Family Survey Research Articles

Comprehensive Genomic Survey, Structural Classification, and Expression Analysis of WRKY Transcription Factor Family in Rhododendron simsii

(1) Rhododendron is one of the top ten traditional flowers in China, with both high ornamental and economic values. However, with the change of the environment, Rhododendron suffers from various biological stresses. The WRKY transcription factor is a member of the most crucial transcription factor families, which plays an essential regulatory role in a variety of physiological processes and developmental stresses. (2) In this study, 57 RsWRKYs were identified using genome data and found to be randomly distributed on 13 chromosomes. Based on gene structure and phylogenetic relationships, 57 proteins were divided into three groups: I, II, and III. Multiple alignments of RsWRKYs with Arabidopsis thaliana homologous genes revealed that WRKY domains in different groups had different conserved sites. RsWRKYs have a highly conserved domain, WRKYGQK, with three variants, WRKYGKK, WRKYGEK, and WRKYGRK. Furthermore, cis-acting elements analysis revealed that all of the RsWRKYs had stress and plant hormone cis-elements, with figures varying by group. Finally, the expression patterns of nine WRKY genes treated with gibberellin acid (GA), methyl jasmonate (MeJA), heat, and drought in Rhododendron were also measured using quantitative real-time PCR (qRT-PCR). The results showed that the expression levels of the majority of RsWRKY genes changed in response to multiple phytohormones and abiotic stressors. (3) This current study establishes a theoretical basis for future studies on the response of RsWRKY transcription factors to various hormone and abiotic stresses as well as a significant foundation for the breeding of new stress-tolerant Rhododendron varieties.

Youth organizations, social mobility and health in middle age: evidence from a Scottish 1950s prospective cohort study.

Informal educational programmes focused on youth development appear to improve health and well-being at time of involvement. Less is known about long-term effects. We investigate their impact on self-reported general health in mid-life using the Aberdeen Children of the 1950s (ACONF) cohort. We use a subset (n = 1333) of the ACONF cohort, born 1950-56, in Aberdeen Scotland, who took part in Family and Reading Surveys in 1964 and a follow-up questionnaire in 2001. We explore exposure to youth development focused clubs in childhood on self-reported general health around age 50 mediated by adult socioeconomic position. Logistic regression and mediation analysis were used to report odds ratios and natural direct and indirect effects, respectively, on multiply imputed data. Being a member of the Scouts/Guides (G&S) was associated with a 53% (95% confidence interval 1.03-2.27) higher odds of 'excellent' general health in adulthood compared to children attending 'other clubs'. Indirect effects of G&S and Boys'/Girls' Brigade (B&GB) on general health acting via higher socioeconomic position show positive associations; 12% and 6% higher odds of 'excellent' general health in adulthood compared to children attending 'other clubs', respectively. Comparison of indirect with direct effects suggests 27% of this association is mediated through a higher adult socioeconomic position in adulthood. These results suggest a beneficial association between attending G&S and B&GB clubs in childhood and adult general health. As these organizations are volunteer-led, this may represent a cost-effective method for improving population health.

Emergence of the ABC Transporter Antibiotic Resistant Gene in Pathogenic Fungi Using In Silico Analysis

Adenosine triphosphate binding cassette proteins (ATP-ABC) transporters belong to a broad superfamily of proteins in all living organisms that have essential physiological functions. They are necessary for transporting a wide range of substrates across lipid membranes. ABC transport proteins share two conserved domain architectures: the multiple transmembrane helices (TMD) nucleotide binding protein domain (NBD). Fungi have evolved active transport pathways through endogenous and exogenous toxicants. Drug efflux from ABC transporters lowers the concentration of intracellular drugs, in many pathogens and cancer cells; therefore, efflux is subjected to extensive studies in pathogens. ABC transporter gene of aspergillus versicolor as reference and evaluated metadata of ABC transporter gene in comparison from dermatophyte and non-dermatophyte fungi using fungi DB and NCBI databases. ABC transporters gene was studied using gene homology via phylogenetic analysis. Study evaluated ABC transporters sub families, number of transcripts, exon, intron numbers sizes and position using gene sequence analysis by NCBI. The evolutionary history of ABC gene analyzed by using 12 proteins of both dermatophytes. Study also explored the single nucleotide polymorphism (SNPs) homology in dermatophytes using the NCBI SNP tool. ABC protein examined five sub-families which include ABC-B, ABC-C, ABC-D, ABC-F. Phylogenetic studies on ABC transporter genes showed its emergence in three major groups of dermatophytes and non- dermatophyte. Exon number of ABC transporter gene varies from 2 to 18 and one transcript number in dermatophytes and non-dermatophytes. The evolutionary history of ABC-B was analyzed by using 12 proteins of both dermatophytes and non-dermatophytes. ABC genes in dermatophytes were found in five subfamilies ABC-B, ABC-C, ABC-D, ABC-F and ABC-G. However, ABC transporter gene family survey suggested that ABC- C family is a highly emerged sub family in dermatophytes and non-dermatophytes. Study revealed that ABC protein has been found in five sub-families of ABC transporter gene in dermatophytes. It has one transcript number in dermatophytes and non-dermatophytes. Whereas, the exon numbers are varied from 2 to 18. Moreover, ABC transporter gene phylogenetic family survey suggested that ABC- C family is highly emerged in both fungal types.

64 A Canadian multicentre survey of family needs when attending the pediatric emergency department

Abstract Background Parents/caregivers strongly influence their child’s experience in the pediatric emergency department (PED). Understanding their needs can improve families’ PED experience and care. Objectives To describe caregivers’ perceived emotional, practical, and informational needs in the PED and how well these needs were met Design/Methods This descriptive, cross-sectional survey with medical record review was conducted at 10 Canadian PEDs from October 2018 to March 2020, over a 1-week period every season, for a total of 4 weeks per site. Digital surveys available in English or French were completed by caregivers in the PED and 7 days after their visit. Health literacy was evaluated by the Newest Vital Sign tool. Results A total of 2005 caregivers participated; mean age was 37.8 (SD 7.7) years, and 74.3% (1462/1969) were mothers. The mean child age was 5.9 (5.1) years and 51.9 % (1040/2003) were male. Caregivers’ main spoken language was mostly English [72.6% (1425/1964)] or French [10.5% (206/1964)]. Over half of caregivers had a university/professional degree [51.0% (997/1956)]; 37.4% (746/1998) had possible/probable limited health literacy. 77.9% (1132/1454) of caregivers reported that their overall care needs were met. 71.7% (1081/1507) of caregivers reported that their emotional needs were met; they reported most emotional support by doctors [(35.6%, 535/1510)] and bedside nurses [(24.2%, 364/1507)]. The median (IQR) length of stay was 3.9 (2.6, 6.1) hours; 36.7% (546/1487) of caregivers felt they waited ‘too long’, and 77.8% (1158/1489) did not know how long they would have to wait. 11.7% of families were dissatisfied with the care updates provided. A safe PED was the top overall identified practical need [(45.1%, 602/1336)]. Internet access was the most important practical need throughout the visit [(28.1%, 378/1345)], while more space was the most reported [(49.8%, 696/1398)] need in the waiting room. The most desired improvements in the PED were better communication of wait times and delays [(41.1%, 745/1812)], shorter wait times [(38.8%, 699/1801)] and faster diagnosis [(24.9%, 449/1803)]. Conclusion Almost one quarter of Canadian caregivers report that their overall needs were not fully met when attending the PED. Safety during the PED visit was of utmost importance. Nationally, caregivers value shorter wait times, rapid diagnosis, and better communication about perceived delays. Top practical needs included internet access and more waiting room space. Creating innovative waiting systems, better methods to share wait time information, free internet access, and improved physical spaces could better address identified caregiver needs in the PED.

Genome-wide analysis of MADS-box families and their expressions in flower organs development of pineapple (Ananas comosus (L.) Merr.).

MADS-box genes play crucial roles in plant vegetative and reproductive growth, better development of inflorescences, flower, and fruit. Pineapple is a typical collective fruit, and a comprehensive analysis of the MADS-box gene family in the development of floral organs of pineapple is still lacking. In this study, the whole-genome survey and expression profiling of the MADS-box family in pineapple were introduced. Forty-four AcMADS genes were identified in pineapple, 39 of them were located on 18 chromosomes and five genes were distributed in five scaffolds. Twenty-two AcMADS genes were defined as 15 pairs of segmental duplication events. Most members of the type II subfamily of AcMADS genes had higher expression levels in floral organs compared with type I subfamily, thereby suggesting that AcMADS of type II may play more crucial roles in the development of floral organs of pineapple. Six AcMADS genes have significant tissue-specificity expression, thereby suggesting that they may participate in the formation of one or more floral organs. This study provides valuable insights into the role of MADS-box gene family in the floral organ development of pineapple.

Child Marriage and Problems Accessing Healthcare in Adulthood: Evidence from India.

The association between child marriage and the access to or utilization of maternal and antenatal healthcare has been widely studied. However, little is known about child brides’ access to healthcare for illnesses later in life. Using data on 496,283 married women aged 18 to 49 years from the India National Family and Health Survey 2015–2016, we developed an 11-point composite score (ranging from 0 to 10) outlining the extent of problems accessing healthcare, as follows: (i) no/little problem (score 0 to 2), (ii) some problems (score 3 to 6), and (iii) big problems (score 7 to 10). The differences between child brides and their peers married as adults were assessed by the relative risk ratios obtained from multinomial logistic regressions. The adjusted risk of having “some problems” and “big problems” accessing healthcare relative to “no/little problem” for child brides was found to be 1.22 (95% CI: 1.20–1.25) and 1.26 (95% CI: 1.22–1.29) times that of those married as adults, respectively. These findings highlight the disproportionate barriers to healthcare access faced by women married as children compared to women married as adults and the need for further research to inform policies regarding effective public health interventions to improve healthcare access.

Caste, Social Inequalities and Maternal Healthcare Services in India: Evidence from the National Family and Health Survey

This study examines the level of access and utilization of maternal care health services among different socially disadvantaged groups in India. The study uses the data from the National Family Health Survey conducted in 2015–2016. We have used descriptive statistics and bivariate analysis to assess the trends and prevalence of maternal healthcare services among different social groups. Using logistic regression, we have estimated the association of different socio-economic variables on maternal healthcare services among different socially disadvantaged groups in India. The results suggest tremendous inequality in access to maternal healthcare services among socially disadvantaged groups in India. It was found that several factors such as women’s education, working status, household wealth quintile and mass media exposure significantly impact access and utilization of maternal healthcare services among various socially disadvantaged groups. In addition, the Scheduled Caste and Scheduled Tribe women are subjected to socio-economic discrimination at multiple levels, and their maternal healthcare situation remains highly fragile. The social identity and caste-based socio-economic inequalities remain a major challenge in India to assure universal access to maternal healthcare services.

Leprosy Caused by Mycobacterium lepromatosis.

Leprosy is caused by Mycobacterium leprae or Mycobacterium lepromatosis. This study reviews literature on M lepromatosis and reports on a Mexican family with this infection. The review included all primary studies. Family history and surveys were used to uncover the infection cluster. Genome-based differential polymerase chain reactions were designed to detect etiologic agents. Since the discovery of M lepromatosis in 2008, 154 cases of M lepromatosis infection from 11 countries in the Americas and Asia have been reported, with most cases coming from Mexico. These cases included diffuse lepromatous leprosy (DLL) and other leprosy forms. Genomes of M lepromatosis strains have lately been sequenced, revealing 3,271,694 nucleotides and approximately 15% mismatches with M leprae. The Mexican family with leprosy involved the grandfather, mother, and 2 grandsons. The index was the oldest grandson, who manifested DLL and likely contracted the infection from his maternal grandfather approximately 13 years earlier. Family surveys diagnosed DLL in the index patient's mother and borderline leprosy in his brother; both were likely infected by the index patient. M lepromatosis was identified from archived biopsies from the index patient and his mother, while M leprae was excluded. M lepromatosis is a significant cause of leprosy in Mexico and requires better surveillance and control.

Lumbar Spinal Involvement in Calcium Pyrophosphate Dihydrate Disease: A Systematic Literature Review.

BackgroundCalcium-pyrophosphate-dihydrate-disease (CPPD) is a crystal-induced arthropathy. The lumbar-spinal involvement is rare and often under-diagnosed. This study aimed to report the case of a lumbar spine CPPD involvement and to perform a systematic review of clinical, imaging features of lumbar involvement in CPPD patients, and treatments that have been implemented.MethodsThis systematic review was conducted in accordance with the Preferred-Reporting-Items-for-Systematic-Reviews and Meta-Analyses (PRISMA) guidelines.ResultsOne hundred and sixty-seven articles met the search criteria using electronic databases searches. We retained 28 articles (20 case reports, 2 case series, 1 family survey, 4 retrospective studies, and 1 prospective study) involving a total of 62 patients. The age ranged between 39 and 89 years old. Among patients with lumbar spine CPPD, 32 were women. The duration of symptoms varied between one day and 8 years. The affection has been discovered during back pain in most cases. In 5 studies, the diagnosis was made on histological specimens of patients operated on for another pathology. X-ray showed calcifications in 2 cases. CT-scan detected calcium deposit in 7 cases. MRI showed lesions going from the increased signal of the disk, to calcified or not-cystic lesion of the facet joints, an intramedullary mass mimicking a schwannoma. Histological examination established the diagnosis of CPPD in 21 patients in all studies. Medical treatment included NSAIDs, Colchicine, Interleukin-1-receptor-antagonist, and antibiotics. Surgery was performed on 13 patients and allowed to establish the histological diagnosis.ConclusionIn the case of inflammatory back pain in elderly subjects, without an infectious gateway, diagnosis of CPPD should be considered, especially for patients with a history of spinal surgery or degenerative radiography changes. CT scan is more sensitive than conventional radiographs. The discovertebral biopsy is the Gold-Standard and should be performed whenever the diagnosis was uncertain. Treatment includes the medical and surgical components.

Systematic and functional analysis of non-specific lipid transfer protein family genes in sugarcane under Xanthomonas albilineans infection and salicylic acid treatment.

Plant non-specific lipid transfer proteins (nsLTPs) are small basic proteins that play a significant regulatory role in a wide range of physiological processes. To date, no genome-wide survey and expression analysis of this gene family in sugarcane has been performed. In this study we identified the nsLTP gene family in Saccharum spontaneum and carried out expression profiling of nsLTPs in two sugarcane cultivars (Saccharum spp.) that have different resistance to leaf scald caused by Xanthomonas albilineans (Xa) infection. The effect of stress related to exogenous salicylic acid (SA) treatment was also examined. At a genome-wide level, S. spontaneum AP85-441 had 71 SsnsLTP genes including 66 alleles. Tandem (9 gene pairs) and segmental (36 gene pairs) duplication events contributed to SsnsLTP gene family expansion. Five SsnsLTP proteins were predicted to interact with five other proteins. Expression of ShnsLTPI.8/10/Gb.1 genes was significantly upregulated in LCP85-384 (resistant cultivar), but downregulated in ROC20 (susceptible cultivar), suggesting that these genes play a positive regulatory role in response of sugarcane to Xa infection. Conversely, ShnsLTPGa.4/Ge.3 appears to act as a negative regulator in response Xa infection. The majority (16/17) of tested genes were positively induced in LCP85-384 72 h after SA treatment. In both cultivars, but particularly in LCP85-384, ShnsLTPIV.3/VIII.1 genes were upregulated at all time-points, suggesting that the two genes might act as positive regulators under SA stress. Meanwhile, both cultivars showed downregulated ShnsLTPGb.1 gene expression, indicating its potential negative role in SA treatment responses. Notably, the ShnsLTPGb.1 gene had contrasting effects, with positive regulation of gene expression in response to Xa infection and negative regulation induced by SA stress. Together, our results provide valuable information for elucidating the function of ShnsLTP family members under two stressors and identified novel gene sources for development of sugarcane that are tolerant of environmental stimuli.

The Impact of Maternal Parenting Style on Sibling Relationships: A Transnational Study on Two-Child Families of China and the United Kingdom

This study, through a survey of two-child families in China and the UK, aimed to explore the differences, similarities, and associations between sibling relationships and maternal parenting styles from a transnational point of view. A total number of 107 mothers (UK: N = 55; China: N = 52) with two children were administered through a battery of online questionnaires respectively. Results showed no significant differences in the quality of sibling relationships between the two countries. Conflict and competitive behaviours among siblings greatly outnumbered warmth-related ones for both countries. In terms of maternal parenting style, permissive and authoritarian parenting styles were more dominant in both China and the UK compared with the authoritative style. However, British mothers tend to be more authoritarian than their Chinese counterparts towards both older and younger children. Although significant transnational correlations were found on the associations between maternal parenting style and the quality of sibling relationships, the authoritative parenting style was found to be more conducive to reduce the conflict behaviours between siblings in the UK, while the authoritarian parenting style turned out to be more effective among Chinese mothers. The above findings deepen our understanding of the association of parenting styles with sibling relationships. Implications on parenting practice to improve the quality of sibling relationships are also offered.

Using Family Narrative Reports to Identify Practices for Improving End-of-Life Care Quality

Patient experiences should be considered by healthcare systems when implementing care practices to improve quality of end-of-life care. Families and caregivers of recent in-patient decedents may be best positioned to recommend practices for quality improvement. To identify actionable practices that bereaved families highlight as contributing to high quality end-of-life care. We conducted qualitative content analysis of narrative responses to the Bereaved Family Surveys Veterans Health Administration inpatient decedents. Out of 5964 completed surveys in 2017, 4604 (77%) contained at least one word in response to the open-ended questions. For feasibility, 1500/4604 responses were randomly selected for analysis. An additional 300 randomly selected responses were analyzed to confirm saturation. Over 23% percent (355/1500) of the initially analyzed narrative responses contained actionable practices. By synthesizing narrative responses to the BFS in a national healthcare system, we identified 98 actionable practices reported by the bereaved families that have potential for implementation in QI efforts. Specifically, we identified 67 end-of-life practices and 31 practices in patient-centered care domains of physical environment, food, staffing, coordination, technology and transportation. The 67 cluster into domains including respectful care and communication, emotional and spiritual support, death benefits, symptom management. Sorting these practices by target levels for organizational change illuminated opportunities for implementation. Narrative responses from bereaved family members can yield approaches for systematic quality improvement. These approaches can serve as a menu in diverse contexts looking for approaches to improve patient quality of death in in-patient settings.

Genome-Wide Survey and Functional Verification of the NAC Transcription Factor Family in Wild Emmer Wheat.

The NAC transcription factor (TF) family is one of the largest TF families in plants, which has been widely reported in rice, maize and common wheat. However, the significance of the NAC TF family in wild emmer wheat (Triticum turgidum ssp. dicoccoides) is not yet well understood. In this study, a genome-wide investigation of NAC genes was conducted in the wild emmer genome and 249 NAC family members (TdNACs) were identified. The results showed that all of these genes contained NAM/NAC-conserved domains and most of them were predicted to be located on the nucleus. Phylogenetic analysis showed that these 249 TdNACs can be classified into seven clades, which are likely to be involved in the regulation of grain protein content, starch synthesis and response to biotic and abiotic stresses. Expression pattern analysis revealed that TdNACs were highly expressed in different wheat tissues such as grain, root, leaves and shoots. We found that TdNAC8470 was phylogenetically close to NAC genes that regulate either grain protein or starch accumulation. Overexpression of TdNAC8470 in rice showed increased grain starch concentration but decreased grain Fe, Zn and Mn contents compared with wild-type plants. Protein interaction analysis indicated that TdNAC8470 might interact with granule-bound starch synthase 1 (TdGBSS1) to regulate grain starch accumulation. Our work provides a comprehensive understanding of the NAC TFs family in wild emmer wheat and establishes the way for future functional analysis and genetic improvement of increasing grain starch content in wheat.

Families with high school children: the need for social assistance

Families with children in Russia have a high risk of poverty. Often mothers do not work in these families, and the income of working family members together with social support measures are not sufficient. In recent years, support for families with children has been priority of social policy. At the same time, the State social assistance depends on the age of a child, and as the child is growing older the social assistance is decreasing. Until 2021 the whole variety of monetary payments to children was limited to the age category of 7 years (for all families) and up to 17 years (for single-parent families). These age limits put other children at a disadvantage as compared to children receiving assistance. That's why in March 2022 the Government announced a monthly cash payment for all children living in low-income families aged from 8 to 17 years. The next age limit for children in low-income families getting social support leaves without benefits children aged 17-18 years. Usually they do not have their own income, but they require not less, but more family expenses for their maintenance. The main goal of the study was to show that families with children aged 16-17 bear the same expenses as families with children under 16 years of age, but they have no additional sources of income. The study was based on the data from a population survey (Household Budget Survey-2019) and a longitudinal survey of families with school-age children (Russian Longitudinal Monitoring Survey of HSE2018-2019). The study emphasized the need of social support for families with senior school-age children.

Phylogenetic survey of the subtilase family and a data-mining-based search for new subtilisins from Bacillaceae.

The subtilase family (S8), a member of the clan SB of serine proteases are ubiquitous in all kingdoms of life and fulfil different physiological functions. Subtilases are divided in several groups and especially subtilisins are of interest as they are used in various industrial sectors. Therefore, we searched for new subtilisin sequences of the family Bacillaceae using a data mining approach. The obtained 1,400 sequences were phylogenetically classified in the context of the subtilase family. This required an updated comprehensive overview of the different groups within this family. To fill this gap, we conducted a phylogenetic survey of the S8 family with characterised holotypes derived from the MEROPS database. The analysis revealed the presence of eight previously uncharacterised groups and 13 subgroups within the S8 family. The sequences that emerged from the data mining with the set filter parameters were mainly assigned to the subtilisin subgroups of true subtilisins, high-alkaline subtilisins, and phylogenetically intermediate subtilisins and represent an excellent source for new subtilisin candidates.

Resource utilization and multidisciplinary care needs for patients with Ehlers-Danlos syndrome.

Ehlers-Danlos syndrome (EDS) represents a family of heritable connective tissue disorders with overlapping phenotypic features, frequently including joint hypermobility, tissue fragility, and skin hyperextensibility. Comorbid symptoms are common for patients with EDS and include multiple body systems marked by neurologic, cardiovascular, gastrointestinal, musculoskeletal issues, chronic pain, headaches, and anxiety and depression. The many comorbidities lead to high disease burden, which requires greater healthcare utilization. This survey of families examines healthcare utilization, of adults and minors, through evaluation of subspecialty care appointments across many healthcare systems in one region. There were 155 adults and 83 minors with a diagnosis of EDS with a total of 693 unique visits across 27 different specialties at over 20 different hospitals or clinics in the surveyed area. Cardiology, neurology, and gastroenterology were the most utilized subspecialties for adults, while rheumatology, cardiology, and neurology were most utilized by minors. Many respondents (67%) reported their medical care needs are not being met, and 87% reported interest in a multidisciplinary clinic for EDS with the most interest in pain management, physical and occupational therapy, and rheumatology. Understanding healthcare utilization and needs of those with EDS can provide the foundation for improved care for those with EDS through a coordinated multidisciplinary care model.

Multifaceted Work-to-Life Negative Spillover and Depressive Symptoms among Working Women: The Moderating Effect of Social Activities Satisfaction.

This study aims to examine how work-to-life negative spillover is associated with depressive symptoms among working women and to explore moderating effect of social activities satisfaction on the relationship between work-to-life spillover and depression. This was a secondary data analysis from a sample of 2869 employed women from the 7th Korean Longitudinal Survey of Women and Families. The results showed that work-to-life negative spillover was positively associated with depressive symptoms. Additionally, there was a significant moderating effect of social activities satisfaction on the relationship between work-to-life negative spillover and depressive symptoms (β = 0.176, p < 0.05). It was found that the low social activity group showed fewer depressive symptoms induced by the negative work-to-life spillover than the high social activity group. Based on the results of our study, effective strategies and policies for work-family compatibility and interventions aimed at reducing the work induced stress and depressive symptoms are recommended.

No cumplimiento del esquema de vacunación nacional en niños menores de 5 años en la selva peruana en el año 2019

In the past decade, levels of coverage on children vaccination had been decreasing nationwide, even more in the Peruvian jungle, reason why is an important public health’s subject to attend. The purpose of this investigation was to analyze maternal and social factors that are associated with incomplete vaccination schedules on children under 5 years old on the Peruvian jungle. It is an observational, analytic investigation, using a secondary source from the Demographic and Family survey (ENDES) from 2019, where is found the information of all the under 5 years old with the healthcare card of oral information given by the mother. Then after selecting the chosen variables, we used the SPSS statistic program for the posterior analysis. Of the 4373 surveys studied; it was shown that 57.5% of children under 5 years have the incomplete vaccination schedule. The multivariate analysis found that non-compliance with the vaccination schedule associated with maternal and social factors such as not having health insurance (ORa 1.72; p&lt;0.01, IC95% 1.39-2,13), poverty (ORa-1,427, p&lt;0.01, IC95% 1.89-1.71), native mother tongue (ORa-1.50, p&lt;0.01, IC-1.13-2,0), problems attending the health center (ORa-1,213, p=0.02, IC95% 1.02-1.44), live outside the city (ORa-1.31, p&lt;0.01, IC95% 1.09- 1.58), age under the age of 24 as a mother/guardian (ORa-1.38, p&lt;0.01, IC95% 1,186-1,619). Not having health insurance, living in poverty, having trouble going to the health center, living outside the city, having a different mother tongue than Spanish and age under 24 are factors associated with non-compliance with the vaccination schedule.

Parents' knowledge and attitude and behavior toward autism: a survey of Chinese families having children with autism spectrum disorder.

BackgroundIn recent years, parent-mediated intervention for children with autism spectrum disorder (ASD) has increased. Therefore, implementing effective parent training programs for parents of children with autism is of paramount importance, particularly in low- and middle-income countries. However, little is known about the status of and gaps in parents’ knowledge on ASD, which may hinder the development of valid parental training programs. Herein, we aimed at exploring the status of Chinese parents’ knowledge, attitude and behavior toward ASD, and potential factors affecting the acquisition of correct knowledge.MethodsThis study used a self-designed parental knowledge questionnaire of autism (PKQA) comprising 20 questions alongside another questionnaire comprising additional 17 questions covering the aspects of family demographics, attitudes, and behaviors of parents. In total, we included 394 parents who visited the outpatient department of the Child’s Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-Sen University between December 2018 and May 2019, with their children meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for ASD.ResultsThe median knowledge score in the PKQA was 15 [interquartile range (IQR), 13–17]. Advanced paternal age and longer time interval from diagnosis to enrolling into the parent training program were associated with a lower total knowledge score (all P<0.001). Higher maternal education attainment, higher family income, child being currently under intervention, and family members sharing a common perception of the diagnosis were associated with a higher total knowledge score (all P<0.01). Reading autism-related books (P<0.001) or attending professional lectures (P=0.019) were also associated with a higher total knowledge score.ConclusionsTaken together, this study revealed that family demographics and parents’ attitudes and behaviors toward ASD may significantly influence their knowledge about autism, suggesting the need for promoting more targeted parental skills training programs.

Asset and consumption gradient of health estimates in India: Implications for survey and public health research

The wealth index based on household assets and amenities is been increasingly used to explain economic variations of health outcomes in the developing countries. While the variables used to compute the wealth index are easy to collect and time- and cost-effective, the wealth index tends to have an urban bias, uses arbitrary weighting, does not provide per capita measures and is a poor measure of inequality. We used micro data from two of the large-scale population-based surveys, the Longitudinal Ageing Study in India, 2017–18 and the India Human Development Survey, 2011–12 that covered over 42,000 households each and collected data on household consumption, assets and amenities in India. We examined the variations and inequality in health estimates by consumption per capita and asset-based measures in India. Descriptive statistics, logistic regression model, concentration index, and concentration curve were used in the analyses.We found a weak association between monthly per capita consumption expenditure (MPCE) and wealth index in both the surveys. Some of the health conditions such as hypertension, cataract, refractive error, and diabetes tended to be underestimated in the bottom 40% of the population when economic well-being was measured using the wealth index compared to consumption. Socio-economic inequality in health outcome, inpatient and outpatient health services were underestimated when measured using the wealth index than when measured using MPCE.We conclude that economic gradients of health by consumption and wealth index are inconsistent and that per capita consumption predicts health estimates better than the wealth index. It is recommended that public health research using population-based surveys that provide data on consumption and wealth index use per capita consumption to explain economic variations in health and health care utilization. We also suggest that the future rounds of the health surveys of National Sample Survey and the National Family and Health Surveys include an abridged version of the consumption schedule to predict better economic variations in health and health care utilization in India.