiotics were amoxicillin/clavunate (31.57%), amoxicillin (21.31%) and clarithromycin (15.26%). We demonstrated that antibiotic dose was inappropriate in 42.89% of our patients. Of dosing errors, 37.4% involved dosing under the prescribed amount, while 62.6% involved dosing above the recommended amount. Conclusion: Healthcare professionals should routinely emphasize the importance of using accurate dose when administering antibiotic suspensions especially in the case of inborn errors metabolism in order to avoid inappropriate treatment, adverse effects and antibiotic resistence.

Transtorno do espectro do autismo e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas

Abstract The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children’s mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.

Maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder.

The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children's mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.

The relationships between the family impact and distress of the coronavirus disease-19 pandemic, parent insomnia, infant temperamental negative affectivity, and parent-reported infant sleep: a path analysis.

The coronavirus disease 2019 (COVID-19) pandemic impact on infant sleep (IS) is understudied. The purpose of this study was to examine the relationships between family impact and distress from COVID-19 pandemic stressors, parental insomnia symptoms, infant temperamental negative affectivity, and parent-reported IS. Parents from the Phoenix metropolitan area with a full-term healthy infant (<1 year) were recruited from February 27, 2021, to August 7, 2021. A sample of 70 parents (baby age 5.5 ± 3.5 months; parental age: 31.7 ± 5.0 years) completed the COVID-19 Exposure and Family Impact Survey (CEFIS) Impact and Distress scales, the Insomnia Severity Index (ISI), the Infant Behavioral Questionnaire-Revised Negative Affectivity subscale (IBQ-R-NA), and the Brief Infant Sleep Questionnaire-Revised (BISQ-R). Based on the transactional model of IS, path analyses were conducted to identify the direct effect of CEFIS scores and the indirect effects of parental ISI and infant IBQ-R-NA scores on BISQ-R scores. The parent sample was predominantly female (94.3%), white (72.9%), and married or in a domestic partnership (98.6%). Although COVID-19 pandemic impact and distress were not directly related to parent-reported IS, pandemic distress was negatively related to parent-reported IS indirectly through infant negative affectivity, including BISQ-R total score (β = -0.14, 95% CI [-0.32, -0.01]) and IS subscale score (β = -0.12, 95% CI [-0.27, -0.01]). Heightened COVID-19 pandemic family distress was related to poorer parent-reported IS through greater parent-reported infant negative affectivity, suggesting the importance of addressing family stress and emotional regulation during crises.

Stories to Prevent Cancer: A Pilot Study Using Cancer Survivor Narratives to Increase Human Papillomavirus Vaccine Intentions.

Human papillomavirus (HPV) vaccination rates are lower than other recommended adolescent vaccines. Cancer survivor narratives are used to promote cancer prevention and control, but little is known about their impact on adolescent HPV vaccination. This pilot study explored the feasibility and effects of a video education intervention using a cancer survivor narrative to improve parents' attitudes toward and intentions to get the HPV vaccine. This study utilized a one-group design; participants completed a pre-intervention survey, watched the video before attending their sons' wellness visits, and completed a post-intervention survey within one week of their appointment. Using the narrative persuasion framework, we developed a 4-minute video of a local HPV-related cancer survivor to promote the HPV vaccine as cancer prevention. We recruited 37 participants between June and October 2020. Participants were parents of males ages 9-17 who had not yet initiated HPV vaccination. After the video, more parents agreed that HPV vaccination is safe (pre: 66% vs. post: 82%; P = .045) and that their child's chances of getting HPV-related cancer in the future are high (pre: 24% vs. post: 46%; P = .014). Overall, 91% of parents felt the cancer survivor story helped them understand the risks of HPV cancers, and 52% said the story influenced their decision to start HPV vaccination for their child. Our findings suggest that cancer survivor narratives influence parents' vaccine opinions and understanding of their child's risk of HPV infection, leading to increased parental intent to get the HPV vaccine for their adolescent males.

Effect of COVID-19 Pandemic on Physical Activity and Screen Time of School Children: A Cross-sectional Study from Chandigarh

Background The nationwide lockdown imposed due to the COVID-19 pandemic disrupted daily routines, especially for children. Being at home and attending virtual classes unintentionally precipitated an increase in both academic and nonacademic screen time and probably led to decreased physical activity in children. However, there is lack of evidence related to the physical activity and screen time of school-age children during the COVID-19 pandemic. So this study aimed to investigate the effect of the COVID-19 pandemic and lockdown on physical activity and screen time of children. Methods An online survey was used to recruit parents of school-age children through convenience sampling. Parents were asked to compare their child’s physical activity and screen time in the previous week with those in the pre-lockdown and lockdown periods. The global physical activity questionnaire was used to assess physical activity, and a screen time questionnaire was developed and validated. Data collection was done from September 2020 to December 2020. Results Data of 104 children were collected from parents’ reports. The average age of parents was 39.1 + 4.8 years for mothers and 40.8 + 6.9 years for fathers. Results revealed a decrease in physical activity from 564.95 min/week before the lockdown to 146.05 min/week during the lockdown, with the absolute decrease of 448.9 min/week. Total screen time increased from 2.42 h/day before the lockdown to 7.41 h/day during the lockdown. Conclusion Necessary steps to mitigate the effect of COVID-19 pandemic unintentionally affected children in terms of decreased physical activity and increased screen time.

Psychological risk factors for upper extremity fractures in preschool children: A case-control study.

In school-age children, upper extremity fractures are associated with both parental and child-related factors and represent a multifactorial entity. This study aims to explore the psychological risk factors associated with upper extremity fractures in preschool children. This single-center, hospital-based, age-matched case-control study involved 55 cases of upper extremity fractures and 55 controls experiencing growing pains. Parents of the children participated in face-to-face interviews. We examined the potential as-sociations between scores on the Mother-to-Infant Bonding Scale (MIBS), Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), Autism-Spectrum Quotient (AQ), State-Trait Anxiety Inventory (STAI), and Strengths and Difficulties Questionnaire (SDQ), and the risk of upper extremity fractures. Advanced parental age and lower household income emerged as risk factors for upper extremity fractures, while longer maternal educational attainment was identified as a protective factor. In the univariate analyses, elevated scores on the Autism-Spec-trum Quotient Communication subscale (AQ-C), overall AQ score, Strengths and Difficulties Questionnaire Hyperactivity subscale (SDQ-H), and Strengths and Difficulties Questionnaire Emotional and Peer Problems subscale (SDQ-Int) were associated with an increased fracture risk (Odds Ratio [OR] (95% Confidence Interval [CI]): 1.15 (1.05-1.27), OR: 1.05 (1.01-1.09), OR: 1.25 (1.01-1.54), and OR: 1.19 (1.04-1.37), respectively). The AQ-C and SDQ-Int scales remained statistically significant as risk factors for upper ex-tremity fractures (OR: 1.15 (1.02-1.28) and OR: 1.21 (1.02-1.43), respectively) in the multivariate regression analyses. Our findings suggest that psychological factors affecting both parents and children could potentially increase the risk of upper extremity fractures in preschool children.

어린이집 선택요인에 대한 요구도 조사

The purpose of this study is to understand the needs of parents based on their importance and satisfaction with childcare center selection factors. To this objective, a questionnaire was administered to parents enrolled in 20 childcare centers in B city. The final 191 data collected were analyzed using SPSS 25.0 and Excel. The results of the analysis are as follows. First, among parental background characteristics, there were differences in the importance of childcare center selection factors based on parental employment status and child age. Parents in their 20s and 30s were more satisfied than parents in their 40s. Second, the IPA results of the childcare center selection factors showed that health, safety, and staff were in the maintenance quadrant (quadrant 1), and childcare curriculum and interaction were in the focus quadrant (quadrant 2). However, in the results of each subfactor, there were differences in the IPA results of the selected factors and the selected subfactors, as health and safety, staff, and childcare curriculum and interaction were in the maintenance area (quadrant 1), and childcare curriculum and interaction, child care environment, and operation management were in the intensive effort area (quadrant 2). Third, the Borich needs analysis showed that the needs for balanced meals, respect for children by teachers, respect without discrimination, appropriate interactions, and health care for children were ranked high. Based on these results, implications for childcare center management and childcare policies were presented.

Childcare Voucher: A Qualitative/Pilot Study, Exploring the Experiences of Expectant and Parenting Teenage Mothers in Washington, District of Columbia (DC)

Objective: The aim of this study is to use human-centered design and journey mapping to explore the experience of Expectant and Parenting Teens in the District of Columbia (DC) in accessing childcare while attending school and/or seeking employment. Methods: In-depth interviews were conducted with 20 young mothers who had experienced teenage pregnancy and 10 providers assisting young parents in accessing support services, including childcare. Journey map interview guide (Table 1) was used for this interview. Interviews were audio recorded and transcribed verbatim to ensure that the participants’ statements were maintained in the transcripts. A thematic analysis was used to examine data and themes arising from the interviews. Open and axial coding was used to code the interview transcripts and organize them into categories and themes following an inductive and deductive approach. Results: The design team conducted 30 deep-dive interviews with 20 young parents (ages 18 - 25) and 10 providers assisting young parents in accessing support services, including childcare. The young parents interviewed were majority Black (66%) and Hispanic (19%), and largely live in wards 7 (33%) and 8 (28%). Their children’s average age was 4 years (range 2 months -8 years). Discussion: Three main themes and categories were identified as (1) Motivation to finish high school and find employment, (2) Challenges of accessing childcare voucher and quality childcare (3) Support staff (school councilors) experience.

Analysis Of the Influence of The Social Network on Childhood Obesity

Childhood obesity is a pressing global public health concern shaped by genetic, nutritional, lifestyle, and socio-economic factors. This study examines the influence of distinct social networks—family, neighborhood, internet, and social-cultural networks—on childhood obesity. To assess each network's impact, scrutinizing their contributing factors and interactions to inform effective policy development. The study employs a comprehensive literature review, incorporating data from Chinese and English sources. It utilizes the Social Ecological Model (SEM) to analyze the impact of the family network on childhood obesity and examines various factors within the neighborhood environment. The study also investigates the influence of internet social networks, particularly through social media influencer marketing, and explores the impact of social and cultural networks, with a focus on China and the United States. The family network significantly influences childhood obesity, with factors like parental characteristics, age, race, and gender exhibiting associations. Proximity to food outlets and physical activity facilities within the neighborhood plays a key role. Internet social networks can sway children's dietary choices, with influencers promoting unhealthy foods leading to increased consumption. Social and cultural networks in different contexts contribute, influenced by traditional beliefs and migration dynamics. This study underscores the intricate and multifaceted influence of social networks on childhood obesity, highlighting the roles played by each network in shaping children's weight status and dietary choices. Understanding these network dynamics is vital for designing effective prevention and intervention strategies.

Parent attitudes and perceptions of integrated behavioral health care delivery for pediatric patients

Introduction: Patient access to high-quality behavioral health services has been a well-documented problem that has only been further complicated by the COVID-19 pandemic, especially within the pediatric population. Although integrated models of care have demonstrated efficacy for improving access, there is little research examining parents’ preferences for key elements of integrated practice, which now include increased utilization of virtual care. Parent/caregiver perspectives are essential to understand and enhance behavioral health service delivery within an integrated model of care because they are largely responsible for initiating, facilitating, and intimately participating in their children’s behavioral health care.&#x0D; Methods and Aims: The Parent Acceptance of Pediatric Integrated Care Survey Revised (PAPICS-R) was developed by a multidisciplinary panel of integrated care experts to evaluate caregiver perceptions of behavior health care delivery models for pediatric patients. A major component of the revised survey was a focus on virtual care, which has become ubiquitous since the beginning of the Covid-19 pandemic. Eight hundred thirty-four parents from diverse backgrounds across the United States who had children under 18-years old completed the revised survey online. Survey responses were analyzed using various statistical modeling techniques. Detailed demographic data was collected and associations of demographic variables with item responses were assessed using ANOVA and Chi-square tests.&#x0D; Results: Results indicated parent support for core components of integrated care such as co-location of medical and behavioral health care, interactive communication between providers, and shared access to health records. Parents also tended to prefer to be involved in their child’s therapy and indicated acceptability of virtual behavioral health care. Significant differences in parent responses were evident across several demographic variables such as race/ethnicity, parent age, child age, number of children and parent education. Notably, patient privacy and stigma were primary concerns for certain groups. These key findings will be shared to explore how specific demographic differences affect parent integrated care perspectives and how best to address these differences in practice.&#x0D; Conclusions: Results from the PAPICS-R provide valuable insight into parent perceptions of integrated behavioral health care. Notably, parent attitudes toward the integrated model of care (including virtual healthcare delivery methods) are largely positive. The findings have directly impacted multiple key aspects of the IBH program including future format of care delivery, trainee education, program expansion, and quality improvement. These adaptations will be discussed along with broader implications.&#x0D; Future Directions: Additional data are being gathered to examine the impact of various parent demographic variables on perspectives of an integrated primary care model. We are also currently working to disseminate results from the PAPICS-R survey to health care providers and organizations as the data are expected to provide valuable insight for those looking to establish integrated pediatric primary care clinics or improve their current model of care. Applicability of implementation within a diverse range of communities and regions will be discussed.&#x0D;

Determinants of stunting in children under five: a scoping review

Background: Inadequate diet, socioeconomic condition, and maternal and child characteristics can damage stunted children under five's mental and physical development. As a result, they have difficulty developing physically and cognitively, have low intellectual abilities, are more susceptible to disease, and have less creativity and innovation. Objective: This study seeks to investigate and summarize the determinants of stunted children under five.Materials and Methods: The study used a scoping review method. The literature search was carried out on indexed databases of Scopus, PubMed, Google Scholar, Crossref, and Pro-Quest in English and Indonesian. There were 720 research articles, and 18 of them met the inclusion criteria. From the 18 journals, information was collected from the publication year 2015-2021. Relevant study articles related to the topic were analyzed qualitatively using NVIVO-12 Plus.Results: Our findings identify that maternal education, low birth weight (LBW), gender, exclusive breastfeeding, parental income, parental age, and child age are the dominant determinants of stunting among under-five children.Conclusion: Higher risk factors of stunting among children are parents' lack of knowledge, low family income, low nutrition, low level of mother's education, and lack of parents' supervision and parenting skills.

Socioemotional Development of Infants and Toddlers During the COVID-19 Pandemic

Understanding the impact of the COVID-19 pandemic on children's socioemotional development is critical to plan for ongoing needs in the early intervention and education systems. To determine if Ages and Stages Questionnaire, Third Edition (ASQ-3) and Ages and Stages Questionnaire Social-Emotional, Second Edition (ASQ:SE-2) scores changed during the COVID-19 pandemic among families served by a nurse-visiting program. This retrospective, cohort study took place from 2015 through 2021 and included 4 cohorts (prepandemic, pandemic 1, pandemic 2, and pandemic 3) with differing pandemic exposure at the time of screening. Analysis was conducted from July 2022 through October 2023. Data from the Nurse-Family Partnership (NFP), a national nurse-visiting program enrolling birthing people during pregnancy and continuing through age 2 years, were used. A total of 60 171 families with a singleton birth at 37 weeks' gestation or longer and at least 1 valid ASQ-3 and/or ASQ:SE-2 screening in the NFP from January 1, 2015, through December 31, 2021, were enrolled. COVID-19 pandemic. Outcomes were a positive screening, defined as scores in the refer area on the ASQ-3 at 10 months and 18 months of age and in the ASQ:SE-2 at 12 months and 18 months of age. Multivariable mixed-effects logistic regression models were used to calculate odds ratios (ORs) for positive screening in pandemic cohorts compared with the prepandemic cohort. Covariates included parent age, race and ethnicity, marital status, income, child's biological sex, and multiparity. Of 60 171 families enrolled, pandemic cohorts had fewer teenagers, were more likely to be married, and were multiparous. Compared with the prepandemic cohort, all pandemic cohorts had higher odds of positive screening on the ASQ-SE at 12 months (pandemic 1: OR, 1.35; 95% CI, 1.09-1.66; pandemic 2: OR, 1.60; 95% CI, 1.30-1.96; and pandemic 3: OR, 1.94; 95% CI, 1.61-2.33) and pandemic 2 and 3 had higher odds of a positive screening at 18 months (pandemic 2: OR, 1.61; 95% CI, 1.29-2.00 and pandemic 3: OR, 1.87; 95% CI, 1.50-2.32). On the ASQ-3, pandemic cohorts 2 and 3 were more likely than the prepandemic cohort to screen positive on the communication subscale at 18 months (pandemic 2: OR, 1.39; 95% CI, 1.17-1.64 and pandemic 3: OR, 1.28; 95% CI, 1.07-1.53). In this study, exposure to the COVID-19 pandemic, especially during the first year of life, was associated with higher odds of positive ASQ:SE-2 screening, even when adjusting for demographics and family risks. These findings suggest that unmeasured community, family, and child factors that changed as a result of the pandemic contributed to delays in young children's socio-emotional development.

Assessment of Knowledge, Attitude, and Practice of Parents Towrds the Use of Antibiotics in Children

Emerging infectious illnesses can potentially have a more direct impact on everyone. Infectious illnesses demand increased attention since they contribute to high rates of morbidity and death worldwide. The misuse of antibiotics is a major contributor to the events of resistance. This study aims to understand parents' knowledge, attitudes, and practice particularly regarding the use of antibiotics. This will help in understanding and improving medication adherence, reduce the risk of antibiotic resistance, and promote rational antibiotic usage among children. An observational study was conducted in the inpatient department of Paediatrics of ESIC MC &amp; PGIMSR hospital, Bengaluru. All the subjects (n = 88) meeting the inclusion and exclusion criteria were briefed about the purpose of the study, and informed consent was obtained using a self-designed data collection form and questionnaires. The collected data were entered, and appropriate descriptive and statistical analysis was performed. The study found that the majority of the interviewees belonged to the age group of 28 to 34 (34%). The majority of parents involved in the study were found to be mothers. Among the parents included in the study, 52% of the parents had moderate knowledge, 45% had a poor attitude, and 37% had poor practices toward the use of antibiotics. 29% of the parents were found to have poor medication adherence. A Pearson’s Product Moment Correlation was performed to find the association between knowledge, attitude, and practice with variables such as knowledge, attitude, practice, age of the patient, age of parent, education, occupation, and siblings present. It did not show a significant association between KAP and medication adherence. There is a need to encourage patients to ask questions and be made aware of the programs provided about antibiotics and other medications to improve the health conditions of the patients and to encourage them to follow appropriate norms to stay healthy and to improve their immunity to avoid death or prolonged ill health by drug resistance in adults, children, or future generations.

Maternal Fiber Intake During Pregnancy and Development of Attention-Deficit/Hyperactivity Disorder Symptoms Across Childhood: The Norwegian Mother, Father, and Child Cohort Study

BackgroundEpidemiological studies suggest that maternal diet quality during pregnancy may influence the risk of neurodevelopmental disorders in offspring. Here, we investigated associations between maternal intake of dietary fiber and attention-deficit/hyperactivity disorder (ADHD) symptoms in early childhood. MethodsWe used longitudinal data of up to 21,852 mother-father-child trios (49.2% female offspring) from MoBa (the Norwegian Mother, Father, and Child Cohort Study). The relationships between maternal fiber intake during pregnancy and offspring ADHD symptoms at ages 3, 5, and 8 years were examined using 1) multivariate regression (overall levels of ADHD symptoms), 2) latent class analysis (subclasses of ADHD symptoms by sex at each age), and 3) latent growth curves (longitudinal change in offspring ADHD symptoms). Covariates were ADHD polygenic scores in child and parents, total energy intake and energy-adjusted sugar intake, parental ages at birth of the child, and sociodemographic factors. ResultsHigher maternal prenatal fiber intake was associated with lower offspring ADHD symptom scores at all ages (Bage3 = −0.14 [95% CI, −0.18 to −0.10]; Bage5 = −0.14 [95% CI, −0.19 to −0.09]; Bage8 = −0.14 [95% CI, −0.20 to −0.09]). Of the derived low/middle/high subclasses of ADHD symptoms, fiber was associated with lower risk of belonging to the middle subclass for boys and girls and to the high subclass for girls only (middle: odds ratioboys 0.91 [95% CI, 0.86 to 0.97]/odds ratiogirls 0.86 [95% CI, 0.81 to 0.91]; high: odds ratiogirls 0.82 [95% CI, 0.72 to 0.94]). Maternal fiber intake and rate of change in child ADHD symptoms across ages were not associated. ConclusionsLow prenatal maternal fiber intake may increase symptom levels of ADHD in offspring during childhood, independently of genetic predisposition to ADHD, unhealthy dietary exposures, and sociodemographic factors.

Different reactions of parents to displays of anger in two- and three-year-old children

Purpose: The aim of this article is to present various parental reactions to displays of anger in two- and three-year-old children (reactive parenting methods) and determine which factors (age, gender, education, and place of residence) differentiate parental reactions to a child's behavior. Additionally, the study aimed to ascertain the reactive parenting methods parents use based on the type of situations reflecting behavioral manifestations of young children's autonomy. Method: A questionnaire-based study conducted with a sample of 120 parents of two- and three-year-old children (60 women and 60 men). An original questionnaire based on Lev Vygotsky's theory of the third year crisis (2002) was utilized. Participants were tasked with describing their reactions to behavioral displays of anger in small children across seven everyday life situations (negativism, stubbornness, defiance, wilfulness, opposition – rebellion, deprecation, and despotism). Results: Parents declared the use of all reactive parenting methods – both inductive and imperative (punitive and psychological aggression) in response to displays of anger in their two- and three-year-old children. Significant predictors for inductive and punitive methods were found to be the parent's age and education level, while for psychological aggression, predictors were gender and place of residence. The study indicated that only women resort to psychological aggression in their relationship with two- and three-year-olds, with its usage being more frequent when the mother's authority is more threatened and the child's opposition to her will becomes increasingly evident. Conclusion: Behavioral manifestations of autonomy in two- and three-year-olds are influenced by the natural developmental crisis of the third year. These are expressions of frustration in young children rather than displays of aggressive behavior, which require appropriate parenting methods. Based on the study, it was determined that parents primarily declare simultaneous use of inductive and punitive methods, yet the more a child demonstrates autonomy, the higher the declared tendency of parents to resort to punitive methods increases.

SEX STEROID HORMONES AND AGE AT DEATH—A MENDELIAN APPROACH

Abstract Lower concentrations of testosterone have been associated with increased mortality and shorter lifespan in observational studies. An association between androgens and decreased epigenetic age was identified among men. Here, we assessed the association between sex steroid hormones and parental age at death using a Mendelian randomization (MR) approach. An inverse-variance weighting (IVW) MR analysis was performed using effect estimates from external GWAS summary statistics. We included independent variants (linkage disequilibrium R2&amp;lt; 0.001) and a P-value threshold of 5x10-8. Sensitivity analysis included changing the P-value thresholds, MR method and multivariable MR analysis. An increase in androsterone sulfate and DHEAS were associated with a lower age at death for both fathers and mothers (-0.04/-0.05 years, P-value: 7e-4/7e-4), as well as the combined parental age at death (-0.06 years, P-value:5e-4). In addition, an increase in SHBG was associated with a higher age at death (0.06 years, P-value:7e-5). We did not find an association with estradiol or testosterone and age at death. Sensitivity analysis showed consistent findings. Our study could suggest that a higher concentration of androgens, specifically androsterone sulfate and DHEAS, decrease lifespan. This is contradictory to observational studies and deserves further attention. However, the SNPs associated with these androgens are also strongly associated with body mass index (BMI). Adjusting for BMI in the MR models removes the association between sex hormones and age at death. We are currently performing more analyses to shed light on this association.

ROLE OF PLACE AS A DETERMINANT OF PARENT–ADULT CHILD GEOGRAPHIC PROXIMITY AND CAREGIVING

Abstract While research has shown that the need for care impacts how close parents and adult children live, the relative importance of various factors shaping parent-child geographic proximity remains unclear, especially as it relates to characteristics of their geographic locations and communities. We explore variation in and determinants of the geographic proximity of older parents and adult children, conditional on parents needing care. Using pooled 2004-2014 data from the Health and Retirement Study on respondents age 65 years or older and their children, alongside detailed county-level contextual information from various sources, we analyze the importance of various determinants of parent-child geographic proximity, including parental health, age, and other personal characteristics, children’s personal characteristics, parent-child dyad characteristics, and place-specific characteristics that relate with availability of different health and aging services, housing affordability, and labor market opportunities. Preliminary regression results show that coresidence is substantially less likely in areas with higher availability of nursing care and continuing care options. Among non-coresidents, living in close proximity (distances under 10 miles) is less likely if parent’s area has more nursing care options, but more likely if health services that support living in place are available. Additionally, local economic and housing conditions play a role, with higher median household income associated with children living closer to parents and higher cost of rent with living further. Place-specific characteristics are important determinants of parent-child coresidence and proximity, and policymakers and care providers should consider them when determining the most effective ways to support older adults who need care.

Parents' willingness to pay for COVID-19 vaccination for children in Malaysia using the contingent valuation method.

Children are susceptible and a potential source of transmission for coronavirus disease 2019 (COVID-19). However compulsory COVID-19 vaccination programs among children have not been a focus in Malaysia. The aim of this study was to measure parents' willingness to pay (WTP) for the COVID-19 vaccine and analyze the effects of socioeconomic variables on parents' WTP. An online cross-sectional study was conducted in Malaysia with two waves of surveys (i.e., different samples for each wave), March and June 2021. The study participants were Malaysian parents above 18 years old. Parents were randomized between two vaccine effectiveness profiles (95% and 50% effectiveness) and two risk levels of an adverse event (5% and 20% risk of fever). The WTP was estimated using a double-bounded dichotomous choice. Socioeconomic variables such as age of parent, gender, insurance, income, and education were examined. A total of 292 parents in March 2021 and 271 in June 2021 were included in the study. The vaccine safety and effectiveness profile did not significantly impact the WTP. In March 2021, the estimated WTP ranged from RM344.74 to RM399.64 (US$82.5 to US$95.6) across vaccine profiles and between RM377.55 and RM444.33 (US$90.3 to US$106.3) in June. Insurance status was associated with the parents' WTP, and during the June wave, the age of parents influenced the WTP. Implementing subsidies or free vaccinations is considerable to increase herd immunity and prevent transmission of COVID-19 in Malaysia.

Social epidemiology of the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay (MIND) diet among early adolescents: the Adolescent Brain Cognitive Development Study

BackgroundThe purpose of our study was to understand the relationship between sociodemographic factors and adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in a demographically diverse national population-based sample of 9–12-year-olds in the US.MethodsWe analyzed data from the Adolescent Brain and Cognitive Development (ABCD) Study (Year 1, N = 8333). Multivariable linear regression analysis was used to identify associations between MIND diet score and sociodemographic factors, including race/ethnicity, household income, parent education level, age, sex, and sexual minority status.ResultsCompared to White adolescents, Latino adolescents showed the greatest adherence to the MIND diet. Boys had lower adherence to the MIND diet than girls. Lower household income was associated with lower adherence to the MIND diet. Older age was associated with lower adherence to the MIND diet. Sexual minorities had a lower adherence to the MIND diet when compared to their heterosexual counterparts.DiscussionFemale sex, Latino ethnicity, Asian and Black race, high household income, heterosexual sexual orientation, and younger age were associated with higher adherence to the MIND diet. These sociodemographic differences can inform targeted screening and counseling for clinicians and public health organizations among diverse adolescent populations.Impact StatementSociodemographic disparities in diet quality have been documented, but none have explored adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in early adolescence.In this demographically diverse sample of 9–12-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in adherence to the MIND diet.Sociodemographic factors associated with higher adherence to the MIND diet included female sex, Latino ethnicity, high household income, heterosexual sexual orientation, and younger age.