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Economic stability is one of the five domains of determinants of health influencing the well-being of families and communities. In this column, the impacts of economic instability, including poverty, employment, food insecurity, and housing instability, will be described. These challenges have unique impacts during pregnancy and the early years, with inequitable and accumulating health burdens over a lifetime. Actions that nurses can take within the NICU setting are described and opportunities for community and policy advocacy are identified. [ABSTRACT FROM AUTHOR]

The epidemiology, care, and outcomes of perineal and genital burns (PG) in high-income countries have been previously described, but an analysis of this topic in LMICs has yet to be performed. We use the World Health Organization's Global Burn Registry to fill this gap. The GBR was searched from inception to November 2023 to identify all burn patients, excluding cases from high-income countries. Demographics and mechanism of injury were retrieved. Primary outcomes were length of hospital stay (LOHS), surgical intervention, discharge with physical impairment, and mortality. A multivariate regression analysis was performed controlling for burnt total body surface area (TBSA), age, sex, inhalation injury, mechanism of burn and care center characteristics. Of 9041 patients identified, 1213 (13.4 %) had PG burns with 136 (1.6 %) isolated to the PG region. PG patients had higher TBSA (p < 0.001) and more inhalation injury (p < 0.001). They had better access to rehabilitation and lower access to theater space for burns (p < 0.001). Multivariable analysis showed that PG patients had longer LOHS (p = 0.001), greater mortality (p < 0.001), were less likely to undergo surgery (p = 0.01) or be discharged home with physical impairment (p = 0.03). Similarities and differences exist between high- and low/middle-income countries in terms of the patterns of injury, care, and recovery in patients with PG burns. The longer LOHS and higher mortality among PG patients, previously reported in high-income countries, are verified. This highlights the importance of greater vigilance when caring for such patients. [ABSTRACT FROM AUTHOR]

This study examines how first-generation (FG) college students make meaning of their social class during their first-year of college. As a method, photovoice allowed for the creation of a rich set of data using student photos and accompanying narratives, through which three key themes were derived: (a) broken American dream, (b) honoring family sacrifices, and (c) lifting generations. This study informs both future practice and research by providing a deep understanding of the intersection of students' individual identities, contexts, and motivations through the lens of the social class worldview model (SCWM). [ABSTRACT FROM AUTHOR]

Childhood adversity plays a fundamental role in predicting youth cardiometabolic health. Our understanding of how adverse experiences in childhood should best be conceptualized remains elusive, based on one-dimensional measures of adversity. The present study fills a major gap in existing research by examining two distinct forms of threat and instability-related exposures that may impact cardiometabolic risk (CMR) in adolescence. We explore two specific subtypes of adversity: trauma (e.g., badly hurt, victim of crime, loss of close person) and instability (e.g., moving, change of schools, change in household structure) as differential influences that can accumulate to impact early childhood onset of CMR (body mass index, high-density lipoprotein (HDL), low-density lipoprotein, diastolic and systolic blood pressure, triglycerides, C-reactive protein, insulin sensitivity). Secondary data were drawn from a randomized control behavioral trial of youth recruited during sixth grade from urban Cleveland (Ohio) schools beginning in 2012–2014 (n = 360) and followed for 3 years. Participants reported on 12 adverse experiences, six trauma- and six instability-specific. Multiple regression assessed effects of prospective and accumulative indices of trauma and instability with 3-year trajectories of eight objective CMR markers. Instability was associated with increased body mass index, decreased high-density lipoprotein, and increased C-reactive protein slopes. Trauma was associated with trends in triglyceride levels but not with any other CMR outcomes. Experiences with instability distinctly impacted adolescent CMR. Future research is needed to examine factors that can enhance stability for families in marginalized communities. [ABSTRACT FROM AUTHOR]

We evaluated patient-level factors associated with receipt of hemoglobin A1c (HbA1c) testing among Alabama Medicaid beneficiaries with type 2 diabetes. We conducted a retrospective analysis of person-year observations from Medicaid claims data from 2011 to 2020. Adults aged 19–64 years with type 2 diabetes and continuous enrollment in Medicaid for study year and year prior were included. Primary outcomes were ≥ 1 and ≥ 2 HbA1c test(s) per year. We conducted multivariable Poisson regression stratified by Medicaid eligibility reason (disability, poverty) examining the association of study year, demographics, clinical factors, and healthcare utilization with HbA1c testing. We analyzed 288,379 observations, 51% with disability-based, 49% poverty-based eligibility. Overall, 57% observations had ≥ 1 HbA1c, 35% had ≥ 2 HbA1c tests. More observations with disability-based than poverty-based eligibility had ≥ 1 (76% vs. 38%) and ≥ 2 HbA1c tests (49% vs. 20%). Patient-level factors were associated with a higher likelihood of having ≥ 1 HbA1c: Black race and older age (disability-based eligibility); year after 2011, female sex, and younger age (poverty-based eligibility); and rurality, insulin use, endocrinology care, diabetes complications, and ambulatory care visits (both groups). Just over one-third of adult Alabama Medicaid beneficiaries with diabetes had ≥ 2 HbA1c tests per year; testing frequency differed by Medicaid eligibility. • Assessing glycemic status is a key component of recommended diabetes care. • We studied patient-level factors associated with receipt of hemoglobin A1c testing • Alabama Medicaid beneficiaries with type 2 diabetes comprised our study population • Only 57% had ≥ 1 HbA1c test/year and just over one third had ≥ 2 tests/year [ABSTRACT FROM AUTHOR]

Systemic inequalities in higher education have contributed to lower retention and completion rates among low-income, first generation, and racially/ethnically minoritized students, who we refer to as "at-promise" students. In response, educators have implemented comprehensive college transition programs that offer students holistic support including academic, social, financial, and major and career support. Scholarship exploring the efficacy of comprehensive college transition programs commonly focuses on the role of this support in promoting academic self-efficacy, retention, sense of belonging, and other intermediate outcomes linked to at-promise college student success. One sorely understudied intermediate outcome related to atpromise college students' success is their confidence in a major and career path (i.e., major and career selfefficacy). This article focuses on a large scale, longitudinal (2015-2020) study of a comprehensive college transition program called Thompson Scholars that offers major and career support to promote at-promise college students' major and career self-efficacy. Based on the Thompson Scholars' approach, we identified a new model for developing major and career self-efficacy among at-promise students called the At-Promise College Student Major and Career-Self Efficacy Ecology Model that explains how and why Thompson Scholars promotes students' confidence in their major and career path. This new approach illustrates how educators can curate a developmentally appropriate set of major and career experiences across multiple contexts responsive to at-promise students' multiple assets to build their confidence. [ABSTRACT FROM AUTHOR]

Rapid growth in metropolitan areas is associated with urban development and revitalization. However, neighborhood gentrification has negatively affected low income and communities of color by displacement and compounding structural and systemic inequities. Black/African American, Hispanic/Latino, and immigrants/refugee communities are burdened with negative health outcomes from adverse circumstances illustrated by disparities in the social determinants of health and health indicators, that is, chronic disease and COVID-19. To remediate the situation and restore health, the multisector response needs to be reframed and emphasize systemic, integrated, and aligned efforts. These include policy, systems and environmental change approaches, community involvement, improvement of data systems, and workforce development. [ABSTRACT FROM AUTHOR]

The successful screening for possible learning disabilities (LD) is a crucial first step in the process of identifying signs of LD, gaining assistance and/or accommodations, and obtaining a more complete LD assessment. Although Latino people are the largest ethnic minority in the United States, and more specifically in California, there remains a clear need for a valid LD screening measure that is appropriate for adult Spanish speakers, particularly low-income individuals. This study evaluated the validity of three brief measures to screen for LD among low-income Spanish-speaking adults: Empire State Screen, Welfare-to-Work [WTW] 18, and MATILDA-R. The study also provides an initial estimate of LD risk in the low-income Spanish-speaking population. To estimate the predictive utility of each screening measure, 1,040 Spanish-speaking adults were administered each of the three screens and then assessed for indications of LD using multiple scoring methods (Bateria Discrepancy Diagnosis [BDD], pattern of strengths and weaknesses [PSW], and DSM-5). The translated WTW 18 Screen and the MATILDA-R appeared most promising. A culturally-sensitive, validated LD screen will help ensure that social workers and other helping professionals have access to appropriate and legally required interventions for this marginalized population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: High quality child care positively affects long-term development in children and is a necessary support for parents who work or are in school. We assessed the association between child care setting and parents' report of difficulties with ability to work and/or further their education ("child care constraints") or material hardships among families with low incomes. METHODS: Cross-sectional data were analyzed from families in Minneapolis, MN with children aged six weeks to 48 months in child care from 2004 to 2017. Associations between child care setting (formal, informal relative, informal non-relative) and child care constraints or material hardships (household/child food insecurity, housing instability, energy instability) were examined. RESULTS: Among 1580 families, 73.8% used informal care. Child care subsidy and public assistance program participation were higher among families utilizing formal care. Compared to formal care, families using informal relative or non-relative care had 2.44 and 4.18 greater adjusted odds of child care constraints, respectively. Families with children in informal non-relative care had 1.51 greater adjusted odds of household food insecurity. There were no statistically significant associations between informal relative care and household or child food insecurity, and no associations between child care setting and housing instability or energy insecurity. CONCLUSIONS: Informal care settings--relative and non-relative-- were associated with child care constraints, and informal non-relative care with household food insecurity. Investment to expand equitable access to affordable, high-quality child care is necessary to enable parents to pursue desired employment and education and reduce food insecurity. [ABSTRACT FROM AUTHOR]

In this paper, we examine the current crisis of regarding preparedness of healthcare industries in Pakistan, analyzing the causes, effects, and potential recommendations to this problem. Highlighting the efforts and issues surrounding this topic is necessary for developing and implementing research-based solutions that accurately reflect the current state of the healthcare industry. This short overview is prepared in accordance with accepted practices in published studies around the world. Our findings were based on a search of the literature databases PubMed, Google Scholar, Journals Online, and the Internet Library. Searching for "Healthcare Preparedness in Pakistan" yielded the expected results. Particularly of interest to the researchers was the question of why, despite efforts to boost vaccination rates and emergency immunization response capacities in the event of epidemics, progress on SDG3 immunization indicators has been minimal. Immunization is critically important because vaccine-preventable diseases pose a significant risk to the general population. Pakistan's authorities and government should take deliberate action to increase immunization rates. Particularly disadvantaged countries and regions are hit the worst by climate change. Pakistan continues to be hit hard by diseases like acute watery diarrhea, dengue fever, malaria, and COVID-19 are on the rise as a result of the flooding, especially in shelters and areas where water and sanitation systems have been affected. After devastating floods in KP, Sindh, and Punjab, over 70 suspected cases of diphtheria were reported. Diphtheria epidemics illustrate the precarious position of flood victims. It would be catastrophic if the newly found diphtheria strain or the covid-19 variation reached the underserved flood victims. Immunization protects against life-threatening illnesses so its government responsibility to improve immunization rates in Pakistan. [ABSTRACT FROM AUTHOR]

Community health and human services workers play an integral role in communal public health. They are especially integral to meeting the needs of patients who are often on the margins of society. While we often conduct research from the perspective of the end-user – the patient or the client – we do not hear the voices of health and human services professionals with the same regularity. The purpose of this study is to examine the healthcare needs of public health patients from the perspective of community health providers in two Georgia counties. Through this case study, utilizing qualitative data garnered through three focus groups with the local public health department’s employees and affiliated human services providers as part of their quintennial Community Health Needs Assessment (CHNA), we call attention to several individual and systemic issues providers have identified as worthy of concern. These include health seeking information and behaviors of their clients, as well as the role of health insurance and health access for improved physical, mental, and sexual health. Systemically, providers identify the challenges of status, stigma, and consumer perceptions in the access and quality of care certain segments of the population receive and how provider bias can impede wellbeing. Although the CHNA data collection took place prior to the COVID-19 pandemic, our examination of the data took place during the height of the pandemic. As such, in this paper, we also provide practical implications and future directions for public health and human services providers who have endured the pandemic and sought to meet their patients’ needs during unprecedented circumstances. [ABSTRACT FROM AUTHOR]

The educational system perpetuates capitalism and material wealth, valuing White and Western ideologies, thus alienating certain identities and narratives. As a first-generation and low-income child of APIDA immigrants, I strive to bring awareness to cultural wealth due to the erasure of marginalized identities and narratives. Rather than just focusing on the struggles of holding multiple marginalized identities, I showcase the joys of practices and traditions in my culture and highlight the hope my communities give me as a descendant of militants and revolutionaries. In this article, I raise awareness of lived experiences that are often left out of the educational pedagogy and institutional structure that is not made for everyone. I will share a personal narrative to explain my first defining experience within an oppressive system. I will reflect on how this experience and researching cultural wealth theory led to newfound compassion for myself, my family and how they persevered, my ancestors and how they inspired me, as well as action and optimism in higher education. This article is intended for readers who struggle to share deeply personal and heavy stories, especially after having dealt with discrimination and exclusion. The intention is that readers will nourish their roots by telling their stories, nourishing the educational space with their lived experiences and the unapologetic love they have for themselves. Also, this article will serve as a reference for higher education practitioners to incorporate more inclusive exercises and practices so we may embrace cultural sensitivity and humility in the academy. By exploring a more liberatory praxis in academia which often denies such notions, we will be able to center marginalized identities and narratives and transform higher education, starting with honoring and celebrating ourselves and our identities with the utmost hope, joy, and love. [ABSTRACT FROM AUTHOR]

In study abroad programs, overall student participation and the representation of minoritized students continue to rise, but barriers to participation for minoritized students persist, especially in engineering. As we strive to broaden participation in engineering study abroad programs, we must critically examine the experiences of minoritized students who engage in these programs so we can facilitate supportive educational environments. This study examines the experiences of minoritized students in a global engineering study abroad program, using the concept of habitus, a student’s collection of identities and embodied cultural capital. We find that students draw on various forms of habitus while studying abroad, connecting their new experiences abroad to their prior experiences. Based on these findings, we make recommendations for designing more equitable and inclusive study abroad programming elements. [ABSTRACT FROM AUTHOR]

Since the eruption of COVID-19, the virus has been taking human lives and inflicting economies worldwide. The economic crisis has intensified global unemployment as the UN and the ILO reports are showing serious concerns. The financial experts estimated that the global economy was already depressing in the year 2018-19 with 1.9 percent; the lowest growth rate in a decade. The virus had further shattered it to -3.3 percent. Its impact in Pakistan is significantly harmful and economic growth was -1.3 percent in 2020. The weak healthcare system has further damaged the fragile economy. All spheres of life have been severely affected by the virus, but the low-income groups are more vulnerable. Prior to the outbreak of COVID-19, Pakistan was facing economic instability and the virus has intensified the situation, raising questions about the survival from the challenges, being faced by the low-income groups and how they have to cope with them. The objective of the study is to examine the socio-economic impact of COVID-19 on marginalized groups of Pakistan as the pandemic has deprived them of their livelihood. The study has applied the qualitative approach with analytical method. Looking at the empirical data, it seems that enslavement by the employees to vulnerable groups has been strengthened because of virus. The study concluded that the virus caused huge economic loss to low-income groups. [ABSTRACT FROM AUTHOR]

Property tax limits have been found to reduce property tax revenue, with compensatory increases in replacement taxes often not sufficiently making up for funding loss and systematically promoting inequity. Consequently, such practices suggest severe implications for school district fiscal capacity. Our study explored this issue in South Carolina after Act 388's reimbursement implementation, with a special focus on rural school districts. We examined through correlation and regression the degree to which revenue served as a function of fiscal capacity, and fiscal capacity as a function of reimbursement. Our results established a plausible link between the state's property tax exemption law and school revenue availability for rural districts, non-rural districts, and the state as a whole. We conclude that consequential funding disproportionality resulted in a negative impact on rural, low-income districts. [ABSTRACT FROM AUTHOR]

This evidence-based practice project established postpartum depression (PPD) screening and followed maternal use of mental health services in a multilingual low socioeconomic status urban population. The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was used to establish a screening protocol for mothers at their infants' well-child checks. For mothers with positive screens, providers referred them to mental health care and updated their child's electronic health record diagnosis to prompt reassessment for future visits. Over 6 months, 273 mothers were screened at 523 eligible office visits (83.5% screening rate), 26 (9.5%) screened positive, 19 (73.1%) were referred to mental health services, and 12 (63.2%) attended the referral. Thirteen (50%) mothers with PPD had the appropriate electronic health record flag in their infant's record. This project successfully implemented the American Academy of Pediatrics PPD screening guidelines and could be applicable to other pediatric outpatient settings. [ABSTRACT FROM AUTHOR]

Objective: The present study tested the protective role of youth's school-age extracurricular involvement and multiple informants' reports of adolescent internalizing and externalizing problems in a sample of youth from low-income households. Method: Participating youth (n = 635, 49% female, 49% White, 28% Black/African American, 14% biracial, 8% other race, 13% Hispanic/Latinx) were drawn from the Early Steps Multisite Study. At ages 7.5, 8.5, and 9.5, primary caregivers reported the number of extracurricular activities for which youth participated (Parent Aftercare Survey). At ages 14 and 16, measures of internalizing and externalizing problems were collected from primary and alternate caregivers (Child Behavior Checklist) and target youth (Child Depression Inventory—Short Form, Multidimensional Anxiety Scale for Children, and Self-Report of Delinquency). At age 16, target youth also contributed measures of risky sexual behaviors and substance use (Youth Risk Behavior Survey). Teachers contributed measures of youth's internalizing and externalizing problems at age 14 (Teacher Report Form). Results: After accounting for the effects of multiple sociodemographic factors, initial levels of child problem behavior, and intervention group status, structural equation models revealed that school-age extracurricular involvement was inversely associated with latent factors representing adolescent externalizing, but not internalizing, problems at ages 14 (β = −.13, p <.01) and 16 (β = −.12, p =.02). Conclusions: The present study suggests that low-income, school-age children's involvement in extracurricular activities serves a protective function in relation to adolescent externalizing problems. Future studies should assess underlying mechanisms and expand the scope of adolescent outcomes to include prosocial functioning. What is the public health significance of this article?: This study suggests that extracurricular involvement in the school-age years protects youth from low-income households from developing behavior problems in adolescence. [ABSTRACT FROM AUTHOR]

This article describes lessons from the feasibility testing of a parent-focused, life skills-based intervention to promote healthy weight in 58 low-income children aged 2 to 5 years. This intervention was feasible and acceptable, with a potential to impact child weight and diet (calories) and parental quality of life (QOL). The group delivery approach through a partnering organization (Head Start) was a more efficient way to reach/engage parents. Compared with one-on-one sessions, the group could provide an avenue to enhance parental psychosocial well-being, given QOL improvements among parents in group sessions. Lessons will inform future research to test the effectiveness of life skills interventions. [ABSTRACT FROM AUTHOR]

Although there are numerous evidence-based benefits to undergraduate research for newmajority students (students who are from traditionally underrepresented ethnicities, first-generation college students, students from lower-income families, or transfer students) (Hurtado, S. et al., 2011; Kinzie et al., 2008a; Lopatto, 2007), they are less likely to participate or stay in mentored research experiences (Finley & McNair, 2013; Haeger et al., 2015). In order to determine not only who has access to undergraduate research, but to also identify what barriers to full-inclusion exist for newmajority students, we conducted a mixed methods study at a public, Hispanic Serving Institution. We analyzed institutional data to explore who participates in research and who does not. We also specifically sampled a group of students who expressed an interest in research experiences but who never actually participated for our student survey (N=96). Additionally, we conducted five focus groups with students, staff, and faculty (N~30). We found positive results in the analysis of patterns of participation and found no significant or substantial differences between students who did or did not participate in undergraduate research in terms of race/ethnicity, gender, or first-generation status. The undergraduate researcher population did have significantly more STEM majors and Pell grant recipients. The qualitative analysis identified barriers to participation in research in the following areas: access to research opportunities, programmatic structures, research culture and norms, and campus climate. We present these findings along with descriptions of initiatives that have been successful in diversifying research participation and strategies to create more inclusive research environments. [ABSTRACT FROM AUTHOR]

Past research shows that high-quality public preschool may disproportionately support low-income children's school readiness because low-income children tend to arrive at school with fewer of the academic skills needed for success. This suggests a compensatory process in human development in which the children who benefit most from a promotive factor are those who stand to gain the most. We propose that high-quality public preschool may similarly confer its greatest health rewards to low-income children, who are generally in poorer health than their peers. If that is true, preschool has the potential to narrow health disparities by income, which without intervention, persist into adulthood. To date, no one has articulated all the pathways through which high-quality public preschool may improve children's health, much less those that should disproportionately benefit those from low-income families. Drawing on the bioecological paradigm of human development, we propose a model identifying specific mechanisms likely to promote equity in child health. These mechanisms reflect core characteristics of high-quality public preschool that may disproportionately benefit low-income children's health. This model serves as a working template for a program of future research. [ABSTRACT FROM AUTHOR]

Objective: Web-based relationship interventions have been shown to improve relationship functioning for low-income couples, with gains maintained up through 12 months (Doss et al., 2020; Roddy et al., 2020). However, little is known about mechanisms of improvements and maintenance for these programs. Method: A sample of 742 low-income couples (Mage = 33; 55% non-Hispanic White; 52% married; Mdn annual household income = $27,000) were randomly assigned to the OurRelationship (OR) program, the ePREP program, or a waitlist control group. Couples were repeatedly assessed over 6 months on two relationship outcomes (satisfaction and breakup potential) and five relationship mechanisms (positive and negative communication, relationship problem intensity and confidence, and emotional support) with self-report measures. Results: Intervention couples, compared with the control couples, experienced significantly greater improvements in all mechanisms by the end of the program (Mean |d| = 0.58). Those with greater improvements in mechanisms also reported greater improvements in both relationship outcomes. From post- to 4-months follow-up, only prepost improvements in negative communication significantly predicted maintenance of gains in satisfaction. In contrast, prepost improvements in all mechanisms significantly predicted maintenance of reductions in breakup potential, with the largest effect via improvements in emotional support. Conclusions: These results indicate that both programs improve targeted mechanisms during the intervention period and support the role of these constructs as mechanisms of improvements in broader relationship functioning. Moreover, findings on mechanisms of maintenance highlighted the importance of including an emphasis on communication and emotional support to better maintain program gains. What is the public health significance of this article?: Understanding how relationship interventions work is critical for further revising them and improving their effectiveness. The current study provides empirical support for five theoretically important mechanisms of improvements in relationship interventions for low-income couples and identifies two mechanisms that are critical in maintaining their gains following the program. [ABSTRACT FROM AUTHOR]

To characterize the electronic media (e-media) use of preschoolers from low-income families comprehensively, in terms of platform interaction potential and content. Parents of 380 preschoolers (mean age, 52.5 ± 3.7 months) from diverse, low-income backgrounds reported on their child's age of exposure to various e-media types, frequency of use, amount of background television, and listed all child shows/cartoons and adult shows/general audience shows the child watches, as well as all electronic games/apps the child plays. We calculated descriptive statistics and conducted latent profile analyses to characterize e-media use. Most children in the sample began watching TV before age 1 year and nearly half watch child shows/cartoons several times a day or more. Most children began playing games/apps before age 3 years and more than one quarter play games several times a day or more. More than 20% of children are exposed to >3 hours of background TV on a typical weekday and 30% are exposed to this amount on a typical weekend day. A Modest E-Media Use profile characterized most children in the sample (70%). Fewer children were characterized by a High Educational Games profile (14%) or a High Adult TV/Elevated Entertainment Games Use and Background TV profile (16%). Collectively, the 3 profiles reflect heterogeneous use patterns with regard to platform interaction potential and educational quality during the course of a typical week. Additional research is warranted to assess linkages between e-media use profiles and indicators of school readiness in cognitive, academic, and social and behavioral domains in diverse, low-income samples. [ABSTRACT FROM AUTHOR]

To examine the association between maternal body dissatisfaction and mother's (mis)perception of their infant's weight classification among families from low-income households. Mother-infant dyads were recruited during well-child visits from 2 urban primary care clinics. Maternal body dissatisfaction was measured using the Stunkard Figure Rating Scale. Perception of infant weight was assessed using a 5-point Likert scale. Infant weight-for-length percentiles were calculated using World Health Organization growth charts. Associations between maternal body dissatisfaction score and mother's (mis)perception of their infant's weight classification were examined using logistic regression allowing for nonlinear associations via restricted cubic splines. Mothers (n = 180) were 26.6 ± 5.1 years old and 72% Black; infants were 8.8 ± 2.1 months old. Mean infant weight-for-length percentile was 64 ± 26. On average, mothers wanted to be one body figure smaller than their perceived current body size. Most mothers (82%) accurately perceived their infant's weight classification while few overestimated (7%) or underestimated (11%) their child's weight category. The probability of mothers misperceiving their infant's weight classification increased as maternal body dissatisfaction increased in either extreme in unadjusted (P <.05) and adjusted analysis (P =.06). Increased maternal body dissatisfaction may be associated with mother's misperception of infant weight classification. Future studies should examine this relationship in a heterogeneous population. [ABSTRACT FROM AUTHOR]

Through the use of interpretative phenomenological analysis (IPA), this study examined the impacts of counseling first-generation, low-income college-bound students by way of a school counselor experiential learning program at one small, private university in the eastern United States. This study explored experiential learning, including from a transformative learning perspective, as well as its overall impact on school counseling student preparation. Themes that emerged indicated that school counseling graduate student interns, when placed in a culturally diverse experiential learning setting, have the potential to increase their counselor competencies including multicultural competencies, and to have a transformative learning experience. These impacts were discussed along with a social justice advocacy perspective. Implications of these findings, including encouragement for the development of similar university-community partnerships, were included. [ABSTRACT FROM AUTHOR]

Objective: Although low-income couples experience greater relationship challenges, they have limited access to effective relationship interventions. Furthermore, most previous efforts to improve low-income couples' relationships have yielded very small effects (Hawkins & Erickson, 2015). In an effort to overcome these limitations, this study investigated the effectiveness of 2 web-based interventions for low-income couples. Method: In total, 742 low-income couples (N = 1,484 individuals; mean [M] age = 33; 55% White, non-Hispanic; 52% married; median [Mdn] annual household income = $27,000) were recruited nationally and randomized to the OurRelationship program, the ePREP program, or a waitlist control group. Couples were repeatedly assessed for 6 months using self-report measures of relationship satisfaction, communication conflict, intimate partner violence, emotional support, and breakup potential. Relationship status was assessed at 6-month follow-up. Results: Compared to the control group, intervention couples experienced significantly greater improvements in all 5 domains of relationship functioning (Mdn |d| = 0.46) by the end of the program; these effects were maintained in the 4 months after treatment. However, neither program significantly reduced the frequency of breakups by the 6-month follow-up. Differences between couples in the two interventions were minimal (Mdn Cohen's |d| = 0.11); however, couples in the OurRelationship program experienced significantly greater decreases in conflict (d = 0.24). Conclusions: The results indicate that brief, web-based interventions can serve a central role in delivering effective services to low-income couples. Additionally, the general equivalence of the two interventions indicates that both communication-focused and problem-focused interventions can be successful in improving the relationship functioning of low-income couples. What is the public health significance of this article?: Web-based interventions are effective in improving relationship functioning of low-income couples. Brief interventions, narrowly focused on improving relationship dynamics, are effective in overcoming multiple barriers to intervention reach and effectiveness in low-income populations. Both communication-focused and problem/insight-focused interventions can be effective for low-income couples. [ABSTRACT FROM AUTHOR]

Objective: Using baseline data from a community-based weight-gain prevention intervention study, the authors examined whether coping self-efficacy moderated the associations between chaotic home environment and psychosocial health (perceived psychosocial stress, depressive symptoms, and positive and negative affect) in low-income women who are overweight or obese. Method: Participants (N = 740; Mage = 28.06 ± 5.12) completed validated self-report measures of coping self-efficacy, chaotic home environment, perceived psychosocial stress, depressive symptoms, and positive and negative affect. Composite indicator structural equation modeling was used to test the moderation effects. Effect size was calculated using proportion of maximum possible (POMP) scores in the endogenous variables per unit change in the exogenous variable. Results: Coping self-efficacy significantly moderated the associations between chaotic home environment and depressive symptoms (p <.001, POMP = −0.62%) and between chaotic home environment and negative affect (p <.01, POMP = −0.36%). However, coping self-efficacy did not moderate the association between chaotic home environment and perceived psychosocial stress or positive affect. Conclusions: This study suggests that coping self-efficacy could explain some individual differences in responses to home chaos or to interventions aimed at alleviating depressive symptoms and negative affect in low-income women who are overweight or obese and who experience chaos at home. [ABSTRACT FROM AUTHOR]

To measure the frequency US pediatricians report screening and referring for social needs and identify pediatrician and practice-level predictors for screening and referral. Data were from the American Academy of Pediatrics Periodic Survey for October 2014 to March 2015 with a response rate of 46.6% (732/1570). Respondents reported on: 1) routine screening of low-income families for social needs, 2) attitudes toward screening, and 3) referral of low-income families for community resources. Results were analyzed by pediatrician and practice characteristics. Although most pediatricians (61.6%) thought that screening is important, fewer (39.9%) reported that screening is feasible or felt prepared addressing families' social needs (20.2%). The topics that pediatricians reported routinely asking low-income families about at visits (defined as ≥50% visits) were need for childcare (41.5%) and transportation barriers (28.4%). Pediatricians were less likely to report asking about housing (18.7%), food (18.6%), and utilities/heating (14.0%) insecurity. In multivariable analyses, pediatricians were more likely to report both that they screen and refer when they reported having more patients in financial hardship and having someone in the practice with the responsibility to connect low-income families to community services. Pediatricians who endorsed the importance of screening and who reported being prepared were also more likely to screen/refer. A minority of pediatricians report routinely screening for social needs. Pediatricians were more likely to report that they screen and refer if they had positive attitudes toward the importance of screening, felt prepared, and had support staff to assist families in need. [ABSTRACT FROM AUTHOR]

To understand the experiences of diverse families when taking their young children to the dentist and to document their prevalence. An exploratory sequential design was used. First, 4 focus groups (N = 33) comprised of low-income female caregivers of children under 6 years of age were conducted in English and Spanish. Discussions centered around facilitators and barriers to taking children to the dentist. Themes derived from the groups were then used to create a survey that was given to 1184 caregivers in English, Spanish, or Vietnamese. Thematic coding of focus groups found little support for typically reported barriers to pediatric oral health care utilization (eg, transportation, cost, knowledge); instead, caregivers reported negative experiences (eg, restraint, separation) as barriers. In the surveys, 66% of caregivers reported being separated from their children, 25% reported that their children were restrained (53.7% for cleanings), 26% of children were given sedating medication for cleanings, and 22% of the caregivers reported experiences that made them not want to return to the dentist. The prevalence of these experiences differed significantly among Latino, Asian, and Caucasian families and for annual incomes under or above $50,000. Families with lower incomes and/or from ethnic and linguistic minority groups were more likely to report negative experiences at the dentist than higher income and Caucasian families. These data document the high prevalence of negative experiences and suggest ethnic, financial, and linguistic disparities in the quality of experiences. More research is needed on the role of dentists in facilitating or hindering oral health care utilization among diverse families. [ABSTRACT FROM AUTHOR]

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Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1000 days—pregnancy through age 2 years—are urgently needed. To examine perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low-income families in the first 1000 days. In this qualitative research, we performed semistructured, in-depth interviews of 25 women and 7 nutrition/health care providers. Eligible women were Women, Infants, and Children program-enrolled and pregnant or had an infant younger than age 2 years. Eligible providers cared for families during the first 1000 days. Using immersion-crystallization techniques, we examined perceptions, barriers, and facilitators related to avoidance of SSB consumption; acceptability of messages framed as positive gains or negative losses; and perceived influence on SSB consumption of various intervention modalities. Themes related to SSB consumption included parental confusion about healthy beverage recommendations and maternal feelings of lack of control over beverage choices due to pregnancy cravings and infant tastes. Themes surrounding message frames included negative health consequences of sugary drink consumption are strong motivators for behavior change; and savings and cost count, but are not top priority. Highly acceptable intervention strategies included use of images showing health consequences of SSB consumption, illustrations of sugar content at the point of purchase, and multimodal delivery of messages. Messages focused on infant health consequences and parental empowerment to evaluate and select healthier beverages based on sugar content should be tested in interventions to reduce SSB consumption in the first 1000 days. [ABSTRACT FROM AUTHOR]

Pediatric asthma has been increasing in LMICs (Low Middle-Income Countries), leading to an important burden for both children and national health systems. Implementing measures to achieve control are influenced by the degree of organization health systems have, the availability and affordability of essential asthma medications, and the effective implementation of asthma programs and asthma guidelines. In this review authors give an updated view of the current situation of these components of asthma management in LMICs. [ABSTRACT FROM AUTHOR]

Background: Poor adherence to long-term therapies is a public health concern that affects all populations. Little is known about the context of adherence in chronic diseases for the uninsured population in the United States.Objective: To evaluate medication adherence and barriers among low-income, uninsured adults recently initiating new therapy for a chronic disease.Methods: A cross-sectional study in two Community Health Centers located in Chatham County, Georgia, was performed between September and December 2015. Patients, randomly selected for inclusion in the study, were eligible if they had been prescribed medication for 2 or more chronic conditions and had recently started a new medication regimen. The Morisky-Green-Levine questionnaire was used to assess adherence. Potential barriers were analyzed using the Multidimensional Model proposed by the World Health Organization-social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. Multivariate logistic regression models were used to analyze factors associated with non-adherence.Results: A total of 150 participants were interviewed at 6 months after treatment initiation. Non-adherence was reported by 52% of the participants. Higher adjusted odds of non-adherence were observed in participants who did not receive information about their medications (adjusted odds ratio [AOR] = 2.40, 95% confidence interval [CI] = 1.01-5.74), did not regularly visit a primary health-care provider (AOR = 2.74, 95% CI = 1.09-6.88), and had changes in their treatment (AOR = 3.75, 95% CI = 1.62-8.70). Alternatively, adjusted odds of non-adherence were lower for patients who reported using pillboxes (AOR = 0.31, 95% CI = 0.10-0.95), having help from a caregiver (AOR = 0.15, 95% CI = 0.04-0.60), and integrating medication dosing into daily routines (AOR = 0.18, 95% CI = 0.06-0.59).Conclusions: Medication non-adherence was common among low-income, uninsured patients initiating therapy for chronic conditions. Several modifiable barriers highlight opportunities to address medication non-adherence through multidisciplinary interventions. [ABSTRACT FROM AUTHOR]

Introduction: Intensive care medicine can contribute to population health in low-income countries by reducing premature mortality related to surgery, trauma, obstetrical and other medical emergencies. Quality improvement is guided by risk stratification models, which are developed primarily within high-income settings. Models validated for use in low-income countries are needed.Methods: This prospective cohort study consisted of 261 patients admitted to the intensive care unit (ICU) of Kamuzu Central Hospital in Malawi, from September 2016 to March 2018. The primary outcome was in-hospital mortality. We performed univariable analyses on putative predictors and included those with a significance of 0.15 in the Malawi Intensive care Mortality risk Evaluation model (MIME). Model discrimination was evaluated using the area under the curve.Results: Males made up 37.9% of the study sample and the mean age was 34.4 years. A majority (73.9%) were admitted to the ICU after a recent surgical procedure, and 59% came directly from the operating theater. In-hospital mortality was 60.5%. The MIME based on age, sex, admitting service, systolic pressure, altered mental status, and fever during the ICU course had a fairly good discrimination, with an AUC of 0.70 (95% CI 0.63-0.76).Conclusions: The MIME has modest ability to predict in-hospital mortality in a Malawian ICU. Multicenter research is needed to validate the MIME and assess its clinical utility. [ABSTRACT FROM AUTHOR]

Lack of sustainable slum redevelopment guidelines in India is a policy gap that needs immediate attention. A rational design and planning route is necessary to ensure sustainability of the upcoming low-income (LIG) housing stocks. In this study, we performed a cross-sectional evaluation of LIG housing layouts through a socio-architectural and site-based wind-flow analysis route. We hypothesise that a better indoor environment in the LIG housing can be achieved through a better wind driven natural-ventilation in the living spaces, which is a function of the housing layout. Specific objectives of this study were: i) to investigate the influence of socio-architectural and geometric parameters on the LIG housing layouts; ii) to examine the effect of site-wind flow on LIG housing layouts using CFD simulations. BDD chawls of Mumbai were adopted as the case study. Results show that the current form of the LIG houses had a poor indoor environment and social interaction spaces, while the hypothesised iterated layout ‘Form A’ performed better in all the socio-architectural and wind-flow metrics that can promote relatively better quality of life. This study is a first-step approach for the development of regulatory guidelines in LIG housing design that is coherent to the context of the space. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Education / Revue Canadienne de l'Éducation is the property of Canadian Society for the Study of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose Many nurses rely on the American Nursing Child Assessment Satellite Training (NCAST) Parent-Child Interaction (PCI) Teaching and Feeding Scales to identify and target interventions for families affected by severe/chronic stressors (e.g. postpartum depression (PPD), intimate partner violence (IPV), low-income). However, the NCAST Database that provides normative data for comparisons may not apply to Canadian families. The purpose of this study was to compare NCAST PCI scores in Canadian and American samples and to assess the reliability of the NCAST PCI Scales in Canadian samples. Methods This secondary analysis employed independent samples t -tests ( p  < 0.005) to compare PCI between the American NCAST Database and Canadian high-risk (families with PPD, exposure to IPV or low-income) and community samples. Cronbach's alphas were calculated for the Canadian and American samples. Results In both American and Canadian samples, belonging to a high-risk population reduced parents' abilities to engage in sensitive and responsive caregiving (i.e. healthy serve and return relationships) as measured by the PCI Scales. NCAST Database mothers were more effective at executing caregiving responsibilities during PCI compared to the Canadian community sample, while infants belonging to the Canadian community sample provided clearer cues to caregivers during PCI compared to those of the NCAST Database. Internal consistency coefficients for the Canadian samples were generally acceptable. Conclusions The NCAST Database can be reliably used for assessing PCI in normative and high-risk Canadian families. Practical implications Canadian nurses can be assured that the PCI Scales adequately identify risks and can help target interventions to promote optimal parent-child relationships and ultimately child development. [ABSTRACT FROM AUTHOR]

Objectives: To pilot-test a Phone-based Postpartum Continuing Care (PPCC) protocol developed from existing evidence-based approaches to address both postpartum smoking relapse among low-income women who quit smoking during pregnancy and postpartum smoking increase among those who had cut down. Methods: One hundred thirty low-income pregnant women who were current or recently quit tobacco smokers were recruited at their first prenatal appointment and randomized to either a Control (standard care) or Experimental (standard care + PPCC) group. An intent-to-treat analysis was conducted on biochemically verified data from 6 in-person interviews during pregnancy and postpartum. Feasibility with regard to recruitment, randomization, assessment, and implementation of PPCC were assessed, along with acceptability among the target population. Results: PPCC was found to be feasible and acceptable to some participants, but not all. There were no significant differences in tobacco products per day at 6 months postpartum between groups; however, effect sizes differed at 6 weeks compared with 6 months postpartum. Similarly, there were no significant differences between groups in cessation rate (24% in each group) and past 90-day tobacco use (59 vs 55 days, for Control and Experimental groups, respectively). Conclusions: The PPCC intervention did not differentially reduce tobacco use postpartum compared with a controlled comparison group, though it was found to be acceptable among a subpopulation of low-income pregnant women and feasible with regard to recruitment, randomization, assessment procedures, and implementation. Further research is needed to identify an intervention that significantly improves smoking relapse rates postpartum. [ABSTRACT FROM AUTHOR]

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Vertical equity and the maximization of farebox revenue are important but conflicting goals in the development of fare policy in the United States. Reducing fares for low-income riders reduces revenue for a transit agency, while increasing fares could disproportionately impact lower-income riders. This paper details this conflict, explores strategies that could account for both goals, and evaluates fare programs in the United States. Two types of low-income strategies are discussed: first generation strategies and targeted subsidy strategies. First generation strategies have several limitations that targeted subsidy strategies account for; first generation strategies focus more on supply, while targeted subsidy strategies focus more on demand. The evaluation of US low-income fare programs found that organizational partnerships can reduce administrative and financial impacts to agencies, local ridership characteristics need to be considered in designing a program, and that smart card technology is useful but not required to create a targeted subsidy program. [ABSTRACT FROM AUTHOR]

This study compared severity of physical violence, intimate partner violence (IPV)-related injury, and lifetime diagnoses of psychiatric disorders among women in relationships with bidirectional, unidirectional, or no IPV. The sample includes 763 low-income women from community-based family planning clinics. Results showed that women in relationships with bidirectional IPV were more likely to experience severe physical violence and severe IPV-related injury compared to women in the unidirectional IPV category. These women were also more likely to be diagnosed with drug abuse and depression than women in relationships without IPV. Similarly, women in the bidirectional IPV category were more likely to be diagnosed with drug abuse when compared to women in the victim-only unidirectional IPV category. Recommendations for health-care providers are discussed. [ABSTRACT FROM AUTHOR]

The arguments for, or against, the use of user fees at outdoor recreation settings are often based upon philosophical, moral, and ethical grounds. Empirically-grounded research on the debate has been sparse. In this study, we report on a unique natural experiment comparing the incomes of individuals visiting very similar outdoor recreation settings which differ only in their requirement of a marginal user fee. Our comparison of the incomes of outdoor recreationists using the settings requiring a fee versus those that do not suggest user fees do play an important role in how low-income individuals choose outdoor recreation settings. Low-income outdoor recreationists tended to choose non-fee settings when they are available and if they support similar activities and opportunities as settings which require a fee. Low-income outdoor recreationists’ aversion of settings which require a fee is not a product of their inability to pay the fee, but rather a product of their unwillingness to pay the fee. Low-income outdoor recreationists reported traveling over three times as far to reach non-fee settings relative to comparable settings which require a fee. If user fees are being considered as a visitor management tool, land-use and outdoor recreation planners should not only expect a shift in the socioeconomic composition of visitors to the areas where the fee will be enforced, they should also anticipate displacement and increased use at nearby non-fee settings. Recreation managers should avoid requiring fees at all outdoor recreation settings within an area to ensure displacement does not become exclusion. [ABSTRACT FROM AUTHOR]

Yoga is underutilized among racial/ethnic minorities and low-income populations. To enhance participation among these demographic groups and to inform a future clinical trial, we conducted a qualitative formative investigation, informed by the Social Contextual Model of health behavior change, to identify barriers and facilitators to yoga that could impact study participation. We recruited twenty-four racially/ethnically diverse adults, with and without prior yoga experience, from a low-income, urban housing community to participate in either an individual interview or focus group. A thematic data analysis approach was employed. Barriers to yoga engagement included the perception that yoga lacks physicality and weight loss benefits, fear of injury, lack of ability/self-efficacy to perform the practices, preference for other physical activities, and scheduling difficulties. Facilitators of yoga engagement included a quality yoga instructor who provides individualized instruction, beginner level classes, and promotional messaging that highlights the potential benefits of yoga, such as stress reduction. [ABSTRACT FROM AUTHOR]

This paper evaluates the effects of thermal insulation on thermal comfort in low-income tropical housing in Uganda. Dynamic thermal simulations are conducted to assess the effects of wall, roof and floor insulation strategies. 96 combination scenarios are simulated for various geometries, insulation and construction methods. Adaptive approach is used to evaluate the conditions within the case study buildings. The results indicate that external wall insulation improves thermal comfort in all conditions whereas internal wall and floor insulation may deteriorate the conditions. Roof insulation is the most effective strategy to reduce the risk of overheating. Due to the effectiveness of roof insulation and marginal improvements of external wall insulation, especially for brick walls, wall insulation may be disregarded when used in conjunction with roof insulation. [ABSTRACT FROM AUTHOR]

This paper evaluates the effects of thermal insulation on thermal comfort in low-income tropical housing in Uganda. Dynamic thermal simulations are conducted to assess the effects of wall, roof and floor insulation strategies. 96 combination scenarios are simulated for various geometries, insulation and construction methods. Adaptive approach is used to evaluate the conditions within the case study buildings. The results indicate that external wall insulation improves thermal comfort in all conditions whereas internal wall and floor insulation may deteriorate the conditions. Roof insulation is the most effective strategy to reduce the risk of overheating. Due to the effectiveness of roof insulation and marginal improvements of external wall insulation, especially for brick walls, wall insulation may be disregarded when used in conjunction with roof insulation. [ABSTRACT FROM AUTHOR]

Adolescence obesity is one of the public health concerns that contribute to health disparities in the United States. Low-income communities are disproportionately impacted due to socioeconomic, environmental, cultural, and behavioral factors. Motivating vulnerable populations is a crucial component in health and behavior change communication. This study seeks to understand adolescents’ motivation in the reduction of obesity and promoting healthier lifestyles in low-income communities. Data were gathered among adolescents in 6th to 8th grades (N = 410) with an age range of 11–15 years in three U.S. States – Kansas, Ohio, and South Dakota. There was a relationship between adolescents’ perceptions of support for physical activity in their communities and their motivation for health. Results also show an association between adolescents’ motivation for health and outcome expectancies, both of which significantly differed by state. Other identified predictors for motivation include their perceptions for physical activity and for peers’ motivation to stay healthy. Nutrition-related predictors include adolescents’ perceptions on food availability and self-efficacy for healthy food choice. Ethnicity contributed to the variance in adolescents’ attitudes toward physical activity, perceptions of healthy food availability, and in their motivation for health. This study suggests focusing culturally relevant communication efforts on available nutritional and physical activity support within the environment and on outcome expectations in motivating health and obesity reduction among adolescents. The role of peers as a crucial motivational factor in preventing adolescence obesity should further be explored. [ABSTRACT FROM PUBLISHER]

This paper evaluates the effects of solar shading strategies on thermal comfort in low-income tropical housing in Uganda. Dynamic thermal simulations are conductedand the effects of various shading strategies including curtains, roof and window overhangs, veranda and tress on solar heat gain and thermal comfort are investigated.Adaptive approach for naturally ventilated buildings defined by CEN standardis used to assess theconditions in the case study buildings. According to the results, although shading significantly reduces solar heat gain, it is less effective inmeeting thermal comfort requirements in low-income tropical houses. Solar shading is however considerably effective during the hottest periods of the year reducing the risk of extreme overheating by up to 52%.In this respect, a north-south building orientation with the main openings on the north elevation is recommended. Due to excessive solar heat gain, large openings on east- and west-facing walls should be avoided. [ABSTRACT FROM AUTHOR]

The purpose of this study is to understand what health and safety hazards low-income households are subject to by surveying the real conditions of the defective housing of low-income households, and to find improvement strategies. For this purpose, we visited the concentrated areas of the multi-dwelling unit (MDU) (also known as multi-family residential) housing in Jungwon-gu and Sujeong-gu in Seongnam City, Kyunggi-do, one of the representative areas in Korea with a massive distribution of the low-income class. Based on the survey data, the level of housing defects were comparison analyzed per income decile (decile 1, decile 2, deciles 3-4), and per housing location, in the categories of subsidence, cracks in the wall, delamination, water leakage/infiltration, condensation, and contamination. The housing condition per income class was more defective in the decile 2 households rather than in the decile 2 households, and in the substructure more than in the superstructure. Among the six defects, contamination problems, caused by substandard living conditions, were the most frequent cases. Structural defects, subsidence and cracks in the wall, were found in the main living areas--the bedrooms and the living rooms. It was confirmed in this study that the conditions of low-income housing are serious, and that it is necessary to explore specific countermeasures in the near future. [ABSTRACT FROM AUTHOR]

The article explores the transformations low-income women make to appropriate their housing that often goes unnoticed. The aim is to document, acknowledge and make low-income women's efforts to appropriate their housing visible. Lessons learned are assumed to inform the Ugandan low-income housing discourse on design considerations that can contribute to the provision of housing designs that are conducive to low-income women. The study confines its investigation to the housing designs provided under the governmental low-income housing projects in Uganda. This article presents results from a case study on Masese Women Housing Project MWHP that targeted women as its main beneficiaries. Post Occupancy Evaluations POE methodology was utilised to collect data on the performance of the housing designs provided by the project and the transformations women make to increase their housing appropriateness. Open-ended interviews were carried out with women owners to investigate the transformations they apply to their houses. Results are documented through photography, sketches and measured drawings. Results are synthesised and analysed under outdoors and indoors transformations. The study confirmed the substantial contribution low-income women make to appropriate their housing. It argues for acknowledging and including women's efforts in the Ugandan low-income housing discourse to support the provision of housing designs that are more user-friendly to them. Design considerations that are essential to attain low-income women convenience with their housing are: its capacity to accommodate women's triple roles, their potential for incremental development and their ability for segmentation into autonomous housing units to allow for their flexible, economic and functional use. The study advocates for directing efforts to the development of traditional building technologies instead of introducing improved but alien ones as an alternative that is more favourable to women. [ABSTRACT FROM AUTHOR]

Despite efforts to improve university retention, many low-income students are leaving college without a degree. The current study evaluated the preliminary effectiveness of Acceptance and Commitment Training for low-income students at risk for academic failure. In general, participants exhibited improved academic performance the following semester, which was predicted from valued living. Fifty-seven percent of participants graduated within six years, surpassing the graduation rate of a comparison group and exceeding national graduation rates. [ABSTRACT FROM AUTHOR]