How Does the Family Influence the Physical Condition and Health of Children in a Rural Environment?
ABSTRACT: The aim of this cross-sectional study was to assess physical conditions related to health status and establish relationships with influencing factors such as family structure, educational level, and parental professional occupation in the infant stage of three to five years in a rural setting. The sample included 205 children between 3 and 5 years of age from rural areas (<10,000 inhabitants) from the region of Castilla-La Mancha (Spain). Fitness level was measured using the PREFIT battery; influencing factors were assessed with a family information questionnaire. The results showed significant differences in all the analyzed variables of physical condition and between genders at each of the educational levels except for body mass index. Boys performed better than girls on cardio-respiratory fitness tests, muscle strength in both hands, speed-agility, and longitudinal jump tests for boys aged three, while girls performed the test better at four years. The type of family structure was not correlated with any of the variables of physical condition; a lower level of education of the father and mother and the professional occupation of the mother were correlated with a higher body mass index. As a main conclusion, physical condition related to health seems to be affected by influencing factors such as educational level and family professional occupation, especially of the mother, but the type of family structure does not have as much influence. There are few studies in children from three to five years of age in exclusively rural areas, so the data in this study provides relevant and innovative information, while opening research to cater to this population group.
Project description:BACKGROUND:Childhood vaccination plays a key role in reducing morbidity and mortality from vaccine-preventable diseases. Numerous studies have assessed the influence of demographic and socioeconomic factors on child immunization around the world. There are few such studies in Afghanistan, however. Therefore, this study aimed to identify factors influencing vaccination status among children age 12-23 months in Afghanistan. MATERIALS AND METHODS:Nationally representative data from the 2015 Afghanistan Demographic and Health Survey were used for this study. A sample of 5,708 children age 12-23 months with a vaccine card and immunization history was analyzed. Multinomial logistic regression was used to identify significant relationships between cofactors and vaccination status. RESULTS:In the study, 51% the subjects were boys, 48% were born at home, and 76% were residents of rural areas. Background characteristics positively associated with vaccination status included delivery in a health facility (RRR = 2.5, 95% CI = 1.9-3.3), maternal age of 30-39 years (RRR = 2.2, 95% CI = 1.2-4.1), attending at least four visits for antenatal care (RRR = 2.7, 95% CI = 1.7-4.5), health facility visit in the past 12 months (RRR = 1.9, 95% CI = 1.4-2.5), paternal professional occupation (RRR = 4.9, 95% CI = 2.0-12.3), family with richer wealth index (RRR = 2.4, 95% CI = 1.4-4.1), and living in the northeast region (RRR = 2.2, 95% CI = 1.2-3.9)were positively associated with vaccination status. Living in the southern region (RRR = 0.3, 95% CI = 0.2-0.5) was negatively associated with vaccination status. CONCLUSION:This study identified maternal age, ANC visits, place of delivery, health facility visits in past 12 months, paternal occupation, wealth quintile, and geographic region as the factors influencing child's vaccination status in Afghanistan.
Project description:Attracting and recruiting health workers to work in rural areas is still a great challenge in China. The rural-oriented tuition-waived medical education (RTME) programme has been initiated and implemented in China since 2010. This study aimed to examine the attitudes of rural-oriented tuition-waived medical students (RTMSs) in Shaanxi towards working in rural areas and the related influencing factors.A cross-sectional survey was conducted in 2015 among 232 RTMSs in two medical universities from the first group of students enrolled in the RTME programme in Shaanxi. Descriptive and analytical statistics were used for the data analyses.Of the 230 valid responses, 92.6% expressed their intentions of breaking the contract for working in rural township hospitals for 6 years after their graduation under the RTME programme. After the contract expired, only 1.3% intended to remain in the rural areas, 66.5% had no intention of remaining, and 32.2% were unsure. The factors related to a positive attitude among the RTMSs towards working in rural areas (no intention of breaking the contract) included being female, having a mother educated at the level of primary school or below, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the policy. The factors related to a positive attitude of the RTMSs towards remaining in rural areas included being female, having a rural origin, having no regular family monthly income, having a father whose occupation was farmer, having a mother educated at the level of postsecondary or above, having the RTMSs be the final arbiter of the policy choice, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the educational scheme.Related policy makers and health workforce managers may benefit from the findings of this study. Appropriate strategies should be implemented to stimulate the RTMSs' intrinsic motivation and improve their willingness to work in rural areas and to better achieve the objectives of RTME policy. Meanwhile, measures to increase the retention of RTMSs should also be advanced.
Project description:Self-concept influences identity and the way that people behave, and it fluctuates over time. The main purpose of this study was to analyze fluctuations in the dimensions of self-concept as a function of gender, educational level, grade, age, physical activity, and weight. In total, 712 Spanish adolescents who were in the 5th and 8th grades (354 boys and 358 girls) and 10 to 14 years old (M = 11.9; SD = 1.3) participated in this study. The Self-Concept Questionnaire, Form 5 was used to analyze several dimensions of self-concept (academic, social, emotional, family, and physical), using the average scores in each dimension. The data showed strong differences in the dimensions of self-concept during the school transition. Middle-school students, compared to elementary-school students, showed significantly lower levels in almost all dimensions (academic, social, family, and physical). Furthermore, student age was a negative predictor of the social and academic dimensions, explaining 33% and 37% of the variance, respectively. Educational level and grade were smaller factors influencing the academic dimension (explaining 29% and 25% of the variance, respectively). The main findings revealed that the school transition and, specifically, increased age were associated with a lower self-concept. These results help us understand the need to strengthen psychological and educational self-concept at school.
Project description:RATIONALE:Little research has evaluated the life course drivers of cognitive aging in South Africa. OBJECTIVES:We investigated the relationships of self-rated childhood health and father's occupation during childhood with later-life cognitive function score and whether educational attainment mediated these relationships among older South Africans living in a former region of Apartheid-era racial segregation. METHODS:Data were from baseline assessments of "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community" (HAALSI), a population-based study of 5059 men and women aged ?40 years in 2015 in rural Agincourt sub-district, South Africa. Childhood health, father's occupation during childhood, and years of education were self-reported in study interviews. Cognitive measures assessed time orientation, numeracy, and word recall, which were included in a z-standardized latent cognitive function score variable. Linear regression models adjusted for age, sex, and country of birth were used to estimate the total and direct effects of each childhood risk factor, and the indirect effects mediated by years of education. RESULTS:Poor childhood health predicted lower cognitive scores (total effect = -0.28; 95% CI = -0.35, -0.21, versus good); this effect was not mediated by educational attainment. Having a father in a professional job during childhood, while rare (3% of sample), predicted better cognitive scores (total effect = 0.25; 95% CI = 0.10, 0.40, versus unskilled manual labor, 29% of sample). Half of this effect was mediated by educational attainment. Education was linearly associated with later-life cognitive function score (0.09; 95% CI = 0.09, 0.10 per year achieved). CONCLUSION:In this post-Apartheid, rural South African context, older adults with poor self-reported childhood health or whose father worked in unskilled manual labor had relatively poor cognitive outcomes. Educational attainment strongly predicted cognitive outcomes, and appeared to be, in part, a mechanism of social stratification in later-life cognitive health in this context.
Project description:Socioeconomic disadvantage is associated with shorter adult stature. Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved, particularly in middle-income former Soviet settings.The sample included 12,463 Belarusian children (73% of the original cohort) born in 1996-1997, with up to 14 stature measurements from birth to 7 years. Linear spline multi-level models with 3 knots at 3, 12 and 34 months were used to analyse birth length and growth velocity during four age-periods by parental educational achievement (up to secondary school, advanced secondary/partial university, completed university) and occupation (manual, non-manual).Girls born to the most (versus least) educated mothers were 0.43 cm (95% confidence interval (CI): 0.28, 0.58) longer at birth; for boys, the corresponding difference was 0.30 cm (95% CI: 0.15, 0.46). Similarly, children of the most educated mothers grew faster from birth-3 months and 12-34 months (p-values for trend ? 0.08), such that, by age 7 years, girls with the most (versus least) educated mothers were 1.92 cm (95% CI: 1.47, 2.36) taller; after controlling for urban/rural and East/West area of residence, this difference remained at 1.86 cm (95% CI: 1.42, 2.31), but after additionally controlling for mid-parental height, attenuated to 1.10 cm (95% CI: 0.69, 1.52). Among boys, these differences were 1.95 cm (95% CI: 1.53, 2.37), 1.89 cm (95% CI: 1.47, 2.31) and 1.16 cm (95% CI: 0.77, 1.55), respectively. Additionally controlling for breastfeeding, maternal smoking and older siblings did not substantively alter these findings. There was no evidence that the association of maternal educational attainment with growth differed in girls compared to boys (p for interaction = 0.45). Results were similar for those born to the most (versus least) educated fathers, or who had a parent with a non-manual (versus manual) occupation.In Belarus, a middle-income former Soviet country, socioeconomic differences in offspring growth commence in the pre-natal period and generate up to approximately 2 cm difference in height at age 7 years. These associations are partly explained by genetic or other factors influencing parental stature.Current Controlled Trials: NCT01352247 assigned 9 Sept 2005; ClinicalTrials.gov. Identifier: NCT01561612 received 20 Mar 2012.
Project description:BACKGROUND: The positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents. METHODS: 5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors. RESULTS: Parental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively. CONCLUSIONS: Adolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.
Project description:PURPOSE:This longitudinal study examined the role of leisure-time physical activity in academic achievement at the end of compulsory basic education and educational attainment in adulthood. METHODS:The data were drawn from the ongoing longitudinal Cardiovascular Risk in Young Finns Study, which was combined with register-based data from Statistics Finland. The study consisted of children who were 12 yr (n = 1723, 49% boys) and 15 yr (n = 2445, 48% boys) of age at the time when physical activity was measured. The children were followed up until 2010, when their mean age was 40 yr. Physical activity was self-reported and included several measurements: overall leisure-time physical activity outside school hours, participation in sports club training sessions, and participation in sports competitions. Individuals' educational outcomes were measured with the self-reported grade point average at age 15 yr and register-based information on the years of completed postcompulsory education in adulthood. Ordinary least squares models and the instrumental variable approach were used to analyze the relationship between physical activity and educational outcomes. RESULTS:Physical activity in adolescence was positively associated with educational outcomes. Both the physical activity level at age 15 yr and an increase in the physical activity level between the ages of 12 and 15 yr were positively related to the grade point average at age 15 yr and the years of postcompulsory education in adulthood. The results were robust to the inclusion of several individual and family background factors, including health endowments, family income, and parents' education. CONCLUSION:The results provide evidence that physical activity in adolescence may not only predict academic success during compulsory basic education but also boost educational outcomes later in life.
Project description:To investigate the possible association between educational level and previous professional occupation, and objective cognitive and functional evaluation in a sample of elderly patients with Alzheimer's disease. Methods:Through retrospective analysis of medical files, 174 patients with probable Alzheimer disease were randomly selected, classified and submitted to analysis according to previous professional occupation and years of formal education. Results:Subjects with lower education and less intellectually-demanding occupations performed worse than higher educated subjects in all cognitive subtests and on the functional scale. Conclusions:Results indicate that not only the total years of education, but also professional occupation has an impact on cognition and functioning in accordance with the hypothesis of cognitive reserve. Our findings confirmed this hypothesis, where subjects with higher education/ higher intellectual demand manifested first symptoms later than low education/ low intellectual demand subjects, with the latter group also exhibiting faster disease progression.
Project description:Importance:This study used multitrajectory modeling to identify distinct trajectories of physical aggression from ages 1.5 to 13 years for boys and girls. Objectives:To trace the development of boys' and girls' physical aggression problems from infancy to adolescence using mother ratings, teacher ratings, and self-ratings and to identify early family predictors of children on the high physical aggression trajectories. Design, Setting, and Participants:This cohort study used data from the Quebec Longitudinal Study of Child Development (QLSCD), a study of a representative, population-based sample of 2223 infants born in 1997 and 1998 in the Canadian province of Quebec. The dates of analysis were January 2017 to January 2018. Main Outcomes and Measures:Trained research assistants conducted 7 interviews (at child ages 1.5, 2.5, 3.5, 4.5, 5, 6, and 8 years) with the person most knowledgeable about the child (mothers in 99.6% [2214 of 2223] of cases). Teachers assessed the child's behavior at ages 6, 7, 8, 10, 12, and 13 years. Self-reports of behavior problems were obtained from the child at ages 10, 12, and 13 years. Results:The sample included 2223 participants, 51.2% of whom were boys and 91.2% of whom were of white race/ethnicity. The mean response rate for mother ratings of physical aggression during the first 8 years of life was 80.9% (range, 65.1%-91.7%). For teacher ratings of physical aggression from ages 6 to 13 years, the mean response rate was 45.7% (range, 35.4%-56.9%), while the mean response rate of physical aggression assessment from self-ratings between ages 10 and 13 years was 57.9% (range, 55.2%-60.5%). Attrition was higher among families with low socioeconomic status and single-parent families, as well as among young mothers and mothers who were not fluent in French or English. A statistical analysis to examine the consequences of attrition was included. For boys and girls, the frequency of physical aggressions increased from age 1.5 years (2039 [91.7%]) to age 3.5 years (1941 [87.3%]) and then substantially decreased until age 13 years (1228 [55.2%]). Three distinct developmental trajectories of physical aggression were observed for girls and 5 for boys. Most family characteristics measured at 5 months after the child's birth were associated with a high physical aggression trajectory for boys and girls. Conclusions and Relevance:Family characteristics at 5 months after the child's birth could be used to target preschool interventions aimed at preventing the development of boys' and girls' chronic physical aggression problems.
Project description:Importance:Low socioeconomic status is associated with higher all-cause mortality and risks for aging-related diseases. Biological aging is a potential process underlying health conditions related to social disadvantages, which may be present from birth onward. Objective:To evaluate the association of parental socioeconomic status with telomere length (TL) at birth, a marker of biological aging. Design, Setting, and Participants:This prospective birth cohort study was conducted among 1504 mother-newborn pairs in Belgium recruited between February 1, 2010, and July 1, 2017. Exposures:Parental socioeconomic measures, including maternal educational level, occupation, paternal educational level, and neighborhood income based on median annual household income. Main Outcomes and Measures:Mean relative TL was measured in cord blood and placental tissue. By constructing a principal component, an integrative socioeconomic measure was derived that integrates parental socioeconomic status and neighborhood income. Multivariable adjusted regression analyses were performed to associate the integrative socioeconomic measure and TL at birth. Results:In 1026 newborns (517 boys; mean [SD] gestational age, 39.2 [1.4] weeks), a higher socioeconomic status was associated with longer cord blood TL and placental TL. Each unit increment in the integrative socioeconomic status measure was associated with 2.1% (95% CI, 0.9%-3.4%; P?<?.001) longer cord blood TL in boys, while no association was observed for girls (0.5% longer cord blood TL; 95% CI, -0.9% to 1.8%; P?=?.50). The sex-specific socioeconomic status interaction revealed a stronger association in boys compared with newborn girls (1.6%; 95% CI, 0.02%-3.3%; P?=?.047 for interaction). In placental tissue, higher socioeconomic status was associated with 1.8% (95% CI, 0.3%-3.3%; P?=?.02) longer TL in newborn boys but not in girls (0.4% longer TL; 95% CI, -1.2% to 2.0%; P?=?.63). For placental tissue, no sex and socioeconomic status interaction on TL was observed (1.4%; 95% CI, -0.5% to 3.4%; P?=?.16 for interaction). Conclusions and Relevance:This study suggests that parental socioeconomic status is associated with newborn TL, especially in boys. The results indicate that familial social economic factors are associated with the potential cellular longevity of the next generation, with a potential higher transgenerational vulnerability for newborn boys.