Parental Country Of Birth Research Articles

Moderators of linear and nonlinear associations between religiosity, xenophobia, and tolerance toward immigrants in italy.

Using secondary survey data from a national representative sample of Italian adult residents (N = 5,863, age range = 18–74 years, 54% females), this study aimed to test linear and nonlinear associations between religiosity and attitudes toward immigrants (i.e., xenophobia and tolerance) and examine moderating mechanisms of sociodemographic variables (i.e., age, gender, education, birth country, parental birth country, and contact with immigrants). Psychological measures included religiosity, xenophobia, and tolerance toward immigrants. A restricted cubic spline regression model with 3 knots best fit the data to explain both xenophobia and tolerance outcomes. Analyses of interaction effects evidenced nonlinearity between religiosity with xenophobia and tolerance only among participants who had contact with immigrants. Higher antiimmigrant attitudes were observed at both extremes of religiosity. Results are discussed in light of the contact hypothesis.

Epidemiology of tuberculosis among children and adolescents in the USA, 2007–17: an analysis of national surveillance data

Understanding tuberculosis epidemiology among children and adolescents informs treatment and prevention efforts, and efforts to eliminate disparities in tuberculosis incidence and mortality. We sought to describe the epidemiology of children and adolescents with tuberculosis disease in the USA, including tuberculosis incidence rates by parental country of birth and for US territories and freely associated states, which have not been previously described. We analysed data for children aged younger than 15 years and adolescents aged 15-17 years with tuberculosis disease reported to the National Tuberculosis Surveillance System during 2007-17, and calculated tuberculosis incidence rates using population estimates from the US Census Bureau. During 2010-17, 6072 tuberculosis cases occurred among children and adolescents; of these, 5175 (85%) of 6072 occurred in the 50 US states or the District of Columbia and 897 (15%) of 6072 in US-affiliated islands. In US states, 3520 (68%) of 5175 cases occurred among US-born people overall, including 2977 (76%) of 3896 children and 543 (42%) of 1279 adolescents. The incidence rate among children and adolescents was 1·0 per 100 000 person-years during 2007-17 and declined 47·8% (95% CI -51·4 to -44·1) during this period. We observed disproportionately high tuberculosis rates among children and adolescents of all non-white racial or ethnic groups, people living in US-affiliated islands, and children born in or with parents from tuberculosis-endemic countries. Overall, tuberculosis incidence among children and adolescents in the USA is low and steadily declining, but additional efforts are needed to eliminate disparities in incidence and mortality. US Centers for Disease Control and Prevention.

Being a second generation Muslim woman in the French labour market: Understanding the dynamics of (visibility of) religion and gender in labour market access, outcomes and experiences

This mixed-method article focuses on Muslim women who are second generation – children of immigrants, born and bred in France – by bringing to the fore the intersection of (visibility of) religion and gender in the production of labour market access, outcomes and experiences. The quantitative analysis uses the Trajectories and Origins Survey 2009 and the European Social Survey (2006–2016) to explore how religious affiliation impacts labour market outcomes and how discriminatory practices are perceived. The qualitative analysis builds on semi-structured interviews which bring together, for the first time, women from a well-established minority ethnic group in France – Algerians – and women from a newly-settled group – Pakistanis. In doing so, the analysis offers a conceptual understanding of the ways in which gendered and religious displays shape labour market experiences. We find that ethnicity (based on parental country of birth) is by far the most commonly cited form of experienced and/or perceived discrimination in labour market access. In terms of outcomes, Muslim women are the least likely to gain employment, work the least number of hours and earn the lowest salaries; those who display their religion (through headscarf wearing practice for example) have an even reduced labour market participation rate. Drawing on the interviews analysis, we suggest that certain professional roles and sectors are believed to be accessible for those who are perceived to be French and white only. This racialised understanding of Frenchness produces inequality in the workplace and blocks professional progression for Muslim women, who are French by birth and educated in France. However, despite experiencing a similar racialisation process, the ways in which the women dealt with unequal treatment at work differed according to their ethnicity.

Trends in the epidemiology of inflammatory bowel disease among Jewish Israeli adolescents: a population-based study.

The incidence and prevalence trends of inflammatory bowel disease (IBD) vary between developed and developing countries. To investigate the prevalence and associated sociodemographic factors of IBD in Israeli Jewish adolescents METHODS: The files of the army medical corps were reviewed for adolescents recruited in 2002-2016 with confirmed IBD. Covariate data included birth date, patient and parental country of birth, number of children in the household, age at diagnosis, and socioeconomic status. Findings were compared with the remaining recruits without IBD. Of the 1,144,213 adolescents recruited, 2372 (0.2%) had IBD (Crohn's disease, 68%). Median age of the cohort was 17.1years (interquartile range, 16.9-17.3). Over the study period, the annual point prevalence per 100,000 examinees significantly increased: total IBD, 58 to 373; Crohn's disease, 42 to 425; ulcerative colitis, 16 to 128. Mean age at IBD diagnosis decreased from 15.0±2.8years in 2002-2008 to 14.3±3.1years in 2009-2016 (P<0.0001). Significance was maintained on separate analyses of Crohn's disease and ulcerative colitis. Both diseases were significantly less prevalent in subjects from families with at least one parent born in a developing country and ≥3 children. There was a significant association of lower socioeconomic status with lower prevalence of Crohn's disease (odds ratio 0.41, 95% confidence interval, 0.31-0.54) and ulcerative colitis (odds ratio 0.25, 95% confidence interval, 0.15-0.42). The point prevalence of Crohn's disease and ulcerative colitis in Israeli Jewish adolescents increased six-fold and eight-fold, respectively, over 15years along with a decrease in age at diagnosis.

Mode of HPV vaccination delivery and equity in vaccine uptake: A nationwide cohort study

Ten years after its introduction, equity in human papillomavirus (HPV) vaccine uptake remains unattained, not least for the groups at highest risk of cervical cancer. In Sweden, three different delivery modes of the vaccine have been in effect since May 2007. We used this as a natural experiment to investigate girls' HPV vaccine uptake in relation to parental country of birth and socioeconomic characteristics, by mode of delivery. Our nationwide study cohort comprised 689,676 girls born between 1990 and 2003. Data on HPV vaccination of the girls and parental birth/socioeconomic characteristics were retrieved from national registers. We examined the association between girls' vaccine uptake and parental characteristics, stratified by mode of delivery. The cumulative uptake of at least one dose of HPV vaccine was 37%, 48% and 79% for subsidised opportunistic, free-of-charge catch-up outside-school and free-of-charge school-based vaccination, respectively. In the subsidised vaccination, having parents born outside of Sweden, with low education and low family income was strongly associated with lower uptake [HR (95% confidence interval (CI)) = 0.49 (0.48–0.50), 0.32 (0.31–0.33), 0.53 (0.52–0.54), respectively]. The associations were partially reduced in catch-up outside-school, and strongly reduced in school-based vaccination delivery [HR (95% CI) =0.82 (0.81–0.83), 0.92 (0.91–0.94), 0.87 (0.85–0.88), respectively]. Free-of-charge school-based HPV vaccination achieved the highest uptake and displayed the least disparity in country of birth and socioeconomic background of the parents. This appears to be the most effective and equitable delivery mode for reaching high population vaccination coverage, including high-risk groups for cervical cancer.

Effect of multi-ethnicity and ancestry on prevalence of allergic disease.

Differences exist among racial and ethnic groups in the prevalence and severity of allergic diseases. However, influence of population admixing on allergic disease has not been studied. We examined the effect of population admixing on the occurrence of allergic disease. We reviewed the data of 68,043 adolescents who participated in the 11th Korea Youth Risk Behavior Web-based Survey, which provides a sample that is representative of the entire Korean middle school and high school student population. Multi-ethnic status was determined by using parental country of birth and prevalence of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) was determined by questionnaire. Multi-ethnic adolescents accounted for approximately 0.9% of the total adolescents. Prevalence of asthma was significantly higher in multi-ethnic group than non multi-ethnic group while that of AR and AD was significantly higher in non multi-ethnic group than multi-ethnic group. Parental region of country at birth showed a significant difference in prevalence of allergic disease. Univariate analysis found that urbanity, perceived economic status (PES), parental region of country at birth, and environmental tobacco smoke (ETS) showed a significant odds ratio (OR) in asthma, AR, and AD. Body mass index (BMI) showed a significant OR in asthma and AD. After adjusting for urbanity, PES, BMI and ETS, multiethnicity showed significantly lower OR in AR and AD. Population admixing appears to have significant effect on the prevalence of allergic disease. Further study will be needed to clarify the effect of population admixing on prevalence of allergic disease.

The familial aggregation of atopic diseases and depression or anxiety in children.

SummaryBackgroundChildren with asthma and atopic diseases have an increased risk of depression or anxiety. Each of these diseases has strong genetic and environmental components; therefore, it seems likely that there is a shared liability rather than causative risk.ObjectiveTo investigate the existence and nature of familial aggregation for the comorbidity of atopic diseases and depression or anxiety.MethodsParticipants came from the Childhood and Adolescent Twin Study in Sweden (CATSS), n = 14 197. Current and ever asthma, eczema, hay fever and food allergy were reported by parents. Internalizing disorders were identified using validated questionnaires. Familial co‐aggregation analysis compared monozygotic (MZ) twins and same‐sex dizygotic (DZ) twins for atopic disease in 1 twin with internalizing disorder in the other to test for genetic liability. Several familial liability candidates were also tested including parental education, recent maternal psychological stress, childhood family trauma and parental country of birth.ResultsFamilial co‐aggregation analysis found that if 1 twin had at least 1 current atopic disease the partner twin was at risk of having an internalizing disorder regardless of their own atopic status (adjusted OR 1.22 (95% CI 1.08, 1.37). Similar results were found for each atopic disease ever and current. MZ associations were not higher than DZ associations, suggesting that the liability is not genetic in nature. Including other familial candidates to the models made little difference to effect estimates.Conclusions and Clinical RelevanceAtopic diseases and depression or anxiety tend to occur together in families; therefore, when treating for 1 disease, the physician should consider comorbidity in both the individual and the individual's siblings. We did not find evidence to support a genetic explanation for comorbidity, and further exploration is needed to disentangle the environmental and epigenetic reasons for familial aggregation.

Male gender, school attendance and sports participation are positively associated with health-related quality of life in children and adolescents with congenital bleeding disorders.

This study assesses health-related quality of life (HRQOL), and variables associated with HRQOL, in children and adolescents with haemophilia and congenital bleeding disorders (CBD) in the Netherlands. Patients <18years with CBD under treatment at the Hemophilia Comprehensive Care Center of the Academic Medical Center were included. Participants completed generic HRQOL questionnaires (TAPQOL 0-5years; PedsQL 6-18years). Differences and effect sizes in HRQOL compared to healthy peers, and between hemophilia severity groups, were tested using Mann Whitney U-tests. Multivariate regression analyses were performed to assess variables associated with HRQOL. Data of 145 patients (81%) were analyzed (N=32 with severe haemophilia). Children (0-12 years) show no significant impairments in HRQOL compared to healthy peers. Adolescent boys (13-18 years) with CBD report a slightly higher HRQOL on the total and emotional functioning scales than healthy peers (small-moderate effect sizes). In contrast, adolescent girls experience lower HRQOL on total, social functioning and psychosocial health scales compared to healthy peers (moderate effect sizes). No differences between severity groups were found in HRQOL, but more problem behaviour was found in young boys (0-5 years) with severe haemophilia. Male gender, participation in sports and school attendance are positively associated with HRQOL. Parental country of birth, type of treatment and number of bleeds are not associated with HRQOL. Continuing monitoring HRQOL in daily clinical practice for children with CBD is important, since possible influencing psychosocial factors can change over time, with special focus on adolescent girls, sports participation and school absence.

DOP033 Trends in epidemiology of inflammatory bowel disease among Jewish Israeli adolescents: a population-based study

Several studies have demonstrated an increasing prevalence of paediatric Inflammatory bowel disease (IBD). However, relatively little is known about paediatric IBD epidemiology in Israel. We aimed to investigate the prevalence and sociodemographic factors associated with diagnosis of IBD among Jewish Israeli adolescents. A total of 1144213 Jewish Israeli adolescents who underwent a general health examination from 2002 to 2016, at a median age of 17.1, were included. Cases were classified into Crohn’s disease (CD) and ulcerative colitis (UC). Covariate data included date of birth, country of birth, parental country of birth, age at diagnosis and socioeconomic status (SES). Overall, 2372 cases of IBD were identified (0.2%). CD accounted for 68% of cases. Total IBD point prevalence increased from 58 per 100000 persons per year to 373 per 100000 persons over the study period. This increase was observed for both CD (from 42 to 245 per 100000 persons per year) and UC (from 16 to 128 per 100000 persons per year, as demonstrated in Figure 1. IBD point prevalence among Jewish Israeli teenagers, 2002–2016. The mean age of IBD diagnosis decreased from 14.97 years of age during the years 2002–2008 to 14.32 during 2009–2016 (p < 0.0001). Significance was maintained for both diseases. Compared with Israeli origin, both CD and UC diagnosis were significantly less prevalent in subjects whose one of their parents was born in Asia, Africa and Ethiopia. Western origin of either parents was associated with increased risk only for CD. Lower SES was also significantly associated with lower prevalence (OR 0.25 for low SES for both diseases). The prevalence of both CD and UC significantly increased during the study period. Average age at diagnosis decreased during our study period for both diseases. Higher SES is a significant independent risk factor for both UC and CD.

Associations of multicultural status with depressive mood and suicidality among Korean adolescents: the roles of parental country of birth and socioeconomic position

BackgroundThe mental health of the offspring of immigrants is a major public health concern. In this study, we examined associations of multicultural status and parental country of birth with adolescent mental health in South Korea, and assessed the effect of socioeconomic position (SEP) on these associations.MethodsWe used four waves of the Korea Youth Risk Behavior Web-based Survey (KYRBS) between 2011 and 2014, including 294,324 participants (149,219 boys and 145,105 girls aged 13–18 years) as study subjects. KYRBS is a cross-sectional survey conducted annually by the Korea Centers for Disease Control and Prevention. The participants in the KYRBS were drawn as stratified multistage clustered samples from Korean middle schools and high schools. We calculated the age-adjusted 12-month prevalence of depressive mood and suicidal behaviors by parental country of birth, and estimated the effects of SEP indicators on the relationship.ResultsThe age-standardized prevalence of suicidality (suicide ideation, plans, and attempts) was significantly different between multicultural and non-multicultural boys. The impact of multicultural status on mental health varied with parental foreign-born status and maternal country of birth. Compared with non-multicultural counterparts, boys with Japan-born mothers showed lower prevalence ratios (PRs) of suicidal plans (PR = 0.34, 95% CI 0.16–0.70). Girls with Japan-born mothers also showed lower PRs of depressive mood (PR = 0.77, 95% CI 0.63–0.95) and suicidal ideation (PR = 0.59, 95% CI 0.41–0.83), while adolescents with Korean-Chinese mothers showed similar PRs. Boys with foreign-born fathers as well as boys with two foreign-born parents were at a greater risk of suicidality than non-multicultural boys. The magnitude of the relationship between multicultural status and mental health outcomes was generally attenuated after adjusting for SEP indicators.ConclusionsIn general, adolescents with Japan-born mothers showed lower PRs of depressive mood and suicidality than non-multicultural adolescents, while those with Korean-Chinese mothers showed similar PRs. Boys who had foreign-born fathers generally showed greater PRs of depressive mood and suicidality than non-multicultural boys. To ensure the effective implementation of policies to reduce mental health problems among multicultural adolescents in South Korea, detailed information should be considered regarding the cultural and socioeconomic backgrounds of families, such as parental country of birth and SEP.

Incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease after quadrivalent human papillomavirus vaccination: a cohort study.

To assess whether quadrivalent human papillomavirus (qHPV) vaccination is associated with increased incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease. This register-based open cohort study included all girls and women between 10 and 30 years of age in Sweden in 2006-2012 diagnosed with at least one of 49 prespecified autoimmune diseases (n = 70 265). Incidence rate ratios were estimated for new-onset autoimmune disease within 180 days of qHPV vaccination using Poisson regression adjusting for, country of birth, parental country of birth, parental income and parental education. A total of 70 265 girls and women had at least one of the 49 predefined autoimmune diseases; 16% of these individuals received at least one dose of qHPV vaccine. In unvaccinated girls and women, 5428 new-onset autoimmune diseases were observed during 245 807 person-years at a rate of 22.1 (95% CI 21.5-22.7) new events per 1000 person-years. In vaccinated girls and women, there were 124 new events during 7848 person-years at a rate of 15.8 (95% CI 13.2-18.8) per 1000 person-years. There was no increase in the incidence of new-onset autoimmune disease associated with qHPV vaccination during the risk period; on the contrary, we found a slightly reduced risk (incidence rate ratio 0.77, 95% CI 0.65-0.93). In this nationwide study, qHPV vaccination was not associated with increased incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease.

Do selective immunisation against tuberculosis and hepatitis B reach the targeted populations? A nationwide register-based study evaluating the recommendations in the Norwegian Childhood Immunisation Programme

BackgroundSelective immunisation is an alternative to universal vaccination if children at increased risk of disease can be identified. Within the Norwegian Childhood Immunisation Programme, BCG vaccine against tuberculosis and vaccine against hepatitis B virus (HBV) are offered only to children with parents from countries with high burden of the respective disease. We wanted to study whether this selective immunisation policy reaches the targeted groups. MethodsThe study population was identified through the Norwegian Central Population Registry and consisted of all children born in Norway 2007–2010 and residing in Norway until their second birthday, in total 240,484 children. Information on vaccinations from the Norwegian Immunisation Registry, and on parental country of birth from Statistics Norway, was linked to the population registry by personal identifiers. The coverage of BCG and HBV vaccine was compared with the coverage of vaccines in the universal programme. ResultsAmong the study population, 16.1% and 15.9% belonged to the target groups for BCG and HBV vaccine, respectively. Among children in the BCG target group the BCG vaccine coverage was lower than the coverage of pertussis and measles vaccine (83.6% vs. 98.6% and 92.3%, respectively). Likewise, the HBV vaccine coverage was lower than the coverage of pertussis and measles vaccine in the HBV target group (90.0% vs. 98.6% and 92.3%, respectively). The coverage of the targeted vaccines was highest among children with parents from South Asia and Sub-Saharan Africa. The coverage of vaccines in the universal programme was similar in targeted and non-targeted groups. ConclusionsChildren targeted by selective vaccination had lower coverage of the target vaccines than of vaccines in the universal programme, indicating that selective vaccination is challenging. Improved routines for identifying eligible children and delivering the target vaccines are needed. Universal vaccination of all children with these vaccines could be considered.

Risk of Preterm Birth According to Maternal and Paternal Country of Birth: A Population-Based Study.

To examine the co-contribution of maternal and paternal country of origin to preterm birth, and the differences in PTB rates between immigrants giving birth in Canada and those giving birth in their country of origin. Using a population-based study for all of Ontario, we included 1 200 864 singleton and twin livebirths from 2002 to 2011. The risk of PTB in infants of immigrant parents from the same country was compared to those whose parents were both Canadian-born. Logistic regression analysis adjusted for maternal and paternal age, parity, marital status, income, infant sex, and twins. We also measured differences in the calculated rate of PTB among immigrants by parental country of birth minus the published PTB rate within their native country. The main outcome measures were PTB < 37 weeks, late PTB at 34 to 36 weeks, and very PTB < 32 weeks. Compared with infants of two Canadian-born parents, those of immigrant parents from the same country had a lower risk of PTB (aOR 0.94, 95% CI 0.92 to 0.96) and late PTB (aOR 0.92, 95% CI 0.89 to 0.94) but a higher risk of very PTB (aOR 1.09, 95% CI 1.04 to 1.16). Infants of couples from Guyana, Trinidad and Tobago, the Philippines, and Jamaica were at increased risk of PTB, late PTB, and very PTB. The rate of PTB was, on average, 3% lower for newborns of immigrant parents than the published rate of PTB in their native country. The rate of PTB is influenced by maternal and paternal country of birth. That rate is generally lower among immigrants than the rate in their native country of origin.

Perinatal risk factors for acute myeloid leukemia.

Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P < 0.001), with peak risk among persons born in winter. Relative to persons born in summer (June-August), incidence rate ratios for AML were 1.72 (95 % CI 1.25-2.38; P = 0.001) for winter (December-February), 1.37 (95 % CI 0.99-1.90; P = 0.06) for spring (March-May), and 1.27 (95 % CI 0.90-1.80; P = 0.17) for fall (September-November). Other risk factors for AML included high fetal growth, high gestational age at birth, and low maternal education level. These findings did not vary by sex or age at diagnosis. Sex, birth order, parental age, and parental country of birth were not associated with AML. In this large cohort study, birth in winter was associated with increased risk of AML in childhood through young adulthood, possibly related to immunologic effects of early infectious exposures compared with summer birth. These findings warrant further investigation of the role of seasonally varying perinatal exposures in the etiology of AML.

Mortality in adult offspring of immigrants: a Swedish national cohort study.

BackgroundHigher risks of psychiatric disorders and lower-than-average subjective health in adulthood have been demonstrated in offspring of immigrants in Sweden compared with offspring of native Swedes, and linked to relative socioeconomic disadvantage. The present study investigated mortality rates in relation to this inequity from a gender perspective.MethodsWe used data from national registers covering the entire Swedish population aged 18-65 years. Offspring of foreign-born parents who were either Swedish born or had received residency in Sweden before school age (<7 years) were defined as “offspring of immigrants.” We used Cox regression models to examine the association between parental country of birth and mortality between 1990 and 2008, with adjustment for education, income, age and family type.ResultsMale offspring of immigrants from the Middle East (HR:2.00, CI:1.66-2.26), other non-European countries (HR:1.80, CI:1.36-2.36) and Finland (HR:1.56, CI:1.48-1.65) showed an age-adjusted excess mortality risk from all causes of death when compared to offspring with Swedish-born parents. Income, but not education, greatly attenuated these increased mortality risks. No excess mortality rates were found among female offspring of immigrants, with the exception of external cause of death among offspring of Finnish immigrants.ConclusionThe study demonstrates high mortality rates in male offspring of immigrants from Finland and non-European countries that are associated with economic, but not educational, disadvantage. No increased mortality rates were found among female offspring of immigrants. Future studies are needed to explain this gender differential and why income, but not education, predicts mortality in male offspring of immigrants.

Perinatal and familial risk factors for brain tumors in childhood through young adulthood.

Perinatal factors, including high birth weight, have been associated with childhood brain tumors in case-control studies. However, the specific contributions of gestational age and fetal growth remain unknown, and these issues have never been examined in large cohort studies with follow-up into adulthood. We conducted a national cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for brain tumor incidence through 2010 (maximum age 38 years) to examine perinatal and familial risk factors. There were 2,809 brain tumors in 69.7 million person-years of follow-up. After adjusting for potential confounders, significant risk factors for brain tumors included high fetal growth [incidence rate ratio (IRR) per additional 1 SD, 1.04; 95% confidence interval (CI), 1.01-1.08, P = 0.02], first-degree family history of a brain tumor (IRR, 2.43; 95% CI, 1.86-3.18, P < 0.001), parental country of birth (IRR for both parents born in Sweden vs. other countries, 1.21; 95% CI, 1.09-1.35, P < 0.001), and high maternal education level (Ptrend = 0.01). These risk factors did not vary by age at diagnosis. The association with high fetal growth appeared to involve pilocytic astrocytomas, but not other astrocytomas, medulloblastomas, or ependymomas. Gestational age at birth, birth order, multiple birth, and parental age were not associated with brain tumors. In this large cohort study, high fetal growth was associated with an increased risk of brain tumors (particularly pilocytic astrocytomas) independently of gestational age, not only in childhood but also into young adulthood, suggesting that growth factor pathways may play an important long-term role in the etiology of certain brain tumor subtypes.

Exploring parental country of birth differences in the use of psychostimulant medications for ADHD: a whole‐population linked data study

ObjectiveTo explore parental country of birth differences in the use of stimulants for attention deficit hyperactivity disorder (ADHD) in Western Australian (WA) children and adolescents. MethodsStatutory WA stimulant notification and dispensing records from 2003 to 2007 were linked to whole‐population state data from 1980 to 2007. Parental attributes were obtained through the WA Family Connections genealogical linkage system. Using multivariate logistic and linear regression, the differences in WA stimulant use for ADHD by parental country of birth, socioeconomic status and geographical remoteness were examined. ResultsOf 671,231 people born in WA between 1980 and 2007, 13,555 (2%) used stimulants for ADHD. Of these, 734 (5%) had parents born in Africa, Asia, the Middle East or South America, and 12,006 (87%) had parents born in Australia, North America and Europe. Children and adolescents with parents born in traditionally non‐Anglophonic countries were less likely to be treated with stimulants (OR=0.17, 95%CI 0.14–0.21) than those with parents born in Anglophonic countries. Socioeconomic advantage and residential remoteness were also significant independent predictors of a decreased likelihood of stimulant use. ConclusionsThe results highlight the importance of improving knowledge about cultural differences in access to and attitudes towards the diagnosis of ADHD and different approaches to its treatment.

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems. However, the role of maternal and paternal PCV is unclear, as these have not been investigated as a risk factor for behaviour problems, with all other risk factors taken into account. Aim of this study is to investigate whether maternal and paternal PCV are independent risk factors for behaviour problems in very preterm (VP) and term born children. The present study is a single centre prospective cohort study. Preterm children (n = 104), born at <30 weeks' gestation and/or birth weight <1000 g, and term children (n = 95) were assessed at age 5. Results showed that risk factors for parent-rated behaviour problems were low/middle parental education, VP birth, parental stress and, in VP children, maternal PCV. Risk factors for teacher-rated behaviour problems were low/middle parental education, foreign parental country of birth, intrauterine growth restriction and objective child vulnerabilities. It can be concluded that maternal PCV is a risk factor for parent-rated behaviour problems in VP children. When VP children are presented with behavioural problems, clinicians ought to be aware of the possibility that parents might still perceive their child as vulnerable. The neonatal history of the child, the way parents experienced that period, their perceptions of the child and possible consequences of these perceptions could be subjects for conversation during visits at follow-up clinics. Copyright © 2015 John Wiley & Sons, Ltd.

Country of birth, parental background and self-rated health among adolescents: a population-based study.

The aim of this study was to investigate differences according to country of birth and parental country of birth, in relation to poor self-rated health (SRH), in Swedish adolescents. The Scania public health survey among children and adolescents, conducted in 2012, is a cross-sectional study including most pupils in grade 9 (15 years old), including in 32 of 33 municipalities. The participation rate was 83% (9,791 of 11,735). We performed logistic regressions to investigate the association between the students' country of birth, parental country of birth and poor SRH. Boys born outside Europe had an odds ratio (OR) 2.1 (1.6-2.8) of poor SRH in the unadjusted model, which was reduced to 0.7 (0.4-1.3) in the multiple model, as compared to boys born in Sweden with both or one parent born in Sweden. Boys born in Europe had an OR 0.4 (0.2-0.9) of poor SRH, after multiple adjustments. Girls born in Sweden with both parents born abroad, and girls born outside of Europe had significantly lower ORs of poor SRH in the multiple model. In particular, adjustment for socio-demographic and psychosocial factors reduced the ORs of poor SRH among boys, but did so to a lesser extent among girls. Differences in socio-demographic and psychosocial factors explained the higher odds of poor SRH among boys born outside of Europe. Girls born in Sweden with both parents born abroad, and girls born outside Europe, had significantly lower ORs of poor SRH. Our results indicate that there are gender differences in the factors behind poor self-rated health, according to the country-related background of adolescents in Sweden.

Increased risk of peanut allergy in infants of Asian-born parents compared to those of Australian-born parents.

Asian infants appear to be over-represented among patients with clinical food allergy in Australia, but this has not been formally examined at the population level. Any difference in prevalence according to parental country of birth may be secondary to modifiable lifestyle factors. We aimed to quantify (i) differences in the prevalence of peanut allergy by parental country of birth and (ii) contribution of measured environmental exposures to these differences. The population-based HealthNuts study in Melbourne, Australia, screened 5276 infants (74% participation) with skin prick tests and sensitized infants underwent food challenge. Of these, 535 had a parent born in East Asia and 574 in UK/Europe. Associations between parents' country of birth and offspring peanut allergy were examined using multiple logistic regression. Compared to infants with two Australian-born parents, peanut allergy was more common among infants with parent/s born in East Asia (OR 3.4, 95% CI 2.2-5.1) but not those with parent/s born in the UK/Europe (OR 0.8, 95% CI 0.4-1.5). Paradoxically rates of allergic disease were lower among Asian parents. A higher prevalence of eczema among infants of Asian parents explained around 30% of the increase in peanut allergy, while differences in dog ownership explained around 18%. The high peanut allergy prevalence among infants of Asian-born parents appears to have occurred in a single generation and was not present among infants with parents migrating from other countries, suggesting gene-environment interactions are important. The role of eczema and microbial exposure in food allergy prevention warrants exploration.