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Background: While school-aged children in low- and middle-income countries remain highly exposed to acute infections, programs targeting this age group remain limited in scale and scope. In this paper, we evaluate the impact of a new and comprehensive primary school-based health intervention program on student-reported morbidity and anthropometric outcomes in Lusaka, Zambia. Methods: A prospective matched control study identified 12 classes in 7 schools for the intervention and 12 classes in 7 matched schools as controls. Teachers in intervention schools were trained to deliver health lessons and to refer sick students to care. In addition, vitamin A and deworming medication were biannually administered to intervention students. The primary study outcome was student-reported morbidity. Secondary outcomes were weight, height, health knowledge, and absenteeism. Multivariable linear and logistic regression models were used to estimate program impact. Results: 380 students ages 4–16 were enrolled in the study in 2015, and 97% were followed up at endline in 2016. The intervention decreased the adjusted odds of self-reported acute illnesses by 38% (95% CI: 0.48, 0.77) and the adjusted odds of stunting by 52% (95% CI: 0.26, 0.87). It also increased health knowledge by 0.53 standard deviations (95% CI: 0.24, 0.81). No impact was found on weight (adjusted mean difference β = 0.17, 95% CI: - 1.11, 1.44) and student absenteeism (adjusted odds ratio (aOR) = 0.89, 95% CI: 0.60, 1.33). Conclusion: The results presented in this paper suggest that comprehensive school-based health programs may offer a highly effective way to improve students’ health knowledge as well as their health status. Given their low cost, a more general adoption and implementation of such programs seems recommendable. Trial registration: ClinicalTrials.gov Identifier: . [ABSTRACT FROM AUTHOR]

Background: Up to 1.45 billion people currently suffer from soil transmitted helminth infection, with the largest burden occurring in Africa and Asia. Safe and cost effective deworming treatment exists, but there is a debate about mass distribution of this treatment in high prevalence settings. While the World Health Organization recommends mass administration of anthelmintic drugs for preschool and school-aged children in high (>20%) prevalence settings, and several long run follow up studies of an influential trial have suggested large benefits that persist over time, recent systematic reviews have called this recommendation into question. Methods and findings: This paper analyzes the long-term impact of a cluster-randomized trial in eastern Uganda that provided mass deworming treatment to preschool aged children from 2000 to 2003 on the numeracy and literacy skills of children and young adults living in those villages in 2010-2015. This study uses numeracy and literacy data collected seven to twelve years after the end of the deworming trial in a randomly selected subset of communities from the original trial, by an education-focused survey that had no relationship to the deworming study. Building on an earlier working paper which used data from 2010 and 2011 survey rounds, this paper uses an additional four years of numeracy and literacy data (2012, 2013, 2014, and 2015). Aggregating data from all survey rounds, the difference between numeracy scores in treatment versus control communities is 0.07 standard deviations (SD) (95% CI -0.10, 0.24, p = 0.40), the difference in literacy scores is 0.05 SD (95% CI -0.16, 0.27, p = 0.62), and the difference in total scores is 0.07 SD (95% CI -0.11, 0.25, p = 0.44). There are significant differences in program impact by gender, with numeracy and literacy differentially positively affected for girls, and by age, with treatment effects larger for the primary school aged subsample. There are also significant treatment interactions for those living in households with more treatment-eligible children. There is no evidence of differential treatment effects on age at program eligibility or number of years of program eligibility. Conclusions: Mass deworming of preschool aged children in high prevalence communities in Uganda resulted in no statistically significant gains in numeracy or literacy 7-12 years after program completion. Point estimates were positive but imprecise; the study lacked sufficient power to rule out substantial positive effects or more modest negative effects. However, there is suggestive evidence that deworming was relatively more beneficial for girls, primary school aged children, and children living in households with other treated children. Research approval: As this analysis was conducted on secondary data which is publicly available, no research approval was sought or received. All individual records were anonymized by the data provider prior to public release. [ABSTRACT FROM AUTHOR]

Background: In order to make informed decisions about how best to support children and young people with disabilities, effective strategies that facilitate active and meaningful participation in school are required. Clinical factors, diagnosis or impairments somewhat helpful in determining what should be provided in interventions. However, clinical factors alone will not offer a clear view of how to support participation. It is helpful then to look at wider psychosocial and environmental factors. The aim of this review was to synthesise evidence of psychosocial and environmental factors associated with school participation of 4–12 year old children with disabilities to inform the development of participation-fostering interventions. Methods: A systematic search and synthesis using realist methods was conducted of published research. Papers had to include consideration of psychosocial and/or environment factors for school participation of children with disabilities. The review was completed in accordance with the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Papers were identified via Boolean search of the electronic databases MEDLINE, CINAHL, PhycINFO and ERIC (January 2006-October 2018). Appraisal focussed on contributions in terms of whether the articles are appropriate for the review (relevance) and research quality (rigour). Data were analyzed using content and thematic analysis methods using a realist framework. A narrative synthesis of results was reported. Results and implications: We identified 1828 papers in the initial search. Seventy two papers were included in the final synthesis. Synthesis of findings led to three overarching mechanisms representing psychosocial factors for children (1) identity (2) competence and (3) experience of mind and body. Environmental aspects (context) compromised five interrelated areas: (1) structures and organization, (2) peers, (3) adults, (4) space and (5) objects. Our synthesis provides insights on how professionals may organize efforts to improve children’s participation. Consideration of these findings will help to proactively deal with suboptimal participation outcomes. Development of theoretically determined assessments and interventions for management of school participation are now required. [ABSTRACT FROM AUTHOR]

Background: Armed conflicts affect more than one in 10 children globally. While there is a large literature on mental health, the effects of armed conflict on children’s physical health and development are not well understood. This systematic review summarizes the current and past knowledge on the effects of armed conflict on child health and development. Methods: A systematic review was performed with searches in major and regional databases for papers published 1 January 1945 to 25 April 2017. Included studies provided data on physical and/or developmental outcomes associated with armed conflict in children under 18 years. Data were extracted on health outcomes, displacement, social isolation, experience of violence, orphan status, and access to basic needs. The review is registered with PROSPERO: CRD42017036425. Findings: Among 17,679 publications screened, 155 were eligible for inclusion. Nearly half of the 131 quantitative studies were case reports, chart or registry reviews, and one-third were cross-sectional studies. Additionally, 18 qualitative and 6 mixed-methods studies were included. The papers describe mortality, injuries, illnesses, environmental exposures, limitations in access to health care and education, and the experience of violence, including torture and sexual violence. Studies also described conflict-related social changes affecting child health. The geographical coverage of the literature is limited. Data on the effects of conflict on child development are scarce. Interpretation: The available data document the pervasive effect of conflict as a form of violence against children and a negative social determinant of child health. There is an urgent need for research on the mechanisms by which conflict affects child health and development and the relationship between physical health, mental health, and social conditions. Particular priority should be given to studies on child development, the long term effects of exposure to conflict, and protective and mitigating factors against the harmful effects of armed conflict on children. [ABSTRACT FROM AUTHOR]

Racial segregation, and in particular school segregation, likely plays an important role in affecting health outcomes. To examine this connection, this paper explores the relationship between the end of court-ordered school desegregation and preterm births among Blacks using birth certificate information between 1992 and 2002 (n = 183,178). The end of court-ordered oversight has important implications for the level of racial segregation in schools: If residential segregation remains high, neighborhood-based student assignment plans would naturally increase school segregation. A rise in school segregation may lead to worse educational, labor, and health outcomes among Blacks. Using multiple difference-in-differences framework that exploits variation in exposure to schools that declared unitary status, it finds that school districts’ release from court oversight is associated with a 0.8 percentage point increase in preterm births among Black mothers. This paper contributes to literature that finds that the end of court-ordered school desegregation in the 1990s have negative implications for Blacks. More research should be conducted to understand the causal relationship between school segregation and infant health. [ABSTRACT FROM AUTHOR]

Background: Substance misuse persists as a major public health issue worldwide with significant costs for society. The development of interventions requires methodologically sound studies to explore substance misuse causes and consequences. This Cohort description paper outlines the design of the Belfast Youth Development (BYDS), one of the largest cohort studies of its kind in the UK. The study was established to address the need for a long-term prospective cohort study to investigate the initiation, persistence and desistance of substance use, alongside life course processes in adolescence and adulthood. The paper provides an overview of BYDS as a longitudinal data source for investigating substance misuse and outlines the study measures, sample retention and characteristics. We also outline how the BYDS data have been used to date and highlight areas ripe for future work by interested researchers. Methods: The study began in 2000/1 when participants (n = 3,834) were pupils in their first year of post-primary education (age 10/11 years, school year 8) from over 40 schools in Northern Ireland. Children were followed during the school years: Year 9 (in 2002; aged 12; n = 4,343), Year 10 (in 2003; aged 13; n = 4,522), Year 11 (in 2004; aged 14; n = 3,965) and Year 12 (in 2005; aged 15; n = 3,830) and on two more occasions: 2006/07 (aged 16/17; n = 2,335) and 2010/11 (aged 20/21; n = 2,087). Data were collected on substance use, family, schools, neighbourhoods, offending behaviour and mental health. The most novel aspect of the study was the collection of detailed social network data via friendship nominations allowing the investigation of the spread of substance use via friendship networks. In 2004 (school year 11; respondents aged 14), a sub-sample of participants’ parents (n = 1,097) and siblings (n = 211) also completed measures on substance use and family dynamics. Results: The most recent wave (in 2010/2011; respondents aged 20/21 years) indicated lifetime use of alcohol, tobacco and cannabis among the cohort was 94, 70 and 45 per cent, respectively. The paper charts the development of drug use behaviour and some of the key results to date are presented. We have also identified a number of key areas ripe for analysis by interested researchers including sexual health and education. Conclusions: We have established a cohort with detailed data from adolescence to young adulthood, supplemented with parent and sibling reports and peer network data. The dataset, allowing for investigation of trajectories of adolescent substance use, associated factors and subsequent long-term outcomes, constitutes an important resource for longitudinal substance misuse research. A planned further wave as the cohort enter their late twenties and potential to link to administrative data sources, will further enrich the datasets. [ABSTRACT FROM AUTHOR]

Background: Against a backdrop of more than four decades of war, conflict and insecurity, Afghanistan is recognised as suffering from endemic violence and children are exposed to multiple forms of violence, including at the family and school levels. This paper presents the results of an evaluation of school-based peace education and a community-based intervention to change harmful social norms and practices related to gender and the use of violence in conflict resolution, implemented in Afghanistan with the aim of reducing violence against and between children. Methods: The evaluation consisted of a cross-sectional, interrupted time series design with three data collection points over 12 months. Data was collected from students in 11 secondary schools (seven girls’ and four boys’ schools) in Jawzjan province of Afghanistan, with a total of 361 boys and 373 girls sampled at endline. All children were interviewed with a questionnaire developed for the study. Key outcomes included children’s experience of peer violence (both perpetration and victimization) at school, corporal punishment both at home and at school, and observation of family violence. Other outcomes included children’s gender equitable attitudes, attitudes towards child punishment, depression and school performance. Results: Between baseline and endline evaluation points, there were significant reductions in various forms of violence at the school level, including both boys’ and girls’ past month experience of peer violence victimization, peer violence perpetration, and corporal punishment by teachers. There were also significant reductions in boys’ and girls’ experience of corporal punishment at home and observation of family violence, with a particularly strong effect observed among girls. Both boys and girls had significantly more equitable gender attitudes and significantly less violence-supportive attitudes in relation to children’s punishment, and significantly fewer symptoms of depression. Girls’ school attendance was also significantly higher at endline. Discussion: To our knowledge this is the first time that a peace education program has been evaluated in Afghanistan, with or without a community intervention to change harmful social norms and practices related to gender and the use of violence for conflict resolution. The evaluation suggests that the intervention may have led to a reduction in various forms of violence, including children’s peer violence, corporal punishment of children both at school and at home, and in children’s reports of domestic violence against women at the household level. [ABSTRACT FROM AUTHOR]

People are connected by various social networks, resulting in the interdependence of consumer choice. Therefore, it is very important and realistic to assume choice interdependence in private car ownership modeling. In this paper, we investigate the interdependence of private car ownership choice using a spatial autoregressive binary probit model estimated by the Bayesian Markov chain Monte Carlo (MCMC) method. Constructing the autoregressive matrix demographically shows that the private car ownership choice of a household is dependent on other household choices. Compared with the pure binary probit model estimated by the MCMC method, the spatial autoregressive model achieves a significant improvement both in loglikelihood value and log marginal density value, which are calculated using the importance sampling method of Newton and Raftery, from approximately -202 to approximately -63 and from -208 to -145, respectively. Moreover, the results indicated by the spatial autoregressive probit model suggest that the number of children, the ownership of an apartment or the availability of a parking lot are positively and significantly associated with the private car ownership level. To test the out-of-sample performance of the model, we estimate the model using 600 data points and test it using another 148 data points. The results indicate that the predictive power is greatly improved. Finally, we analyze the augmented parameter and discover that it is associated with the parking variable in addition to the license variable. [ABSTRACT FROM AUTHOR]

Previous school-based interventions have produced positive effects upon measures of children’s health and wellbeing but such interventions are often delivered by external experts which result in short-term effects. Thus, upskilling and expanding the resources available to classroom teachers could provide longer-term solutions. This paper presents a feasibility study of an online health resource (Healthy Schools Resource: HSR) developed to assist primary school teachers in the delivery of health-related education. Four schools (n = 2 intervention) participated in this study. Study feasibility was assessed by recruitment, retention and completion rates of several outcomes including height, weight, waist circumference, blood pressure and several metabolic markers including HDL-cholesterol, triglycerides, glucose and dietary knowledge following a 10-12-week intervention period. The process evaluation involved fidelity checks of teachers’ use of the HSR and post-intervention teacher interviews. A total of 614 consent forms were issued and 267 were returned (43%), of which, 201 confirmed consent for blood sampling (75%). Retention of children participating in the study was also high (96%). Of the 13 teachers who delivered the intervention to the children, four teachers were excluded from further analyses as they did not participate in the fidelity checks. Overall, teachers found the online resource facilitative of teaching health and wellbeing and several recommendations regarding the resource were provided to inform further evaluations. Recruitment and retention rates suggest that the teacher led intervention is feasible and acceptable to both teachers, parents and children. Initial findings provide promising evidence that given a greater sample size, a longer intervention exposure period and changes made to the resource, teachers’ use of HSR could enhance measures of health and wellbeing in children. [ABSTRACT FROM AUTHOR]

The 5Rights Youth Juries are an educational intervention to promote digital literacy by engaging participants (i.e. jurors) in a deliberative discussion around their digital rights. The main objective of these jury-styled focus groups is to encourage children and young people to identify online concerns and solutions with a view to developing recommendations for government policy-makers and industry chiefs. The methodology included a series of dramatized scenarios that encourage jurors to deliberate about their digital rights. This paper compares two formats for these scenarios: live actors and professionally recorded and edited videos of the same actors. Results failed to show any major differences between formats indicating the cost-effectiveness of the video-recorded format and the possibility for others to run the 5Rights Youth Juries with the support of an online open educational resource. [ABSTRACT FROM AUTHOR]

Recent study shows that 617 million children and adolescents–or six out of 10 globally- are not acquiring minimum levels in literacy and mathematics, indicating the magnitude of the learning acquisition problem. For children with disabilities in context of conflict, the situation is arguably even worse: the literature shows that they face difficulties to access the education system due to multiple barriers, and when they do access, they are not learning. Our paper examines if an active education policy promoting inclusion since 2005 in Afghanistan, a protracted crisis context, has been effective. Using two cross sectional household surveys carried out eight years apart (2005–2013), our study shows that access to school and literacy did not improve between 2005 and 2013 for children and youth with disabilities. Both access and literacy outcomes were worse for girls with disabilities, those with a mental, learning or associated disability and those living in household where the head was uneducated. Finally, odds of being mentally distressed significantly declined between 2005 and 2013 indicating that schools might play a protective role for children with disabilities in Afghanistan. Our findings suggest that a multilevel multi-pronged adaptation of the existing system to improve the learning experience and promote children’s resilience, particularly for children with disabilities, in conflict context such as Afghanistan, is required. [ABSTRACT FROM AUTHOR]

Concerns about the use of child labor in West African cocoa production became widespread in the early 2000s in many high-income countries. In 2015 in Ghana, 91.8% (or a total of 878,595) of the children working in the cocoa sector were involved in a form of hazardous work. Child labor in cocoa production is not just a symptom of poverty but also a contributing factor, as children often forgo a formal education to work in cocoa orchards. Current Ghanaian law prohibits child labor, but, with many cocoa households living in poverty, child labor becomes a necessity for survival, and as such, current child labor laws are rarely enforced. Therefore, an effective policy that eliminates child labor could compensate farmers by providing an economic incentive. In this paper, we develop and calibrate a farm household model to estimate the cocoa price premium necessary to eliminate child labor from cocoa production while leaving the farm household welfare unchanged. This welfare-neutral price premium removes the negative effects of eliminating child labor for the farm household. Varying degrees of child labor exists, with certain forms posing a greater risk to children’s wellbeing. The results show that eliminating the worst forms of child labor would require a cocoa price premium of 2.81% and eliminating regular work (non-hazardous work but over the maximum hours allowed for a child) and the worst forms would require an 11.81% premium, which could be paid for by the well-established Ghanaian Cocoa Marketing Board. An incentive for the Cocoa Marketing Board to pay the price premium and monitor and enforce this policy would be the ability to differentiate their cocoa as child-labor free and not lose market share to countries who cannot currently certify this practice. [ABSTRACT FROM AUTHOR]

A straightforward technique to explore the "total effects" of neighborhoods on health outcomes is to compare the degree of similarity of outcomes of neighbors with those of non-neighbors. Several issues arise in interpreting these estimates around spatial and temporal definitions of "neighbors" and life course mobility patterns. Indeed, much work uses "cross- sectional neighbors," which makes the interpretation of the estimates unclear because they combine short-term effects (for movers) and long-term effects (for stayers). This paper contributes to the literature by assessing the importance of measuring neighbor mobility as well as neighborhood selection. Using the Panel Study of Income Dynamics, we examine the extent to which having longitudinal measures of "neighbors" shapes estimates of neighborhood effects, and also use a negative test of neighborhood effects to assess the importance of neighborhood selection. Specifically, we estimate similarity in self-rated health of adults over 30 years old who live in the same county over various periods of time and find that "cross-sectional" neighbor definitions may understate neighborhood effect estimates by as much as 35%. However, when we contrast these health estimates with contemporaneous neighborhood "effects" on completed education, we find that much of the "understated" effects on health are likely related to selection effects rather than causal effects of neighborhoods. [ABSTRACT FROM AUTHOR]

Background: Centile curves and standard scores are common in epidemiological research. However, standardised norms and centile growth curves for language disorder that reflect the entire UK local school population do not exist. Methods: Scores on six language indices assessing receptive and expressive functioning of children were obtained from the SCALES population survey. Monolingual English speaking participants were aged between five and nine years. Children who attended special schools at study intake, or who were learning English as an additional language were excluded. We constructed language norms using the LMS method of standardisation which allows for skewed measurements. We made use of probability weights that were produced from a two-step logistic model. Distributions of estimated standard scores from an intensively assessed sub-population and from the full population were contrasted to demonstrate the role of weights. Results: Non-overlapping centile curves and standardised scores at each age were obtained for the six language indices. The use of weights was essential at retrieving the target distribution of the scores. An online calculator that estimates standardised scores for the measures was constructed and made freely available. Conclusions: The findings highlight the usefulness and flexibility of the LMS method at dealing with the standardisation of linguistic and educational measures that are sufficiently continuous. The paper adds to the existing literature by providing population norms for a number of language tests that were calculated from the same group of individuals. [ABSTRACT FROM AUTHOR]

This paper demonstrates how Geographic Information Systems (GIS) can be utilized to study the effects of spatial phenomena. Since experimental designs such as Randomized Controlled Trials are generally not feasible for spatial problems, researchers need to rely on quasi-experimental approaches using observational data. We provide a regression-based framework of the key procedures for GIS-based empirical research design using georeferenced point data for both spatial events of interest and subjects exposed to the events. We illustrate its utility and implementation through a case study on the impacts of the Cambodian genocide under the Pol Pot regime on post-conflict education. [ABSTRACT FROM AUTHOR]

Background: Nutrition outcomes among young children in Nigeria are among the worse globally. Mother’s limited knowledge about food choices, feeding, and health care seeking practices contributes significantly to negative nutrition outcomes for children in most developing countries. Much less is known about the relationship between mother’s nutrition-related knowledge and child nutritional outcomes in rural Nigeria. This paper investigates therefore: (i) the association of mother’s nutrition-related knowledge with nutrition outcomes of young children living in rural Nigeria, where access to education is limited, and (ii) whether mother’s education has a complementary effect on such knowledge in producing positive child nutrition outcomes in such settings. Methods: Using the Demographic and Health Survey data for Nigeria, we employ both descriptive and regression analyses approaches in analyzing the study’s objectives. In particular, we apply ordinary least square (OLS) to investigate the association of mother’s nutrition-related knowledge with child HAZ and WHZ while controlling for maternal, child, household and regional characteristics. An index was constructed for mother’s nutrition-related knowledge using information on dietary practices, disease treatment and prevention, child immunization, and family planning. Results: We found that mother’s knowledge is independently and positively associated with HAZ and WHZ scores in young children. Higher levels of mother’s education, typically above primary, have a significant, positive association with child HAZ and WHZ scores. We argue that mother’s knowledge of health and nutrition may substitute for education in reducing undernutrition in young children among populations with limited access to formal education. However, the present level of mother’s education in rural Nigeria appears insufficient to reinforce knowledge in producing better nutrition outcomes for children. Conclusions: This study suggests promotion of out-of-school (informal) education, such as adult literacy and numeracy classes where women without formal education can gain health and nutrition knowledge, and practices that could enhance child nutrition outcomes in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Children born to adolescent mothers generally perform more poorly on school readiness assessments than their peers born to adult mothers. It is unknown, however, whether this relationship extends to the grandchildren of these adolescent mothers. This paper examines the multi-generational outcomes associated with adolescent motherhood by testing whether the grandchildren of adolescent mothers also have lower school readiness scores than their peers; we further assessed if this relationship was moderated by whether the child’s mother was an adolescent mother. Methods: We used population-based data to conduct the retrospective cohort study of children born in Manitoba, Canada, 2000–2009, whose mothers were born 1979–1997 (n = 11,326). Overall school readiness and readiness on five domains of development were analyzed using logistic regression models. Results: Compared with children whose mothers and grandmothers were both ≥ 20 at the birth of their first child, those born to grandmothers who were < 20 and mothers who were ≥ 20 years old at the birth of their first child had 39% greater odds of being not ready for school (95% CI: 1.22–1.60). Children whose grandmothers were ≥ 20 and mothers were < 20 at the birth of their first child had 25% greater odds of being not ready for school (95% CI: 1.11–1.41), and children born to grandmothers and mothers who were both <20 at the birth of their first child had 35% greater odds of being not ready for school (95% CI: 1.18–1.54). Conclusions: These findings suggest a multigenerational effect of adolescent motherhood on school readiness. [ABSTRACT FROM AUTHOR]

School health and nutrition (SHN) programmes are recognized as a significant contributor to both health and education sector goals. The school system offers an ideal platform from which to deliver basic health interventions that target the most common health conditions affecting school-age children (SAC) in low-income countries, leading to improved participation and learning outcomes. However, governments require evidence to cost, design, and implement these programmes. In Ethiopia, prevalent health conditions affecting SAC's education participation and learning outcomes include infection with soil-transmitted helminths (STHs), hunger, and malnutrition. In recognition of the multiple issues affecting the health and education of SAC, the government has taken a proactive approach, coordinating an integrated SHN programme designed to be implemented in partnership and monitored and financed through a single, integrated mechanism. The programme, known as the Enhanced School Health Initiative (ESHI), integrates three complimentary health interventions: deworming; school feeding; and provision of a water, sanitation, and hygiene (WASH) package in schools, which in delivery aim to maximize the benefits of each of the individual components. Operational research surrounding the ESHI programme includes both qualitative and quantitative analyses. Here, we present an overview of the ESHI programme and its genesis. We also introduce three additional supporting papers that provide in-depth analyses of key findings, including the baseline situational analysis, the costs, and community perceptions of the programme. The findings from ESHI provide initial evidence to develop an understanding of the related costs and synergies of integrating multiple health interventions onto a single platform. The work has translated into strengthened institutional capacity and improved cross-sectoral coordination. The government is now committed to supporting 25 million school children in Ethiopia through SHN. The ESHI model serves as a reference point for other countries looking to scale up targeted SHN interventions. [ABSTRACT FROM AUTHOR]

Aim: We aimed to identify and evaluate the quality and evidence of the motor learning literature about intervention studies regarding the contextual interference (CI) effect (blocked vs. random practice order) in children with brain lesions and typically developing (TD) children. Method: Eight databases (Cinahl, Cochrane, Embase, PubMed, Pedro, PsycINFO, Scopus and Web of Knowledge) were searched systematically with predefined search terms. Controlled studies examining the CI effect in children (with brain lesions or TD) were included. Evidence level, conduct quality, and risk of bias were evaluated by two authors independently. A best evidence synthesis was performed. Results: Twenty-five papers evaluating TD children were included. One of these studies also assessed children with cerebral palsy. Evidence levels were I, II, or III. Conduct quality was low and the risk of bias high, due to methodological issues in the study designs or poor description thereof. Best evidence synthesis showed mainly no or conflicting evidence. Single tasks showed limited to moderate evidence supporting the CI effect in TD children. Conclusion: There is a severe limitation of good-quality evidence about the CI effect in children who practice different tasks in one session, especially in children with brain lesions. [ABSTRACT FROM AUTHOR]

Background: Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women. Methods: A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or sexual abuse before 15 years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age 16. Multivariate analyses assessed the associations between mother’s HIV status and child physical and sexual abuse while controlling for confounding variables. Results: More than one in four (26.6%) reported abuse before the age of 15: 14.6% physical abuse and 9.1% sexual abuse,14.3% reported forced first sex and 9.0% first sex before 16 with someone 5+ years older. Fifteen percent of women tested HIV positive during the recent antenatal care visit. In multivariate analysis, childhood physical abuse (aOR 3.30 95%CI 1.58–6.90), sexual abuse (3.18 95%CI: 1.64–6.19), forced first sex (aOR 1.42, 95%CI: 1.00–2.02), and 5+ years age difference with first sex partner (aOR 1.66 95%CI 1.09–2.53) were independently associated with HIV infection. Conclusion: This study highlights that child physical and/or sexual abuse may increase risk for HIV acquisition. Further research is needed to assess the pathways to HIV acquisition from childhood to adulthood. Prevention of child abuse must form part of the HIV prevention agenda in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Attitudes and beliefs about menstruation can place restrictions on menstruating women and girls, limiting their ability to fully participate in community life, education and employment. This paper presents evidence on menstruation-related beliefs contributing to restrictive practices in Papua New Guinea (PNG), Solomon Islands (SI) and Fiji. Focus group discussions and interviews were undertaken with 307 adolescent girls, women and men in a rural and urban site in each country. Data were analysed using an inductive thematic approach. Participants described a range of attitudes and beliefs that restrict the behaviour of menstruating women and girls. Themes include the belief that menstrual blood is ‘dirty’; that when menstruating, girls and women can bring ‘bad luck’ to men; secrecy and shame associated with menstruation; and beliefs about the impact of certain behaviours on menstruation and health. Restrictive practices were more frequently reported in PNG and SI than Fiji, and more common in rural compared with urban sites. Some restrictions, such as avoidance of household chores, were perceived as desirable or driven by women themselves. However participants identified other restrictions, such as not being able to attend church or hygienically wash menstrual hygiene materials, as unwanted, in some cases impacting on participation in school, work and community life. Education initiatives guided by women and girls, implemented by local stakeholders and grounded in a sound understanding of specific contexts are needed to address discriminatory attitudes and beliefs that contribute to unwanted restrictions, and to support enabling attitudes and beliefs regarding menstruation. [ABSTRACT FROM AUTHOR]

Telomere length (TL) has been associated with a range of aging outcomes as well as mortality. Recent research has shown both high heritability (~70%) of TL as well as moderate spousal similarity (r~0.3) using European datasets. This paper explores the level of spousal concordance in telomere length in the Health and Retirement Study, a national sample of adults in the US. The results show that the spousal correlations are lower (r~0.11). Regression-based associations in TL in the US are low (beta~0.08) and also vary by the number of times respondents have been married, where spouses married a single time have higher associations in TL (beta~.12) than spouses married more once (beta~0.03). I also find variation in spousal TL association levels based on husband’s education level. These findings suggest the possibility of both assortative mating patterns related to telomere length as well as likelihood of shared environmental factors that cause TL similarity in people who are socially connected. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of childhood experiences of parental corporal punishment (CP) and neglectful parenting (NP) on Japanese university students’ endorsement of parental CP (EPP) to discipline children, in relation to subjective happiness (SH). A total of 536 undergraduate students who showed no physical symptoms completed anonymous paper-based questionnaires addressing demographic characteristics, undergraduate classes, and recent health conditions on SF-8 (PCS, MCS). It was found that the proportions of participants who experienced pervasive CP and NP were larger in men than in women (36.5% vs. 19.4% for CP; 22.1% vs. 9.7% for NP). Multiple regression analyses (n = 346) revealed that the CP score was associated with positive EPP (β = 0.310, p < 0.001). Further, students whose major was nursery education reported significantly lower level of EPP; however, neither SH nor good recent health conditions significantly reduced EPP. The NP score was inversely associated with the SH score (β = -0.253, p < 0.001) (n = 346). In conclusion, childhood experiences of parental CP may affect adolescents’ views related to their own parenting. Further investigation using internationally comparable methodologies, especially in prospective cohort studies, is warranted, not only in Japan but also in other Asian countries. [ABSTRACT FROM AUTHOR]

In this paper I develop a model to reproduce the phenomenon of high intergenerational correlations in education observed in Latin American Countries. The model is based on empirical evidence and implemented through agent based modeling techniques. The effect of conditional cash transfer programs on educational mobility is then analyzed. The results suggest that conditional cash transfer program can substantially increase intergenerational mobility in education. I find that using parental education as eligibility criterion and adapting the subsidies to the income level can improve the efficiency of a program in increasing educational mobility as compared to a purely income based program. [ABSTRACT FROM AUTHOR]

Background: Despite the known benefits of a physically active lifestyle, there are few examples of interventions that have been successfully implemented at a population level over a long period of time. One such example is The Daily Mile, a school based physical activity initiative, where a teacher takes their class out daily during class time for a short bout of ambulatory activity. At one school, this activity appears has been sustained over a long period (6 years), has the whole school participating and is now incorporated into its daily routine. The aim of this paper was to understand how The Daily Mile was implemented in primary schools and to assess factors associated with its successful implementation. Methods: Semi-structured interviews with school staff who had a significant role in implementing The Daily Mile were conducted at four primary schools in central Scotland. Interviews were digitally recorded and transcribed verbatim. Data were analysed using thematic analysis and descriptive analysis and interpretation of data undertaken. Details regarding the school grounds and facilities were also noted during the interviews. Results: Having simple core intervention components, flexible delivery that supports teacher autonomy and being adaptable to suit the specific primary school context appear to be key aspects of The Daily Mile that are related to its implementation success. Other factors relating to how The Daily Mile was developed, trialled and rolled out might also have contributed towards its successful implementation. Conclusion: The Daily Mile appears to have several factors which may relate to its implementation success. These are important considerations for others looking to implement The Daily Mile effectively in their primary school or in other contexts. [ABSTRACT FROM AUTHOR]

Problem Solving (PS) skills allow students to handle problems within an educational context. PS is a core competence of Computer Science education and affects programming success. In this vein, this paper aims to investigate PS ability performance in primary school pupils of a computer course, implemented according to the Neo-Piagetian theory of cognitive development. The study included 945 Slovenian pupils, ranging from fourth to sixth grade. The effects of gender, age and consecutive years of attending the course were examined on pupils’ PS ability at the pre-operational and concrete operational stages. Pupils completed a survey questionnaire with four types of tasks (a series of statements, if-statements, loops and variables) at both stages. The analysis revealed three findings: the performance of PS ability in all tasks was, at the pre-operational stage, associated positively with performance at the concrete operational stage; there were no gender differences in PS performance at both stages, and both the grade and consecutive year of taking the computer course had an effect on PS ability performance at both stages. Those in the lowest grade and those taking the course for the first year reported lower performances than their older counterparts. These findings may help curriculum designers across the world develop efficient approaches to teaching computer courses. [ABSTRACT FROM AUTHOR]

Background: Making inferences about measles distribution patterns at small area level is vital for more focal targeted intervention. However, in statistical literature, the analysis of originally collected data on one resolution with the purpose to make inferences on a different level of spatial resolution is referred to as the misalignment problem. In Namibia the measles data were available in aggregated format at regional level for the period 2005 to 2014. This leads to a spatial misalignment problem if the purpose is to make decisions at constituency level. Moreover, although data on risk covariates of measles could be obtained at constituency level, they were not available each year between 2005 and 2014. Thus, assuming that covariates were constant through the study period would induce measurement errors which might have effects on the analysis results. This paper presents a spatio-temporal model through a multi-step approach in order to deal with misalignment and measurement error. Methods: For the period 2005–2014, measles data from the Ministry of Health and Social Services (MoHSS) were analysed in two steps. First, a multi-step approach was applied to correct spatial misalignment in the data. Second, a classical measurement error model was fitted to account for measurement errors. The time effects were specified using a nonparametric formulation for the linear trend through first order random walk. An interaction between area and time was modelled through type I and type II interaction structures. Results: The study showed that there was high variation in measles risk across constituencies and as well as over the study period (2005–2014). Furthermore, the risk of measles was found to be associated with (i) the number of people aged between 0 and 24 years, (ii) the percentages of women aged 15–49 with an educational level more than secondary, (iii) the percentages of children age 12–23 months who received measles vaccine, (iv) the percentages of malnourished children under 5 years, and (vi) the measles cases for each previous year. Conclusion: The study showed some of the determinants of measles risk and revealed areas at high risk through disease mapping. Additionally, the study showed a non-linear temporal distribution of measles risk over the study period. Finally, it was shown that ignoring the measurement errors may yield misleading results. It was recommended that group and geographically targeted intervention, prevention and control strategies can be tailored on the basis these findings. [ABSTRACT FROM AUTHOR]

Birth registration and obtaining physical birth certificates impose major challenges in developing countries, with impact on child and community health, education, planning, and all levels of development. However despite initiatives, universal registration is elusive, leading to calls for new approaches to understanding the decisions of parents. In this paper, we report results of a survey of students in grades six to eight (age ~12–16) in an under-registered area of Kenya regarding their own understanding of registration issues and their suggestions for improvement. These students were selected because they themselves were also nearing the age for high school enrollment/entrance examinations, which specifically requires possession of a birth certificate. This assessment was also a companion to our previous representative survey of adults in the same Kenyan region, allowing for parent-child comparison. Results supported previous research, showing that only 43% had birth certificates. At the same time, despite these low totals, students were themselves quite aware of registration factors and purposes. The students also made quite prescient sources for understanding their households’ motivations, with many of their suggestions—for focus on communication of pragmatic benefits, or automatic measures shifting responsibility from parents—mirroring our own previous suggestions, and showing a level of pragmatism not witnessed when surveying their parents. This paper therefore adds evidence to the discussion of registration policy planning. More generally, it also builds on an important trend regarding the treatment of children as stakeholders and important sources of information, and raising an intriguing new avenue for future research. [ABSTRACT FROM AUTHOR]

The current paper reports long-term treatment impact estimates for a randomized evaluation of an early childhood intervention designed to promote children's developmental outcomes and improve the quality of Head Start centers serving high-violence and high-crime areas in inner-city Chicago. Initial evaluations of end-of-preschool data reported that the program led to reductions in child behavioral problems and gains in measures of executive function and academic achievement. For this report, we analyzed adolescent follow-up data taken 10 to 11 years after program completion. We found evidence that the program had positive long-term effects on students’ executive function and grades, though effects were somewhat imprecise and dependent on the inclusion of baseline covariates. Results also indicated that treated children had heightened sensitivity to emotional stimuli, and we found no evidence of long-run effects on measures of behavioral problems. These findings raise the possibility that developing programs that improve on the Head Start model could carry long-run benefits for affected children. [ABSTRACT FROM AUTHOR]

School-based comprehensive sexuality education (CSE) can help adolescents achieve their full potential and realize their sexual and reproductive health and rights. This is particularly pressing in low- and middle-income countries (LMICs), where high rates of unintended pregnancy and STIs among adolescents can limit countries’ ability to capitalize on the demographic dividend. While many LMICs have developed CSE curricula, their full implementation is often hindered by challenges around program planning and roll-out at the national and local level. A better understanding of these barriers, and similarities and differences across countries, can help devise strategies to improve implementation; yet few studies have examined these barriers. This paper analyzes the challenges to the implementation of national CSE curricula in four LMICs: Ghana, Kenya, Peru and Guatemala. It presents qualitative findings from in-depth interviews with central and local government officials, civil society representatives, and community level stakeholders ranging from religious leaders to youth representatives. Qualitative findings are complemented by quantitative results from surveys of principals, teachers who teach CSE topics, and students aged 15–17 in a representative sample of 60–80 secondary schools distributed across three regions in each country, for a total of around 3000 students per country. Challenges encountered were strikingly similar across countries. Program planning-related challenges included insufficient and piecemeal funding for CSE; lack of coordination of the various efforts by central and local government, NGOs and development partners; and inadequate systems for monitoring and evaluating teachers and students on CSE. Curriculum implementation-related challenges included inadequate weight given to CSE when integrated into other subjects, insufficient adaptation of the curriculum to local contexts, and limited stakeholder participation in curriculum development. While challenges were similar across countries, the strategies used to overcome them were different, and offer useful lessons to improve implementation for these and other low- and middle-income countries facing similar challenges. [ABSTRACT FROM AUTHOR]

Background: This investigation compared the perceived effectiveness of supportive counselling (SC) and prolonged exposure for adolescents (PE-A) by treatment users (adolescents with PTSD) and non-specialist treatment providers (supervised nurses). Method: Adolescent participants and nurse providers were purposively recruited to share their experiences of trial participation through face to face semi-structured in-depth interviews and treatment-specific focus groups (all recorded). Twelve adolescent participant transcripts (ten interviews and two focus groups) and three nurse provider transcripts were doubly transcribed. Thematic content analysis was applied using Atlas.ti software. Two emerging themes are presented in this paper: 1) Perceptions of the intervention and 2) Usefulness of the intervention. Results: Regardless of treatment arm, adolescents experienced warm counselling relationships and described the process of extending trust to the counselor. Adolescents in the PE-A arm provided clear descriptions of session structure and treatment rationale compared with adolescents receiving SC. The most helpful tools were breathing retraining and imaginal exposure for PE-A and creation of distraction strategies during non-directive SC. Adolescents in both arms continued to use the techniques acquired during treatment and reported symptom improvement. Participants who received SC acknowledged ongoing reexperiencing. Nurses perceived SC to be an immediately transferable skill, but feedback on their preference for one intervention over the other was inconclusive. Conclusion: Both PTSD treatment strategies, implemented by non-specialists, were perceived as helpful. Overall, adolescents reported warm therapeutic relationships and a reduction in PTSD symptoms. Nurses stated that they would require institutional support to ensure delivery of these interventions in a scalable and sustainable manner. [ABSTRACT FROM AUTHOR]

In the public transport industry, travellers’ perceived satisfaction is a key element in understanding their evaluation of, and loyalty to ridership. Despite its notable importance, studies of customer satisfaction are under-represented in the literature, and most previous studies are based on survey data collected from a single city only. This does not allow a comparison across different transport systems. To address this underrepresentation, this paper reports on a study of train passengers’ satisfaction with the fare paid for their most recent home-based train trip in five Australian capital cities: Sydney, Melbourne, Brisbane, Adelaide, and Perth. Two data sources are used: a nation-wide survey, and objective information on the train fare structure in each of the targeted cities. In particular, satisfaction with train fares is modelled as a function of socio-economic factors and train trip characteristics, using a random parameters ordered Logit model that accounts for unobserved heterogeneity in the population. Results indicate that gender, city of origin, transport mode from home to the train station, eligibility for either student or senior concession fare, one-way cost, and waiting time as well as five diverse interaction variables between city of origin and socio-economic factors are the key determinants of passenger satisfaction with train fares. In particular, this study reveals that female respondents tend to be less satisfied with their train fare than their male counterparts. Interestingly, respondents who take the bus to the train station tend to feel more satisfied with their fare compared with the rest of the respondents. In addition, notable heterogeneity is detected across respondents’ perceived satisfaction with train fare, specifically with regard to the one-way cost and the waiting time incurred. An intercity comparison reveals that a city’s train fare structure also affects a traveller’s perceived satisfaction with their train fare. The findings of this research are significant for both policy makers and transport operators, allowing them to understand traveller behaviours, and to subsequently formulate effective transit policies. [ABSTRACT FROM AUTHOR]

Introduction: High incidence of HIV infection among adolescent girls and young women (AGYW) has been attributed to the numerous and often layered vulnerabilities that they encounter including violence against women, unfavourable power relations that are worsened by age-disparate sexual relations, and limited access to sexual and reproductive health information and services. For AGYW living in urban informal settlements (slums), these vulnerabilities are compounded by pervasive poverty, fragmented social networks, and limited access to social services including health and education. In this paper, we assess sexual risk behaviours and their correlates among AGYW in two slum settlements in Nairobi, Kenya, prior to the implementation of interventions under the Determined Resilient Empowered AIDS-free Mentored and Safe (DREAMS) Partnership. Methods: We drew on secondary data from the Transition to Adulthood study, the most recent representative study on adolescent sexual behaviour in the two settlements. The study was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Data were collected in 2009 from 1,390 AGYW aged 12–23 years. We estimated the proportions of AGYW reporting ever tested for HIV, condom use, multiple sexual partners and age-disparate sex by socio-demographic characteristics. “High risk” sexual behaviour was defined as a composite of these four variables and age at first sex. Multivariable regression analyses were performed to identify factors associated with risk behaviours. Results: Fifty-one percent of AGYW reported that they had ever tested for HIV and received results of their last test, with the proportion rising steeply by age (from 15% to 84% among those <15 years and 20–23 years, respectively). Of 578 AGYW who were sexually active in the 12 months preceding the survey, 26% reported using a condom at last sex, 4% had more than one sexual partner, and 26% had sex with men who were at least 5 years older or younger. All girls aged below 15 years who had sex (n = 9) had not used condoms at last sex. The likelihood of engaging in “high risk” sexual risk behaviour was higher among older AGYW (19–23 years), those in marital unions, of Luo ethnicity, out of school, living alone or with a friend (versus parents), living with spouse (versus parents), and those whose friends engaged in risky/anti-social behaviours. In contrast, Muslim faith, co-residence with both parents, and belonging to an organised social group were associated with lower odds of risky sexual behaviours. Conclusion: Our study findings suggest that multifaceted approaches addressing the educational and social mediators of AGYW’s vulnerability and that also reach the people with whom AGYW live and interact, are needed to reduce the rapid onset of sexual risk during the adolescent years. There is a particular need to reach the youngest adolescent girls in poor urban settings, among whom condom use and awareness of HIV status is rare. [ABSTRACT FROM AUTHOR]

In this paper we report an initial validation of the Shape Trail Test–Child Version (STT-CV) with a non-clinical sample of children aged 6 to 9 years. The STT-CV has been developed as an age-appropriate and culturally fair direct downward extension of the Trail Making Test (TMT) for the assessment of cognitive flexibility. Children completed the STT-CV and four established measures of executive functions that assessed working memory, inhibitory control and task switching. Results showed the expected age-based differences in completion times for both parts of the STT-CV (Trail A and Trail B). Children’s performance on the STT-CV correlated significantly with all four measures of executive functions. After controlling for the effects of chronological age, completion times for Trail B remained correlated with most other measures of executive functions. These findings provide emerging evidence for the utility of the STT-CV, and highlight the need for designing and using appropriate variants of the TMT in the behavioural assessment of cognitive flexibility in developmentally and culturally diverse populations. [ABSTRACT FROM AUTHOR]

Background: Crime and violence causes massive disruptions to the health, survival and development of populations. In South Africa, incredibly high rates of crime and violence are noted. The country also has a very large youth population whose health, survival and development are key to economic growth. Among other efforts to encourage healthy youth development and the promotion of social activities such as sports, youth groups, choirs and so forth. This study examines the relationship between perceived community safety and the uptake of social activities among youth in South Africa. Data and methods: This paper uses data from the National Youth Lifestyle Survey (2008) with an unweighted sample of 4,391 youth (age12-22 years old). Using chi-square and logistic regression analysis the association between perceived community safety and social activity participation are tested. Findings: The results indicate that youth participation in social activities in South Africa is high (55% of males and 45% of females). Among males, the most prominent activity is sports (51.8%), while for females there is high participation in choir and singing groups (55.68%). More than 50% of males perceive their communities as risky while less than half of females feel the same. Male youth are more likely to participate in social activities if they perceive their communities as risky (OR = 1.04). Females (OR = 0.83), youth have a negative view of their future (OR = 0.43) are less likely to participate in social activities. Conclusions: There exists an association between youth’s perception of community safety and their participation in social activities. Whether sports and groups are protective or enabling environments for youth from unsafe communities is moot. More in-depth research is needed on why youth participate in these clubs and groups to truly understand the role of social activities in South African societies. [ABSTRACT FROM AUTHOR]

Household air pollution from burning solid fuels is responsible for an estimated 2.9 million premature deaths worldwide each year and 4.5% of global disability-adjusted life years, while cooking and fuel collection pose a considerable time burden, particularly for women and children. Cleaner burning biomass-fuelled cookstoves have the potential to lower exposure to household air pollution as well as reduce fuelwood demand by increasing the combustion efficiency of cooking fires, which may in turn yield ancillary benefits in other domains. The present paper capitalises on opportunities offered by the Cooking and Pneumonia Study (CAPS), the largest randomised trial of biomass-fuelled cookstoves on health outcomes conducted to date, the design of which allows for the evaluation of additional outcomes at scale. This mixed methods study assesses the impact of cookstoves on primary school absenteeism in Karonga district, northern Malawi, in particular by conferring health and time and resource gains on young people aged 5–18. The analysis combines quantitative data from 6168 primary school students with in-depth interviews and focus group discussions carried out among 48 students in the same catchment area in 2016. Negative binomial regression models find no evidence that the cookstoves affected primary school absenteeism overall [IRR 0.92 (0.71–1.18), p = 0.51]. Qualitative analysis suggests that the cookstoves did not sufficiently improve household health to influence school attendance, while the time and resource burdens associated with cooking activities—although reduced in intervention households—were considered to be compatible with school attendance in both trial arms. More research is needed to assess whether the cookstoves influenced educational outcomes not captured by the attendance measure available, such as timely arrival to school or hours spent on homework. [ABSTRACT FROM AUTHOR]

Objectives: Demographic change has led to an increase of older people in need of long-term care in nearly all European countries. Informal carers primarily provide the care and support needed by dependent people. The supply and willingness of individuals to act as carers are critical to sustain informal care resources as part of the home health care provision. This paper describes a longitudinal study of informal care in six European countries and reports analyses that determine those factors predicting the outcomes of family care over a one-year period. Methods: Analyses are based on data from the EUROFAMCARE project, a longitudinal survey study of family carers of older people with baseline data collection in 2004 and follow-up data collection a year later in six European countries (Germany, Greece, Italy, Poland, Sweden, and the United Kingdom), N = 3,348. Descriptive statistics of the sample characteristics are reported. Binary logistic random-intercept regressions were computed, predicting the outcome of change of the care dyad’s status at follow-up. Results: Where care is provided by a more distant family member or by a friend or neighbour, the care-recipient is significantly more likely to be cared for by someone else (OR 1.62) or to be in residential care (OR 3.37) after one year. The same holds true if the care-recipient has memory problems with a dementia diagnosis (OR 1.79/OR 1.84). Higher dependency (OR 1.22) and behavioural problems (OR 1.76) in the care-recipient also lead to a change of care dyad status. Country of residence explained a relatively small amount of variance (8%) in whether a care-recipient was cared for by someone else after one year, but explained a substantial amount of variance (52%) in whether a care-recipient was in residential care. Particularly in Sweden, care-recipients are much more likely to be cared for by another family or professional carer or to be in residential care, whereas in Greece the status of the care dyad is much less likely to change. Discussion: The majority of family carers continued to provide care to their respective older relatives over a one-year period, despite often high levels of functional, cognitive and behavioural problems in the care-recipient. Those family carers could benefit most from appropriate support. The carer/care-recipient relationship plays an important role in whether or not a family care dyad remains intact over a one-year period. The support of health and social care services should be particularly targeted toward those care dyads where there is no partner or spouse acting as carer, or no extended family network that might absorb the caring role when required. Distant relatives, friends or acquaintances who are acting as carers might need substantial intervention if their caregiving role is to be maintained. [ABSTRACT FROM AUTHOR]

Objectives: To describe the comprehensive sex education (CSE) coverage and to evaluate a set of indicators related to knowledge, attitudes, and practices associated with the seven components of the CSE framework among Mexican high-school students. Methods: We conducted a cross-sectional survey of a nationally representative sample of students in public and private high schools in Mexico. Questions about CSE coverage and about knowledge, attitudes, and practices related to sexual health were included. We present descriptive statistics for demographic characteristics, exposure to CSE, and sexual health outcomes. We fitted a series of multivariate logistic regression models to examine the association between each CSE component exposure and sexual health outcomes, adjusting for age and sex. Results: There were significant associations between being exposed to each CSE components and the related sexual health outcomes. The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH) (OR 4.10; 95%CI[2.93,5.75]). Also, students exposed to the relationships component had 20% higher odds of affirming they could convince their partner to use condoms (OR 1.20; 95%CI[1.05,1.36]). Conclusions: This paper provides evidence of the potential beneficial effects of CSE on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents. In addition, it identifies areas that should be strengthened to increase the positive impact of CSE. [ABSTRACT FROM AUTHOR]

Background: Child peer violence is a global problem and seriously impacts children’s physical and psychological health, and their education outcomes. There are few research studies on children’s peer violence available in South Asian countries, particularly in Afghanistan. This paper describes the prevalence of children’s peer violence perpetration and victimization and associated factors among school children in Afghanistan. Methods: A total of 770 children were recruited into a baseline study conducted as part of an intervention evaluation in 11 schools (seven girls’ and four boys’ schools). All children were interviewed with a questionnaire developed for the study. The main outcome is a three-level peer violence variable consisting of (a) no violence, (b) victimization only, or (c) perpetration (with or without victimization). Peer violence victimization was measured through the Multidimensional Peer-Victimization Scale, and peer violence perpetration was measured through an adjusted version of the same scale with wording changed to measure perpetration. Results: 49.7% of boys and 43.3% of girls reported having experienced more than one instance of violence victimization in the past month, and 31.7% of boys and 17.6% of girls disclosed perpetration of more than one instance of violence in the past month, with considerable overlap found between experience of victimization and perpetration, particularly among boys. Multinomial models of factors associated with peer violence show that for boys, food insecurity was associated with perpetration of peer violence but not with victimization, and experiencing corporal punishment at school in the last month was significantly associated with both peer victimization and perpetration. For girls, food insecurity, more depressive symptoms and experiencing any beating at home were associated with both violence victimization and perpetration. Having a disability was associated with victimization only, and having witnessed their father fighting and experiencing any kind of corporal punishment were associated with peer violence perpetration only. Discussion: Peer violence in Afghanistan is linked to food insecurity, exposure of children to witnessing family violence, and children’s experience of physical violence at home and corporal punishment at school. School-based settings provide an important platform for interventions to reduce and prevent peer violence; however, such interventions may benefit from broader violence-prevention initiatives conducted at the community level. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the role of parental education in child disability in China. We used nationally representative data from China’s National Sample Survey on Disability, iterated twice, in 1987 and 2006, with data of 764,718 children aged 0–14 years. Logit models were used for statistical analysis. Results showed that the prevalence of child disability was significantly associated with each parent’s education. Maternal education was more important than paternal education in child disability in both surveys. The analysis of marginal effect indicated a one-year increase in maternal and paternal schooling led to an average decrease of 0.121% and 0.091% in the probability of child disability in 1987, and 19 years later, these figures had dwindled to 0.091% and 0.072%, respectively. [ABSTRACT FROM AUTHOR]

Studies with convenience samples have suggested that the lay public’s conception of intellectual property laws, including how the laws should regulate and why they should exist, are largely incommensurate with the actual intended purpose of intellectual property laws and their history in the United States. In this paper, we test whether these findings generalize to a more diverse and representative sample. The major findings from past work were replicated in the current study. When presented with several potential reasons for IP protection, the lay public endorsed plagiarism and felt that acknowledging the original source of a creative work should make copying that work permissible—viewpoints strongly divergent from lawmakers’ intent and the law itself. In addition, we replicate the finding that lay people know remarkably little about intellectual property laws more generally and report little experience as users or creators of creative works. [ABSTRACT FROM AUTHOR]

Introduction: This research paper aims to assess factors reported by parents associated with the successful transition of children with complex additional support requirements that have undergone a transition between school environments from 8 European Union member states. Methods: Quantitative data were collected from 306 parents within education systems from 8 EU member states (Bulgaria, Cyprus, Greece, Ireland, the Netherlands, Romania, Spain and the UK). The data were derived from an online questionnaire and consisted of 41 questions. Information was collected on: parental involvement in their child’s transition, child involvement in transition, child autonomy, school ethos, professionals’ involvement in transition and integrated working, such as, joint assessment, cooperation and coordination between agencies. Survey questions that were designed on a Likert-scale were included in the Principal Components Analysis (PCA), additional survey questions, along with the results from the PCA, were used to build a logistic regression model. Results: Four principal components were identified accounting for 48.86% of the variability in the data. Principal component 1 (PC1), ‘child inclusive ethos,’ contains 16.17% of the variation. Principal component 2 (PC2), which represents child autonomy and involvement, is responsible for 8.52% of the total variation. Principal component 3 (PC3) contains questions relating to parental involvement and contributed to 12.26% of the overall variation. Principal component 4 (PC4), which involves transition planning and coordination, contributed to 11.91% of the overall variation. Finally, the principal components were included in a logistic regression to evaluate the relationship between inclusion and a successful transition, as well as whether other factors that may have influenced transition. All four principal components were significantly associated with a successful transition, with PC1 being having the most effect (OR: 4.04, CI: 2.43–7.18, p<0.0001). Discussion: To support a child with complex additional support requirements through transition from special school to mainstream, governments and professionals need to ensure children with additional support requirements and their parents are at the centre of all decisions that affect them. It is important that professionals recognise the educational, psychological, social and cultural contexts of a child with additional support requirements and their families which will provide a holistic approach and remove barriers for learning. [ABSTRACT FROM AUTHOR]

We explored the characteristics and motivations of people who, having obtained their genetic or genomic data from Direct-To-Consumer genetic testing (DTC-GT) companies, voluntarily decide to share them on the publicly accessible web platform openSNP. The study is the first attempt to describe open data sharing activities undertaken by individuals without institutional oversight. In the paper we provide a detailed overview of the distribution of the demographic characteristics and motivations of people engaged in genetic or genomic open data sharing. The geographical distribution of the respondents showed the USA as dominant. There was no significant gender divide, the age distribution was broad, educational background varied and respondents with and without children were equally represented. Health, even though prominent, was not the respondents’ primary or only motivation to be tested. As to their motivations to openly share their data, 86.05% indicated wanting to learn about themselves as relevant, followed by contributing to the advancement of medical research (80.30%), improving the predictability of genetic testing (76.02%) and considering it fun to explore genotype and phenotype data (75.51%). Whereas most respondents were well aware of the privacy risks of their involvement in open genetic data sharing and considered the possibility of direct, personal repercussions troubling, they estimated the risk of this happening to be negligible. Our findings highlight the diversity of DTC-GT consumers who decide to openly share their data. Instead of focusing exclusively on health-related aspects of genetic testing and data sharing, our study emphasizes the importance of taking into account benefits and risks that stretch beyond the health spectrum. Our results thus lend further support to the call for a broader and multi-faceted conceptualization of genomic utility. [ABSTRACT FROM AUTHOR]

Background: Socioeconomically deprived children are at increased risk of ill-health associated with sedentary behavior, malnutrition, and helminth infection. The resulting reduced physical fitness, growth retardation, and impaired cognitive abilities may impede children’s capacity to pay attention. The present study examines how socioeconomic status (SES), parasitic worm infections, stunting, food insecurity, and physical fitness are associated with selective attention and academic achievement in school-aged children. Methodology: The study cohort included 835 children, aged 8–12 years, from eight primary schools in socioeconomically disadvantaged neighborhoods of Port Elizabeth, South Africa. The d2-test was utilized to assess selective attention. This is a paper and pencil letter-cancellation test consisting of randomly mixed letters d and p with one to four single and/or double quotation marks either over and/or under each letter. Children were invited to mark only the letters d that have double quotation marks. Cardiorespiratory fitness was assessed via the 20 m shuttle run test and muscle strength using the grip strength test. The Kato-Katz thick smear technique was employed to detect helminth eggs in stool samples. SES and food insecurity were determined with a pre-tested questionnaire, while end of year school results were used as an indicator of academic achievement. Principal findings: Children infected with soil-transmitted helminths had lower selective attention, lower school grades (academic achievement scores), and lower grip strength (all p<0.05). In a multiple regression model, low selective attention was associated with soil-transmitted helminth infection (p<0.05) and low shuttle run performance (p<0.001), whereas higher academic achievement was observed in children without soil-transmitted helminth infection (p<0.001) and with higher shuttle run performance (p<0.05). Conclusions/Significance: Soil-transmitted helminth infections and low physical fitness appear to hamper children’s capacity to pay attention and thereby impede their academic performance. Poor academic achievement will make it difficult for children to realize their full potential, perpetuating a vicious cycle of poverty and poor health. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Methodologies to measure gender-based violence (GBV) have received inadequate attention, especially in humanitarian contexts where vulnerabilities to violence are exacerbated. This paper compares the results from individual audio computer-assisted self-administered (ACASI) survey interviews with results from participatory social mapping activities, employed with the same sample in two different post-conflict contexts. Eighty-seven internally displaced adolescent girls from the Democratic Republic of the Congo and 78 Sudanese girls living in Ethiopian refugee camps were interviewed using the two methodologies. Results revealed that the group-based qualitative method elicited narratives of violence focusing on events perpetrated by strangers or members of the community more distantly connected to girls. In contrast, ACASI interviews revealed violence predominantly perpetrated by family members and intimate partners. These findings suggest that group-based methods of information gathering frequently used in the field may be more susceptible to socially accepted narratives. Specifically, our findings suggest group-based methods may produce results showing that sexual violence perpetrated by strangers (e.g., from armed groups in the conflict) is more prevalent than violence perpetrated by family and intimate partners. To the extent this finding is true, it may lead to a skewed perception that adolescent GBV involving strangers is a more pressing issue than intimate partner and family-based sexual violence, when in fact, both are of great concern. [ABSTRACT FROM AUTHOR]

Background: Immigration often results in changes in family dynamics, and within this process of dynamic relational adjustment youth can be conceptualised as contested sites of culture and associated intergenerational conflicts. This paper considers the experiences of migrant youth in Greater Western Sydney, New South Wales, Australia using conflict as a useful lens through which to view issues of migrant youth identity and their sense of social connectedness, belonging, and agency. The aim of this study was twofold: 1) to explore how migrant youth cope with acculturative stress and intergenerational conflicts, and 2) to better understand the systemic and family-related factors that facilitate positive settlement experiences for migrant youth. Methods: A total of 14 focus group discussions, comprising 164 people, were carried out in Greater Western Sydney, New South Wales, Australia. These focus groups targeted newly arrived migrant parents and young adults (aged 18–24) of African, Burmese, Nepalese, Indian, Afghani, Bangladeshi and Iraqi backgrounds. Each focus group was 1.5 hours in duration and was conducted by a team of three people (an experienced facilitator, an accredited interpreter/bilingual worker, and a note taker). Data were collected using a standard interview schedule, and an accredited interpreter/bilingual worker asked the questions in the appropriate language and translated participant responses into English. Results: The findings highlight how youth in new migrant families become contested sites of culture as they try to balance integration into the new culture while maintaining their originating country’s cultural values. Two themes and four subthemes emerged from the analysis: Intergenerational acculturation gap (loss of family capital and intergenerational conflicts); and factors that successfully protected positive family values while still allowing young people to integrate (the legal system that disarm authoritarian parenting practices and family rules; and parental use of children’s increased knowledge of the new environment to navigate their new environment). Migrant families conceptualised family capital as the social solidarity, influence, and control governing obligations and expectations, intergenerational knowledge transmission and information flow, social norms, and cultural identity. The loss of family capital was characterised by children’s refusal to associate with or meet family members, preferring to be alone in their rooms and private space. Migrant youth find themselves caught between and negotiating two cultures, with unwanted negative consequences at the family level in the form of intergenerational conflicts. The new found freedom among children and their rapid transition into the Australian society gives children an increased sense of agency, which in turn threatens parental authority, allowing children to exercise three forms of power: increased assertiveness due to legal protection of children against any corporal punishment; and English language fluency and greater understanding of the functioning of Australian social institutions. Conclusion: Our findings suggest the need for an inter-generational approach to healthy family dynamics within migrant communities when dealing with youth negotiating the complexity and sensitivity of forging their cultural identity. [ABSTRACT FROM AUTHOR]

Youth alcohol consumption has been steadily declining in Australia, as in other countries; fewer young people are drinking and the age of initiation is increasing. However, young people, their parents and others in their communities continue to believe that adolescent (excessive) drinking is the norm. This perception, and the concurrent misperception that the majority of parents are happy to provide their underage children with alcohol, creates a perceived culture of acceptance of youth alcohol consumption. Young people believe that it is accepted, and even expected, that they will drink; and parents perceive that not providing their adolescent children with alcohol will lead to social exclusion. There is evidence that shifting social norms can have an immediate and lasting effect adolescents’ (and adults’) alcohol related attitudes and behaviors. This paper reports on a novel, community based social marketing intervention designed to correct misperceptions of alcohol related social norms in an Australian community. The project utilized a social marketing approach, informed by the full complement of Andreasen’s social marketing benchmarking criteria, and concurrently targeted adolescents, parents of adolescents and the broader community. Using extensive formative research and multiple evaluation techniques, the study demonstrates that shifts in community social norms are possible and suggests that this approach could be used more widely to support the positive trends in youth alcohol consumption and parental supply. [ABSTRACT FROM AUTHOR]

This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population. [ABSTRACT FROM AUTHOR]

The paper reports the results of two studies on the spelling performance of 1st graders in a transparent writing system. The spelling performance of Italian children was assessed to determine the cross-task relationship between spelling to dictation and spontaneous spelling at the single word level (Study 1) and at the text level (Study 2), respectively. In study 1, 132 Italian children’s spelling performance was assessed in 1st grade through two standardized tasks, i.e., word dictation, and spontaneous word spelling. In study 2, spelling performance of 81 Italian children was assessed in 1st grade through two tasks, i.e., text dictation, and spontaneous text spelling. In Study 1, spelling words and pseudo-words to dictation was found to be more difficult than spontaneous spelling of words. This effect was verified for all children (including low achievers and spelling impaired). The moderate correlation found between spelling to dictation and spontaneous spelling indicated that the two tasks are supported by partially different spelling processes and confirmed suggestions for including both types of spelling assessments in the school. In Study 2, children's spelling performances were not dependent across the two tasks (i.e., spelling a text under dictation or spontaneously). The two tasks shared the level of difficulty but performance in one task was not predictive of performance in the second task. Strong individual differences between children were found at the text level as a function of task. Similar to Study 1, the moderate correlation between spelling text to dictation and spontaneous spelling confirmed the usefulness of adopting both spelling assessments at school. [ABSTRACT FROM AUTHOR]

Research on juvenile justice aims to identify profiles of risk and protective factors in juvenile offenders. This paper presents a study of profiles of risk factors that influence young offenders toward committing sanctionable antisocial behavior (S-ASB). Decision tree analysis is used as a multivariate approach to the phenomenon of repeated sanctionable antisocial behavior in juvenile offenders in Spain. The study sample was made up of the set of juveniles who were charged in a court case in the Juvenile Court of Almeria (Spain). The period of study of recidivism was two years from the baseline. The object of study is presented, through the implementation of a decision tree. Two profiles of risk and protective factors are found. Risk factors associated with higher rates of recidivism are antisocial peers, age at baseline S-ASB, problems in school and criminality in family members. [ABSTRACT FROM AUTHOR]