The effect of the presence of children on adult smoking behaviour: empirical evidence based on China family panel studies.

BACKGROUND: Despite a number of studies linking family and marriage factors with health behaviour, the effects of children on the health behaviour of parents are still understudied. This study explored the association between the presence of children and adults' smoking behaviours. METHODS: This study used panel data from the China Family Panel Studies 2010 and 2012, and the data set included 23,157 households and 45,513 adults. Logistic regression was performed to analyse the association of the presence of children on adults' smoking behaviours. Subgroup regression was used to examine heterogeneous effects. RESULTS: Full sample regressions showed that the number of children was significantly inversely associated with smoking behaviour (OR = 0.93; 95% 0.90-0.96). Further subsample regression finds that such effect is only significant among the high-education group (OR = 0.92; 95% 0.87-0.97), high-skill workers (OR = 0.89; 95% 0.80-0.99) and couples who had an age gap greater than 2 years (OR = 0.91; 95% 0.88-0.95). CONCLUSIONS: Our findings confirm the existence of the upward intergenerational effect of the presence of children on adults' smoking behaviour in China. However, such effects are not equal across all demographic characteristics. Future research could explore other parts of the upward mechanism and possible pathways for a stronger effect. In resource-poor areas, targeting cessation activities at those who have children at an early age may be an effective strategy.

Construction and validation of a clinical differentiation model between peripheral lung cancer and solitary pulmonary tuberculosis.

OBJECTIVE: To establish and validate a clinical model for differentiating peripheral lung cancer (PLC) from solitary pulmonary tuberculosis (SP-TB) based on clinical and imaging features. MATERIALS AND METHODS: Retrospectively, 183 patients (100 PLC, 83 SP-TB) in our hospital were randomly divided into a training group and an internal validation group (ratio 7:3), and 100 patients (50 PLC, 50 SP-TB) in Sichuan Provincial People's Hospital were identified as an external validation group. The collected qualitative and quantitative variables were used to determine the independent feature variables for distinguishing between PLC and SP-TB through univariate logistic regression, multivariate logistic regression. Then, traditional logistic regression models and machine learning algorithm models (decision tree, random forest, xgboost, support vector machine, k-nearest neighbors, light gradient boosting machine) were established using the independent feature variables. The model with the highest AUC value in the internal validation group was used for subsequent analysis. The receiver operating characteristic curve (ROC), calibration curve, and decision curves analysis (DCA) were used to assess the model's discrimination, calibration, and clinical usefulness. RESULT: Age, smoking history, maximum diameter of lesion, lobulation, spiculation, calcification, and vascular convergence sign were independent characteristic variables to differentiate PLC from SP-TB. The logistic regression model had the highest AUC value of 0.878 for the internal validation group, based on which a quantitative visualization nomogram was constructed to discriminate the two diseases. The area under the ROC curve (AUC) of the model in the training, internal validation, and external validation groups were 0.915 (95 % CI: 0.866-0.965), 0.878 (95 % CI: 0.784-0.971), and 0.912 (95 % CI: 0.855-0.969), respectively, and the calibration curves fitted well. Decision curves analysis (DCA) confirmed the good clinical benefit of the model. CONCLUSION: The model constructed based on clinical and imaging features can accurately differentiate between PLC and SP-TB, providing potential value for developing reasonable clinical plans.

The Incidence and Characteristics of Perinatal Stroke in Beijing: A Multicenter Study.

Objective: To assess the incidence, risk factors, and clinical characteristics of perinatal stroke in Beijing. Methods: This multicenter prospective study included all the live births from 17 representative maternal delivery hospitals in Beijing from March 1, 2019 to February 29, 2020. Neonates with a stroke were assigned to the study group. Clinical data, including general information, clinical manifestations, and risk factors, were collected. Up until 18 months after birth, neonates were routinely assessed according to the Ages and Stages Questionnaire (ASQ) and/or the Bayley scale. Statistical analysis was done using the chi-squared, t-tests, and logistic regression analysis using SPSS version 26.0. Outcomes: In total, 27 cases were identified and the incidence of perinatal stroke in Beijing was 1/2,660 live births, including 1/5,985 for ischemic stroke and 1/4,788 for hemorrhagic stroke. Seventeen cases (62.96%) of acute symptomatic stroke and convulsions within 72 h (10 cases, 37.04%) were the most common presentations. Ten patients showed no neurological symptoms and were found to have had a stroke through routine cranial ultrasonography after being hospitalized for non-neurological diseases. The risk factors include primiparity, placental or uterine abruption/acute chorioamnionitis, intrauterine distress, asphyxia, and severe infection. In the study group, 11.1% (3/27) of patients had adverse neurodevelopmental outcomes. The patients in the study group had lower scores for the ASQ than those in the control group in the communication, gross, and fine motor dimensions. Conclusion: The incidence of perinatal stroke in Beijing was consistent with that in other countries. Routine neuroimaging of infants with risk factors may enable identification of asymptomatic strokes in more patients. Patients who have suffered from a stroke may have neurological sequelae; therefore, early detection, treatment, and regular follow-ups are beneficial for improving their recovery outcomes.

Spillover effects of children's political status on elderly parents' health in China.

BACKGROUND: Due to the sustained increases in life expectancy over the past half century, the elderly today will receive supports from their children for a longer period than ever before. Therefore, understanding the spillover effects of children's socioeconomic status on parents' health becomes increasingly important for both scholars and policy makers. METHODS: The Ordinary Least Squares regression is applied to the China Health and Retirement Longitudinal Study 2011, a national representative dataset including approximately 10 000 households and 17 600 middle-aged and elderly respondents. The Sobel test is used to examine the mediation role of social integration. RESULTS: The elderly who have a cadre child reported better health (coefficient=0.1347; 95% CI 0.067 to 0.202), had fewer activities of daily living (ADLs) limitations (coefficient=-0.1289; 95% CI -0.216 to -0.042) and were more socially integrated (coefficient=0.2321; 95% CI 0.103 to 0.361). Such effects are mainly driven by the parents of higher-ranking cadres. For the parents of higher ranking cadres, the Sobel test suggests that 12.6% of the total effects on self-reported health and 21.9% of the total effects on ADL limitations are mediated by the increase in parents' social integration. CONCLUSION: The findings suggest positive spillover effects of children's political status on parents' health. The benefits of having a cadre child are at least equivalent to the rural-urban gap in health and even stronger for the parents of higher ranking cadres. One potential explanation for such spillover effects is that a child's political status can improve parents' community involvement and social interactions.