Are Rural Areas Holdouts in the Second Demographic Transition? Evidence From Canada and the United States.

A central premise of the first demographic transition theory is that demographic change would occur more slowly in rural than urban areas. Few studies, however, have investigated whether rural areas remain holdouts during the second demographic transition. To address this gap, this study (1) examines trends among rural and urban families in Canada and the United States over a 30-year period and (2) determines whether compositional differences in demographic, socioeconomic, and religious factors explain current differences between rural and urban families. We find that rural Canadian women continue to have, on average, 0.6 more children than urban women. However, rural families do not trail behind urban families on any other indicator of family change. In fact, rural women in both countries are now significantly more likely to cohabit and roughly 10 percentage points more likely to have children outside of marriage than urban women. These differences are largely explained by lower levels of education and income among rural American women and fewer immigrants in rural Canada. Examining family change through a rural-urban lens fills important empirical gaps and yields novel insights into current debates on the fundamental causes of ongoing family change in high-income countries.

Role of Whole Genome Sequencing in Assessing Resident and Transient Listeria monocytogenes in a Produce Packinghouse.

Whole genome sequencing (WGS) is a powerful tool that may be used to assist in identifying Listeria contamination sources and movement within environments, and to assess persistence. This study investigated sites in a produce packinghouse where Listeria had been historically isolated; and aimed to characterize dispersal patterns and identify cases of transient and resident Listeria. Environmental swab samples (n = 402) were collected from 67 sites at two time-points on three separate visits. Each sample was tested for Listeria, and Listeria isolates were characterized by partial sigB sequencing to determine species and allelic type (AT). Representative isolates from the three most common L. monocytogenes ATs (n = 79) were further characterized by WGS. Of the 144 Listeria species positive samples (35.8%), L. monocytogenes was the most prevalent species. L. monocytogenes was often coisolated with another species of Listeria. WGS identified cases of sporadic and continued reintroduction of L. monocytogenes from the cold storages into the packinghouse and demonstrated cases of L. monocytogenes persistence over 2 years in cold storages, drains, and on a forklift. Nine distinct clusters were found in this study. Two clusters showed evidence of persistence. Isolates in these two clusters (N = 11, with one historical isolate) were obtained predominantly and over multiple samplings from cold storages, with sporadic movement to sites in the packing area, suggesting residence in cold storages with opportunistic dispersal within the packinghouse. The other seven clusters demonstrated evidence of transient Listeria, as isolation was sporadic over time and space during the packing season. Our data provide important insights into likely L. monocytogenes harborage points and transfer in a packinghouse, which is key to root cause analysis. While results support Listeria spp. as a suitable indicator organism for environmental monitoring surveys, findings were unable to establish a specific species as an index organism for L. monocytogenes. Findings also suggest long-term persistence with substantial SNP diversification, which may assist in identifying potential contamination sources and implementing control measures.

Support from Adult Children and Parental Health in Rural America.

Adult children are a primary source of care for their aging parents. Parents in rural areas, however, live further from their adult children than parents in urban areas, potentially limiting the support they receive and compromising their health and ability to age in place. We use two waves of the Panel Study of Income Dynamics (2013 and 2017) to investigate the relationships among geographic proximity, adult children's instrumental and financial support, and parental health. Rural parents live further from their adult children and receive less financial support, but they are more likely to receive instrumental assistance. In addition, rural parents have worse health and more functional limitations than urban parents, and these differences persist after controlling for proximity to and support from adult children. Our findings indicate that factors beyond proximity influence the complex relationships between spatial and social boundaries and their consequences for older adults' health and well-being.

A life course perspective on BMI in rural America.

Rural Americans are substantially more likely to be obese than their urban counterparts. A life course perspective offers insights into how growing up in rural areas may affect weight in young adulthood. Using data from the Panel Survey of Income Dynamics, this study follows the residential trajectories of 3157 respondents since birth. Living in a rural area during the critical period of early childhood (before age two) is predictive of higher BMI, while residence in later childhood and adolescence is not. Improving the health and wellbeing of rural mothers and infants could potentially help address the roots of rural obesity.

The Psychological Benefits of Marriage and Children in Rural Malawi.

Despite an extensive literature on the psychological rewards of marriage and children in high-income countries, research on these relationships in low-income countries remains limited. This paper draws on data from 4,133 adult women and men interviewed in the Malawi Longitudinal Study of Families and Health to examine how marital status, categorized as never, formerly, monogamously, and polygynously married, and number of children are associated with psychological well-being. With respect to marital status, we find that women in polygynous unions fare worse than monogamously married women and this detrimental effect is stronger for women than for men. Formerly married men and women of reproductive age experience the worst psychological outcomes, although this association wanes with age. In contrast, the benefits of having children is only evident among older Malawian women. These findings offer novel insights into the patterns of nearly universal marriage and high fertility that characterize Malawi and much of sub-Saharan Africa.

The Impact of Childcare on Poor Urban Women's Economic Empowerment in Africa.

Despite evidence from other regions, researchers and policy-makers remain skeptical that women's disproportionate childcare responsibilities act as a significant barrier to women's economic empowerment in Africa. This randomized control trial study in an informal settlement in Nairobi, Kenya, demonstrates that limited access to affordable early childcare inhibits poor urban women's participation in paid work. Women who were offered vouchers for subsidized early childcare were, on average, 8.5 percentage points more likely to be employed than those who were not given vouchers. Most of these employment gains were realized by married mothers. Single mothers, in contrast, benefited by significantly reducing the time spent working without any loss to their earnings by shifting to jobs with more regular hours. The effects on other measures of women's economic empowerment were mixed. With the exception of children's health care, access to subsidized daycare did not increase women's participation in other important household decisions. In addition, contrary to concerns that reducing the costs of childcare may elevate women's desire for more children, we find no effect on women's fertility intentions. These findings demonstrate that the impact of subsidized childcare differs by marital status and across outcomes. Nonetheless, in poor urban Africa, as elsewhere, failure to address women's childcare needs undermines efforts to promote women's economic empowerment.

Kin support and child health: Investigating two approaches in an African slum.

Extensive research from sub-Saharan Africa shows that mothers frequently rely on help from other family members to ensure their children's health and well-being. Yet, there is considerable debate about the relative importance of support from grandmothers versus fathers. Using an innovative survey instrument to interview 462 unmarried mothers in a slum area of Nairobi, Kenya, we provide insight into this debate by showing that a status versus transfers approach to measuring kin support asks subtly different questions and yields different results. A status approach reflects an evolutionary perspective that argues that maternal grandmothers have a greater incentive than non-residential fathers to provide material and practical support for young children. In contrast, a transfers approach is consistent with social support theories whereby the social capital provided by fathers may be more beneficial to children's health than that afforded by grandmothers. Demonstrating that different approaches to measuring kin support matter highlights the need for kin research that crosses disciplinary boundaries and encourages the development of more nuanced family policies designed to protect children's health in Africa.

An assets-based approach to promoting girls' financial literacy, savings, and education.

PURPOSE: This study examined whether micro-savings programs can improve young adolescent girls' financial knowledge, savings behaviors, and schooling outcomes in Ghana. METHODS: We evaluated the short- and medium-term effects of a randomized control trial in which a sub-sample of over 1400 girls living in the Eastern Region of Ghana received financial literacy training and a micro-savings account. RESULTS: Girls in the intervention arm of the study initially exhibited higher levels of financial knowledge, planning, and savings, but some of these effects disappeared within two years. Nonetheless, girls with micro-savings retained their greater knowledge of interest rates, had higher levels of savings, and were more likely to save for school. The effects on girls' educational enrollment was strongest in the second year. CONCLUSIONS: Our results suggest that even relatively young girls can manage micro-savings accounts and that such programs, if sustained, can effectively build girls' financial and educational assets.

Measuring extended families over time in informal settlements in Nairobi, Kenya: Retention and data consistency in a two-round survey.

BACKGROUND: Researchers have increasingly turned to longitudinal data to understand how the family environment of children changes over time and how this change affects their well-being. While the value of such efforts is clear, the inherent challenges of collecting robust data over time may limit or bias our understanding of family complexity. OBJECTIVE: Drawing on data from an exploratory study on kinship structure and support for low income single mothers and their young children in Nairobi, Kenya, this paper aims to (1) assess the strengths and weaknesses of our approach in reflecting the complexities of kinship dynamics and (2) analyze how methodological issues such as selection and reporting inconsistency can influence our understanding of the role of kin in children's lives. METHODS: The analysis used data from two waves of the Kinship Support Tree (KST) project. The starting sample consisted of 462 single mothers with at least one child under the age of 7, with data collected on approximately 5,000 resident and nonresident kin. Descriptive statistics and conventional tests of significance were used to analyze selection factors and inconsistencies in reporting across waves. RESULTS: The study yielded a 91% retention rate after six months and the analysis provides some assurance that selectivity from attrition and reporting inconsistency are not entirely driven by shifts in support provision by kin. However, the selectivity of the sample underscores caution in generalizing the results. CONCLUSIONS: While the challenges of conducting follow-up surveys such as the KST are serious, these findings suggest that it is possible to collect consistent data on kinship structure and support from the perspective of children in a mobile population. Tracking kinship structure over time using the KST is not only feasible but more importantly is unlikely to lead to incomplete or biased understanding of kinship. CONTRIBUTION: After further testing with a wider range of women, we hope to disseminate our results for use in a wide range of contexts both in and out of Africa. We believe this data is vital to designing appropriate interventions to improve the well-being of children growing up in these communities.

Gendered Emotional Support and Women's Well-Being in a Low-Income Urban African Setting.

Emotional support is crucial to the well-being of low-income, single women and their children in most contexts. Support from women may be especially important for single mothers because of precarious ties to their children's fathers, the prevalence of extended matrifocal living arrangements, and gendered norms that place men as providers of financial rather than emotional support. However, in contexts marked by economic insecurity, spatial dispersion of families, and changing gender norms and kinship obligations, such an expectation may be problematic. Applying theories of emotional capital and family bargaining processes, we address three questions: 1) what is the gender composition of emotional support that single mothers receive? 2) how does gender composition change over time? and 3) does the gender composition of emotional support affect self-reported stress of single mothers? Drawing on data from a unique dataset on 462 low-income single mothers and their kin from Nairobi, Kenya, we uncover three key findings. One, whereas the bulk of strong emotional support comes from female kin, about 20% of respondents report having male dominant support networks. Two, nearly 30% of respondents report change in the composition of their emotional support over six months favoring men. Three, having a male dominant emotional support network is associated with lower stress. These results challenge what is commonly taken for granted about gender norms and kinship obligations in non-Western contexts.

Variation in the link between parental divorce and children's health disadvantage in low and high divorce settings.

Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent's diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are more severe in regions of sub-Saharan Africa where divorce is rare, and less so where divorce is a more common family experience. Using Demographic and Health Survey data from 290 subnational regions within 31 sub-Saharan African countries, multilevel models document the previously shown link between having a divorced mother and child morbidity and mortality. The study results further demonstrate that the childhood health disadvantage is accentuated in subnational African regions where fewer women are divorced and muted in areas where more women are divorced. The findings demonstrate that the broader context can powerfully moderate childhood health inequalities traditionally thought of as operating at the family or individual level.

Moving beyond the household: Innovations in data collection on kinship.

Across settings, it has been shown that the co-residential household is an insufficient measure of family structure and support. However, it continues to be the primary means of population data collection. To address this problem, we developed a new instrument, the Kinship Support Tree (KST), to collect kinship structure and support data on co-residential and non-residential kin and tested it on a sample of 462 single mothers and their children in a slum community in Nairobi, Kenya. This instrument is unique in four important ways: (1) it is not limited to the co-residential household; (2) it distinguishes potential from functional kin; (3) it incorporates multiple geospatial measures; and (4) it collects data on kin relationships specifically for children. In this paper, we describe the KST instrument, assess the data collected in comparison to data from household rosters, and consider the challenges and feasibility of administration of the KST.

Recent Trends in Premarital Fertility across Sub-Saharan Africa.

The rising age of first marriage across sub-Saharan Africa over the past 25 years has led many scholars to predict a concurrent increase in premarital childbearing. We examine whether this anticipated increase has materialized using data from 27 countries. Our results reveal considerable heterogeneity. Although levels of premarital fertility have risen by up to 13 percent in recent years in some African countries, other countries have experienced a 7 percent decline. Adolescent premarital childbearing, in particular, has shown marked decline in several countries. Furthermore, although the rising age of marriage exerts clear upward pressure on premarital fertility, decomposition analyses indicate that in half of the countries examined, other factors such as delayed sexual debut and use of contraception counteract this effect. These results temper concerns about the rising numbers of unwed mothers and demonstrate that countries can simultaneously delay marriage and achieve relatively stable, or even declining, levels of premarital childbearing.

Who Helps Single Mothers in Nairobi? The Role of Kin Support.

Single mothers often turn to their extended kin for financial assistance and to help with child care. Such support may be especially important in areas of high poverty and poor environmental conditions. Using novel kinship data, this paper assesses the extent of support given by over 3,000 relatives to 462 single mothers living in a slum area of Nairobi, Kenya. Contrary to stereotypes about families in sub-Saharan Africa, the active kin network of single mothers is relatively small and nearly a fifth of mothers do not receive any financial or child care assistance. Different types of kin offer different kinds of support according to culturally proscribed roles. However, support also depends heavily on kin's employment status, geographic proximity, and age. These findings offer a nuanced picture of how single women living in slum areas draw upon their kin network to cope with their daily demands as mothers.

Instability in Parent-Child Coresidence and Adolescent Development in Urban South Africa.

There is widespread recognition of the importance of family stability for child development. South Africa presents an interesting context in which to study the consequences of family instability because of the traditionally fluid nature of household composition due to labor migration, child fostering, and non-marital fertility. More recently, the HIV pandemic has added another source of instability. Within South Africa, however, patterns of instability differ markedly across racial groups. We use the Cape Area Panel Study (CAPS) data to examine the implications of changes in parent-child coresidence for educational and sexual development of young South Africans. We show that changes in maternal and paternal coresidence have implications for the timing of sexual initiation for both black and coloured adolescents. Maternal and paternal transitions also lead to poorer educational outcomes for coloured adolescents, but parental disruptions are not significantly related to educational outcomes for blacks. These findings suggest that the implications of coresidential instability vary by race, reflecting racial differences with respect to cultural, social, and economic conditions.

Cervical & thoracic manipulations: Acute effects upon pain pressure threshold and self-reported pain in experimentally induced shoulder pain.

BACKGROUND: Emerging evidence suggests that cervical and thoracic joint manipulations may be advocated in treating patients with shoulder pain. OBJECTIVES: To determine the acute effects of cervical, cervicothoracic, and thoracic joint manipulations on outcomes of self-reported pain and pain pressure threshold in experimentally induced shoulder pain. DESIGN: Repeated measures. METHODS: Twenty (20) healthy volunteers were tested on two sessions. Session 1 consisted on baseline assessment of pain pressure threshold testing over the infraspinatus bilaterally and self-reported shoulder pain using the shoulder pain and disability index (SPADI) pain scale. An isokinetic exercise protocol was used to induce delayed onset muscle soreness. In session 2 (24-48 h later), all variables were reassessed before and immediately after a combination of cervical, cervicothoracic and thoracic manipulations. RESULTS: SPADI pain scale scores were significantly different between time points (p < 0.001): the exercise protocol significantly increased reported pain [mean increase 14.1, p < 0.001] while the manipulation significantly decreased reported pain (mean decrease 5.60, p < 0.001)) although pain remained higher than baseline levels. Pain pressure threshold differences were also found between time points (p = 0.001): manipulation significantly increased pain threshold bilaterally (p < 0.001) similar to baseline levels. CONCLUSIONS: Cervical, cervicothoracic, and thoracic joint manipulations acutely increased pain pressure threshold and decreased self-reported shoulder pain in participants with experimentally induced shoulder pain. Physiotherapists may consider the combination of such techniques to achieve short-term hypoalgesic effects and facilitate the application of more active interventions.

Family Ties and Young Fathers' Engagement in Cape Town, South Africa.

Young South African fathers are often engaged in their children's lives even if they do not live together. Using longitudinal data on children (n = 1,209) from the Cape Town area, the authors show that although only 26% of young fathers live with their children, 66% of nonresidential fathers maintain regular contact, and 61% provide financial support. The father-child relationship, however, is embedded in broader family ties. The type of father-mother relationship is strongly associated with whether fathers coreside with their children, but not with fathers' contact with nonresidential children. Close mother and maternal grandmother bonds reduce the likelihood that fathers live with their children, whereas close ties between fathers and paternal grandmothers increase the chance that fathers visit nonresidential children. Family ties do not affect fathers' financial contributions, which are driven by men's current economic situation. These findings illustrate that father-child relationships are best understood in the context of interacting family systems.

The effect of marriage and HIV risks on condom use acceptability in rural Malawi.

A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use.

The initial noncovalent binding of glucose to human hemoglobin in nonenzymatic glycation.

Mechanisms for nonenzymatic protein glycation have been extensively studied albeit with an emphasis at the later stages that gives rise to advanced glycation end products. No detailed investigation of the initial, noncovalent binding of d-glucose to human hemoglobin A (HbA) exists in the literature. Although anionic molecules 2,3-bisphosphoglycerate (BPG), inorganic phosphate (Pi) and HCO3(-) have been implicated in the latter stages of glycation, their involvement at the initial binding of glucose to HbA has not yet been assessed. Results from this computational study involving crystal structures of HbA predict that the transient, ring-opened glucose isomer, assumed to be critical in the later stages of glycation, is not directly involved in initial binding to the ß-chain of HbA. All the five structures of glucose generated upon mutorotation will undergo reversible, competitive and slow binding at multiple amino acid residues. The ring-opened structure is most likely generated from previously bound pyranoses that undergo mutarotation while bound. BPG, Pi and HCO3(-) also reversibly bind to HbA with similar energies as glucose isomers (~3-5 kcal/mol) and share common binding sites with glucose isomers. However, there was modest amino acid residue selectivity for binding of certain anionic molecules (1-3 regions) but limited selectivity for glucose structures (≥ 7 regions). The clinical difference between average blood glucose and predicted HbA1c, and the presence of unstable HbA-glucose complexes may be more fully explained by initial noncovalent binding interactions and different concentrations of BPG, Pi and HCO3(-) in serum vs. erythrocytes.

Single motherhood and child mortality in sub-Saharan Africa: a life course perspective.

Single motherhood in sub-Saharan Africa has received surprisingly little attention, although it is widespread and has critical implications for children's well-being. Using survival analysis techniques, we estimate the probability of becoming a single mother over women's life course and investigate the relationship between single motherhood and child mortality in 11 countries in sub-Saharan Africa. Although a mere 5 % of women in Ethiopia have a premarital birth, one in three women in Liberia will become mothers before first marriage. Compared with children whose parents were married, children born to never-married single mothers were significantly more likely to die before age 5 in six countries (odds ratios range from 1.36 in Nigeria to 2.61 in Zimbabwe). In addition, up to 50 % of women will become single mothers as a consequence of divorce or widowhood. In nine countries, having a formerly married mother was associated with a significantly higher risk of dying (odds ratios range from 1.29 in Zambia to 1.75 in Kenya) relative to having married parents. Children of divorced women typically had the poorest outcomes. These results highlight the vulnerability of children with single mothers and suggest that policies aimed at supporting single mothers could help to further reduce child mortality in sub-Saharan Africa.