Child disability as a family issue: a study on mothers' and fathers' health in Italy.

BACKGROUND: Disability does not simply affect the health status of the individual who directly experiences that condition, but it has important consequences on the health and well-being of the other family members as well. Focusing on Italy, an extremely interesting test-bed due to its strong familialist welfare regime, we show significant spillover effects of children's disability on parental health and well-being. METHODS: We use data from a nationally representative household survey on almost 13 000 mothers and fathers and adopt a multivariate regression setting providing evidence that the disability of a child is negatively associated with parents' health and life satisfaction. RESULTS: Parents of a disabled child report lower levels of general and mental health, as well as lower levels of well-being compared with parents with a healthy child. Strong heterogeneity by gender and socio-economic characteristics is observed, with mothers being more affected by the disability status of the child than fathers. The estimated coefficients suggest that education remains an important protective factor even for parents of a disabled child. CONCLUSION: This study claims and documents that child disability is an overlooked source of health disadvantage for parents. Such disadvantage is especially relevant for mothers and lower-educated parents, evidence that suggests the importance of taking an intersectional approach to study health disparities.

Prospective study of nasal growth in bilateral cleft lip and palate patients after naso-alveolar moulding and primary columella lengthening compared to controls at 5, 10 and 20 years.

INTRODUCTION: A short columella, wide nostrils and a flat nasal tip are common features in patients with bilateral complete cleft lip and palate (BCLP). The objective of this study was to evaluate nasal morphology during growth in patients treated with naso-alveolar moulding (NAM) and primary surgical columella lengthening (PCL) compared with matched non-cleft individuals. STUDY DESIGN: Prospective longitudinal case-control study. PARTICIPANTS AND METHODS: Thirty-four consecutively treated BCLP patients at 5 and 10 years and at the end of growth (19.7 ± 2.0 years) were compared through normalized photogrammetry to a control of 34 age and sex-matched non-cleft individuals. Regression Models for Panel Data assessed how nasal measurements were influenced by surgery, age and gender. RESULTS: Nasal protrusion was equal to non-cleft controls at all ages. Length of the columella was also comparable to controls at 5 and 10 years, but significantly shorter at the end of growth. Inter-alar and nasal tip width and nasolabial angle were significantly wider than controls at all ages: More than 60% of the patients have asked for correction of the nasal width, but no early surgery for columella lengthening was needed. CONCLUSIONS: NAM and PCL have provided a nasal projection close to that of non-cleft individuals until adulthood, while length of the columella was physiological at 5 and 10, but shorter than controls at age 20. Width of the nasal tip and width of the alar bases were significantly wider than the controls and eventually required secondary nasal width correction in over two thirds of the sample.

Repartnering of women in the United States: The interplay between motherhood and socio-economic status.

We examine the socio-economic differentials in mothers' and non-mothers' repartnering behaviours following the dissolution of a co-residential (marital or cohabiting) union. Based on five waves of the National Survey of Family Growth (N = 11,479), we use discrete-time event history models, jointly modelling exit from a partnership and entry into a new union. Few differences are found for entry into direct marriage, which is a rarely observed event. However, when we examine women's entry into cohabitation (a possible stepping stone to marriage), we observe: (1) a motherhood gap, where mothers are less likely to repartner than non-mothers; (2) a negative association between educational attainment and repartnering probability; and (3) the motherhood gap existing only for low-educated women. Supplementary analyses on the impact of the Great Recession demonstrate that whereas the economic cycle mattered for the repartnering of low-educated women, it made no difference for more highly educated women.

Fertility Drain or Fertility Gain? Emigration and Fertility During the Great Recession in Italy.

How does emigration affect fertility in the country of origin? We address this question by estimating counterfactual fertility during the Great Recession in order to understand what the effect of the recession on fertility would be in the absence of emigration. Between 2009 and 2014, Southern European countries suffered from harsh economic instability, which triggered a sharp drop in fertility and a spike in emigration. We focus on Italy, exploiting the richness of the Italian Administrative Registry of Italians Residing Abroad (AIRE), which records information about all Italian citizens moving their residence abroad, as well as Italian birth records. Using an instrumental variable approach, which helps overcome endogeneity issues in the fertility-migration relationship, we find a positive impact of emigration on the total fertility rate at the Italian province level. This result suggests that emigrants are selected among those individuals who have a lower risk of having children. Therefore, in the absence of emigration, counterfactual fertility would have been lower than it actually is. Such a positive effect of out-migration on fertility in the area of origin could thereby lead to an underestimation of the effect of the recession on fertility.

Cementing the Stepfamily? Biological and Stepparents' Relationship Satisfaction After the Birth of a Common Child in Stepfamilies.

This article studies the relationship between having a common child in stepfamilies and partners' relationship satisfaction. Previous works have primarily looked at children's adjustment in stepfamilies and have cautioned against seeing a common offspring as a way to "cement" the partnership because the addition of a shared child does not benefit the child from an earlier union. We used seven waves of the German "Panel Analysis of Intimate Relationships and Family Dynamics" to examine the relationship satisfaction of partners in a stepfamily and its association with the potential birth of a common child. After controlling for initial relationship satisfaction, we see that having a common child is linked to higher satisfaction over time. Interestingly, for those whose common child is between 1 and 3 years old, we saw temporarily lower relationship satisfaction, which was less pronounced for the partner who was a stepparent in the context of the union.

The Role of Family Orientations in Shaping the Effect of Fertility on Subjective Well-being: A Propensity Score Matching Approach.

This article investigates whether and how having a child impacts an individual's subjective well-being, while taking into account heterogeneity in family attitudes. People with different family orientations have different values, gender attitudes, preferences toward career and family, and expectations about how childbearing can affect their subjective well-being. These differences impact fertility decisions and the effect of parenthood on an individual's life satisfaction. We define three groups of people based on their family orientations: Traditional, Mixed, and Modern. Applying propensity score matching on longitudinal data (British Household Panel Survey), we create groups of individuals with very similar socioeconomic characteristics and family orientations before childbearing. We then compare those who have one child with those who are childless, and those who have two children with those who have only one child. We show that parents are significantly more satisfied than nonparents, and this effect is stronger among men than among women. For men, we do not find significant differences across family orientations groups in the effect of the birth of the first child on life satisfaction. Among women, only Traditional mothers seem to be more satisfied than their childless counterparts. Women who have a second child are never more satisfied than those who have only one child, regardless of their family orientations. Traditional and Mixed men experience a gain in life satisfaction when they have a second child, but this effect is not found for Modern men.

It Takes Two to Tango: Couples' Happiness and Childbearing.

The existing literature has so far considered the role of the individual's subjective well-being on fertility, neglecting the importance of the partner's well-being. Using data from the British Household Panel Survey (BHPS) and event history models estimated separately by parity, we find that in a couple, women's happiness matters more than that of the male partner in terms of having the first child. Specifically, we observe that couples in which either partner is happier than usual are more at risk of having the first child, but the effect is stronger with higher happiness of the woman. For the transition to the second child, we find that couples in which the woman declares to be happier or less happy than usual have a lower risk of childbirth. We, moreover, find support for a multiplicative effect of partners' SWB on the decision to have a first child. Our results show that failing to acknowledge that the subjective well-being of both partners matters for the inherently joint decision making of childbearing can lead to an incomplete view of how subjective well-being affects fertility.

The impact of humanitarian context conditions and individual characteristics on aid worker retention.

High employee turnover rates constitute a major challenge to effective aid provision. This study examines how features of humanitarian work and aid workers' individual characteristics affect retention within one humanitarian organisation, Médecins Sans Frontières (MSF) Holland. The study extends existing research by providing new theoretical explanations of employment opportunities and constraints and by engaging in the first large-scale quantitative analysis of aid worker retention. Using a database of field staff (N=1,955), a logistic regression is performed of the likelihood of reenlistment after a first mission. The findings demonstrate that only 40 per cent of employees reenlist for a second mission with MSF Holland, and that workplace location and security situation, age, and gender have no significant effect. Individuals are less likely to reenlist if they returned early from the first mission for a personal reason, are in a relationship, are medical doctors, or if they come from highly developed countries. The paper reflects on the findings in the light of policy.

Comparison of the psychosocial impact on patients affected by cranio facial anomalies between traditional orthodontic brackets and aligners.

OBJECTIVES: Malocclusion affects the psychological wellness and social interaction, impacting negatively on adolescents' quality of life and self-esteem. Facial attractiveness is mostly based on the esthetics of the smile and patients seek orthodontic treatment mainly to improve aesthetics. The aim of this prospective clinical study is to compare the psychosocial impact of aligners (AL) and fixed appliances (FA) as orthodontic treatments in patients affected by craniofacial anomalies (CFA). METHODS: 100 syndromic Caucasian patients with CFA followed in two different hospitals were divided in two groups: 50 patients treated with AL and 50 patients treated with FA. The two groups were matched for gender, age and CFA and filled out a modified psychosocial impact of dental aesthetics questionnaire (mPIDAQ). RESULTS: Patients affected by CFA treated with AL reported a better psychosocial impact than patients treated with FA, showing higher esthetic self-perception and self-esteem, lower social interaction impairments, and lower physical/practical disturbances. CONCLUSIONS: The results of this study suggest that AL could be a valid alternative, especially in complex patients with CFA. Since AL application requires more cooperative patients the orthodontist should dedicate more time to motivate the patient to adhere to the treatment schedule.

Investigating the relationship between interventions, contact patterns, and SARS-CoV-2 transmissibility.

BACKGROUND: After a rapid upsurge of COVID-19 cases in Italy during the fall of 2020, the government introduced a three-tiered restriction system aimed at increasing physical distancing. The Ministry of Health, after periodic epidemiological risk assessments, assigned a tier to each of the 21 Italian regions and autonomous provinces. It is still unclear to what extent these different sets of measures altered the number of daily interactions and the social mixing patterns. METHODS AND FINDINGS: We conducted a survey between July 2020 and March 2021 to monitor changes in social contact patterns among individuals in the metropolitan city of Milan, Italy, which was hardly hit by the second wave of the COVID-19 pandemic. The number of daily contacts during periods characterized by different levels of restrictions was analyzed through negative binomial regression models and age-specific contact matrices were estimated under the different tiers of restrictions. By relying on the empirically estimated mixing patterns, we quantified relative changes in SARS-CoV-2 transmission potential associated with the different tiers. As tighter restrictions were implemented during the fall of 2020, a progressive reduction in the mean number of daily contacts recorded by study participants was observed: from 15.9 % under mild restrictions (yellow tier), to 41.8 % under strong restrictions (red tier). Higher restrictions levels were also found to increase the relative contribution of contacts occurring within the household. The SARS-CoV-2 reproduction number was estimated to decrease by 17.1 % (95 %CI: 1.5-30.1), 25.1 % (95 %CI: 13.0-36.0) and 44.7 % (95 %CI: 33.9-53.0) under the yellow, orange, and red tiers, respectively. CONCLUSIONS: Our results give an important quantification of the expected contribution of different restriction levels in shaping social contacts and decreasing the transmission potential of SARS-CoV-2. These estimates can find an operational use in anticipating the effect that the implementation of these tiered restriction can have on SARS-CoV-2 reproduction number under an evolving epidemiological situation.

The effects of social capital and social pressure on the intention to have a second or third child in France, Germany, and Bulgaria, 2004-05.

This study investigates the importance of the effect of an individual's web of informal relationships with family and peers on the intention to have a second or third child. Drawing on sociological theories of social capital (help with childcare, emotional support) and social pressure, the study extends existing research by evaluating cross-national differences (between France, Germany, and Bulgaria) in the impact of personal network and institutional circumstances. It tests a non-linear relationship between social capital and fertility intentions. Social pressure and social capital are highly institutionally filtered, with the impact of personal network stronger where institutions are less family-supportive.

Trends in the use of mind-altering drugs among European adolescents during the Great Recession.

Despite the growing evidence of health-responses to macroeconomic fluctuations, little research has been carried out on the economic reflexes of licit and illicit drug-consumption, especially among teenagers. This paper uses data on adolescents between 15 and 17 years old from 25 European countries to test, if and how, the substance-use pattern has changed during the Great Recession. The data come from two cross-sectional waves (2007 and 2011) of the European School Survey Project on Alcohol and Other Drugs (ESPAD) (n = 137,989 individuals). One percentage point increase in the unemployment rate is associated with an increase [decrease] in the probability of having tried inhalants and cocaine [ecstasy] at least once, by about 0.005 (95 % CI: 0.004, 0.006) and 0.001 (95 % CI: 0.0001, 0.001) [-0.001 (95 % CI: -0.001, -0.001)] respectively. Social protection expenditure reduces the use of inhalants, whereas ecstasy consumption rises. The pattern for cocaine is unclear.

Grandparenting, education and subjective well-being of older Europeans.

We study whether grandparenthood is associated with older people's subjective well-being (SWB), considering the association with life satisfaction of having grandchildren per se, their number, and of the provision of grandchild care. Older people's education may not only be an important confounder to control for, but also a moderator in the relation between grandparenthood-related variables and SWB. We investigate these issues by adopting a cross-country comparative perspective and using data from the Survey of Health, Ageing and Retirement in Europe covering 20 countries. Our results show that grandparenthood has a stronger positive association with SWB in countries where intensive grandparental childcare is not common and less socially expected. Yet, this result is driven by a negative association between grandparenthood without grandparental childcare and SWB that we only found in countries where intensive grandparental childcare is widespread. Therefore, in accordance with the structural ambivalence theory, we argue that in countries where it is socially expected for grandparents to have a role as providers of childcare, not taking on such a role may negatively influence SWB. However, our results show that grandparental childcare (either intensive or not) is generally associated with higher SWB. Overall, we do not find support for a moderating effect of education. We also do not find striking differences by gender in the association between grandparenthood and SWB. The only noteworthy discrepancy refers to grandmothers being often more satisfied when they provide grandchild care.

Fertility in Advanced Societies: A Review of Research: La fécondité dans les sociétés avancées: un examen des recherches.

This paper provides a review of fertility research in advanced societies, societies in which birth control is the default option. The central aim is to provide a comprehensive review that summarizes how contemporary research has explained ongoing and expected fertility changes across time and space (i.e., cross- and within-country heterogeneity). A secondary aim is to provide an analytical synthesis of the core determinants of fertility, grouping them within the analytical level in which they operate. Determinants are positioned at the individual and/or couple level (micro-level), social relationships and social networks (meso-level); and, by cultural and institutional settings (macro-level). The focus is both on the quantum and on the tempo of fertility, with a particular focus on the postponement of childbearing. The review incorporates both theoretical and empirical contributions, with attention placed on empirically tested research and whether results support or falsify existing theoretical expectations. Attention is also devoted to causality and endogeneity issues. The paper concludes with an outline of the current challenges and opportunities for future research.

RésuméCet article présente un aperçu des recherches dans le domaine de la fécondité réalisées dans les sociétés dites avancées, c'est-à-dire les sociétés dans lesquelles le contrôle des naissances est l'option par défaut. L'objectif principal est de fournir une vue d'ensemble complète résumant comment la recherche contemporaine explique les changements de fécondité actuelle et prévue dans le temps et dans l'espace (c'est-à-dire l'hétérogénéité à l'intérieur d'un pays ou entre pays). Un second objectif vise à fournir une synthèse des principaux déterminants de la fécondité en les regroupant par niveau d'analyse dans lequel ils se situent. Les déterminants sont ainsi situés au niveau individuel ou au niveau du couple (niveau micro), au niveau des relations sociales et des réseaux sociaux (niveaux méso) et au niveau des cadres institutionnels et culturels (niveau macro). L'accent est mis tant sur l'intensité que le calendrier de la fécondité avec un intérêt particulier sur le report de la procréation. Cette synthèse de la littérature concerne les recherches tant théoriques qu'empiriques, une attention particulière étant portée à celles qui sont testées empiriquement et dont les résultats confirment ou infirment les théories explicatives existantes. De même nous nous sommes particulièrement intéressés aux problèmes de causalité et d'endogénéité. En conclusion, un tableau des défis actuels et des perspectives futures en matière de recherche est esquissé.