The purpose of this study was to identify factors that contribute to women delaying seeking treatment for obstetric fistula. A stratified random sampling technique was used to select 384 study participants. A cross sectional analytical research design was used; data was collected by structured, closed ended questionnaires. Bivariate and multivariate logistic regression models were applied. Results show a significant correlation between traditional treatment and delay in seeking treatment (P-Value = 0.012). The presence of parents has a significant correlation in reaching treatment centres (p-value = 0.013), those women who are speaking about their fistula have less chance of delay in seeking treatment (p-value = 0.008), having no income significantly associated with delay in seeking treatment (AOR = 0.28) and women living closer to the treatment centres have less chance of delay (p-value = 0.008). Therefore, there are a number of factors that significantly influence women from early seeking of treatment for their fistulae. / Health Studies / M.A. (Public Health)

The development of children’s language skills during the preschool years plays a crucial role in subsequent reading and school success. Some children may enter kindergarten with oral language skills that lag behind their peers’. Two such groups are children from low-socioeconomic status (SES) families and those who are deaf or hard of hearing (DHH). Study 1 considered parents’ linguistic input during interactions with their Head Start pre-kindergarten children in two conversational contexts. The first, shared storybook reading, has featured prominently in early language interventions but proven less efficacious among low-SES samples. The second, shared reminiscing, offers a theoretically promising setting in which to promote child vocabulary skills but lacks empirical support. This study examined features of parental language known to relate to children’s vocabulary, including parents’ quantity of speech, lexical diversity, syntactic complexity, and intent to elicit child language. Parents’ and children’s expressive vocabulary knowledge was also considered. Forty parent-child dyads’ conversations during storybook reading and shared reminiscing were audiorecorded, transcribed, analyzed, and coded. Paired t-tests revealed that, while parents talked more during book reading, they used greater levels of syntactic complexity and language-eliciting talk during shared reminiscing. Parents’ own vocabulary knowledge was related to their children’s but not to linguistic input in either context. Study 2 considered the oral narrative skills of DHH preschoolers relative to language-matched hearing children. School-age DHH children often experience delays in the development of narrative skills compared to their hearing peers. Little is known about the narrative abilities of DHH children during the preschool years. This study examined 46 DHH and 58 vocabulary-matched hearing preschoolers’ overall language production, lexical diversity, syntactic complexity, and narrative comprehension skills. DHH children produced a similar number of words and demonstrated similar levels of narrative understanding compared to their hearing peers. However, DHH children’s narratives contained significantly less complex syntax. Gains in lexical diversity differed by group, with DHH children demonstrating less growth over the course of the school year despite making more gains on a standardized measure of vocabulary. Implications for instruction, assessment, and future research are discussed for both low-SES and DHH children.

For generations, researchers have been examining attributes that make low socioeconomic status students resilient. Attributes that help one become resilient are known as protective factors. The purpose of this study was to describe the protective factor(s) that contributed to the first-generation, low socioeconomic status students’ enrollment at The University of Kentucky. The population for this study consists of the University of Kentucky First Scholars participants during the 2015 – 2016 academic year. The researcher examines the existing literature on low socioeconomic status effects on post-secondary education. Recommendations were made for the University of Kentucky’s First Scholars Program on how to further enhance their program and continue promoting low socioeconomic status students with opportunities in higher education.

This study examined the effects of a learning environment (embodying many of De Corte et al.’s, (2004) CLIA-model components) on secondary students’ mathematical beliefs. Such mathematical beliefs have been of interest to the research community due to their expected impact on students’ willingness to engage in mathematical problem-solving. This research adopted an action research methodology using a quasi-experimental sequential explanatory mixed methods design. Data was collected using the Mathematics Related Beliefs Questionnaire (MRBQ) and a number of focus groups and individual interviews were undertaken. The sample selected (age 13-14) was from a population of convenience. There was one treatment class (N=22) and three control classes (N=45). The classroom intervention was of six months duration and was carried out by the researcher teacher in a secondary community school. Findings revealed no significant positive effects on students’ beliefs from the new learning environment about the teacher’s role in the classroom, their personal competence and the relevance to their lives and mathematics as an inaccessible subject. A more negative outcome for the fourth factor of the MRBQ scale, ‘mathematics as an inaccessible subject’, resulted for all participants (experimental and control combined) with a moderate effect of eta2=0.09. Findings from the qualitative data indicated the experimental participants found mathematics to be a difficult but useful subject. Findings, overall, revealed no significant differences between the experimental and control classes, indicating the new learning environment had not had a positive impact on the beliefs examined. Possible factors identified were the length of the intervention, the ages of participants and the socio-economic status of the majority taking part in this study. Qualitative data also indicated participants in the treatment class had found some of the activities used in the intervention to be interesting and enjoyable. Responses to the use of group work indicated participants were both willing and able to enter into communities of learners. Other results showed that participants with the highest achievement scores appeared to be the most confident learners of mathematics. Participants appeared to accept the need to have patience and perseverance when solving difficult problems but this was not translated into action in the classroom. The importance of understanding mathematics appeared to be accepted by participants. Implications for methodology, research and practice are discussed in light of these findings.

Human population-based studies of longitudinal design observe that higher intelligence in youth confers protection from premature mortality in adulthood. This field of study (“cognitive epidemiology”; Deary & Batty, 2007) has firmly established associations between intelligence and health outcomes, and has begun to address the likely mechanisms involved. The present thesis assessed some social, educational, and lifestyle factors that potentially confound and/or mediate the intelligence-mortality link. First, I carried out a systematic review of longitudinal cohort studies reporting intelligence differences in youth in relation to adult mortality risk, and in meta-analysis I aggregated the effect sizes from 16. A one SD advantage in intelligence scores was associated with 24% (95% CI 23% to 25%) lower risk of death, during 17- to 69-year follow-up; this magnitude showed no sex differential. Socioeconomic status in early life did not explain the effect. Rather, the person’s own occupational status in adulthood and educational attainment explained a third and a half of the association, respectively. One issue in controlling for education, in such models, is its strong correlation with intelligence test performance, which could lead to statistical overadjustment. A second aspect of this thesis, therefore, addressed the nature of the intelligence-education covariance in two behaviour-genetic studies of large general population-based samples of schoolchildren from England and The Netherlands. Previous studies that reported intelligence—education genetic covariances were potentially biased in their use of twin self-selection or pre-selection sampling. Moreover, the analysis in this thesis used a novel statistical approach, and included non-twin data to represent fully the variance in performance scores of a population. Analysis of the English cohort confirmed the top end of estimates from previous studies: 76% to 88% of the phenotypic correlation was due to heritability. The Dutch cohort showed greater variance for equivalent estimates (33% to 100%). The results indicate a limit to the extent to which education and intelligence might be causative of one another suggesting caution in interpreting some of the substantive attenuation effects by education reported in the literature. Third, I investigated pathways from intelligence to cardiovascular disease risk factors, given the consistent and robust finding that an advantage in intelligence relates to lower cardiovascular disease-outcomes. I used data from the 1958 National Child Development Study to investigate age-11 intelligence in association with inflammatory and haemostatic biomarker status at age 46 years. The results replicated inverse associations previously reported in an older age sample, and a one SD advantage in intelligence related to a 1.1mg/L decrease in C-reactive protein. The effect was largely mediated by lifestyle factors, including smoking, occupational status and abdominal obesity. In two further studies I used the west of Scotland Twenty-07 cohort, to investigate processing speeds among 16, 36 and 56 year-olds in relation to: (1) Inflammation, and (2) metabolic-risk, after 20 years. The advantage of experimental rather than psychometric measures of cognitive ability is their reduced cultural and social bias. Faster reaction time predicted lower systemic inflammation in the youngest male cohort, which appeared to be partially confounded by baseline smoking and socioeconomic status. Furthermore, advantage in reaction time performance in the young and middle-aged cohorts significantly predicted reduced metabolic risk. This was partially explained by occupational status, but retained statistical significance in some fully-adjusted models. A one SD advantage in age 16 simple reaction time variability, related to the 21% (95% CI 12% to 30%) reduced odds of metabolic syndrome by age 36 in the basic model, and this effect remained unchanged after controlling for all covariates. The growing evidence for specific social and behavioural factors that mediate intelligence-to-mortality pathways are discussed, in respect of indirect evidence that underlying system integrity or early life confounding may contribute incrementally to the effect.

Statistical learning (SL) is believed to be a mechanism that enables successful language acquisition. Language acquisition in turn is heavily influenced by environmental factors such as socioeconomic status (SES). However, it is unknown to what extent SL abilities interact with SES in affecting language outcomes. To examine this potential interaction, we measured event-related potentials (ERPs) in 38 children aged 7-12 while performing a visual SL task consisting of a sequence of stimuli that contained covert statistical probabilities that predicted a target stimulus. Hierarchical regression results indicated that SL ability moderated the relationship between SES (average of both caregiver’s education level) and language scores (grammar, and marginally with receptive vocabulary). For children with high SL ability, SES had a weaker effect on language compared to children with low SL ability, suggesting that having good SL abilities could help ameliorate the disadvantages associated with being raised in a family with lower SES.

The purpose of this study was to investigate the developmental outcomes of Chinese American children's social competence in their transition to elementary school. In this study, I used a mixed-methods research design. The first part of the study was a secondary analysis of data from the Early Childhood Longitudinal Study-Kindergarten Cohort. I examined cultural differences in the effects of parental warmth, parental SES, parent-child communication, and children's participation in peer-oriented structured extracurricular activities on the social development of European American and Chinese American children. For the second part of the study, I developed questions based on the findings of the quantitative analysis and conducted interviews to further explore how Chinese immigrant mothers' parenting beliefs and practices contributed to their children's development of social competence. The results showed that in Chinese immigrant families, parental SES influenced parent-child communication, which in turn promoted children's social competence. Parental SES, but not parental warmth, predicted their children's participation in peer-oriented structured extracurricular activities. Years of stay in the U.S. positively predicted children's participation in peer-oriented structured extracurricular activities, while it negatively predicted parent-child communication in Chinese immigrant families. The qualitative data suggested that Chinese immigrant mothers facilitated their children's social development by giving them verbal guidance for peer problems, encouraging conversations at home, and serving as role models for their children. Children's activity participation was restricted by the affordability of activities and parents' ability to provide transportation for their children. The Chinese immigrant mothers perceived taking on daily responsibilities and spending quality time together with their children as ways to express love toward them. These mothers' childrearing practices were influenced by the generational gap and acculturation. This study broadens our understanding of Chinese American children's development of social competence in their transition to formal schooling. It contributes new knowledge about 1) cultural differences in the effects of parental warmth and SES on parent-child communication; 2) the influences of parental SES on parent-child communication and Chinese American children's participation in peer-oriented structured extracurricular activities; and 3) the effect of years of stay in the U.S. on parent-child communication in Chinese immigrant families. / text

Using the G8 countries’ (Canada, France, Germany, Italy, Japan, the Russian Federation, the United Kingdom, and the United States) samples from the 2003 Programme for International Student Assessment (PISA), this study aimed to explore the phenomenon of double jeopardy in mathematics achievement for socially disadvantaged students. Double jeopardy is a situation of dual penalties where coming from low socioeconomic status (SES) families and attending low SES schools results in concurrent penalties at both the student level and school level in mathematics achievement. This study examined the phenomenon of double jeopardy in the G8 countries across four school locations: rural regions, towns, cities, and metropolitan areas. This study also examined four separate definitions of socioeconomic status in order to determine the effectiveness of each definition. The four definitions corresponded to four SES measures utilized in this study: father’s SES, mother’s SES, family occupation SES, and combined family SES. Multilevel analysis with students nested within schools indicated that significant double jeopardy effects varied according to SES measure, school location, and country. However, the majority of the double jeopardy effects across all the variables were large in magnitude. Furthermore, the combined family SES and the metropolitan school location were often the most sensitive SES measure and school location, respectively, to double jeopardy in the G8 countries.

This study will examine how domestic violence manifests differently across socioeconomic status, and how these manifestations affect a victim’s self-esteem, self-efficacy, and locus of control. Participants in this study will be female victims of domestic violence over the age of 18 who reside in the San Francisco Bay Area, and who are also members of domestic violence support groups. Participants will complete a survey that includes questions about self-esteem, self-efficacy, and locus of control, in addition to a domestic violence assessment that includes questions about financial and emotional abuse, and barriers that they may face in receiving the support they need. Results will highlight the different ways that domestic violence manifests across SES, and indicate that affluent women have lower levels of self-esteem, self-efficacy, and a more external locus of control than their low-income counterparts. This is mainly due to the perception that domestic violence doesn’t occur in affluent communities, and thus the distribution of resources is skewed, leading to increased shame and isolation. This information will hopefully provide a foundation for developing programs that seek to provide support for affluent victims of domestic violence.

The Beck Depression Inventory (BDI) is a popular screening and research instrument for measuring severity of depression. The instrument was translated to Portuguese for use in Brazil in 1979; however, it was not until recently that its psychometric properties have been tested empirically for the Brazilian population. The purpose of the present study was to explore the BDI's psychometric properties in a northern region of Brazil and to test for possible relationships between certain demographic variables and BDI outcomes. Samples used in this study were from an urban area in Roraima, the northernmost state of Brazil. The BDI showed adequate levels of internal consistency in nonclinical and clinical samples. Female respondents had significantly higher scores than male respondents. Those who had lower levels of education, income, or occupational status had significantly higher scores than those with higher levels of these variables. Adolescents had significantly higher scores than adults from all age groups except those from age 19 to 22. No significant difference was found between those who identified themselves as “indigenous” and those who identified themselves as “non-indigenous.” Regression analysis results showed that the combination of gender, education, and age best accounted for the variance in BDI scores. An ANCOVA revealed that clinically depressed adults had significantly higher BDI scores than nonclinically depressed adults. Factor analysis results showed that there were two main factors in the item structure for both female respondents and male and female respondents combined: one factor of mainly cognitive-affective items and the other factor of mainly somatic items. The results were discussed in terms of the future use of the BDI in Brazil.