Children's education and level of health care utilization among parents: a pooled cross-sectional study from national population-based survey in India.
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ABSTRACT:
SUBMITTER: Ambade M
PROVIDER: S-EPMC8599543 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This study aimed at understanding the perception and perspectives of rheumatology trainees about specialist training in India. Rheumatology trainees (Doctorate of Medicine, Diplomate of National Board) in Indian universities (2010 onwards) were contacted to complete a validated e-survey consisting of 41 questions to evaluate the current rheumatology training in India. Of 53 respondents (M:F 3.4:1, mean age 37 years ± 12.7), 81.1% trained at government hospitals, and 15.1% trained at private hospitals. During training period, 37.5% respondents were exposed to 6-7 h of didactics/week. They treated nearly 175 patients (175 ± 35.4) per week and reported a reasonable level of independence in management of patients with common rheumatic diseases (RDs) during their training (7.5 ± 0.7 SD). However, nearly one-third of the trainees were not exposed to basic immunology and laboratory techniques. Similarly, placement in the radiology department was not a part of the curriculum for nearly half of the trainees, 80% were not confident to manage paediatric RDs and soft tissue rheumatism. Almost 60% did not feel comfortable in addressing ancillary care including patient counselling as they had not received formal training. Among the participants, 59% were not satisfied by the current system of assessment, 86.8% suggested for multiple time point-based assessment systems and 45.3% preferred objective and subjective assessment in final examinations. Rheumatology training in India offers notable exposure to patients and independence in managing cases. However, there is an unmet need for improvement in training in the field of laboratory, radiology and ancillary care, and to overhaul assessment system by including objective evaluation.
| S-EPMC8343210 | biostudies-literature
Project description:Using five waves of the Taiwanese Longitudinal Study of Aging (1996-2011), we investigate (1) the association between family members' education and the age trajectories of individuals' depressive symptoms and (2) gender differences in those relationships. Our examination is guided by several theoretical frameworks, including social capital, social control, age as leveler, and resource substitution. Nested models show that having a more educated father is associated with lower depressive symptoms, but the relationship disappears after controlling for respondent's education. Including spouse's education attenuates the coefficient for respondent's education. A similar pattern appears when children's education is added to the model. Among all the family members, children's education has the strongest association with depressive symptoms, with a similar magnitude for both genders, although its strength gradually weakens as respondents age. Our findings suggest the importance of the transfer of resources from children to parents and how it may affect mental health at older ages.
| S-EPMC5579841 | biostudies-literature
Project description:BackgroundMindfulness practices are associated with improved health and well-being for children. Few studies have assessed parents' acceptance of learning about mindfulness practices.ObjectiveThis study aims to assess parents' beliefs and interest in learning about mindfulness, including from their health care provider, and differences across demographic backgrounds.MethodsWe conducted a national cross-sectional survey of parents with children aged 0-18 years in October 2018. Measures included beliefs and interest in learning about mindfulness. These measures were compared across demographic backgrounds using chi-square analysis. Multivariate linear and logistic regression analyses were used to perform adjusted comparisons between demographic backgrounds.ResultsParticipants (N=3000) were 87% (n=2621) female and 82.5% (n=2466) Caucasian. Most (n=1913, 64.2%) reported beliefs that mindfulness can be beneficial when parenting, 56.4% (n=1595) showed interest in learning about mindfulness to help their child stay healthy, and 40.8% (n=1214) reported interest in learning about mindfulness from their health care provider. Parents with a college degree 49.6% (n=444) were more likely to report interest in learning about mindfulness from a health care provider compared to those without 37.1% (n=768; P<.001). Parents interested in learning about mindfulness were more likely to be male 62.6% (n=223; P<.001). There was no significant difference in interest in learning about mindfulness from a health care provider based on race.ConclusionsThis study indicates that many parents believe mindfulness can be beneficial while parenting and are interested in learning how mindfulness could help their child stay healthy. Findings suggest there is an opportunity to educate families about mindfulness practices.
| S-EPMC8596283 | biostudies-literature
Project description:ObjectiveTo describe the location, staffing, clientele, safety product disbursement patterns, education provided and sustainability of safety resource centres (SRCs) in US children's hospitals.MethodsA cross-sectional survey was distributed to children's hospital-based SRC directors. Survey categories included: funding sources, customer base, items sold, items given free of charge, education provided and directors' needs.Results32/38 (84.2%) SRC sites (affiliated with 30 hospitals) completed the survey. SRCs were in many hospital locations including lobby (28.1%), family resource centres (12.5%), gift shop/retail space (18.8%), mobile units (18.8%) and patient clinics (12.5%). 19% of respondents reported that their SRC was financially self-sustainable. Sales to patients predominated (mean of 44%); however, hospital employees made up a mean of 20% (range 0-60%) of sales. 78.1% of SRCs had products for children with special healthcare needs. Documentation kept at SRC sites included items purchased (96.9%), items given free of charge (65.6%) and customer demographics (50%). 56.3% of SRCs provided formal injury prevention education classes. The SRCs' directors' most important needs were finances (46.9%), staffing (50%) and space (46.9%). All of the directors were 'somewhat interested' or 'very interested' in each of the following: creation of a common SRC listserv, national SRC data bank and multisite SRC research platform.ConclusionsSRCs are located in many US children's hospitals, and can be characterised as heterogeneous in location, products sold, data kept and ability to be financially sustained. Further research is needed to determine best practices for SRCs to maximise their impact on injury prevention.
| S-EPMC3975766 | biostudies-literature
Project description:ObjectivesDespite growing awareness that children's education benefits the health of older parents, the underlying mechanisms of this relationship are not well-understood. We investigated (a) the associations between children's education and biological functioning of parents, (b) psychosocial and behavioral factors that explain the associations, and (c) gendered patterns in the associations.MethodsUsing longitudinal data from a nationally representative sample of older Taiwanese, we performed mediation analysis of the association between adult children's education and physiological dysregulation of their parents.ResultsOffspring's schooling is inversely associated with parental inflammation after controlling for parental socioeconomic status and baseline health. Parents who have well-educated children report higher social standing and life satisfaction, experience fewer stressful events, and are more likely to engage in healthy behaviors related to smoking and diet. These factors moderately attenuate the associations between children's education and parental inflammation. There is no conclusive evidence that mothers and fathers benefit differently from having well-educated children.DiscussionParents who devote family and personal resources to their offspring's schooling may have better biological profiles in later life. Well-educated children may promote their parents' wellbeing by strengthening perceived social status, reducing exposure to stressors, and encouraging a healthy lifestyle.
| S-EPMC6093314 | biostudies-literature
Project description:BackgroundSimulation-Based Medical Education (SBME) is a teaching method commonly used in undergraduate medical education. Although Thai medical schools have developed a system that incorporates SBME, various aspects of that system require improvement. We surveyed medical school administrators, instructors, and students about SBME in their institutions and the obstacles involved in its implementation, as well as their experiences, expectations, and attitudes regarding the current system.MethodsWe conducted a cross-sectional online survey between August 2019 and July 2020 among administrators, instructors, and 6th-year medical students. A structured questionnaire was developed and distributed to volunteers as an online survey. We recorded details about the SBME system as well as participant characteristics, obstacles, experiences, expectations, and attitudes. We used descriptive statistics as appropriate.ResultsWe received responses from 15 (68.2%) administrators, 186 instructors, and 371 (13.7%) sixth-year medical students. SBME was commonly used in teaching and evaluation but less so in research. It was mainly used to improve psychomotor tasks, knowledge, patient care, and communication skills. The expected outcomes were improvements in students' performance, knowledge, and practice. The clinical courses were longer and had fewer participants than the pre-clinical courses. Obstacles encountered included shortages of faculty and simulators, time and space limitations, inadequate faculty training, and insufficient financial support. The administrators surveyed had positive attitudes toward SBME. Medical students reported having experience with SBME and strongly agreed that it was beneficial; however, they expected fewer students per class and more learning time to be devoted to these methods.ConclusionsSBME in Thailand is focused on teaching and assessment. The system could be improved through better-trained faculty, greater available space, more simulators, and sufficient funding. There were also some aspects that failed to meet students' expectations and need to be addressed. However, participants expressed positive attitudes toward SBME.Trial registrationTCTR20210524003 (Thai Clinical Trials Registry).
| S-EPMC9019967 | biostudies-literature
Project description:ObjectivesTo deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups.Design/setting/participantsA national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications.Main outcomes/measuresSelf-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months.ResultsAlmost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5'8 and BMI ≥ 25 individuals.Conclusions/relevanceMany trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of healthcare.
| S-EPMC4794154 | biostudies-literature
Project description:The well-being of older adults is frequently tied to support from their adult children. Here, we assess whether the education of adult offspring is associated with changes to older parents' short- and long-term health in Mexico, a rapidly aging context with historically limited institutional support for the elderly. Educational expansion over the past half century, however, provides older adults with greater resources to rely on via the education of their children. Using longitudinal data from the Mexican Health and Aging Study (2001-2012), we find that offspring education is not associated with short-term changes in parents' physical functioning, but is associated with increased parental longevity, net of children's financial status and transfers. In addition, we find that mothers' longevity is more sensitive to offspring education than fathers. Our findings add to a growing body of literature that urges policy-makers to consider the multi-generational advantages of expanding educational opportunities in Mexico.
| S-EPMC5600815 | biostudies-literature
Project description:The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world's largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015-2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0-72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother-child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.
| S-EPMC7246906 | biostudies-literature
Project description:ImportanceBilling errors and healthcare fraud have been described by the WHO as 'the last great unreduced health-care cost'. Estimates suggest that 7% of global health expenditure (US$487?billion) is wasted from this phenomenon. Irrespective of different payment models, challenges exist at the interface of medical billing and medical practice across the globe. Medical billing education has been cited as an effective preventative strategy, with targeted education saving $A250?million in Australia in 1?year from an estimated $A1-3?billion of waste.ObjectiveThis study attempts to systematically map all avenues of medical practitioner education on medical billing in Australia and explores the perceptions of medical education stakeholders on this topic.DesignNational cross-sectional survey between April 2014 and June 2015. No patient or public involvement. Data analysis-descriptive statistics via frequency distributions.ParticipantsAll stakeholders who educate medical practitioners regarding clinical practice (n=66). 86% responded.ResultsThere is little medical billing education occurring in Australia. The majority of stakeholders (70%, n=40) did not offer/have never offered a medical billing course. 89% thought medical billing should be taught, including 30% (n=17) who were already teaching it. There was no consensus on when medical billing education should occur.ConclusionsTo our knowledge, this is the first attempt of any country to map the ways doctors learn the complex legal and administrative infrastructure in which they work. Consistent with US findings, Australian doctors may not have expected legal and administrative literacy. Rather than reliance on ad hoc training, development of an Australian medical billing curriculum should be encouraged to improve compliance, expedite judicial processes and reduce waste. In the absence of adequate education, disciplinary bodies in all countries must consider pleas of ignorance by doctors under investigation, where appropriate, for incorrect medical billing.
| S-EPMC6082471 | biostudies-literature