Parental Education Status Research Articles

A Comparative Analysis of Determinants of Family Dynamics of Children with ADHD with and without Comorbid Conduct Disorder

Background: Comorbidity of attention-deficit/hyperactivity disorder (ADHD) is one of the most actively studied topics in the field of child and adolescent psychiatry. Among clinic-referred children, comorbidity is frequently found between ADHD and conduct disorder (CD). However, little is known regarding the probable association between the co-occurrence and external factors. One factor that has recently sparked interest is family dynamics.
 Objective: To compare the children with attention deficit/ hyperactivity disorder (ADHD) with and without co-morbid conduct disorder (CD) in terms of selected determinants of family dynamics and the influences of catchment area and gender on these differences.
 Methodology: This case-control study was conducted upon a sample of 114 pre-diagnosed ADHD children from July 2017 to June 2019 at the Liaquat University Hospital & Sir CJIP. After taking written informed consent from parents of children diagnosed with ADHD, the children were re-evaluated using the Diagnostic & Statistical Manual (DSM) - V criteria. Vanderbilt Parent Rating Scale was also used to screen for possible comorbidities with ADHD. Children with intellectual disability were excluded from the study. Family dynamics like family type, family size, socio-economic status, parental educational and occupational status, family relationships, parental discord, and history of psychiatric illness in family were explored via self-structured interview-based questionnaire. The data obtained was analyzed using SPSS v. 21.0.
 Results: The cumulative mean age of the sample of ADHD children stood at 7.6 years (SD ± 0.52). Most of the sample of the children hailed from urban (64.3%) areas and were raised in joint families (71.4%). Consanguinity was common among the parents (72.8%) and especially prevalent among the ADHD children with co-morbid CD. The key features that were notably high among families of the children with comorbid CD included positive parental psychiatric history, ADHD among siblings and parental discord.
 Conclusion: After careful consideration, it can be concluded that consanguinity of parents, joint family system. And family history of psychiatric disorder affects the occurrence of comorbidity of conduct disorder among children with ADHD.

Evaluation of Nursing Students' Sociotropic-Autonomic Personality Characteristics and Their Orientation to Care Roles.

AIMIn this study, the aim is to evaluate student nurses’ sociotropic-autonomic personality traits and orientation to the caring role in line with these advancements and requirements in the profession.METHODThis descriptive study included 372 nursing students studying in the 2018-2019 spring term. A 9-question questionnaire, 60-item Sociotropy Autonomy Scale and 24-item Nursing Care Role Orientation Scale were used to collect data. In the analysis of the data, descriptive statistics such as frequency, percentage, arithmetic mean, standard deviation, minimum and maximum were applied. An independent sample t-test was used to compare the means of two independent groups and a one-way ANOVA test was used to compare more than two independent groups. Written consent was obtained from the participants.ResultsIt was determined that the total Sociotropy Autonomy Scale (SAS) average score of the students was 152.35 ± 19.96 while the total score of the Nursing Care Role Orientation Scale (NCROS) was 79.48 ± 7.51. In addition, there were significant differences in SAS score averages related to age, gender, parental education status, and parental attitudes. Meaningful differences were also found in the total scores of NCROS according to age, gender, class grade, mother’s education level, and willingness to choose the nursing department. There was no statistically significant correlation between SAS total score and NCROS total score (p > .05).ConclusionIn line with the results obtained from the research, it can be recommended that the courses which can contribute to the orientation of the students to the sociotropic and autonomic personality characteristics and the orientation of nursing care roles contents should be developed, and the training and activities of awareness should be conducted.

Testing socioeconomic status and family socialization hypotheses of alcohol use in young people: A causal mediation analysis.

The effect of socioeconomic status on adolescent substance abuse may be mediated by family socialization practices. However, traditional mediation analysis using a product or difference method is susceptible to bias when assumptions are not addressed. We aimed to use a potential outcomes framework to assess assumptions of exposure-mediator interaction and of no confounding of the results. We revisited a traditional mediation analysis with a multiple mediator causal mediation approach using data from 17,761 Norwegian young people (13-18 years), 51% female. Data were collected through a print questionnaire. Socioeconomic status was operationalized as parental education and employment status (employed or receiving welfare); drinking behavior as the frequency of alcohol consumption and frequency of intoxication in the past year; and socialization practices as general parenting measures, alcohol-related parental permissiveness, and parent drinking behavior. There was no consistent evidence of exposure-mediator interaction. Formal sensitivity analysis of mediator-outcome confounding was not possible in the multiple mediator model, and this analysis supported the hypothesis that socioeconomic status effects on adolescent substance abuse are fully mediated by family socialization practices, with apparently stronger effects in younger age groups observed in plots. We found that the effect of socioeconomic status on adolescent substance abuse was fully mediated by family socialization practices. While our analysis provides more rigorous support for causal inferences than past work, we could not completely rule out the possibility of unmeasured confounding.

Respiratory Sinus Arrhythmia as a Physiological Resilience Marker for Children's Health.

The current study aimed to test parasympathetic nervous system activity, indexed through resting respiratory sinus arrhythmia (RSA) as a resilience factor that moderates the associations between socioeconomic status (SES), circulating cytokines, and somatic health in children. The sample included 181 parent-child dyads (mean [standard deviation] child age = 9.91 [0.57] years; 50.3% boys). Parents reported on family income, parental education, and subjective social status, to index SES. Children provided serum samples for assaying circulating inflammatory cytokines and had RSA measured during a 5-minute seated resting period. We used a composite measure of inflammation that combined standardized measures of interleukin 6, interleukin 10, and tumor necrosis factor α. Parents reported on their child's global health impairment and number of chronic health conditions. Lower SES was associated with poorer global health, and higher levels of inflammation were associated with poorer global health, but these associations were not significant among children with high resting RSA. Specifically, resting RSA moderated the association between SES and global health impairment (B = 0.09, standard error [SE] = 0.02, p < .001). Preliminary evidence suggests that resting RSA may also moderate the association between inflammation and global health impairment (B = -0.12, SE = 0.03, p < .001), although this effect was no longer significant after Winsorizing an outlier value of a child with high global health impairment (B = -0.06, SE = 0.03, p = .04). High resting RSA may represent a physiological profile of resilience in children, weakening the associations between low SES and poor somatic health, and between greater inflammation and poor somatic health.

A Study on the Social Determinants Affecting Nutritional Status of the Children of Guwahati City, Assam

The present study aims to understand the nutritional status of the pre-adolescent urban Guwahati boys and girls belonging to the age group of 6–10 years in relation to some social determinants such as parental education, parental occupation, family income, food habit, family type, and consumption of fast food. A total sample of 471 boys and girls going to the elite private schools of the city were collected cross-sectionally and measured for their stature and body weight. The Centers for Disease Control and Prevention cutoff for body mass index was used to study the nutritional status. Result shows that the boys are more malnourished than the girls. On contrary, the girls are found to be more at risk of overweight but are also healthier than the boys. The relationship of parental education and nutritional status is found to be statistically significant at 5% level among the boys. Further, this was supported by multiple logistic regression analyses performed to understand the association between the nutritional status and the social determinants which shows significance in fathers’ education and underweight (odds ratio [OR] – 3.043) and overweight (OR – 4.612) at 5% level. Father’s occupation and nutritional status are also found to be significant with underweight (OR – 2.961) at 5% level for the same. Maternal occupation and fast-food consumption are also found to be significantly associated with the nutritional status of the children. It may, therefore, be concluded that the nutritional status of the boys and girls is dependent on a number of social factors, thus making them vulnerable to malnutrition.

Türkiye'deki Hemşirelik Öğrencilerinin Beyin Göçüne Yönelik Tutumları: Kesitsel Bir Çalışma

Objective: Brain drain is increasing in the field of health in the world. This study was conducted to determine the opinions and attitudes of nurses of the future on brain drain in Turkey. Material and Methods: The study was conducted descriptively with 617 nursing department students who agreed to participate in the study between April and June 2019. The data were collected using the questionnaire form including socio-demographic characteristics and the 16-item Attitude Scale for Brain Drain (ASBD). The analysis of the data was performed by using percentage, average, parametric and nonparametric tests in the computer environment. Results: It was observed that the mean ASBD total score of the students participating in the study was 53.88±11.03. A statistically significant difference was found between the mean ASBD total score and the variables of age, gender, class, income status, employment status, educational status of parents, previous abroad experience, abroad experience of relatives in the immediate vicinity, information about working conditions as a nurse abroad, and desire to work abroad after graduation (p<0.05). Conclusion: The results of this study revealed that the students had positive attitudes and tendencies towards brain drain and their attitudes were affected by the age, gender, class, working status, income status, educational status of parents, previous abroad experience, abroad experience of relatives in the immediate vicinity, information about working conditions as a nurse abroad, and desire to work abroad after graduation.

Nomadic and Rural Population of Balochistan: Exploring the Pockets of Poor Childhood Immunization in the Most Under-Vaccinated Province of Pakistan

<i>Objective: </i>To assess the immunization coverage of children less than 2 years of age in rural and nomadic population of Balochistan. To assess the knowledge of parents about EPI immunization and find reasons of poor vaccination. <i>Material and methods: </i>The cross-sectional survey was conducted in rural population and nomadic tribes located in suburbs of district Zhob, Balochistan. One hundred families of rural areas and 100 families of nomadic tribes were interviewed. Information regarding the vaccination status of children, parents’ knowledge of EPI vaccinationand reasons of not vaccinating children or skipping vaccines were asked and noted. Education status of parents and socioeconomic status was also noted. <i>Results: </i>There were 295 children under 2 year age in the study population with 146 (49.5%) males and 149 (50.5%) females. Among rural population, 25 (16.4%) children were completely vaccinated, 106 (69.7%) children were partially vaccinated and 21 (13.8%) children never received any vaccination. In nomadic population, 10 (7%) children were completely vaccinated, 88 (61.5%) were partially vaccinated and 45 (31.5%) were unvaccinated. There was significant difference between vaccination status of families belonging to rural population versus those of nomadic population (P=0.002). Most common reason of skipping one or more vaccines was lack of knowledge and awareness in 28.8% cases. There was significant association between education status of fathers and mothers with vaccination status of families. <i>Conclusion: </i>Routine immunization of children in rural and nomadic population of Balochistan is dismal. Main culprits are lack of knowledge and awareness, compounded by illiteracy and poor education status of parents.

EXAMINATION OF LIFE SATISFACTION LEVELS OF SPORTS SCIENCES FACULTY STUDENTS AT HOME DURING THE PANDEMIC PROCESS (FIRAT UNIVERSITY EXAMPLE)

Aim: In this study, it is aimed to examine the life satisfaction levels of the students of the faculty of sports sciences during the pandemic process. In addition to the stated purpose, there is a significant difference in terms of gender, age, marital status, place of residence, department of education, class, parent education status and parental coexistence and number of people living together among students' levels of satisfaction with life at home during the pandemic process. It is also aimed to determine whether In the research, the scanning model, which is included in the quantitative research designs, was used as a method. The universe of the research The universe of the research consists of students studying at the Faculty of Sports Sciences of Fırat University in the 2021-2022 academic year. The sample of the study consists of 534 students who were randomly selected from the population and participated voluntarily. While the "Personal Information Form" consisting of 13 questions was used to determine the personal information of the students as a data collection tool in the research, the "Life Satisfaction at Home During the Global Epidemic (Covid-19) Process" scale was used to determine the level of life satisfaction of the students at home during the pandemic process. The research data collected with the specified data collection tools were analyzed by using Independent Samples t-Test and One-Way Analysis of Variance, together with descriptive statistical methods, due to their normal distribution. In the study, it was determined that the students of the faculty of sports sciences were above the average at home life satisfaction during the pandemic process. This result was evaluated as the students were happy to be at home during the pandemic process. In addition, in the study, it was determined that the level of satisfaction with life at home of the students of the faculty of sports sciences during the pandemic period differed significantly according to the variables of gender, marital status, age and place of residence.

Preferences of parents for mental health services to suit children with chronic medical conditions.

Objectives To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care. Methods A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children's Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity. Results The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities. Conclusions Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care.

Association of Low Visual Acuity and Head Injury among the Undergraduate Students of Bingham University, Karu, Nigeria

A laboratory-based cross-sectional study was conducted among Bingham University undergraduate students, Karu, to investigate the proportion of visual acuity (VA) among the students. The study aimed at investigating an association between head injury with low VA of students whose parent’s use medicated eye glasses. A total of 262 undergraduate students participated in the study. A predesigned, pre-tested, self-administered questionnaire was filled by the students. Eye examination using the optotype Snellen E Chart followed and the VA of the right (VARE) and left eyes (VALE) were tested separately. A regression and correlation model was used to assess the relationship between head injury and low VA. Head injury at one point of time in their life was strongly associated with low VA for both eyes (VARE, r = 0.524, R2 = 0.274, p = 0.040; VALE, r = 0.0.531, R2 = 0.282 p = 0.010). Parents’ use of medicated eye glasses was also associated with low VA of students (VARE p = 0.009; VALE p &lt; 0.001). Our results showed that students that had any form of head injury at any point in their life either as a child, teenager or an adult, were more likely to have low VA. However, the educational status of parents, anthropometric parameters and ethnicity had no association with low VA. We conclude that any form of head injury, at any point in one’s life, and parent’s use of eye glasses are risk factors for low VA.

Evaluation of Attitudes and Knowledge Levels of University Employess towards Rational Drug Use and Health Perception

This survey study was aimed at determining the Rational Drug Use (RDU) behaviors and health perceptions of the staff working in a state university. The population of this cross-sectional study consists of all the staff working in a state university in Turkey. The study sample consisted of a total of 342 staff including academicians, administrative personnel, janitors and security guards. The data were collected through an online questionnaire due to pandemic precautions. The obtained data were recorded on the SPSS version 18 program and descriptive statistics, normality tests, Mann-Whitney U Test, Kruskal-Wallis Test, and Spearman correlation were used in the analysis. The mean age of the participants in the study were found to be 36,54±8,05. 79,2% of the participants were male. 29,2% of them had a PhD. 44,4% were academic staff working in all departments while 55,6% included administrative personnel, janitors and security guards. The RDU knowledge mean scores of the participants (35,69±5,30) were considered sufficient. It was found that factors such as personal and parental educational status, profession, socioeconomic level, family type, gender, and distance from the health center of the residence had important effects on Rational Drug Use (p

Growth during times of fear and emotional stress

Twenty-one scientists met for this year’s virtual conference on Auxology held at the University Potsdam, Germany, to discuss child and adolescent growth during times of fear and emotional stress. Growth within the broad range of normal for age and sex is considered a sign of good general health whereas fear and emotional stress can lead to growth faltering. Stunting is a sign of social disadvantage and poor parental education. Adverse childhood experiences affect child development, particularly in families with low parental education and low socioeconomic status. Negative effects were also shown in Indian children exposed prenatally and in early postnatal life to the cyclone Aila in 2009. Distrust, fears and fake news regarding the current Corona pandemic received particular attention though the effects generally appeared weak. Mean birth weight was higher; rates of low, very and extremely low birth weight were lower. Other topics discussed by the participants, were the influences of economic crises on birth weight, the measurement of self-confidence and its impact on growth, the associations between obesity, peer relationship, and behavior among Turkish adolescents, height trends in Indonesia, physiological neonatal weight loss, methods for assessing biological maturation in sportsmen, and a new method for skeletal age determination. The participants also discussed the association between acute myocardial infarction and somatotype in Estonia, rural-urban growth differences in Mongolian children, socio-environmental conditions and sexual dimorphism, biological mortality bias, and new statistical techniques for describing inhomogeneity in the association of bivariate variables, and for detecting and visualizing extensive interactions among variables.

A Research about Mathematical Visualization Perceptions of Mathematics Teacher Candidates in Terms of Some Variables

This study was conducted to examine mathematical visualization perceptions of mathematics teacher candidates in terms of gender, grade level, and parental educational status. Survey model was used. The population of the research consisted of mathematics teacher candidates who studied at the faculty of education of a university in the east Anatolia part of Turkey in 2018-2019 spring semester. The sample of the study consisted of 231 mathematics teacher candidates (168 Female, 63 Male) chosen by simple random sampling method from this population. In the study, Mathematical Visualization Perception Scale was used for getting data. The data were analyzed using SPSS. The descriptive analysis, study variable; average, percentage, and standard deviation were used. In addition, unpaired t-test for analyzing variation about gender variable, ANOVA, and LSD tests were preferred for analyzing variation about grade level and parental education status. As a result of the study findings, it was determined that the level of mathematical visualization perceptions of mathematics teacher candidates was no significant difference in terms of gender, but it was a significant difference in terms of grade level. Furthermore, math visualization perception level significantly differed according to parental education status.

Symptoms of depression in parents after discharge from NICU associated with family-centred care.

AimsThe aim of this study was to examine the potential association of family‐centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age.DesignA longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries.MethodsParents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalizations. They responded to Digi‐FCC daily text messages inquiring about their perception of family‐centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family‐centred care at discharge. Parents’ depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age.ResultsThe mothers’ and the fathers’ perceptions of family‐centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents’ participation in infant care, care‐related decisions and emotional support provided to parents by staff explained the variation in the parents’ perceptions of family‐centred care. The factors facilitating the implementation of family‐centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents.ConclusionsOur study shows that family‐centred NICU care associates with parents’ depressive symptoms after a NICU stay.ImpactDepression is common in parents of preterm infants. The provision of family‐centred care may protect the mental well‐being of parents of preterm infants.

Four Decades of Intergenerational Educational Mobility in Sub-Saharan Africa

Using nationally representative survey data from 34 countries, we assess the extent of intergenerational educational mobility for three-quarters of Africa’s population, over four decades and by gender. We employ both transition probability matrices and regression-based estimates of intergenerational elasticities and correlation coefficients. We find that the educational status of parents is a strong determinant of their children’s educational outcomes, but the strength of this link has diminished in Africa between 1960 and 1999, particularly since the 1980s. We also find that there are considerable differences between countries and by gender. Those in the Southern and Central African region and those with historical links to former British colonies experience relatively higher intergenerational mobility in education. Intergenerational educational mobility is less pronounced for daughters than for sons and mother’s education is generally more strongly associated with children’s educational attainment than fathers’ education.

Engaging Parents in Special Education: An Examination of Knowledge and Access to Resources

ABSTRACT Parental engagement in special education promotes positive student outcomes and parent-school relationships. In order to promote engagement, parents must possess a basic knowledge and understanding of special education processes and parent and student rights. Little is known regarding parental knowledge about special education or how they learn about and access information on the special education process. This exploratory study surveyed 133 parents of students with disabilities to identify how they received special education related information, specific information received or searched across primary special education topics, and their perceived current and retrospective understanding of these topics as well as how these may differ based on specific parent and special education status characteristics. Findings indicate that parents gain the majority of information from personal communication (i.e., conversations with special education teachers, other parents), often independently search out additional information on key aspects of special education, and feel most knowledgeable about Individualized Education Programs (IEPs) and least knowledgeable about the legal aspects of special education. Significant differences were noted on some family characteristics in areas of satisfaction with resources, overall special education knowledge, and ways in which parents obtain information (e.g., school or on their own). Limitations, implications, and future research are discussed.

Differences in birthweight by maternal and paternal nativity status in Canada.

Parental nativity, as well as duration of residence of foreign-born parents in the host country, has been shown to be associated with size at birth. However, most studies have focused on maternal nativity status only and have not accounted for important characteristics of both parents. To explore whether maternal and paternal nativity and length of residence (LOR) are independently associated with birthweight for gestational age in a representative sample of infants in Canada. We compared mean differences in sex- and gestational age-standardised birthweight z-score by nativity status of both parents in a nationally representative sample of 130,532singleton infants born between May 2004 and May 2006 to mothers residing in Canada. We categorised parental nativity status into four groups (both parents Canada-born, mother only foreign-born, father only foreign-born and both parents foreign-born) and parents' LOR into three (both ≤10years, only one parent ≤10years and both >10years). We estimated mean differences in birthweight z-score and their 95% confidence intervals in linear regression models adjusted for parity, parents' ages, education, ethnicity and marital status of the mother. Compared with babies of Canada-born couples, those of two foreign-born parents had on average smaller birthweight z-score, -0.23 (95% CI -0.28, -0.25). However, after adjustment, the mean difference in z-score was -0.02 (95% CI -0.05, 0.00). Infants born to parents who had both resided in Canada for ≤10years had a unadjusted mean difference in z-score of -0.27 (95% CI -0.29, -0.26), compared infants whose parents were both Canada-born, but the difference became negligible (-0.02, 95% CI -0.04, 0.01) after adjustment. The birthweight differences by parental nativity or length of residence observed in our study population could be attributed to differences in the distribution of other parental characteristics that affect birthweight.

The Effect of Parental Education and Socioeconomic Status on Dental Caries among Saudi Children.

Parental attitudes toward the importance of oral hygiene have an impact on the formation of their children’s oral habits and the prevalence of oral diseases. Our aim was to assess the association between parents’ education and socioeconomic status and their children’s oral health. A cross-sectional study was conducted between the years of 2018 and 2020 in the eastern province of Saudi Arabia among primary school children. Two pre-calibrated dentists performed the clinical examination of the children, and a self-administered validated questionnaire was obtained from their parents. Clinical examination was performed on 589 children with an age range of 3 to 14 years, where 47% were males and 53% were females, 70% with dental caries. Both parents with higher education and a high monthly income were significantly associated with lower prevalence of decayed teeth in their children, respectively. Mother’s education, age, gender and application of sealant were found significantly associated with the high prevalence of caries. High prevalence of tooth decay was reported among school children in the eastern province of Saudi Arabia. A high educational level of parents and high income were correlated with a lower prevalence of decayed teeth, similarly to the situation in the case of presence of medical insurance.

Racism May Interrupt Age-related Brain Growth of African American Children in the United States

Background: Considerable research has documented age-related growth in brain size as a marker of normal brain development. This is particularly important because brain volume has a significant role in overall cognitive performance. However, less research is done on whether age-related changes in the global brain volume differ across diverse racial and ethnic groups. We hypothesized that age-related growth in brain size would be disrupted in African American children who are historically affected by racism. Purpose: Considering race as a proxy of racism rather than genetics, this study tested racial and ethnic differences in the effects of age on global brain volume using structural brain imaging data. Built on a sociological, rather than a biological theory, we built our study on Marginalization-related Diminished Returns (MDRs) framework, which argues that under racism, resources and assets are less effective for social groups that are historically racialized, discriminated against, marginalized, and segregated. Considering age as an asset/resource that increases the global brain volume, we expected weaker effects of age on overall brain size of African American and Hispanic children, than White and non-Hispanic children, again as a result of racism. Methods: We borrowed the structural Magnetic Resonance Imaging (sMRI) data from the Children Brain Cognitive Development (ABCD) study, which included 9,311 9-10 year old children. The independent variable was the child’s age treated as a continuous measure (in months). The primary outcome was global brain volume. Sex, parental employment, parental education, household income, and parental marital status were the covariates. Race and ethnicity, as proxies of racism, were the moderators. To analyze the data, we used linear regression models. Results: Age was positively associated with the global brain size in children. In line with the MDRs, the positive association between age and global brain volume was weaker for African American than White children, while family structure, sex, and family socioeconomic status was controlled. Conclusions: Under racism, age has unequal effects on global brain size of diverse racial groups. In line with the MDRs, we observe diminished agerelated growth of the brain for African American children, which documents detrimental effects of racism. For White children who are not affected by racism, age makes a large difference regarding global brain volume. Age-related growth of global brain size is diminished in African American children, whose daily lives are shaped by racism. School and residential segregation may have a role in reducing the effect of age on children’s brain growth in African American families. The results should not be interpreted as inferiority of one group but social processes that hinder normal development of a historically oppressed group.

Social Determinants of Health and Neurocognitive Functioning in Sickle Cell Disease

Sickle cell disease (SCD) is associated with significant neurocognitive risk due to a combination of disease and environmental factors. Neurological complications, including overt stroke, silent cerebral infarctions, and chronic insufficiencies in oxygen and/or glucose delivery to the brain contribute to neurocognitive decline. Environmentally, patients with SCD experience greater rates of poverty and fewer protective socioeconomic factors when compared with the Black population in the United States. Both personalized (e.g. familial education and occupation) and community measures of socioeconomic status uniquely contribute to neurocognitive outcomes. However, no studies have examined the specific community-level factors that contribute to neurocognitive performance. The primary objective of this study was to investigate associations between familial and community-level social determinants with cognitive and academic outcomes in a large prospectively recruited sample of patients with SCD ranging from childhood to young adulthood.We included 103 patients with SCD (51% HbSS/HbSβ 0-thalassemia). The mean age of participants was 12.86 (SD=4.04) years. Familial socioeconomic status was measured using the Barratt Simplified Measure of Social Status (BSMSS), a composite of parent education and occupation status. Community-level (based on census block) socioeconomic variables included: poverty rate, unemployment rate, percentage of individuals with a bachelor's degree, and access to food nutrition services. Following informed consent, patients completed gold-standard neurocognitive measures supervised by a psychologist, assessing intellectual (Wechsler Abbreviated Scale of Intelligence - Second Edition) and academic functioning (Woodcock Johnson Tests of Achievement - Third Edition). Multivariate linear regression was used to examine associations between community and familial level socioeconomic status with cognitive/academic outcomes after adjusting for age, sickle genotype, and hydroxyurea exposure. Stepwise linear regression was used to identify the independent factors associated with cognitive/academic outcomes. The False discovery rate (FDR) developed by Benjamini and Hochberg was used to control for multiple testing and FDR-adjusted p-values (pFDR) <0.05 were considered statistically significant. Otherwise, p-values <0.05 were considered significant.Patients with SCD lived in communities with high rates of poverty (26.57%) and unemployment (13.58%) and low rates of college education (13.26%). In multivariate analyses adjusting for age, sickle genotype, and hydroxyurea exposure, IQ was associated with the BSMSS (estimate = 0.31, standard error [SE] = 0.10, p=0.003) at pFDR<0.05 but measures of basic reading and math were not (all pFDR>0.05).In contrast, reduced intellectual functioning was associated with increased poverty rates (Estimate=-0.29, SE=0.09, p=0.003), increased unemployment rates (estimate=-0.43, SE=0.18, p=0.018), increased access to food nutrition services (Estimate=-0.21, SE=0.09, p=0.015), and decreased percentage of individuals with a bachelor's degree (Estimate=0.33, SE=0.10, p=0.003) at pFDR<0.05. Measures of basic reading and math were not associated with any of the community-level variables. Stepwise linear regression analysis showed that the BSMSS (Estimate=0.22, SE=0.11, p=0.04) and poverty rates (Estimate=-0.18, SE=0.09, p=0.049) are independently associated with full scale IQ after adjusting for age, sickle genotype and hydroxyurea exposure. Overall, community and familial socioeconomic factors accounted for greater variance in intellectual functioning than age, genotype, and hydroxyurea treatment exposure (see Figure 1).Social determinants at the community-level contribute to intellectual development in patients with SCD independent of familial socioeconomic status. Surprisingly, academic performance was not associated with community-level social determinants. Evaluation of community-level social determinants may provide insights into potential targets for neurodevelopmental interventions. [Display omitted] DisclosuresEstepp: Global Blood Therapeutics: Consultancy, Research Funding. Hankins: Bluebird Bio: Consultancy; UpToDate: Consultancy; Global Blood Therapeutics: Consultancy; Vindico Medical Education: Consultancy.