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The present case report utilises the International Classification of Functioning, Disability and Health (ICF) model to assess the health condition and its impact on various health domains of a 46-year-old male who experienced recurrent Guillain-Barré Syndrome (GBS) for the second time within three years. The patient presented with sudden difficulty swallowing solid food and bilateral lower limb weakness, struggling to rise from a sitting position. The report explores the patient’s ICF profile, highlighting the effect of GBS on his daily life and recovery process. The patient’s remarkable recovery can be attributed to several factors, despite the challenges faced. These factors include good socio-economic status, motivation, family support and consistent physiotherapy. Together, these elements played pivotal roles in facilitating the recovery process.

Background: Zinc deficiency is common in the Paediatric age group but the extent of this disorder is unknown in HIV infected children in Nigeria prompting this study. Objective: To determine the prevalence of zinc deficiency in HIV seropositive children, and compare this with age and sex matched controls. Methods: A case control study of 70 HIV sero-positive and age and sex matched HIV sero-negative children was carried out in the University of Port Harcourt Teaching Hospital between 1st of June, 2009 and 31st of May, 2010. We collected demographic, clinical, haematological and biochemical parameters from cases and controls, and analysed these using SPSS 20. Results: Sixty percent of the subjects were zinc deficient as against 41.4% of the controls, p= 0.028. Subjects that were zinc deficient were more likely to be in higher HIV disease stages, p = 0.003, in lower socio-economic classes and aged less than 60 months. We conclude that there is a high prevalence of zinc deficiency in HIV sero-positive children and they should have zinc supplementation immediately they are diagnosed to reduce their morbidity and mortality.

Background: Sparse data are available regarding congenital heart disease (CHD) from southern India. This study was designed to document the sociodemographic factors, clinical profile and pattern of CHD at a referral centre. Methods: A cross-sectional observational study was done by direct interview method and review of medical records of 414 participants using internally validated, pre-defined proforma. Results: More than half of the cases (54.6%) referred were within 1 year of age. Wasting was present in 45%. Most of the cases belonged to middle and lower socio-economic status group (79%) and were referred by paediatricians (70%); 48% had travelled more than 500 km to avail cardiac services. Predominant symptoms of referral were respiratory distress (61.8%), feeding difficulties (50%), cyanosis (43.7%) and palpitation (24.9%). Major abnormalities detected were ventricular septal defect (31.2%) and tetralogy of Fallot (21.7%). Conclusions: This study highlights the need of prioritising and planning for the implementation of affordable and accessible cardiac infrastructure to people from rural areas with low socio-economic background.

Introduction: Chronic respiratory diseases are known risk factors for Coronavirus Disease-2019 (COVID-19) associated morbidity and mortality. With the fourth wave of COVID-19 looming in India, it is crucial to prioritise preventive measures at both individual and community levels. However, following the third wave of COVID-19, adherence to preventive measures has declined. Aim: To assess the socio-clinical factors affecting COVID-19 preventive behaviour among patients with chronic respiratory diseases. Materials and Methods: This cross-sectional observational study was conducted at the outpatient department of Respiratory Medicine, Narayana Medical College Hospital, Nellore, a tertiary care centre in Andhra Pradesh, India from March to April 2022. The estimated sample size was 600 patients. Data was collected using a validated questionnaire, and analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 28.1 {International Business Machines (IBM) Corporation}. The association between independent and dependent variables was assessed using binary logistic regression. Results: A total of 671 patients’ data were analysed. The mean age was 51.45 (±14.397) years, with 390 (58.1%) being male. Among the participants, the prevalence of wearing face masks in workplaces was 47.8%, wearing face masks in public places was 43.6%, frequent hand sanitisation was 39.9%, and maintaining physical distance in public areas was 35.2%. The main factors associated with non adherence were women, rural dwellers, non smokers, patients with co-morbidities, those who had not experienced a detrimental impact of COVID-19 on themselves, and the perception that COVID-19 was a mild disease. Conclusion: Among patients with chronic respiratory diseases, the practice of COVID-19 preventive measures was inadequate. Factors that positively influenced COVID-19 behaviour were being married, having a high school education level or above, and being a smoker. The impact of age varied depending on the type of preventive measure. Socio-economic status had no significant impact.

Background: Cadavers are essential for anatomical education, yet their scarcity plagues medical colleges in Kerala and India. However, the Government Medical College in Thrissur has experienced a rise in annual body donations. Aims and Objectives: This study aims to explore the motivating factors behind this increase among the population of Thrissur. Materials and Methods: This study employed a cross-sectional survey design conducted at the Department of Anatomy, Government Medical College in Thrissur, Kerala. The study utilized data from the Body Donation Register, which covered a period from May 1st, 2011 to April 30th, 2012, encompassing a total of 223 individuals. During this specific period, which was selected due to the notable surge in body donation trends, there was a significant increase observed. The sample size was set at 110 participants. Data collection was conducted through face-to-face interviews with the voluntary body donors and was analyzed using the statistical package for the social sciences, version 16.0. Results: Gender distribution: Among 120 donors, 56.7% were male and 26.7% were female. Age groups 61–70 had the highest percentage (36%) of body donors. Socioeconomic status: the majority were above the poverty line (78.2%). Religious affiliation: Hindus had the largest representation (40 individuals). Marital status: Most donors were married (92 out of 110). Number of children: Most donors had two children (64 individuals). Sources of information: Family and relatives were the primary sources. Awareness of dissection: An equal number of donors were aware and unaware. Motivations for donation varied, including social service and avoiding burden after death. Conclusion: A good proportion of donors had a socioeconomic status above the poverty line, and most of them were graduates or postgraduates. The majority of body donors did not have a religious affiliation. However, they had a strong family background and received support from their families. Interestingly, most of the donors were unaware of how their bodies would be used after donation.

Introduction: Anemia is the most common nutritional deficiency disorder in the world. Its Prevalence is inordinately higher among developing nations, because of unfavorable socio- demographic factors and indigent access to healthcare services. Therefore, it is pertinent to find the prevalence of anemia and its associated factors. Objective: To find out prevalence and socio- demographic factors associated with anaemia among females of age group 10-45 years in a rural population of Gurugram, Haryana. Method: A cross sectional study was conducted in villages under PHC Garhi Harsaru in Gurugram, Haryana among 452 females of age group 10-45 years by two stage random sampling technique. Results: The mean age of the study subjects was 25 ± 6.39 years. The overall prevalence of anemia among women of age group of 10-45 years was found to be 62.39%. Joint family, lower literacy, and low socioeconomic status were found to be statistically significant risk factors for anaemia among study subjects. Conclusion: The prevalence of anemia was very high; therefore attempts should be made to sensitize the rural population through health and nutrition education, information, education and communication (IEC) and appropriate behaviour change communication (BCC) activities.

There are unexpectedly a few statistics about the socio-economic status (SES) and related socio-demographic factors (SDFs) of parents having child with ASD in Bangladesh. The prevalence of ASD might correlate with SES and related SDFs. A case-control study was conducted in 24 locations across 21 districts, encompassing all divisions, to assess the association between SES and the risk of developing ASD in Bangladesh. The structured questionnaire was administered through face-to-face interviews with 620 parents of the subject (310 ASD and 310 healthy controls) from January 2020 to June 2021. For univariate, bivariate and multivariate analyses, IBM SPSS version 23 was employed. The significance level was set at P ≤ 0.05, and the Odds Ratio (OR) within a 95 % CI was used to determine whether the variable poses a higher odd or not. After adjusting all significant covariates of binary logistic regression (including some dummy variables) in forward logistic regression model analysis, the higher level of SES, advanced level of father’s education (≥master), 22–35 years old age group of the father, and nuclear family were strongly associated with decreased odds of ASD compared to healthy controls. Only the male gender was strongly associated with an increased odds of ASD compared to the control. The results will aid policymakers in developing plans considering the SES and related SDFs that influence the risk of developing ASD in Bangladesh. Further research using population-based cohorts or nested case-control designs with matched control is necessary to observe and generalize the association.

Background: Management of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient’s socio-economic status has not been recently assessed in the Brazilian population. Aims: To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population. Methods: Survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant’s educational level and income (in multiples of the basic salary per capita) was collected. Results: Of the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes. Conclusion: Better-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.

In high-income countries, one's relative socio-economic position and economic inequality may affect health and well-being, arguably via psychosocial stress. We tested this in a small-scale subsistence society, the Tsimane, by associating relative household wealth (n = 871) and community-level wealth inequality (n = 40, Gini = 0.15-0.53) with a range of psychological variables, stressors, and health outcomes (depressive symptoms [n = 670], social conflicts [n = 401], non-social problems [n = 398], social support [n = 399], cortisol [n = 811], body mass index [n = 9,926], blood pressure [n = 3,195], self-rated health [n = 2523], morbidities [n = 1542]) controlling for community-average wealth, age, sex, household size, community size, and distance to markets. Wealthier people largely had better outcomes while inequality associated with more respiratory disease, a leading cause of mortality. Greater inequality and lower wealth were associated with higher blood pressure. Psychosocial factors did not mediate wealth-health associations. Thus, relative socio-economic position and inequality may affect health across diverse societies, though this is likely exacerbated in high-income countries.

Background: India like many other developing countries in the world is witnessing the rapid aging of its population. Urbanization, modernization, and globalization have led to change in the economic structure, the erosion of societal values, weakening of social values, and social institutions such as the joint family. Active aging aims to extend healthy life expectancy and quality of life (QOL) in older persons, and the QOL are largely determined by its ability to maintain autonomy and independence. Aims and Objectives: The present study was conducted at a teriary apex institute to study the socio-demographic characteristics, and the functional assessment in the elderly subjects in urban community. Materials and Methods: It was a cross-sectional observational study conducted at the area situated near western suburb of metro city and population of around one lakh sixty thousand. It consisted of housing buildings, multiple slum area. The current study was conducted over 1 year 6 months (18 months).The sampling unit being 102 Geriatric individuals of selected area of urban health center. Results: Out of 102 study, subjects 22 (21.56%) were complete independent to perform daily instrumental activities. Maximum study 48 (47.05%) subjects were required moderate assistance for performing the instrumental activities. Numbers of female study subjects were more among moderates assistance 24 (44.44%) and modified assistance 20 (19.60%). Out of 102 study subjects 55 (53.92%) were complete independent followed by 30 (29.41%) modified independence. Numbers of female subjects were more among moderate assistance 10 (58.82%). Conclusion: No study subject was dependent or maximal assistance for their self-care activities. Male and female in the present study can perform their self-care activities of daily living with equal efficiency.

Background: An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies. The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi, Kenya. Methods: Data from the second Nairobi Cross-Sectional Slum Survey (NCSS 2012) was examined. The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index (CI). The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status. Results: A total of 2 027 qualified women were included in this study. About 16.6% of children born of younger mothers aged < 20 years had diarrhea and a similar proportion of children (16.3%) was observed among mothers who were unemployed. The CI of −0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor (95% confidence interval: −0.028 to −0.023). Conclusion: Occupation of parents, age of mothers, ethnicity, marital status and children's age were major determinants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses. Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.

Historically, colorectal cancer (CRC) screening rates have been lower among African Americans. Previous studies that have examined the relationship between community characteristics and adherence to CRC screening have generally focused on a single community parameter, making it challenging to evaluate the overall impact of the social and built environment. In this study, we will estimate the overall effect of social and built environment and identify the most important community factors relevant to CRC screening. Data are from the Multiethnic Prevention and Surveillance Study (COMPASS), a longitudinal study among adults in Chicago, collected between May 2013 to March 2020. A total 2,836 African Americans completed the survey. Participants’ addresses were geocoded and linked to seven community characteristics (i.e., community safety, community crime, household poverty, community unemployment, housing cost burden, housing vacancies, low food access). A structured questionnaire measured adherence to CRC screening. Weighted quantile sum (WQS) regression was used to evaluate the impact of community disadvantages on CRC screening. When analyzing all community characteristics as a mixture, overall community disadvantage was associated with less adherence to CRC screening even after controlling for individual-level factors. In the adjusted WQS model, unemployment was the most important community characteristic (37.6%), followed by community insecurity (26.1%) and severe housing cost burden (16.3%). Results from this study indicate that successful efforts to improve adherence to CRC screening rates should prioritize individuals living in communities with high rates of insecurity and low socioeconomic status.

Objectives: The current study aimed to examine the relationships between resilience and personal characteristics such as socio-economic status, employment, satisfaction with life, and anxiety, during the period of returning to routine life after mass vaccination for COVID-19. Method: 993 Israeli participants, 52% female and 48% male, with a mean age of 40 years (18 to 89 years old) responded to an online questionnaire during March 2021. We hypothesized that (1) unemployed individuals and those with a low SES would have lower resilience, lower satisfaction with life and higher anxiety, (2) individuals who were ill with COVID-19 would have lower resilience and satisfaction with life and a higher level of anxiety, and (3) a higher resilience would be related to a lower level of anxiety. Results: The findings showed that unemployed individuals had lower levels of resilience and satisfaction with life and higher levels of anxiety than employed individuals. Specifically, those who experience a large gap between their socio-economic and employment statuses are at a greater risk than others. In addition, differences were found between people who had experienced COVID-19 illness and those who had not, but only with their satisfaction with life. People who had been ill were more satisfied than those who had not been ill. Eventually, as expected, a higher resilience was related to a lower level of anxiety, specifically at the lower levels of resilience. Conclusions: The findings of this study can provide additional perspectives on the day after a crisis (COVID-19) and the need for the development of intervention programs to strengthen the resilience of individuals who experience a gap between their SES and employment statuses when returning to their routine life after a crisis. The study also shed light on the unique correlation between anxiety and resilience, implying that following a crisis, high-resilience individuals face their anxiety better than low-resilience individuals.

Considering the rising life expectancy, the growing population of older adults poses challenges in providing adequate healthcare services. Self-reported health is an important indicator of overall health, predicting morbidity and mortality. This study investigated self-reported health inequalities among older adults in Saudi Arabia and the underlying factors contributing to establishing such inequalities. The study utilized data from the 2018 Saudi Family Health Survey, focusing on 2023 respondents aged ≥60 years with complete data. Univariate, bivariate, and multivariate logistic regression analyses were employed to explore socio-economic factors linked to health inequalities. Additionally, concentration curves and indices were used to assess the magnitude of health inequalities among older adults. The findings indicate a higher prevalence of self-reported poor health among respondents aged ≥70 years and those with chronic diseases. Age, education, income level, marital status, and insurance coverage were other factors significantly linked to reporting poor health. Inequality analysis revealed a concentration of poor health among less educated individuals (concentration index = −0.261, p < 0.01). Both income- and education-based indices highlighted a concentration of poor health among men with lower income and education levels. Addressing healthcare inequalities among older adults requires targeted policy efforts, focusing on those aged ≥70, unmarried individuals, those without insurance coverage, those with chronic illnesses, and those with lower education levels. Targeted interventions for these groups can address their unique healthcare needs and promote equitable health outcomes.

Background: The health-related problems of the tribal population depend on their ecology and culture. Often the tribal people do not utilize the medical and preventive health services available to them. Health problems in tribal groups need special attention because many tribal communities are backward. The current study was planned to determine the healthcare-seeking behavior of the tribal population in India. Method: A descriptive, cross-sectional study, conducted by interviewing key respondents of each participating family. Result: Two-thirds of the key respondents were literate and half (53.8%) of the total households in the three villages had a per capita monthly income between Rupees 500-1499. More than half (57%) of all respondents preferred government institutions for moderate illness, and the rest equally opted for private practitioners and quacks. However, for emergencies, dog bites, and snake bites, all key respondents in the three study villages unanimously preferred government institutions. A significant population (38.5%) got their children delivered at home. The majority of illiterate respondents (86.1%) preferred government institutions for health care of under-five children, while 60% of literates expressed a similar view. The choice of government institutions as a source of health care was increasingly favored with decreasing per capita monthly household income. Conclusion: Traditional healers are no longer preferred among the tribal population but they are reluctant to avail them because of the loss of valuable time. Home delivery is still prevalent. With improving socioeconomic status, people are going further away from government services as private practitioners, and quacks take less time.

Objective (s): In recent years decreasing fertility in Iran has become one of the demographic problems which has attracted the attention of policymakers. The purpose of this study was to identify the association between socio-economic factors with childbearing tendency. Methods: This was a cross sectional study. A sub-sample of data from the “2017 Iran Fertility Transition Survey” was used. The sample comprised of 374 ever married men and women aged 15-49 in Kermanshah, Iran. They were selected through the clustered sampling and the data was analyzed via SPSS 22 software using linear regression, Pearson correlation, independent t-test, and one-way analysis of variance Results: The results obtained from data analysis indicated no significant relationships between residency, housing, home size, employment, education and social class and attitudes toward childbearing (p>0.05). However, significant relationships between sex preference, gender, spouse age, birth interval, Internet consumption, birth space and attitudes toward childbearing was observed (p

Aim of the study was to analyze the socio-economic determinants and prevalence of possibly presence CHD in residents of a large industrial region.Material and methods. The study sample included residents of rural settlements of the Kemerovo region and districts of the city of Kemerovo. The study involved 1600 respondents aged 35-70 years. The determinants of socio-economic status (SES) were assessed: the level of education and income, professional affiliation, marital status / family composition, place of living.Results. The majority residents of rural settlements (50.9 %) had a secondary vocational education, compared with urban residents (46 %). A high level of income (over 20 000 rubles) was observed 1.53 times more often among the urban population than rural population. It was revealed that one third (29.3 %) of the rural population is employed in agriculture, and about 40.4 % do work that does not require vocational qualification. Among residents of rural settlements, there are statistically significant more those marriage/living with a partner, than among urban residents (75.6 % versus 62.9 %, respectively). The SES analysis of the study participants with possibly presence CHD indicates a predominant share (50.9 %) of vocational secondary education and medium income level (48.9 %). It was revealed that among the lonely rural residents possibly presence CHD occurred 10.0 % more often (urban 26.7 %, rural 36.7 %, p = 0.035) than among those living in the city.Conclusion. In the Kemerovo Oblast CHD possibly presence is more common in women, depending on socio-economic determinants it is more often observed in persons with a secondary vocational education and medium income level, equally among both skilled and low/ unskilled workers living with partner in urban settings.

The goal of this article is to analyse leisure time physical activity (LTPA) and health-driven motivations to engage in such activity among elderly people in the European Union. We use as a base the recommendations of the World Health Organisation (WHO) and the theory of the correlation between physical activity according to individual factors (age, gender, socio-economic status) and contextual factors (habitat, community infrastructures, the model of the welfare state of the country of residence). Data are taken from Eurobarometer 88.4. The Generalized Structural Equation Model (GSEM) methodology was used, with the STATA program. The results show that 65.3% of EU citizens over the age of 60 engage in some form of LTPA, that 40.4% do so for health reasons, and that only 32.3% engage in LTPA that meets the minimum guidelines set by the WHO. In addition, there are large differences based on individual and contextual characteristics. The following group was found to be those who practice the most: men, with high socio-economic status, belonging to the middle and upper social classes, living in rural areas where there is infrastructure for physical activity, and above all, in the countries of the Nordic model of social welfare.

Background: Caesarean section (C-section) delivery is a serious maternal health concern in the long run. Notedly, there is a lack of studies dealing with understanding the ways and reasons of C-section deliveries becoming a public health issue in today's time in India and the measures to reduce the unnecessary caesarean sections. We have conducted this study to study the changes in the state-wise prevalence of C-section deliveries in India and understand C-section delivery's socioeconomic and biomedical predictors. Materials and Methods: The study uses data from the fourth and fifth rounds of the National Family Health Surveys (NFHS). The per cent differences in the C-section deliveries from NFHS-4 to NFHS-5 across the states were measured through relative changes. The association between the C-section delivery and socioeconomic and biomedical factors were assessed using multiple logistic regression. Results: This study revealed that the C-section deliveries are higher in the southern states than in the other parts of India. Literacy plays a vital role in C-section deliveries. The probabilities of C-section deliveries are more in 30–40 and 40 + years. The women belonging to the median wealth index category were more likely (OR–CI, 1.62 [1.55–1.66]) to undergo the C-section followed by the women from wealthy households (OR–CI, 1.46 [1.41–1.52]). Conclusion: The Government's health policymakers should take the initiative to reduce the C-section section delivery by means of building maternal health literacy and awareness among women and the community so that its future implications can be minimised. It is crucial to formulate a mandate and implement it in the states where C-sections are too high through community health workers and primary care providers.

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease which affects different body systems and different aspects of health. It has an irreversible course. Identifying the needs of SLE afflicted patients is the first step to help them manage and cope with their illness. Qualitative research among patients with SLE can identify aspects of the disease relevant to clinical research and practice. Aim: To explore the forgotten needs of patients with SLE. Materials and Methods: This qualitative study was conducted in Iran from April 2020 to March 2021 using conventional content analysis. All participants were patients with definite diagnosis of SLE purposefully selected from Iranian Lupus Association and Rheumatology Clinics in Kashan, Kerman and Bandarabbas, Iran. Data were collected with deep, semi-structured, and face-to-face interviews, which are focused on patients’ experiences of needs. Data collection continued until saturation was reached. Finally, 17 patients with SLE participated in this study. Data collection and data analysis were conducted concurrently. Data were analysed with conventional content analysis, and managed with the MAXQDA software 2020. Results: The forgotten needs of patients with SLE came into three main categories, namely social needs (with three subcategories), economic needs (with two subcategories), and need for self-control (with two subcategories). The seven subcategories of these three categories were the need for family support, the need for professional support by healthcare providers, the need for social support, the need for financial support by family members, the need for financial support by the government, the need for gaining autonomy, and the need for effective role performance. Conclusion: Patients with SLE have many forgotten psychological and socio-economic needs. Patient education, referrals to mental health professionals, and support organisations are important supplements to medical treatment. The findings can be used to develop strategies for providing quality care to patients with SLE and other chronic disabling conditions.

Introduction: Socio-demographic factors may play a pivotal role in anxious and depressed alcohol dependent patients. Identifying the patterns and impact of these factors may be important in the successful management of Alcohol Use Disorders (AUDs). Aim: To assess the patterns and impact of socio-demographic factors in anxious and depressed alcohol dependent patients. Materials and Methods: This cross-sectional study was conducted at Rama Medical College Hospital and Research Centre Hapur, Uttar Pradesh, India, from August 2018 to January 2020. Patients with history of substance dependence, gross brain damage, severe medical complications, or evidence of drinking during the hospital stay were excluded. Severity of Alcohol Dependence Questionnaire (SADQ) was used to rate the extent of alcohol dependence and Hamilton Depression Rating Scale (HAM-D or HDRS) to rate depression. Socio-demographic data was recorded in each patient which included age, gender, background, education level, employment status, occupation, marital status, and family type. The severity of anxiety symptoms was measured on Hamilton Anxiety Rating Scale (HAM-A). Independent t-tests, Chi-square tests, one-way Analysis of Variance (ANOVA) and Pearson’s correlation analysis were used for statistical analysis. A p-value

OBJECTIVE: To find out the association between socio-economic factors with depression in women of Gilgit Baltistan (GB), Pakistan. METHODS: This case-control study was conducted at various psychiatric facilities located in three districts of GB. Out of 450 participants, recruited through convenient sampling technique, 300 were depressed women according to DSM-5 criterion of depression, while 150 were well-matched controls from the same population. Logistic regression was applied to find out the association of socio-economic factors with depression. RESULTS: Mean age of the participants was 36±11.2 years. About 40.7% (n=122/300) of cases and 16% (n=24/150) of controls were un-educated. Majority of cases (n=222/300: 74%) and controls (n=94/150; 62.7%) were married. About 66.7% (n=200/300) of cases and 48% (n=72/200) of controls were housewives. Odds of depression were 0.334 (95% CI: 0.132-0.848), 0.524 (95% CI: 0.186-1.475), 0.17 (95% CI: 0.045-0.637), & 0.38 (95% CI: 0.127-1.158) for women having primary, secondary, higher-secondary or graduation-level education respectively. Emotional abuse (odds=34.92, 95% CI: 6.281-194.190), lack of economic independence (freedom to spend) [odds=6.39; 95% CI: 1.535-26.630] and do not own land (odds=3.40; 95% CI: 1.126-10.307) were significantly associated with depression. Families with household income >20,000 Rupees/month (odds=0.22; 95% CI: 0.051-0.961) and cordial relationships with in-laws (odds=0.55; 95% CI: 0.241-1.262) were less likely to be depressed. CONCLUSION: The study showed significant association of low level of education, emotional abuse, and lack freedom of spending with depression in women of northern Pakistan. The study underscores that socio-economic factors need to be considered in the management of depression among women.

Purpose of the study. The goal is to conduct a comparative analysis of the correlation of learning success with self-assessment of physical and mental status and objective health status, taking into account the influence of demographic and socio-economic variables in senior students of medical and humanitarian specialties Materials and methods. The study was conducted from 01.12. 2017 to 01.03.2019 at the Far Eastern Federal University and the Pacific State Medical University. The sample size was 410 students (207 (50.6%) female, 203 (49.4%) male, average age 21.5 (1.2) years), who at the time of the study were studying in 4–6 courses. Information on demographic parameters, social conditions of study, residence, subjective data on morbidity and appeal was collected using: a comprehensive questionnaire on student status of a university (Pozdeeva, 2008; with additions of authors). The objective state of health and the comorbidity index were investigated when studying the medical documentation of medical institutions attached: Form 025 / y; 001–1 / y; 062 / y. In the study of quality of life associated with health, we used the international questionnaire “A short form of self-assessment of quality of life related to health MOS SF-36”. Results. The total score of self-esteem of physical well-being among students of humanities was 66.1 points, among students of medical specialties 56.4 points. Academic performance was higher among students of both directions, marking their learning conditions as satisfactory and good (r = 0.034; r = 0.048 / r = 0.045; r = 0.065). Student performance was also higher for students in both areas, evaluating the quality of education as high (r = 0.032; r = 0.046 / r = 0.033; r = 0.043), but lower for students with a high comorbidity index (r = –0.038 / r = –0.036). We also found that an increase in the number of HRQoL points is accompanied by a significant increase in academic performance in students of both directions (r = 0.035; r = 0.045 / r = 0.033; r = 0.050). An analysis of the linear regression model describing the association of academic performance with variables in the pooled sample revealed that this indicator strongly correlates with the comorbidity index (r = 8.27), HRQoL (r = 7.28), quality of education, and family income (5.55 / 5.06). At the same time, academic performance had an unreliable relationship with age, individual income, and weakly correlated with the conditions of study and residence. Conclusion. Chronic morbidity among senior medical and humanitarian students is high (comorbidity index 1.5–1.7), but the total self-assessment of the quality of life associated with health is 59–62 points and falls within the normal range of values. Thus, despite the high level of chronic somatic pathology, students generally positively assess their physical and psychological status.

Abstract Field and objective: Characteristics of any job and its socio-economic outcomes are related to the social health of the working population. Social health attempts to identify the mutual effects of social interaction on the individuals’ well-being. An individual’s positive or negative willingness to the society-benefiting environmental subjects with high sensitivity, care, and intelligence along with the ability to understand the others, share their experiences and emotions, and actively participate in the social processes falls in the field of social health. In a society where the conditions are becoming healthier, an individual with social well-being is expected to adaptively see the conditions improving, accepting his society with all its positive and negative aspects and attempting to help the society’s improvement. In addition to its importance in terms of the individual and occupational health and interaction with the coworkers and other society members, social health is important in terms of the public health. If a baker does not have a proper social well-being, not caring about his society, the bread health of a majority of the population may negatively change, leading to low quality bread. Thus, the current study aimed to investigate the social health of the bakers and the related variables in Isfahan, Iran. Methodology: This study was cross sectional-analytical and was conducted in 2017. The statistical population consisted of 469 bakers working in 171 traditional bakeries in Isfahan, who were selected out of 633 qualified bakeries by stratified sampling method in proportion to the size according to Cochran formula with the confidence level of 95% and error level of 0.07. The data were collected by the Adult Social Health Questionnaire (validated by Rafiey et al.) and Demographic Information Questionnaire. Each individual’s score were derived from 29 questions in the social health questionnaire with the components of social interaction, social responsibility, conscientiousness, attitude to society, empathy, family relationship, and social participation. In addition to the overall score, each component was scored. The social health was classified into five groups: very weak, weak, medium, good, very good, with their relationships with the demographic variables and each individual’s perceived social-economic status being assessed. The data were analyzed by Spearman correlation test and non-parametric covariance in SPSS 20. Findings: Three individuals worked in most of the studied bakeries. The mean age was 39.9 (±11.83). Those who worked in the bakeries had the work experience of 1 to 65 years with the average of 18.3 years (±12.31). Half of them had lower than 16.5 years of experience. However, 17% of the bakers had higher than 30 years of experience. Their social health scores were 18 to 40 (The minimum and maximum scores possible in the social health questionnaire were 10 and 145, respectively). Among the bakers, 3%, 36%, 27%, 26%, and 7% fall in very weak, weak, medium, good, and very good classes, respectively. 95.7% of the bakers viewed their socio-economic status to be in the 5th of 10 grades or lower in the society. Most of them (79.7%) evaluated their income to be low. These bakers’ social health had positive and direct relationship with their work experience (P-value≤0.05), such that an increase in each of the two variables by one unit increased the other by 0.304 and 0.316, respectively. The married individuals’ mean social health score were approximately higher than that of the unmarried ones by 9.7. Moreover, the social health of those with medium income was higher than that of the individuals with income by 6.22 (P-value=0.34). Discussion and Conclusion: The social health status was weak to medium among the traditional bakers in Isfahan. This seems to be resulted from the limited number of the bakers, alternating working time (early morning and late night), and reduced productive social interactions of them. The bakers probably do not have proper responsibility for their role in the society and are weak at understanding the others. These individuals might not have appropriate relationships with their families and relatives, not participating in the society improving programs. They also might not find themselves having a share in the society, being separated from it. These individuals have a relatively low subjective assessment of their socio-economic status. The mentioned bakers must be improved in the components of social interaction, empathy, conscientiousness, and attitude to society. Interventions are required, such as redesigning the workplace to increase the interactions between the bakers and people while observing the food hygiene. Moreover, programs have to be implemented to enhance the bakers’ social activities. The improvement of their business environment through socio-political pursuance to increase their income and reduce punishments of the governmental organizations probably enhances the bakers’ social health.

Background and Aim: Chronic periodontitis is the most prevalent form of periodontitis and it generally considered as a progressive inflammatory disease. Environmental and systemic factors can alter the immune response to biofilm and lead to progressive degenerative disease. Chronic periodontitis is defined as an infectious disease that causes inflammation in the tooth-supporting tissues, periodontal attachment loss, and bone loss. Identification of risk factors for this disease is important. Hence, this study aims to evaluate the risk factors for chronic periodontitis. Methods & Materials: This case-control study was conducted on 120 periodontitis patients and 120 healthy controls in Arak, Iran. A questionnaire was used to estimate their Socio-Economic Status (SES) and survey demographic and risk factors. For the diagnosis of chronic periodontitis, the identification of plaque accumulation site and clinical examination were performed. To investigate the association of chronic periodontitis with study variables, multilevel logistic regression analysis was used in STATA V. 11 software. Ethical Considerations: This study obtained its ethical approval from the Research Ethics Committee of Arak University of Medical Sciences under code: 1397.145. Results: The Odds Ratio (OR) of chronic periodontitis in adults aged above 30 years was 2.91 (95% CI: 1.01-8.73). Compared to subjects with low SES, the OR of chronic periodontitis was 2.28 (95% CI: 1.22- 4.27) in those with moderate SES and 0.89 (95% CI: 0.79-0.98) in those with high SES. Compared to patients who did not brush their teeth, the OR of chronic periodontitis was 0.67 (95% CI: 0.39-0.89) in patients reported toothbrushing. Compared to those who reported changing toothbrush sooner than 3 months, the OR was 4.96 (95% CI: 2.27-11.3) in those their changed their toothbrush for more than 6 months interval. The OR of chronic periodontitis in current smokers was 3.09 (95% CI: 1.52-4.76). Conclusion: Cigarette smoking, alcohol consumption, tooth brushing, and SES are the risk factors associated with chronic periodontitis.

Background: The demographic particulars of Gujar-Bakarwals are mostly dominant on mountainous regions of Kashmir Valley. Their housing, sanitation, health care facilities are very low sub-standard than other sections of population. Behavioral risk factors including tobacco use and skipping meals are prevalent. Objective: The present study focuses on the socio-economic and demographic profile among the tribal population of Kashmir; their major risk factors of some non-communicable diseases. Methods: The study is community based cross sectional survey undertaken in selected districts of Jammu and Kashmir. Results: Around 94.3% of the tribal population fell under low income groups with an annual income of Rs.

Introduction: Inspite of being advised surgery by doctor and several health schemes made available by the Government of India for the economically backward section, people still present late for surgery, inviting many complications in the long run. Aim: To study the causes of delayed cataract surgery in Below Poverty Line (BPL) patients in a tertiary health care centre in Eastern India. Materials and Methods: The present hospital-based and cross-sectional study included 58 patients who presented to the Outpatient and Emergency Department of a tertiary care hospital in Eastern India between December 2020 to April 2021. At presentation, detailed history was taken and patients were asked questions related to the cause of delay, which was categorised into- barriers to patient’s attitude and barriers related to cost, affordability and service delivery. Comprehensive ophthalmological examination for each and every patient was done. Routine blood investigations needed for cataract surgery were done. Surgery was done for all cases by a single surgeon and intraocular complications if any were noted. Results: A total of 58 patients included in this study, females (57%) were more than males (43%). Majority of them were from semi urban areas (13.79%). A 60% were dependent on family members for their expenses. About 94.8% had government insurance schemes but still had financial constraints which caused delayed presentation. A 70.7% of people did not attend hospital due to negative peer group effects and almost 84.5% people had no direct means of transportation to the hospital. Fear of surgery (96.6%) and fear of contracting Coronavirus Disease-2019 (COVID-19) (94.8%) were certain other factors which caused delay in presentation for surgery. Conclusion: Through this study, certain possible reasons were found, catering to social, economic as well as factors like fear of surgery, negative peer pressure, financial constraints responsible for the delay in acceptance of cataract surgery in such a set up.

Background Changing family models have resulted in a large increase in the number of single-person households. This phenomenon has certain implications for society and the economy as single people often exhibit different behaviours, including their engagement in health-related physical activity, than those who are married and living with partners. However, the results of studies on determinants of physical activity in people of different marital status have been inconclusive. The aim of this study was to identify associations between physical activity and socioeconomic status in single and married urban adults. Methods The study material consisted of 4,460 persons (1,828 single and 2,632 married and living with partners). A cross-sectional study was conducted in Wroclaw (Poland). A diagnostic survey-direct interview method was used. Two research tools were applied: the International Physical Activity Questionnaire Short Form (IPAQ-SF) and the Socioeconomic Status Questionnaire (S-ESQ). The level of respondents’ physical activity was assessed following WHO recommendations. The descriptive statistics included the number and frequency of categories of dependent and independent variables as well as measures of association between them, i.e., crude and adjusted odds ratios. Results The odds ratio of meeting the WHO physical activity recommendations was almost 70% higher in single than in married respondents (OR = 1.67; CI [1.46–2.19]), and slightly more than 40% higher after adjusting for sex, age and education (aOR = 1.42; CI [1.21–1.67]). In both groups socioeconomic the respondents’ status revealed a significant and slightly different association with their levels of physical activity. Occupational status and financial savings significantly affected the level of physical activity in single respondents, while net disposable income was a significant modifier of physical activity levels in respondents who were married or lived with their partners. Conclusions Assessment of the levels and determinants of physical activity among people of different marital status should be continued and extended to other subpopulations. This will allow effective preventive and therapeutic measures to be taken for groups most at risk of hypokinesia. Programs aimed at improving physical activity accounting for the socioeconomic status and marital status of their beneficiaries are particularly important.

Introduction: National Family Health Survey-4 reports that 44.8% of boys and 41.9% of girls aged 15-19 are underweight. Globally, there is a lacuna of data on early adolescent children (10-14 years). Aim: To estimate the prevalence of malnutrition among school going adolescent children in Medchal, Telangana and also to assess the correlation between nutritional status of adolescent children and their parents’ literacy level and socio-economic class. Materials and Methods: A cross-sectional study was carried out in 1000 adolescent children aged between 10-16 years. Pilot study was conducted on 110 students to test the questionnaire comprising basic data and socio-demographic characteristics before starting the study. Weight and height were measured. Body Mass Index (BMI) was calculated and based on BMI, children were classified into undernutrition, normal, overweight and obese. Parental literacy was ascertained. Parents were divided into five categories of socio-economic class according to BG Prasad Classification. Primary endpoint measured was prevalence of malnutrition among adolescent children and secondary endpoint measured was correlation of mother’s and father’s literacy status with nutritional status which was ascertained using spearman’s rank correlation test. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Prevalence of undernutrition and overnutrition (overweight and obesity) was 48.5% and 4.6% respectively. There was statistically significant (p=0.046) difference between boys and girls with respect to prevalence of undernutrition and overnutrition. Majority of undernourished boys (49.1%) and girls (46.8%) were 13-14 years old. Spearman’s rank coefficient (rho-ρ) showed strong positive correlation between nutrition and socio-economic class (ρ:0.706) with moderate and weak correlation seen for mothers’ education (ρ:0.425) and fathers’ educational status (ρ:0.333), respectively. Conclusion: Undernutrition remains to be a common problem among early adolescents. Socio-economic class and literacy level of parents play significant role in nutrition of adolescents. At school level, adolescent children and their teachers need to be empowered to understand better about the necessity and impact of maintaining a normal nutritional status on their future health.

Wealth and inequality impact blood pressure in a population with the lowest risk of heart disease in the world.

Abstract Background Efforts to improve health equity should be informed by the best available evidence. However, equity-related research is inconsistently indexed, and uses a variety of terms to describe key concepts, making it difficult to reliably identify all relevant studies. We report the development and validation of a search strategy for studies investigating whether the effects of interventions differ by ethnicity or socio-economic status, using the field of transport and health as an example. Methods Adapting previously described methods, we followed four steps: generation of a test set of eligible studies, search strategy development, search strategy validation, and documentation. Results Drawing from 12 systematic reviews, supplemented by additional studies identified by experts and colleagues, we identified a test set of 11 studies that met our eligibility criteria. We assigned five studies to a development set, which we used to develop and refine our search strategy. We assigned the remaining six studies to a validation set, against which we tested our final search strategy. The final search strategy identified all studies in both validation and development sets. Conclusions The validated search strategy derived in this study facilitates the conduct of systematic reviews and other literature searches investigating whether the effects of interventions differ by ethnicity or socio-economic status and may be further developed in future for other equity-focused searches and reviews.

In high-income countries, one’s relative socio-economic position and economic inequality may affect health and well-being, arguably via psychosocial stress. We tested this in a small-scale subsistence society, the Tsimane, by associating relative household wealth (n = 871) and community-level wealth inequality (n = 40, Gini = 0.15–0.53) with a range of psychological variables, stressors, and health outcomes (depressive symptoms [n = 670], social conflicts [n = 401], non-social problems [n = 398], social support [n = 399], cortisol [n = 811], body mass index [n = 9,926], blood pressure [n = 3,195], self-rated health [n = 2523], morbidities [n = 1542]) controlling for community-average wealth, age, sex, household size, community size, and distance to markets. Wealthier people largely had better outcomes while inequality associated with more respiratory disease, a leading cause of mortality. Greater inequality and lower wealth were associated with higher blood pressure. Psychosocial factors did not mediate wealth-health associations. Thus, relative socio-economic position and inequality may affect health across diverse societies, though this is likely exacerbated in high-income countries.

Introduction: Women in India are not fully educated on contraception usage. In 2017, a central family planning initiative called Mission Pariwar Vikas was launched by the Ministry of Health and Family Welfare (MoHFW).Aim: This study was conducted among mothers in an urban slum in Kolkata to establish their unmet family planning needs, as well as different factors associated with it.Materials and Methods: A cross-sectional community-based study was conducted from February 2019 to May 2019 among mothers residing at an urban field practice area (Dhapa UHTC, Kolkata). All mothers of under-five children present in the slum were included in the study (n=246). Pre-designed, pre-tested, semi-structured schedule with both open and closed-ended questions were used.Results: The majority of the mothers were Muslim, of whom 37.8% were below 18 years of age. Among the mothers, 46.3% were adolescent mothers (

Background: Age at menarche (AAM) marks the formal beginning of sexual maturation in girls. Present study focuses on determining the AAM among Tibetan girls and its association with socio-economic status (SES) and physical activity level. Materials and Methods: This study was conducted on 276 Tibetan adolescent girls (13 to 18 years) in Kangra district of Himachal Pradesh. Data was collected using a proforma, consisting of questions regarding socio-demographic profile, AAM and physical activity level (PAQ-A). Data was entered in MS-Excel and analyzed in SPSS 20.0. Results: Early menarche was observed in majority of girls with most frequent AAM as 13 years for the sample. A significant difference of AAM categories was found with SES and level of physical activity. Conclusion: Girls who were in better socio-economic category and were physically more active attained menarche at an earlier age in comparison to others.

INTRODUCTION: This study aimed to analyze the spatial distribution and capacities of public health facilities and assess utilization of the facilities in Biu area of Borno State, Nigeria. METHODS: a descriptive survey of health facilities and households were conducted by stratifying the area into 11 electoral wards. Data collection instruments include a hand-held GPS (Garmin 76CSx) and 2 sets of structured questionnaires (facility and household). The hand-held GPS was used in taking the coordinates of each health facility in the area. Twenty-five facility-based and 400 household-based questionnaires were administered. RESULTS: it was identified that 138 public health personnel serve the area´s population of 240,838. Medical professionals (doctors/nurses/midwives) to patient ratio is 1:2973, about 7 times less than the minimum WHO recommendation of 2.5 medical personal per 1000 population. Uneven distribution of facilities exists, which impact on utilisation. For instance, a ward (Mandaragrau) with a population of 18,732 have 5 facilities (4 dispensaries and 1 primary health care) in comparison to a ward (Miringa) with a population of 21,343 with only one Dispensary. Income level and distance were significant socio-economic factors affecting service utilisation (p = 0.001). Area´s households Gini index was 26.7, most of which (49.7%) survive on less than USD2/day and majority (33.6%) spend an average cost of treatment of ¦ 2,750 (approx. $8) per clinic visit. CONCLUSION: it was concluded that insufficiency and inequity in distribution of healthcare services exist in Borno state. It is thus recommended that future policies be directed toward improving healthcare in under-served areas.

The present study aimed to examine the nutritional deprivation of Paraguayan households (measured as households' access to diverse diets) and investigate the association between nutritional deprivation and socio-economic characteristics in a large sample. An extension of Alkire–Foster methodology, a technique widely employed in multidimensional poverty measurement, was used to calculate both the incidence and intensity of nutritional deprivation. The resulting Nutritional Deprivation Index allows us to consider minimum food group requirements that vary by food groups as well as by individual characteristics such as age, sex and activity level. Applying the methodology to a nationally representative sample of households from the 2011–2012 Income and Expenditures Household Survey, the study found that about two in every three Paraguayan households (67 %) were inadequately nourished in at least four (of the total of six) food groups. Although no significant differences were found between rural and urban households, the incidence of multi-dimensionally deprived households generally decreased as income increased. Logistic regression results showed that nutritional deprivation decreased as household income and mother's education increased and increased with household size. Our study concludes that the majority of Paraguayan households is significantly nutritionally deprived across most food groups and suggests that strategies are needed to improve their access to diverse diets, especially among its lower- and middle-income segments.

Amaç: Bu çalışmanın amacı düşük sosyoekonomik statüdeki popülasyonda kronik otitis media (KOM) ile ilişkili olduğu düşünülen bazı değiştirilebilir risk faktörlerinin rolünü incelemek ve bu konuda geliştirilebilecek sağlık politikalarına katkıda bulunmaktır.Gereç ve Yöntemler: 1 Ekim 2017 - 1 Mayıs 2018 tarihleri arasında Balıklıgöl Devlet Hastanesi Kulak Burun Boğaz polikliniklerine başvuran ve gönüllü olan düşük sosyo-ekonomik düzeye sahip 759 hasta değerlendirildi. Tüm hastaların öyküsü alınarak muayenesi yapıldı. Perforasyonlu KOM tanısı otoskopik muayenede kulak zarında 3 aydan uzun süreli, iyileşmeyen perforasyon bulunması ile konuldu. Hastalar en az bir kulakta perforasyonlu KOM’u olup olmamasına göre iki gruba ayrıldı. Tüm hastalar yaş, cinsiyet, ebeveynlerin eğitim durumu ve meslekleri, yaşadıkları evin durumu, evde yaşayan birey sayısı, ekonomik gelirleri, anne sütü alım süreleri, mama kullanımı, biberonla beslenme ve pasif sigara içiciliği öyküleri açısından sorgulandı.Bulgular: Çalışmamıza dahil edilen 759 hastanın 221 (%29,1)’ine perforasyonlu KOM tanısı konuldu. Gruplar karşılaştırıldığında KOM (+) hastalarda kadın cinsiyet oranı, pasif sigara maruziyeti ve biberonla beslenme; KOM (-) hastalara göre istatistiksel olarak anlamlı izlendi (p=0,035, p

Abstract Background Head and neck cancer incidence is increasing worldwide. Despite overall improvements in survival, numerous studies suggest worse survival in more disadvantaged populations; however, this literature has not been systematically reviewed. The aim of this review is to investigate whether lower compared to higher socioeconomic status (SES) influences survival in head and neck squamous cell cancer (HNSCC) and explore possible explanations for any relationship found. Method A systematic strategy will be used to identify articles, appraise their quality and extract data. Online databases including MEDLINE, Web of Knowledge, ESBCO Host and Scopus will be used to locate observational studies of adults with a primary diagnosis of head and neck cancer in EU15+ countries (15 members of the EU, Australia, Canada, Norway, USA and New Zealand) where the outcomes report associations between SES and survival. This will be augmented by searching for grey literature and through reference lists. Data will be extracted using a standardised form. Study quality will be assessed using the Newcastle Ottawa scale and where possible meta-analysis of the pooled data will be conducted. Discussion This review will quantify the association between SES and survival outcomes for adult head and neck cancer patients in developed countries. The results will help identify gaps in the literature and therefore direct further novel research in the field. Ultimately, this will inform public policy and strategies to reduce the inequalities in HNSCC survival. Systematic review registration PROSPERO CRD42016037019 .

In Germany, a biennial preventive health check-up has been available for individuals aged 35 and older since 1989. The check-up includes identification of cardiovascular disease risk factors and examinations for diabetes mellitus type 2 and kidney disease. Participation in preventive health check-ups among 19,351 women aged 35 to 74 in Germany in 2004 was investigated. Logistic regression was performed to examine associations between participation and age, marital status, education, socio-economic status (SES) and region of residence. In total, 53.4% of women attended at least every two years, 23.4% attended irregularly and 23.2% never attended. In adjusted models, single, divorced, separated or widowed women were less likely to have a preventive health check-up at least every two years compared to married women (OR 0.63, 95% CI 0.57–0.71), while women in eastern Germany were less likely to participate (OR 0.80, 95% CI 0.75–0.86) than women in western Germany. Education showed no association with having a preventive health check-up at least every two years; however, women with low SES were less likely to participate compared to those with high SES (OR 0.82, 95% CI 0.74–0.92). About half of eligible women reported participating in health check-ups at least every two years, with participation varying according to socio-demographic characteristics. Women who are less likely to participate may benefit from receiving invitation letters within the framework of an organised programme. The benefits of general health checks, however, need to be evaluated.

National Insti­tute for Health and Clinical Excellence (NICE) and a number of conducted aim analyses, confirmed the presence of intercommunications between socio-economic status of children and teenagers and their antisocial behavior and distinguished the role of such factors, as their psychological features, age and sex. The clinical and psychological inspection of teenagers enabled to distinguish in them such types of personality forming as: aggressive, labial states, instable, with "absence of brake", sexually-fixed, hysteroid, apathetical, schizoid, paranoidal. Processes of socialization, absence or presence of paternal attention to education, capacity for co-operation between parents and teenagers, depression in a mother or father, genetic and phenotype (external) factors cause antisocial behavior of teenagers. It is shown, that genetic factors that affect antisocial behavior of teenagers were more expressive in rich families, while phenotype (external) – in poor families. A review of undertaken studies showed, that there is the necessity of deep research of interaction of social and biological factors for understanding of the role of socio-economic factors in forming of antisocial behavior of children and teenagers.

National Insti­tute for Health and Clinical Excellence (NICE) and a number of conducted aim analyses, confirmed the presence of intercommunications between socio-economic status of children and teenagers and their antisocial behavior and distinguished the role of such factors, as their psychological features, age and sex. The clinical and psychological inspection of teenagers enabled to distinguishin them such types of personality forming as: aggressive, labial states, instable, with "absence of brake", sexually-fixed, hysteroid, apathetical, schizoid, paranoidal. Processes of socialization, absence or presence of paternal attention to education, capacity for co-operation between parents and teenagers, depression in a mother or father, genetic and phenotype (external) factors cause antisocial behavior of teenagers. It is shown, that genetic factors that affect antisocial behavior of teenagers were more expressive in rich families, while phenotype (external) – in poor families. A review of undertaken studies showed, that there is the necessity of deep research of interaction of social and biological factors for understanding of the role of socio-economic factors in forming of antisocial behavior of children and teenagers.

Background. Although decision-making authority is associated with maternal healthcare utilisation, the evidence on the relative importance of individual-level v. community-level decision-making participation for child survival in sub-Saharan Africa is limited. Objectives. To assess the net effects of individual- and community-level measures of decision-making involvement (DMI) on under-5 mortality in Nigeria. Methods. Data on a nationally representative sample of 31 482 children in the 2013 Nigeria Demographic and Health Survey were analysed. Mothers who reported involvement in decision-making on own healthcare, major household purchases and visits to friends and relatives were categorised as having high DMI. Community-level measures of DMI were derived by aggregating the individual measures at the cluster level. Kaplan-Meier estimates of childhood mortality rates were computed. Multilevel discrete-time hazard models were employed to investigate the net effect of individual- and community-level DMI on childhood mortality. Results. Childhood mortality, at 59 months, was higher among children of women with low DMI (120 per 1 000) compared with those with high DMI (84 per 1 000). The full multilevel model showed that there was no difference in the risk of childhood death between children whose mothers had high v. low DMI (hazard ratio (HR) 1.01, CI 0.90 - 1.12). However, mortality risk was found to be lower among children in communities with medium DMI (HR 0.84, CI 0.74 - 0.96). Maternal age at child’s birth, education, household wealth index and preceding birth interval were significantly associated with under-five mortality. Conclusion. Besides socioeconomic and biodemographic characteristics, community- and not individual-level DMI was associated with under-5 mortality. Women’s empowerment programmes targeting maternal and child health outcomes should also focus on communities.

DMFT index is one of the best dental epidemiological indices, which represent the oral health status of the population and has been accepted by authorities and international organizations such as the World Health Organization. The aim of this study was to assess the permanent teeth DMFT index in guidance school students to determine the influencing factors such as brushing, tea and sugar consumption , number and type of snacks, parents education status, family member number, economic situation and visiting the dentist status. In this descriptive, cross-sectional study, 320 student girls from guidance school (12 years old) were randomly selected in Piranshahr city. Their health information was obtained by referring to their health files to determine DMFT. For some related factors to the index a questionnaire was designed by researcher and completed by the students. The data was statistically analyzed using independent T-test and ANOVA. The mean DMFT in the students was 2.53 ± 2.28. The frequency of brushing, snack consumption, visiting the dentist, family economic status had significant correlation with the DMFT index (P0.05). The average of DMFT in Piranshahr guidance school students is higher than World Health Organization standards; thus, to improve the present situation, it is necessary to design a proper plan. More attention to families dental and oral health is necessary via mass media, heath service centers and health teachers in schools.

Background Poor diet and high infection rates inflicted by low socio-economic status and poor environments among infants and young children appear to be major causes of severe malnutrition. Objective To determine the practical and likely effectiveness in rehabilitation of severe malnutrition. Methods A descriptive observational study was conducted on 27 children at three different sites: (1) Five inpatients at the Inpatient Ward, Cipto Mangunkusumo Hospital, Jakarta (IP-CM); (2) 8 out- patients at the Metabolic and Nutrition Clinic, Cipto Mangunkusumo Hospital (OP-CM); (3) 14 outpatients at the Nutrition Clinic, Bogor (NC). All the patients followed were aged

Background: Eczema is one of the important causes of public health problem. So, we conducted a study to assess the socio-demographic characteristics (age, sex, occupation, socio-economic condition, site of lesion, diabetes status etc) and to find out their relationship with the complicated eczema. Objective: The objective of the study was to find out the eczema cases attending in Department of Dermatology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital and to identify the surface complications of eczema and the occurrence of eczema among the diabetic patients of BIRDEM Hospital. Materials and Methods: This cross-sectional study was carried out among the outdoor diabetic patients attending the Department of Dermatology of BIRDEM Hospital, Dhaka, Bangladesh during the period of 1st September to 31st November, 2014. Results: A total of 600 patients were interviewed. Of them, 60% were female and 40% were male. Among them, majority (29.17%) were in the age group of 40–49 years. Most of the subjects (66.67%) were service holders. Majority of the subjects (61.67%) were from low socio-economic status. In majority cases (41.67%) lesions were in hand and in 33.33% in legs. Diabetes was uncontrolled in 76.67% cases and only 15% controlled it and 8.33% controlled strictly. Conclusion: Factors like occupation, diabetes status etc. were found associated with high occurrence of eczema.

Purpose: Increased life expectancy leads to an increase in the elderly population. However, with an increase in the age, the number of chronic diseases and cognitive disorders also increases. Since the social, cultural, environmental, lifestyle and health-related behavior is specific to each nation, the present study aimed at investigating the relationship between socio-economic status, health, physical fitness, and cognitive function in older adults with functional performance in Iran. Methods: It is a cross-sectional study involving 42 older adults (20 women, 22 men) through a survey questionnaire and accessible sampling method. The age range of the study participants was 60 to 91 years. The questionnaire was used by the examiner to collect information on the age, height and weight, history of diseases, health status, physical fitness, and socio-economic status, for assessing the functional performance of older adults. The three performed tests included Sit-to-Stand test to examine the strength and lower extremity function, the Timed Up and Go (TUG) test to measure the speed and balance while walking and the Purdue Pegboard Test (PPT) for measuring the hand function. A step-wise regression model analysis was applied by using SPSS (version 19). Results: In sit-to-stand test, the test of significance of regression coefficients was profound in case of dependent variables (marital status (P=0.003) and overweight (P=0.014)). In TUG test, the dependent variables, age (P=0.002), marital status (P=0.081), and cognitive function (P=0.048) were influential on the TUG performance. In PPT, the independent variables, age (P=0.041), gender (P=0.012), marital status (P=0.058), and cognitive function (P=0.001), had a significant effect on the hand function. Conclusion: Age-related changes, cognitive functions, and socioeconomic status were the most important factors affecting the functional performance of the elderly. Weight and gender also affected some aspects of functional performance. The author further recommends controlling and preventing loss of cognitive function and improving the social status and age-related changes in the older Iranian adults.

Introduction: The present study aims to compare general health and life expectancy between students with favorable and unfavorable socioeconomic status. Methods: The statistical population in this study consists of all the students of Lamerd city in the second semester of the academic year of 2013-2014. The sample of this study consists of 200 male and female students. A hundred of them are in the favorable socioeconomic status and the other 100 are in the unfavorable socioeconomic status which were selected by multistage random sampling. Results: The results of the analysis of MANOVA on the mean of life expectancyand general health scores indicated that there is a significant difference between the two groups regarding the investigated variables. Conclusion: In general, given the vulnerability of people who are in low socioeconomic status compared to the other segments of the society, more attention should be paid to this issue by the authorities.

Diabetic Foot Ulcer subjects (DFUS) were clinically examined in the urban areas of Karachi. Neuropathy, peripheral vascular disease, foot deformity, improperly fitted shoes can make a diabetic person at risk of foot ulcer. In the present study, prevalence, role of inadaptable risk factors (age, gender, height) and socio-economic status were examined in DFUS and normal diabetic patients (NDP) taken as control. A total of randomly selected subjects N= 59; male=33, female=26 (DFUS: n=41; male=22, female=19; NDP: n=18; male=11, female=7). In this study prevalence of DFU was found in male gender as 54% of our patients were male and 46% were female. Mean ± S.E.M. of male DFUS height was 5.7 ± 0.353 ft while that of women was 5 ± 0.306 ft, this greater height in male makes them predominant for DFU. Mean ± S.E.M. of age for DFUS males: 58 ± 10.237 years, that is comparatively higher than control NDP males: 56.81 ± 10.235 years. Mean ± S.E.M. of age for DFUS females: 54 ± 11.18 years which is also significantly higher than control NDP females: 49.57 ± 9.727 years. The greater part of the investigated patients belonged to lower class (54% males & 74% of females).