Parental Marital Status Research Articles

Gut Microbiome Differences in Infants at High vs. Low Risk of Early Obesity

Abstract Objectives Fifty % of infants above the BMI 85th percentile will develop overweight or obesity by age 6. This study aimed to evaluate differences in the gut microbial ecology of infants at high- and low-risk of developing overweight or obesity. Methods Infants enrolled at age 6 months were classified into high-risk or low-risk based on BMI ≥85th or <85th percentile; stool samples were collected from the diaper and microbial DNA extracted. Metagenomic shotgun sequencing was performed on the Illumina HiSeq at an average depth of 15 million paired-end reads per sample. Taxonomic profiling was performed using Kraken against a custom genome database. Multiple linear regression was used to test for group differences in observed species richness and Shannon diversity, adjusted for age, delivery type, breast feeding, and introduction of solid food. Beta-diversity ordinations assessed group clustering according to species community composition. Moderated negative binomial regression using DESeq2 was used to identify differentially abundant species. Functional profiling of microbial pathways was conducted using HUMAnN2, and group differences assessed using ALDEx2. Results Sixty-one infants (46% male, 69% black) were enrolled; 13 (21%) were high-risk. Low-risk and high-risk infants differed by race (mixed race more common in high-risk, P = 0.02), and marginally by parent marital status and number of older children in the household (both P = 0.06). Number of observed species were marginally higher in the high-risk group (P = 0.09), with no group differences in beta-diversity ordinations. Several Streptococcus, Enterobacter, Bacteroides and Lactobacillus species were more abundant in high-risk infants, while Haemophilus, Bifidobacterium and Prevotella species were more abundant in low-risk infants. High-risk infants had a more “mature” microbiome characterized by increased abundance of Ruminococcus, Blautia, and Lachnospiraceae. The PWY.5676 Acetyl-CoA fermentation to butyrate pathway was also significantly enriched in high-risk infants. Conclusions Infants at high risk for obesity are characterized by a microbiome more abundant in species seen in older children, and with a greater functional capacity to harvest energy from complex carbohydrates. Funding Sources Digestive Health Center Pilot Grant.

0930 Prenatal Cannabis Use and Sleep Outcomes in Children 9-10 Years of Age in the Adolescence Brain Cognitive Development Study

Abstract Introduction The fetal brain is densely populated with CB1 receptors that increase in number throughout gestation and might be involved in sleep processes since they are found in many brain areas related to the regulation of the sleep-wake cycle. THC binds to CB1 receptors, possibly altering neurodevelopment and fetal cortical circuitry in the womb. Studies have found prenatal cannabis use is associated with early sleep factors from as early as few days after birth to 3 years of age, yet no studies have examined associations in later childhood. Methods We used data from the Adolescent Brain Cognitive Development (ABCD) study to determine whether maternal reports of cannabis use while pregnant were associated with child sleep outcomes (The Sleep Disturbance Scale for Children) among 11,875 children ages 9-10. Regression analyses accounted for the nested nature of families (twin and non-twin sibling) and were estimated controlling for potential covariates including daily tobacco and weekly alcohol use during pregnancy, mother’s education, combined household income, parental marital status, child sex, and child age. Results Amongst mothers in our sample, 6% endorsed using cannabis while pregnant. Prenatal cannabis use was associated with lower sleep duration, disorders of initiating and maintaining sleep, disorders of arousal, sleep wake disorders, disorders of excessive somnolence, and a summed sleep score (all b >0.09 and p < 0.04) but not with sleep latency, sleep breathing disorders, and sleep hyperhidrosis (all b <0.08 and p >0.09). Conclusion Prenatal cannabis use was associated with increased childhood sleep deficits including shorter sleep duration and higher endorsements of sleep disorder symptoms. This is the first report of prenatal cannabis use being associated with sleep in childhood as late as 9-10 years of age. Although causality is not established, the results suggest potential long-term effects of prenatal cannabis use on sleep and the need for abstinence from cannabis use while pregnant. Support T32 DA017637. The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, U24DA041147, U01DA041093, and U01DA041025 (https:// abcdstudy.org/federal-partners.html).

The mediating effect of dietary patterns on the association between mother\u2019s education level and the physical aggression of five-year-old children: a population-based cohort study

BackgroundRelatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children’s behavior problems. The study aims to examine whether preschoolers’ dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression.MethodsData came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers’ physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children’s sex, parental marital status, household income, mental distress at age 5 and children’s physical aggression at age 3.ResultsMaternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers’ physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers’ physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers’ physical aggression was partially mediated by preschoolers’ healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178.ConclusionsPreschoolers’ dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers’ healthy development.

Parental Educational Attainment and Social Environmental of Urban Public Schools in the U.S.: Blacks' Diminished Returns.

Background: Recent research has documented marginalization-related diminished returns (MDRs) of socioeconomic status (SES), defined as weaker effects of SES indicators, such as parental educational attainment, on securing tangible outcomes for the members of socially marginalized (e.g., racial and ethnic minority) groups, compared to privileged social groups (e.g., non-Hispanic Whites). Aims: To explore race/ethnic differences between non-Hispanic Blacks vs. non-Hispanic Whites who attend urban public schools on the effect of parental education on lower school environmental risk among American high schoolers. Methods: For this cross-sectional study, we borrowed the Education Longitudinal Study (ELS-2002) baseline data, a nationally representative study that enrolled 1706 10th grade youths who were attending urban public schools. From this number, 805 (47.2%) were non-Hispanic Black and 901 (52.8%) were non-Hispanic White youths. The dependent variable was the level of school social environmental risk measured using 18 items as self-reported, and was treated as a continuous variable. The independent variable was parental educational attainment, treated as a continuous measure. Gender, region, and parental marital status were the covariates. Race/ethnicity was the moderating variable. Linear regressions were applied to perform our data analysis. Results: Black students were found to attend schools with higher levels of social environmental risk. Youths with parents with a higher educational attainment were found to attend schools with a lower social environmental risk. We found a significant interaction between race (non-Hispanic Black vs. non-Hispanic White) and parental educational attainment on the level of school social environmental risk, suggesting that the protective effect of high parental education on reducing the school social environmental risk was smaller for non-Hispanic Black than for non-Hispanic White youths. Conclusions: Although high parental educational attainment is protective against social environmental risk for American youths, this protective effect is weaker for non-Hispanic Black than non-Hispanic White youths. The diminished returns of parental education in reducing school social environmental risk may explain why the effects of parental education on educational outcomes are smaller for non-Hispanic Black than non-Hispanic White youths (i.e., MDRs). The social environment indirectly generates racial youth educational disparities through deteriorating non-Hispanic Black youth educational outcomes across all SES levels. To prevent the confounding effects of private, suburban, rural, and Catholic schools, we limited this analysis to public urban schools. More research is needed on other settings.

Protective Effects of Parental Education Against Youth Cigarette Smoking: Diminished Returns of Blacks and Hispanics.

BackgroundHigh parental educational attainment is protective against youth health risk behaviors such as tobacco use. According to the Marginalization-related Diminished Returns (MDRs) theory, however, higher parental education is less protective for marginalized groups relative to non-Hispanic Whites.ObjectiveTo explore race/ethnic differences in the effects of parental educational attainment on cigarette smoking in a national sample of American adolescents.MethodsIn a cross-sectional study, we used baseline data of 10,878 American youth who had participated in the Population Assessment of Tobacco and Health (PATH 2013). The independent variable was parental educational attainment. The dependent variables were lifetime cigarette smoking, current (past 30-day) cigarette moking, and daily cigarette smoking. Youth age, youth gender, and parental marital status were the covariates. Race/ethnicity was the moderating variable. Logistic regression model was used for data analysis.ResultsOverall, a higher parental educational attainment was associated with a lower lifetime cigarette smoking, current (past 30-day) cigarette smoking, and daily cigarette smoking. Parental educational attainment showed significant interaction with race/ethnicity suggesting smaller protective effects of parental educational attainment on youth tobacco outcomes for Black and Hispanic than for non-Hispanic White youth.ConclusionFor American youth, race/ethnicity limits the health gains that are expected to follow parental educational attainment. While high parental educational attainment is protective against smoking overall, non-Hispanic Whites (the most socially privileged group) gain most and Blacks and Hispanics (the least socially privileged groups) gain least from such resource. In addition to addressing low SES, researchers and policymakers should identify and address mechanisms by which high SES minority youth remain at risk of tobacco use.

The Importance of Engaging Children in Research Decision-Making: A Preliminary Mixed-Methods Study.

Studies demonstrate deficiencies in parents' and children's comprehension of research and lack of child engagement in research decision-making. We conducted a cross-sectional and interview-based study of 31 parent-child dyads to describe decision-making preferences, experiences, and comprehension of parents and children participating in research. Parents and children reported that parents played a greater role in decisions about research participation than either parents or children preferred. The likelihood of child participation was associated with the extent of input the parent permitted the child to have in the decision-making process, the child's comprehension, whether the study team asked the child about participation, whether the child read study-related materials, the parent's marital status, and the child's race. Children had lower comprehension than adults. Comprehension was related to age, education, verbal intelligence, and reading of study-related information. Parent understanding was associated with prospect for benefit and illness severity. Child participation may be improved by increasing parent-child communication, emphasizing important relational roles between parent and child, respecting the developing autonomy of the child, increasing engagement with the study team, providing appropriate reading materials, and assessing comprehension.

Causes of school dropouts from the point of view of parents: أسباب التسرب من المدارس من وجهة نظر الوالدين

This study aimed to identify the reasons for dropping out of school from the point view of parents, which the study identified in two areas: the school environment and the financial and living conditions of the family. The study used the descriptive approach by designing a questionnaire. The sample consisted of (217) parents of student at secondary level in the non-governmental schools in Bethany and Abu Dis. The results indicated that the area of ​​school environment is high, while the financial and living conditions of the family are medium. The results of the study also indicated that there are statistically significant differences in the reasons for dropping out of schools from the parents' point of view due to variables of educational level and family income level. While, there are no statistically significant differences due to variables parental status (father, mother) and marital status. The study recommends the importance of implementing awareness and guidance programs for teachers and school administrators on the problem of dropout and understand the psychological, social and academic needs of students, especially the academic, as well as the importance of the implementation of individual case studies on the school environment and its relationship to school dropout.

Place-Based Diminished Returns of Parental Educational Attainment on School Performance of Non-Hispanic White Youth.

Youth educational outcomes are a function of a wide range of factors including parental education level. This effect, however, is shown to be smaller for African American, Hispanic, and Asian American youth, a pattern called Marginalization-related Diminished Returns (MDRs). It is, however, unknown if it is race/ethnicity or other conditions associated with race/ethnicity (e.g., poor neighborhood quality) which reduces the marginal returns of parental education for youth. To explore whether MDRs are only due to race/ethnicity or if they also remain for non-Hispanic Whites in poor neighborhoods, we compared the association between parental education level and adolescents' school performance based on neighborhood quality in a nationally representative sample of non-Hispanic Whites in the United States. This cross-sectional study used wave 1 of the Add Health study, an ongoing nationally representative cohort, 1994-2019. Participants included 849 non-Hispanic White adolescents between the ages of 12 and 21 years and their parents. The independent variable was parental education level, which was treated as a continuous measure. Age, grade, gender, and parental marital status were the covariates. The dependent variable was school performance (sum of school grades in Math, English, History, and Science). Linear regression models were used for data analysis. Overall, worse neighborhood quality was associated with worse school performance. Parental education level, however, was not directly associated with youth school performance. We found a statistically significant interaction between parental education level and neighborhood quality suggesting that the strength of the association between parental education and youth school performance weakens as neighborhood quality declines. Parental education level is a more salient determinant of youth educational outcomes in better neighborhoods. The result suggests that MDRs may not be solely due to race/ethnicity but contextual factors that commonly covary with marginalization and poverty. These contextual factors may include segregation, concentration of poverty, and social and physical neighborhood disorder.

Lifetime caregiver strain among mothers of adolescents and young adults with attention-deficit/hyperactivity disorder.

The lifetime maternal caregiver strain (CS) associated with raising a child with attention-deficit/hyperactivity disorder (ADHD) into adolescence and young adulthood was examined in the Pittsburgh ADHD Longitudinal Study (PALS), a longitudinal study of individuals diagnosed with ADHD in childhood and recontacted in adolescence and young adulthood for yearly follow-up. Mothers of adolescents/young adults with (n = 364, 89.6% male; Mage = 19.79) and without childhood ADHD (n = 240, 88.8% male; Mage = 18.97) rated their lifetime maternal CS at Wave 3. Adolescent/young adult (AYA) ADHD and ODD severity measured at Wave 1, AYA delinquency measured at Wave 2, and school disciplinary actions combined from Waves 1 and 2 were explored as mediators of the association between childhood ADHD and lifetime maternal CS at Wave 3 using path analysis. AYA gender and age, parental marital status, maternal depression and ADHD, and highest parental education were included as covariates. Greater lifetime CS was reported among mothers of adolescents/young adults with versus without childhood ADHD. In the mediation model, direct effects of childhood ADHD on AYA ADHD and ODD severity, delinquency, and school discipline problems emerged, and direct effects of AYA ODD severity, delinquency, and school discipline problems on lifetime CS emerged. AYA ODD, delinquency, and school discipline mediated the association between childhood ADHD and lifetime maternal CS. These findings extend research on childhood ADHD to identify AYA sequelae contributing to maternal CS. Future research on the transaction between AYA functional impairment and maternal CS across the transition from adolescence into adulthood is needed to clarify opportunities for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Timing of vape use among adolescents: Differences by family structure

BackgroundThe prevalence of adolescent e-cigarette (vape) use has increased significantly over the past several years. Given the risks associated with vape use, it is important to identify predictors of adolescent vape use onset. PurposeThe primary aim was to examine the time to vape use among adolescents, as a function of parental marital status and living arrangements. MethodsA sample of 863 adolescents (Mage = 12.73, SD = 0.70; 52% girls; 61% non-Hispanic White) from public middle schools in the Northeast United States were asked about whether they vaped over the course of three years (fall 2016-spring 2019). Cox proportional hazards (PH) regression models were conducted to examine associations between parental divorce and the timing of vape use, gender differences in the association, and potential differences in the association as a function of living arrangements. ResultsFindings indicated that adolescents with divorced parents at Time 1 vaped earlier, and were 51% more likely to vape than adolescents with married parents. There were no gender differences, or differences in timing among those with divorced parents as a function of living with a step-parent. ConclusionThese findings highlight the importance of identifying familial risk factors associated with early vape use in adolescents.

Parental Human Capital and Adolescents' Executive Function: Immigrants' Diminished Returns.

Racial minorities, particularly non-Hispanic Blacks in the US, experience weaker effects of family socioeconomic position (SEP) on tangible outcomes, a pattern called Minorities' Diminished Returns (MDRs). These MDRs are frequently shown for the effects of family SEP on immigrant adolescents' school performance. As a result of these MDRs, immigrant adolescents from high SEP families show worse than expected cognitive outcomes, including but not limited to poor school performance. However, the existing knowledge is minimal about the role of executive function in explaining diminished returns of family SEP on adolescents' outcomes. To investigate racial differences in the effects of parental human capital on adolescents' executive function, we compared non-Hispanic White non-immigrant and immigrant adolescents for the effect of parental human capital on adolescents' executive function. This was a cross-sectional analysis that included 2,723 non-twin non-Hispanic White adolescents from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental human capital (parental educational attainment), treated as a continuous measure with a higher score reflecting higher subjective socioeconomic status. The primary outcome was adolescents' executive function measured by the stop-signal task (SST). Age, sex, parental marital status, parental employment, family income, and financial difficulties. Immigration status was the effect modifier. Overall, high parental human capital was associated with higher task-based executive function. Immigration status showed statistically significant interactions with parental human capital on adolescents' executive function outcomes. This interaction term suggested that high parental human capital has a smaller effect on increasing immigrants' executive function compared to non-immigrant adolescents. The boosting effect of parental human capital on executive function is diminished for immigrants compared to non-immigrant adolescents. To minimize the inequalities in executive function-related outcomes such as school performance, we need to address the diminishing returns of existing resources for immigrants. Not only should we equalize groups based on their SEP but also equalize the marginal returns of their existing SEP. Such efforts require public policies that aim for equal processes. As such, social policies should address structural and societal barriers such as xenophobia, segregation, racism, and discrimination that hinder immigrant families' ability to effectively utilize their resources. In a fair society, immigrant and non-immigrant families should be equally able to leverage their SEP resources and turn them into tangible outcomes.

Kvalitet bliskih odnosa u odraslom dobu - uloga sociodemografskih i sredinskih faktora

In order to better understand the phenomenon of the quality of different types of close relationships of adults, we have investigated several determinants which define them more clearly. We focused on the relational differences of the respondents according to several sociodemographic (age, gender, employment, marital status and children) and environmental factors (structure and relationships in the family). A total of 400 males and females, ranging from 19 to 51 years, completed a general questionnaire. It collected the data related to sociodemographic and environmental characteristics, as well as the Social Relations Network Inventory (NRI), which assessed the quality of five types of close relationships. The results indicate significant differences between the respondents in the quality of individual close relationships, based on the factors of age, gender, employment, marital status and parenthood, as well as according to the factors of the quality of family relations and parental marital status. The identified differences are particularly pronounced in terms of the quality of the relationship with the mother and the quality of the relationship with the friend, which is explained by the characteristic nature of these relationships, as well as the developmental roles and tasks of the adulthood.

Characteristics and Trends of Suicide Attempt or Non-suicidal Self-injury in Children and Adolescents Visiting Emergency Department.

BackgroundNon-suicidal self-injury (NSSI) and suicidality are common reasons for child and adolescent psychiatric emergencies. We aimed to investigate the incidence of pediatric emergency department (PED) utilization for psychiatric problems in children and adolescents and to identify demographic and clinical characteristics of youths who visited the PED for suicide attempt (SA) and/or NSSI.MethodsThe medical records of children and adolescents who visited the PED for psychiatric problems from January 2015 to November 2019 were reviewed retrospectively. Demographic and clinical variables including psychiatric disorders were collected. We compared the characteristics of youths who presented to the PED for SA and/or NSSI with those of youths without SA or NSSI. Student's t-test, χ2 test, and multivariate logistic regression were used for statistical analysis.ResultsDuring 59 months of observation, 194 youths visited the PED and the number of total PED visits was 336. Among them, 46 youths (23.7%) visited the PED for SA and/or NSSI at least once, and the number of visits was 91 (27.1% of PED visits). Youths with SA and/or NSSI were older (P = 0.001) and more likely to be a girl (P = 0.005) and to report parental absence (P = 0.023). Bipolar and related disorders (P = 0.032) and depressive disorders (P = 0.004) were more common in youths with SA and/or NSSI, while schizophrenia spectrum and other psychotic disorders (P = 0.030) and somatic symptom and related disorders (P = 0.007) were more common in those without SA and NSSI. After adjusting for age, sex, and parental marital status, bipolar and related disorders (odds ratio [OR], 6.72), depressive disorders (OR, 9.59), and somatic symptom and related disorders (OR, 0.12) were significantly associated with SA and/or NSSI. Youths with SA and/or NSSI also stayed longer in the PED (P = 0.007).ConclusionSA and NSSI are one of the main reasons for child and adolescent admittance to psychiatric services in the PED and are associated with psychiatric comorbidities. An appropriate risk assessment for suicidality and self-injury and proper management and referral to mental health services at the PED are of the utmost importance.

Parental Educational Attainment and Black-White Adolescents' Achievement Gap: Blacks' Diminished Returns.

Recent research has documented Minorities' Diminished Returns (MDRs), defined as weaker protective effects of parental educational attainment and other socioeconomic status (SES) indicators for racial and ethnic minority groups. To explore racial differences in the associations between parental educational attainment and youth educational outcomes among American high schoolers. This cross-sectional study used baseline data from the Education Longitudinal Study (ELS-2002), a nationally representative survey of 10th grade American youth. This study analyzed 10702 youth who were composed of 2020 (18.9%) non-Hispanic Black and 8682 (81.1%) non-Hispanic White youth. The dependent variables were youth math and reading grades. The independent variable was parental educational attainment. Gender, parental marital status, and school characteristics (% students receiving free lunch, academic risk factors, urban school, public school) were the covariates. Race was the moderating variable. Linear regression was used for data analysis. Overall, higher parental educational attainment was associated with higher math and reading test scores. We found a significant interaction between race (Non-Hispanic Black) and parental education attainment on math and reading test scores, suggesting that the boosting effects of high parental educational attainment on youth educational outcomes might be systemically smaller for Non-Hispanic Black than for Non-Hispanic White youth. While high parental educational attainment promotes educational outcomes for youth, this association is weaker for Non-Hispanic Black youth than non-Hispanic White youth. The diminished returns of parental education are beyond what can be explained by school characteristics that differ between Non-Hispanic Black and non-Hispanic White students. Diminishing returns of parental educational attainment (MDRs) may be an unrecognized source of racial youth disparities. Equalizing SES would not be enough for equalizing outcomes. There is a need for public and economic policies that reduce diminished returns of SES for Black families.

Race and Economic Opportunity in the United States: an Intergenerational Perspective*

AbstractWe study the sources of racial disparities in income using anonymized longitudinal data covering nearly the entire U.S. population from 1989 to 2015. We document three results. First, black Americans and American Indians have much lower rates of upward mobility and higher rates of downward mobility than whites, leading to persistent disparities across generations. Conditional on parent income, the black-white income gap is driven by differences in wages and employment rates between black and white men; there are no such differences between black and white women. Hispanic Americans have rates of intergenerational mobility more similar to whites than blacks, leading the Hispanic-white income gap to shrink across generations. Second, differences in parental marital status, education, and wealth explain little of the black-white income gap conditional on parent income. Third, the black-white gap persists even among boys who grow up in the same neighborhood. Controlling for parental income, black boys have lower incomes in adulthood than white boys in 99% of Census tracts. The few areas with small black-white gaps tend to be low-poverty neighborhoods with low levels of racial bias among whites and high rates of father presence among blacks. Black males who move to such neighborhoods earlier in childhood have significantly better outcomes. However, less than 5% of black children grow up in such areas. Our findings suggest that reducing the black-white income gap will require efforts whose impacts cross neighborhood and class lines and increase upward mobility specifically for black men.

Looking beyond the individual: How family demands and capabilities affect family adjustment following pediatric solid organ transplant.

Better family adjustment following pediatric solid organ transplantation has been associated with a number of beneficial medical and psychosocial outcomes. Yet few studies have examined which pretransplant variables are associated with posttransplant family adjustment. This information can aid in identifying families that may need support going into the transplantation process and those who are at lower risk of worse posttransplant adjustment. The sample included 66 parents of children with solid organ transplants and 22 children with solid organ transplants. Information regarding demographic factors, parent and child emotional functioning, and child social support was collected during the child's pretransplant evaluation and information on family adjustment was collected 6 months after transplantation. Results indicated that pretransplant demands such as worse parent and child emotional functioning were related to worse family adjustment 6 months after transplantation. Pretransplant capabilities (i.e., higher family income, parent education level, parent marital status, child social support) were not associated with posttransplant family adjustment. Pretransplant family demands such as parent and child emotional functioning, as opposed to family capabilities, should be assessed by family health care team members prior to transplantation because they may be related to worse family adjustment after the transplant. We offer recommendations for ways to assess and, if indicated, intervene upon pretransplant family demands in an effort to decrease the risk of worse posttransplant family adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Future Living Arrangement for Aging Parents and Its Associated Factors

Background: Shift in demographic structure in Indonesia has raised concern over number of issues, including change in living arrangement of older people. Objectives: The purpose of this study is to examine adult children’s choice of future living arrangement for elderly parent and its associated factors. Methods: A cross sectional study was conducted among 300 young adults in Central Java, Indonesia. Descriptive statistics, Chi-Square and Fisher exact test were used to analyze the data. Results: Majority of respondents (97.3%) preferred parents to live at home, in multi-generational household with children and/or grandchildren (84.5%) in their old age. The choice was significantly influenced by children gender, marital status of parent, and family type (p=0.00; p=0.05, and p=0.05 respectively). Conclusions: In certain circumstances, living in multigenerational household still became a favorable option of living arrangement for elderly parents. Children gender, parent’s marital status and family type were likely to influence the choice. Further researches are needed to investigate which best living arrangement that support older people well-being.

Prevalence and risk factors of gross motor delay in pre-schoolers.

Gross motor skills are important for children's health and development. Delays in these skills are a concern for healthy developmental trajectories and therefore early identification of delay is important. This study screened for gross motor delay in children from low-income communities and investigated potential risk factors associated with gross motor delay. This cross-sectional study involved 701 pre-schoolers (Mage = 54.1 ± 8.6 months, 52.8% boys) from childcare services in low-income and remote communities in Australia. Gross motor delay was assessed using the Ages and Stages Questionnaire - third edition. Potential risk factors included: sex, age, birthweight, prematurity status, weight status, childcare service, postcode, parent's education, parent's marital status, parent's employment and family income. Results showed 4.4% of the children were delayed in gross motor skills and 8.8% were at risk of delay. Logistic regression showed being a boy (odds ratio (OR) 1.78, 95% confidence interval (CI) 1.12-2.84), underweight (OR 2.72, 95% CI 1.18-6.30) or overweight (OR 1.83, 95% CI 1.00-3.33), and parental unemployment (OR 1.79, 95% CI 1.01-3.16) were factors associated with a higher odds of children being delayed or at risk of gross motor delay. A higher family income (OR 0.35, 95% CI 0.13-0.93) was associated with lower odds of delay. This unique study demonstrated children in low-income communities, especially boys, underweight and overweight children, have higher odds of being at risk of gross motor delay. Therefore, early screening is vital in this population in order to identify delays and potentially intervene with appropriate motor skill interventions.

Evaluation of disparity in care for perforated appendicitis in a universal healthcare system.

Racial and socioeconomic disparities have been reported in the management of appendicitis. Perforated appendicitis (PA) is used as an index for barriers to care due to delays in treatment. This study evaluates the effect of racial and socioeconomic differences on the likelihood of PA in a universally insured national healthcare system. A retrospective review of pediatric patients enrolled in TRICARE who underwent appendectomy during a 5-year period was performed. Logistic regression was used to examine the association between ethnicity, age, gender, parent, or guardian marital status and deployment status of the active duty parent, type of facility, and type of admission with the odds of perforated appendicitis. A total of 3124 children met inclusion criteria. One-third of children carried the diagnosis of PA. Increased odds of PA was associated with younger age of patient among children of military personnel with enlisted ranks and senior officer ranks. In a universal healthcare system, no disparities across race with regard to presentation of appendicitis were identified. Increased odds of perforated appendicitis were observed in younger patients, but this was demonstrated in families of both high and low socioeconomic status. Universal coverage does appear to eliminate some barriers to healthcare.

Parental Educational Attainment Differentially Boosts School Performance of American Adolescents; Minorities’ Diminished Returns

Objective: To explore racial and ethnic variation in the effects of parental educational attainment on students' grade point average (GPA) in the US. As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment. For example, the differential impacts of parental educational attainment on school performance of youth from various racial and ethnic backgrounds are still unknown. Materials and methods: The Population Assessment of Tobacco and Health (PATH 2013 - 2014) is a nationally representative survey in the US. The total sample was 10,701 youth (12-17 years old) were enrolled. The independent variable was parental educational attainment. The main outcome was GPA measured using self-report. Age, gender, and parental marital status were the covariates. Race and ethnicity were the effect modifiers. Linear regression models were used to analyze the data. Results: Overall, higher parental educational attainment was associated with a higher GPA, independent of all possible confounders. Race and ethnicity, however, both showed significant interaction with parental educational attainment on students' GPA, indicating smaller positive effects of parental educational attainment on students' GPA for Hispanic and Black compared to non-Hispanic White youth. Conclusion: The boosting effect of parental educational attainment on GPA is smaller for Black and Hispanic compared to White youth. To minimize diminished returns of parental educational attainment for Black and Hispanic families, there is a need for innovative public and social policies and programs that are not limited to equalizing SES but also address the structural barriers that disproportionately limit upward social mobility of racial and ethnic minority students and their families. The US society should reduce extra costs of upward social mobility for racial and ethnic minority families. As the underlying mechanisms are multifaceted, multi-level approach is needed to undo minorities' diminished returns, so every individual can gain the same tangible outcome from their SES resources.