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Skin diseases are complex and cannot be explained solely by genetic or environmental factors but are also significantly shaped by social influences. This review illuminates the bidirectional relationship between social factors and skin diseases, demonstrating how social determinants such as socioeconomic status, living environment, and psychosocial stress can influence the onset and progression of skin conditions. Simultaneously, it explores how skin diseases can affect individuals' social lives and work capability, leading to a cycle of social withdrawal and further deterioration of the condition. The paper describes the need for a holistic approach in dermatology that goes beyond the biomedical perspective and incorporates social factors to develop effective prevention and treatment strategies. The increasing prevalence of skin diseases in Europe and the expected rise in allergies due to climate change make the consideration of social determinants even more urgent. The findings of this review aim to raise awareness of the complex interconnections between social factors and skin health and contribute to reducing social disparities in skin health., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Pain, specifically chronic pain, is a major public health issue worldwide with considerable health-related consequences and large economic impact. The relation between socioeconomic status and pain occurrence is well established. However, little is known on the relation between socioeconomic factors and worsening of pain, including progression from non-chronic pain to chronic pain., Methods: To assess the relation between socioeconomic status and pain worsening, we used the Stockholm Public Health Cohort Study from 2006 to 2014 and analysed data of 9721 participants who completed follow-up. The adjusted incidence rate ratios (IRRs) of moderate and severe pain worsening episodes were computed, using a pain amplification model, which encompasses spreading, somatisation, and psychological distress components. Multiple imputation analysis was performed subsequently to adjust for cohort attrition., Results: Compared with non-skilled workers, self-employed subjects (IRR=1.18; 95% confidence interval [CI], 1.01-1.39) and non-manual employees were at higher risk of moderate worsening (lower non-manual employees: IRR=1.21; 95% CI, 1.03-1.41; intermediate non-manual employees: IRR=1.26; 95% CI, 1.10-1.44; higher non-manual employees: IRR=1.25; 95% CI, 1.08-1.45). This risk increase was limited to worsening starting at stage 0 (non-chronic pain). No association was found between socioeconomic status and severe pain worsening., Conclusion: Our results support a moderate association between intermediate and high socioeconomic status, and moderate pain worsening. This association could be explained by the heterogeneous composition of the socioeconomic variable used in this cohort, and by changes in exposure and other time-varying covariables' status during follow-up., (Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11-12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group-three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points ( p < 0.001) and in the total sample by 0.4 ( p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80-7.31 and 2.99, 1.60-5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.

Background: A large number of the population experienced panic during the pandemic of the coronavirus disease 2019 (COVID-19) in China. The current study explored the trajectory of panic and its associated factors to develop promising strategies for controlling the global spread of COVID-19 and improving the mental health emergency management., Methods: A total of 812 unmarried adults (aged from 18 to 42 years, M = 23.3, SD = 3.45) from all over China participated online in our investigation. A Growth Mixture Model (GMM) was developed and analysed., Results: Three classes of trajectories for panic were identified: the "continuous decline group (CDG)", the "continuous low group (CLG)," and the "continuous high group (CHG)". With reference to the CDG, people in the CHG were more sensitive to social factors. With reference to the CDG, people in the CLG were more likely to possess some of the following traits: being men, in Hubei Province (center of the pandemic), with a lower income, and less sensitive towards social factors and individual factors. With reference to the CLG, people in the CHG were more likely to be women, located outside of Hubei Province, and more sensitive to social factors, family factors, and individual factors., Conclusion: Social factors, family factors, and individual factors predicted the different trajectories of panic., (© 2020 International Association of Applied Psychology.)

Objectives: We aimed to investigate possible differences in the aggregated hospital fatality rate from coronavirus disease 2019 (COVID-19) in France at the early phase of the outbreak and to determine whether factors related to population or healthcare supply before the pandemic could be associated with outcome differences., Study Design: This is a nationwide observational study including all French hospitals from January 24, 2020, to April 11, 2020., Methods: We analyzed the aggregated hospital fatality rate. A Poisson regression was performed to investigate associations between characteristics pertaining to populational health, socio-economic context and local healthcare supply at baseline, and the chosen outcome., Results: On April 11, 2020, a total number of 30,960 patients were hospitalized among the 3046 French healthcare facilities, including 6832 patients in the intensive care unit (ICU). A total of 8581 deaths due to COVID-19 had been recorded, with a median mortality rate per 10,000 people per department of 0.53 (interquartile range: 0.29-1.90). There were significant variations between the 95 French departments even after adjusting for outbreak inception (P < 0.001). After multivariable analysis, four factors were independently associated with a significantly higher aggregated hospital fatality rate: a higher ICU capacity at baseline (estimate = 1.47; P = 0.00791), a lower density of general practitioners (estimate = 0.95; P = 0.0205), a lower fraction of activity from the for-profit private sector (estimate = 0.99; P < 0.001), and the ratio of people older than 75 years (estimate = 0.91; P = 0.0023)., Conclusions: The aggregated hospital fatality rate from COVID-19 in France seems to vary among geographic areas, with some factors pertaining to local healthcare supply being associated with the outcome., (Copyright © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Depressive symptoms and suicidal ideation are common internalizing problems during adolescence. Numerous studies have explored the role of certain demographic, social, and economic factors in their development in referred or non-referred adolescents, but not simultaneously in both groups. In this study, we examined the association between age, gender, parents' educational level, and socioeconomic status (SES) and depressive symptoms and suicidal ideation in a referred group ( n = 211) and a non-referred ( n = 1401) group of adolescents. We also examined the moderating role that these factors play in the relationships between both internalizing problems. The results showed: higher levels of depressive symptoms and suicidal ideation in the referred group; an increase in both problems during early-to-middle adolescence in the non-referred group; an association between low SES and suicidal ideation in both groups; an association between low father's education level and depressive symptoms in the non-referred group; and no gender differences in either of these two internalizing problems. The moderation analyses showed that age, in referred adolescents, and SES, in non-referred adolescents, moderated the relationship between depressive symptoms and suicidal ideation. This study contributes to the identification of groups of vulnerable adolescents that could constitute the target populations of preventive programs.

Aims: Portugal was one of the European countries most affected by the period of economic recession initiated in 2008. Social inequalities are likely to widen during such periods and disproportionately affect people with mental disorders. The present study aims to compare self-reported changes in indicators of socioeconomic position during the economic recession in Portugal among people with and without mental disorders in the beginning of this period. Three dimensions were assessed, namely employment situation, experiences of financial hardship and subjective social status., Methods: Data from the World Mental Health Survey Initiative Portugal (2008/2009) and from the National Mental Health Survey Follow-up (2015/2016) were used (n = 911). Multinomial and logistic recession models were performed to examine the association between the presence of any 12-month mood or anxiety mental disorder in 2008/2009 and indicators of socioeconomic position in 2015/2016. All analyses were adjusted for gender, age, presence of any physical disorder and education at the baseline., Results: Participants that had any mental disorder in the beginning of the economic recession reported 2.20 (95% CI 1.31-3.71; P < 0.01) higher odds of financial hardship related to daily life in 2015/2016, when compared with those without any mental disorder, after adjusting for age, gender, education and presence of any physical disorder. The results may also suggest a pattern of increased socioeconomic disadvantage among people with prior mental disorder, despite not reaching statistical significance., Conclusions: The results of this study suggest that the economic recession may have contributed to wider social inequalities between people with and without mental disorders. Policies to support these individuals, such as access to treatment and alleviation of financial hardship, should be a priority in times of economic downturn.

Intimate partner violence (IPV) poses a threat to the attainment of reproductive justice. Women who experience IPV are limited in their ability to parent their children in a secure and nurturing environment, which can have negative effects on the mother and child immediately and long-term, potentially distressing reproductive well-being across generations. Societal inequities faced by women, particularly women of color, within education, economic, and legal systems are associated with risk factors for IPV. This article will use national- and state-level data with case examples and the lens of reproductive justice to consider the impact of and potential solutions to historical and institutional inequities related to IPV., (© 2019 Michigan Association for Infant Mental Health.)

The aim of this study was to identify relationships between the physical activity and sociodemographic status of respondents aged 18-64 years. The research was conducted in 2014 and 2015 in Wrocław, Poland. The study group comprised 4460 people. The sample selection was random and stratified. The research tool was the International Physical Activity Questionnaire-Short Form. Levels of physical activity declared by respondents were compared with the recommendations of the American College of Sports Medicine (ACSM). Data on respondents' sociodemographic status was also obtained. The Mann-Whitney U test for samples, Kruskal-Wallis test by ranks, and total and binary logistic regression were used in statistical analysis. Among the respondents, the ACSM health recommendations were met by 43.7% in total (43.2% women and 44.3% men). All analyzed sociodemographic variables differentiated respondents' physical activity. The youngest respondents were found to be the most physically active. Wrocław residents with a secondary education declared the highest level of physical activity. Among the respondents, manual workers revealed the highest, and the unemployed the lowest odds of meeting the ACSM standards of health-related physical activity. The level of physical activity of unmarried respondents was higher than that of married respondents. The highest percentage of respondents (50.9% women and 54.2% men) with sufficient physical activity levels was found among people living alone. Measures aimed at reducing hypokinesia should be addressed primarily in vulnerable groups, i.e., the unemployed and oldest men.

Background: Environmental pollution exposure during pregnancy has been identified as a risk factor for preterm birth. Most studies have evaluated exposures individually and in limited study populations., Methods: We examined the associations between several environmental exposures, both individually and cumulatively, and risk of preterm birth in Fresno County, California. We also evaluated early (< 34 weeks) and spontaneous preterm birth. We used the Communities Environmental Health Screening Tool and linked hospital discharge records by census tract from 2009 to 2012. The environmental factors included air pollution, drinking water contaminants, pesticides, hazardous waste, traffic exposure and others. Social factors, including area-level socioeconomic status (SES) and race/ethnicity were also evaluated as potential modifiers of the relationship between pollution and preterm birth., Results: In our study of 53,843 births, risk of preterm birth was associated with higher exposure to cumulative pollution scores and drinking water contaminants. Risk of preterm birth was twice as likely for those exposed to high versus low levels of pollution. An exposure-response relationship was observed across the quintiles of the pollution burden score. The associations were stronger among early preterm births in areas of low SES., Conclusions: In Fresno County, we found multiple pollution exposures associated with increased risk for preterm birth, with higher associations among the most disadvantaged. This supports other evidence finding environmental exposures are important risk factors for preterm birth, and furthermore the burden is higher in areas of low SES. This data supports efforts to reduce the environmental burden on pregnant women.

Background: The epidemiological literature has reported differences by sex in the prevalence of psychiatric diagnoses. However, we know little about how other socio-demographic factors participate in these differences., Aim: To identify the socio-demographic factors that correlate with prevalent psychiatric diagnoses in women and men in a Chilean urban psychiatric hospital population., Method: Socio-demographic information (age, educational level, marital status, family group and work status), psychiatric diagnoses and sex of the population were collected for 3,920 patients of a tertiary care hospital during a period of 8 years (2007-2014). The data were subjected to bivariate and multivariate analyses comparing the results by sex., Results: Among the most prevalent psychiatric diagnoses, those significantly correlated with sex were eating disorders and major depression (women) and schizophrenia (men). Socio-demographic factors behave differently in men and women regarding those diagnoses. Among the differences, working and being married correlated directly with the diagnosis of depression only among women. Living alone correlated directly with the diagnosis of schizophrenia among men, but correlated inversely among women., Conclusion: Dissimilar associations between sex, psychiatric diagnosis and socio-demographic factors found in this Latin American sample invite us to reflect on how social conditions crosscut the relation between sex and psychopathology and to include gender perspectives in psychiatric practices.

The study was carried out to analyze national and international publications evaluating impact of social factors on population mortality. The analysis was made on the basis of publications accessible in prints and electronic format (MEDLINE, EMBASE, ISI Web of Science) in Russian and English from 1990 to 2015. The results of generalized studies testify a valuable impact on standardized mortality coefficients of such factors as social support and social integration, higher level of education, higher social position, global peacefulness index, developed infrastructure. The negative impact is made by social stress, lower level of education, higher level of unemployment, social deprivation. It is established that social factors are ones the main factors effecting population mortality level. The effect of social factors is ambivalent and heterogeneous in time and by population groups. he quantitative evaluation of effect of every one of social factors is difficult.

Objectives: Financial strain has important consequences for patients, providers, and health care systems. However, there is currently no gold standard measure to screen for financial strain. This study compared the performance of 3 single-item screeners using a composite measure of financial strain as a "gold standard." Methods: We conducted a secondary analysis of unweighted data from a 2021 survey of Kaiser Permanente Northern California health plan members comparing the percentages of adults who experienced financial strain based on 3 general single-item screeners, a screener specific to medical and dental health care use, and a composite financial strain measure. The study sample was comprised of 2734 non-Medicaid insured adults who answered all financial strain questions. Kappa statistics evaluating agreement of the 3 general screeners with the composite measure were calculated for the sample overall, by age group, and within age group, by 4 levels of income and 4 racial/ethnic subgroups. Results: Among 947 adults aged 35 to 65, 30.7% had just enough money or not enough money to make ends meet, 23.3% had a somewhat hard or hard time paying for basics, 18.8% had trouble paying for ≥1 type of expense, 20.5% had delayed/used less medical/dental care, and 41.5% had experienced financial strain based on the composite measure. Among 1787 adults aged 66 to 85, the percentages who screened positive on these measures were 22.7%, 19.4%, 12.9%, 19.8%, and 34.4%, respectively. Across the sample, by income categories and racial/ethnic groups, the making ends meet screener identified higher percentages of adults experiencing financial strain and performed better when compared with the composite measure than the hard to pay for the very basics and trouble paying for expenses screeners. Overall, substantial decreases in the percentages of adults who screened positive on the financial strain measures were seen as level of income increased. Within income categories, middle-aged adults were more likely than older adults to have experienced financial strain based on the composite and general single-item screeners. Conclusions: As social risk screening becomes part of the standard of care, it will be important to assess how well different brief screeners for financial strain perform with diverse patient populations. [ABSTRACT FROM AUTHOR]

Social determinants of health encompass the social environmental factors and lived experiences that collectively shape an individual's health. Recently, the polysocial score approach has been introduced as an innovative method for capturing the cumulative impact of a broad spectrum of social factors. This approach offers a promising opportunity to complement and enhance conventional methodologies in the advancement of research on social determinants of health. In this issue of the Journal , Jawadekar et al (Am J Epidemiol. 2024;193(9):1296‑1300) evaluate the value of the polysocial score for predicting cognitive performance and mortality among middle-aged and older adults. Models built on a smaller set of social determinants, including race/ethnicity, sex, and education, performed comparably to the polysocial score models in which a more complex set of social factors was included. In this invited commentary, I evaluate the predictive ability of the polysocial score and discuss its merits and limitations. I also summarize the practical utility of the polysocial score in predicting health outcomes and its mechanistic significance in unveiling the relationship between genetics, social environment, and lifestyles in shaping an individual's health and elucidate health disparities. Lastly, I propose several avenues for future research. [ABSTRACT FROM AUTHOR]

While far-right movements are commonly associated with masculinity and women are in the minority, it is notable that they often play significant roles within these movements. To deepen our understanding of the motivations behind women's participation, this study challenges Blee's argument that women's motivations for participating are shaped by their interactions with other members. By using the psychosocial method devised by Hollway and Jefferson and developed by Gadd, the present study argues that women's pre-participation experiences can play a vital part in drawing them to the movements. Through analyzing the life stories of six far-right women in Japan and conducting an in-depth case study of three of them, the study aims to uncover a wide range of experiences that may initially appear unrelated to far-right ideology but ultimately led these subjects to become involved in far-right movements. It highlights the importance of paying attention to their complex subjectivities, which are formed by the interplay between their unique trajectories and societal transitions concerning gender norms, particularly within the era of neoliberal "emancipation." The study finds that the duality of far-right movements, which combine conservatism with deviance, enables some women to express paradoxical desires that they experience in response to living through a transitional era. [ABSTRACT FROM AUTHOR]

Inconsistent results are found regarding social inequalities related to healthcare appointment cancellations during the COVID-19 crisis. Whether rescheduling was associated with social status is unknown. By studying both cancellations and rescheduling, we comprehensively describe which social groups were affected by care disruption. First follow-up of a random population-based cohort was used, including 95 118 people aged 18 or older at baseline and who live in France. Poisson and multinomial regressions were used to study social factors associated with experiencing both medical appointment cancellation by health professionals during the first COVID-19 lockdown, and rescheduling within six months. Among all individuals (including those without scheduled appointment), 21.1% reported cancellations initiated by healthcare professionals. Women, the richest, and those with a chronic disease were the most affected by these cancellations. Although 78.1% who had their appointment cancelled obtained a new appointment within six months, 6.6% failed to reschedule and 15.2% did not want to reschedule. While the oldest were more likely to reschedule, regardless of their health status, the poorest and those with multiple chronic diseases were less likely to do so. Difficulties in rescheduling revealed certain social groups were ultimately more penalized by the restriction of access to care during the first wave of the COVID-19 pandemic. Given that the poorest people, a social group that is in poorer health condition compared to other groups, were the most affected, our results raise questions about the ability of the healthcare system to reduce social health inequalities during a major health crisis. [ABSTRACT FROM AUTHOR]

Context Nutrition plays a critical role in adolescence. Adolescents are vulnerable to the impact of different factors that distance them from healthy habits, increasing their risk of chronic diseases in adulthood. Qualitative methodologies allow for a better understanding of these factors. Objective This systematic review aims to consolidate qualitative research evidence from the past 10 years to analyze the facilitators and barriers influencing adolescents' eating behaviors. Data Sources Databases searched for relevant studies were Scopus, Medline/PubMed, PsycINFO, and Web of Science. Data Extraction A total of 4176 records were identified. The authors used the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative Research) quality-assessment tool. Results Fifty articles with qualitative or mixed methodologies were finally included. The most applied techniques were focus groups and semi-structured interviews. The factors influencing adolescents' diets were classified into 4 dimensions: individual, social, community, and macrosystem factors. The most influential were the following—(1) at the individual level: gender (facilitator or barrier), taste and appearance of food (barrier), and lack of time (barrier); (2) at the social level: parents' and caregivers' influence (facilitator or barrier), peer group influence (barrier), and socioeconomic position (barrier); (3) at the community level: school food environment (facilitator or barrier), neighborhood food environment (barrier), household food environment (facilitator or barrier), food insecurity (barrier), and availability and affordability of ultra-processed foods (barrier); and (4) at the macrosystem level: digital tools (facilitator or barrier). Conclusions This systematic review identified several facilitators and barriers influencing eating behaviors among adolescents. Qualitative research provides a rich source of knowledge to inform interventions aimed at improving adolescents' diets. Qualitative research is very useful for collecting researches that help to implement intervention programs that improve adolescent nutrition. [ABSTRACT FROM AUTHOR]

Life expectancy at birth is considered a parameter of the social development, health system, or economic development of a country. We aimed to investigate the effects of GDP per capita (as the economic factor), health care expenditure, the number of medical doctors (as social factors), and CO2 emissions (as the environmental factor) on life expectancy. We used panel data analysis for 13 Eastern European countries over the 2000–2020 period. After performing the analysis, we used a cross-country fixed-effects panel (GLS with SUR weights). According to our model, a one percent increase in health expenditure (as % of GDP) increases life expectancy at birth by 0.376 years, whereas each additional medical doctor per 10,000 inhabitants increases life expectancy at birth by 0.088 years on average. At the same time, each additional 10,000 USD per capita each year would increase life expectancy at birth by 1.8 years on average. If CO2 emissions increase by 1 metric ton per capita, life expectancy at birth would decrease by 0.24 years, suggesting that higher carbon emissions are capable of reducing longevity. Every European country has to make special efforts to increase the life expectancy of its inhabitants by applying economic and health policies focused on the well-being of the population. [ABSTRACT FROM AUTHOR]

Background: The work of the WHO Commission on the Social Determinants of Health has been fundamental to provide a conceptual framework of the social determinants of health. Based on this framework, this study assesses the relationship of income inequality as a determinant of neonatal mortality in the Americas and relates it to the achievement of the Sustainable Development Goal target 3.2 (reduce neonatal mortality to at least as low as 12 deaths per 1,000 live births). The rationale is to evaluate if income inequality may be considered a social factor that influences neonatal mortality in the Americas. Methods: Yearly data from 35 countries in the Americas during 2000–2019 was collected. Data sources include the United Nations Inter-agency Group for Child Mortality Estimation for the neonatal mortality rate (measured as neonatal deaths per 1,000 live births) and the United Nations University World Institute for Development Economics Research for the Gini index (measured in a scale from 0 to 100). This is an ecological study that employs a linear regression model that relates the neonatal mortality rate (dependent variable) to the Gini index (independent variable), while controlling for other factors that influence neonatal mortality. Coefficient estimates and their robust standard errors were obtained using panel data techniques. Results: A positive relationship between income inequality and neonatal mortality is found in countries in the Americas during the period studied. In particular, the analysis suggests that a unit increase in a country's Gini index during 2000–2019 is associated with a 0.27 (95% CI [− 0.04, 0.57], P =.09) increase in the neonatal mortality rate. Conclusion: The analysis suggests that income inequality may be positively associated with the neonatal mortality rate in the Americas. Nonetheless, given the modest magnitude of the estimates and Gini values and trends during 2000–2019, the findings suggest a potential limited scope for redistributive policies to support reductions in neonatal mortality in the region. Thus, policies and interventions that address higher coverage and quality of services provided by national health systems and reductions in socio-economic inequalities in health are of utmost importance. [ABSTRACT FROM AUTHOR]

This article presents data on family caregiving for elders with dementia in Oaxaca, Mexico. Drawing on a year of ethnographic research, this article explores how caregivers engage in health-seeking behaviors and how they choose between biomedical and traditional medical alternatives. While caregivers are primarily concerned to maintain elders' health, decisions about which medical providers to (not) consult invoke broader social factors that go beyond their relationships with elders, and concern socioeconomic realms of power, as well as broader ideals concerning local tradition and its maintenance in the contemporary world. [ABSTRACT FROM AUTHOR]

Purpose: To determine older adults' metaphorical perceptions of the concept of aging. Method: Participants in this qualitative study comprised 57 older adults as determined using convenience and criterion sampling methods. Data were obtained using a personal data form and the metaphor form and analyzed with descriptive and content analysis techniques. Results: Fifty-seven metaphors were identified within three themes: 24 within Mental Aspect, 18 within Physical Aspect, and 15 within Psychosocial Aspect. Conclusion: The fact that most metaphors appeared within the Mental Aspect theme was interpreted as an indication that participants felt the effects of aging more in the mental dimension. Results of the research show that aging is perceived as experience and accumulation mentally, as inadequacy physically, and as the end or loneliness psychosocially. [Journal of Gerontological Nursing, 50(5), 27–34.] [ABSTRACT FROM AUTHOR]

Globally, adolescent pregnancy is one of the key issues in women's reproductive health. Adolescent mothers face a higher risk of obstetrical concerns, and motherhood in adolescence is strongly influenced by lower education level and lower socioeconomic status. The present study was carried out across all Indian states and Union Territories using the National Family Health Survey, rounds 1 to 5 (1992–1993 to 2019–2021) in which various socioeconomic and cultural factors associated with adolescent pregnancies was examined in detail. The article uses univariate, bivariate with chi-square test, and multivariate logistic regression models to understand the extent of which socioeconomic factors and sexual behavior of the couple are related to early motherhood experiences. It was found that age at marriage, respondent education, employment, age gap between partners, and religion are some of the important variables that affect the likelihood of adolescent pregnancy among females in Indian states. Comprehensive institutional efforts like free contraceptives and counseling services should be provided to address the increasing risk of pregnancy among adolescents. [ABSTRACT FROM AUTHOR]

Serbia has gained international recognition for its fruit production, particularly establishing itself as one of the top five global producers and exporters in the raspberry sector. Given the highly intensive nature of raspberry production and the diverse range of producers, spanning from small farms to large corporate entities, research on the sustainability of production and future strategies has become increasingly important. The study explores the significance of economic, environmental, and social factors influencing raspberry producers' practices. It also delves into their future production strategies, examining these aspects from the perspective of farmers. The findings derived from interviews with farmers reveal statistically significant differences between the two subsamples, namely formal and informal, across basic socio-economic and sustainability indicators, as well as in their anticipated future production strategies. The specific approaches and measures in achieving overall sustainability were emphasised in the concluding remarks. [ABSTRACT FROM AUTHOR]

The rise and spread of antibiotic-resistant bacteria have become a global health problem. At the community level, bacterial resistance has been linked to antibiotic misuse practices. These practices are related to social factors such as education level, poverty, ethnicity, and use of traditional medicine. Through a survey, this study aims to analyse the knowledge, attitudes, and practices (KAP) of antimicrobial use, in an indigenous community in the south of Oaxaca, Mexico. It was observed that the population had a low socioeconomic profile, poor access to healthcare services, low academic level, little knowledge of antibiotics, the use of traditional medicine, and proper attitudes and practices regarding antibiotics use. Therefore, social factors are related to bacterial resistance only if they make the population prone to the use of antimicrobials. Lack of medical access and cultural factors drives this population to use ancestral alternatives such traditional medicine to treat conditions that in other contexts could be treated with antibiotics. This is an example of how the population can reduce the consumption of antimicrobials in infections if they have a reliable alternative that improves their symptoms. [ABSTRACT FROM AUTHOR]

The article is devoted to solving the problem of "budgetary financial adequacy of higher education" in China through a fairer, uniform, and sufficient distribution of financial costs for higher education among the provinces of this country, considering significant differences in the natural, economic, and social conditions of development in various regions. Currently, in China, the calculation of standard financial costs for the education sector is carried out according to the legal requirements of the Budget Department of the Ministry of Finance, taking into account the number of people studying at the corresponding level of education, the cost norm for this level of education, and the deviation coefficient. Instead, this article proposes a more comprehensive and rational approach that considers regional differences in the cost of living and the financial burden on higher education institutions, increasing the government's responsibility for supporting a balanced distribution of financial resources for higher education. To take into account regional differences, it is proposed to use a system of indices for the difference in the costs of regional development, which includes three main categories of indicators: natural factors (the complexity of the terrain and the share of the area planted with forests), economic factors (the index of prices for raw materials, GDP per capita, freight traffic, and the total duration of operation of urban public transport), and social factors (population density in municipal areas, number of graduates of general education colleges and universities). To determine the fair size of budgetary expenditures on higher education, it is proposed to make adjustments to the index of differentiation of regional development expenditures, which combines these indicators using the geometric regression average benchmark method (without including a constant term). A higher value of this index means that the region needs more resources to achieve the same level of development as another region, so the standard budget expenditures for higher education should be higher for it. For all provinces in China, the coefficient of financial adequacy of higher education was calculated as the ratio between the standard financial costs of higher education (calculated according to the proposals outlined in this article) and the actual costs incurred. It is proposed that this coefficient be used as a basis for optimizing their distribution. The article emphasises the need to form a strategy for financing higher education in China, which should be based on a dynamic permanent adjustment of the amount of allocated financial resources depending on changes in the regional social and economic conditions of development of each province, an effective institutional mechanism that would allow adapting this strategy to endogenous and endogenous changes in China's economy, optimisation of horizontal transfer payments and partnership assistance programs, and incentive mechanisms for local governments to invest in higher education. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to reflect on how the COVID-19 pandemic has intensified the social and economic vulnerability of Indian elderly women, thereby making them prone to varied forms of abuse and denying them of the basic rights of secured existence. Design/methodology/approach: This study was conducted by analyzing primary data from government sources that dealt with the aging Indian population and the common predicaments that elderly women experienced during the pandemic. A qualitative interview was conducted in three old-age homes in India where the experiences of 26 elderly female residents were documented for understanding their experiences during the pandemic. The secondary data collected from different newspaper articles and online resources also enabled in perusing the difficulties that they faced both at home and the caregiving space at the critical juncture of COVID-19. Findings: Nearly 73% of the elderly population in the country has faced an incidence in different forms of abuse and exploitation during the subsequent waves of the pandemic. Disrespect and neglect were the most common type of mistreatment and around 23.1% reported physical assault. The elderly women were victimized further on socioeconomic grounds and their rights of living a secured and dignified life were significantly neglected. Research limitations/implications: The basic premise of this paper operates on the ground that the family as an institution has shunned taking care of the responsibilities vis-a-vis the elderly and therefore formal institutions have been introduced to aid in the conventional caretaking responsibilities in the Indian societal structure. This situation became all the more grave during the pandemic and therefore needed much intervention. This paper follows the theoretical lens of gender theory and case study method to analyze the data. Social implications: The HelpAge India report findings entail that elderly women/widows are doubly marginalized in the Indian society, and the COVID-19 pandemic has escalated the caregiver stress on manifold levels, thus exacerbating the problem. As most of the female senior citizens are economically dependent on their children and relatives, financial exploitation became one of the important premise that deprived them of a healthy living both at home and elderly caregiving institution. Despite the prevalence of certain elderly assistance schemes in the country, the older women's needs and well-being got heavily impacted and their voice gets hardly recognized in the wider spectrum of sociopolitical events. To extend the requisite help and assistance to this socially vulnerable section, the government on September, 2021, launched a pan-India, toll-free helpline number "Elder Line" to provide relevant information on elderly legal and medical aid and guidance on procuring pension. Originality/value: According to the secondary findings, a significant percentage of elderly women have been susceptible to physical and emotional abuse and factors such as widowhood, economic dependency, physical infirmity, cognitive impairment along with other stressors have aggravated their exposure to ill-treatment during the pandemic span. Thus, to recognize and mitigate the existing problems affecting the elderly subjects, the government should devise the necessary protocols and adopt essential measures to ensure the welfare of the marginalized section and protect their basic rights of a holistic existence. [ABSTRACT FROM AUTHOR]

Racial/ethnic minorities have experienced higher COVID-19 infection rates than whites, but it is unclear how individual-level housing, occupational, behavioral, and socioeconomic conditions contribute to these disparities in a nationally representative sample. In this study, we assess the extent to which social determinants of health contribute to racial/ethnic differences in COVID-19 infection. Data are from the Understanding America Study's Understanding Coronavirus in America survey (UAS COVID-19 waves 7-29). UAS COVID-19 is one of the only nationally representative longitudinal data sources that collects information on household, work, and social behavioral context during the pandemic. We analyze onset of COVID-19 cases, defined as a positive test or a diagnosis of COVID-19 from a healthcare provider since the previous survey wave, over a year of follow-up (June 2020-July 2021). We consider educational attainment, economic resources, work arrangements, household size, and social distancing as key social factors that may be structured by racism. Cox hazard models indicate that Hispanic people have 48% higher risk of experiencing a COVID-19 infection than whites after adjustment for age, sex, local infection rate, and comorbidities, but we do not observe a higher risk of COVID-19 among Black respondents. Controlling for engagement in any large or small social gathering increases the hazard ratio for Hispanics by 9%, suggesting that had Hispanics had the same social engagement patterns as whites, they may have had even higher risk of COVID-19. Other social determinants-lower educational attainment, working away from home, and number of coresidents-all independently predict higher risk of COVID-19, but do not explain why Hispanic Americans have higher COVID-19 infection risk than whites.

Aim: To identify the barriers associated with inadequate antenatal attendance by disadvantaged women in Australia and to further explore how these barriers are experienced by this population group. Design: A qualitative descriptive study utilizing semi‐structured interviews and thematic analysis. Methods: Interviews were conducted with 11 pregnant women who self‐identified as experiencing disadvantage, purposively sampled from a local government area of Victoria, Australia, characterized by socio‐economic disadvantage. Data were collected from February to July 2019. Results: Study participants reported a range of barriers to receiving timely and adequate antenatal care (ANC). For several women, a combination of personal (e.g., emotions, knowledge), health service provision (e.g., limited access to continuity of care provider and continuity of information, inflexible scheduling, difficulty travelling, staff attitudes), and broader social‐contextual factors (e.g., financial situation, language, cultural norms) were ultimately insurmountable. Whereas some barriers were experienced as hassles or annoyances, others were unacceptable, overwhelming, or humiliating. Conclusion: Women experiencing disadvantage in Australia value ANC but face multiple and complex barriers that undermine timely and regular access. Implications for the Profession and/Patient Care: A wide range of strategies targeting barriers across multiple levels of the social‐ecological environment are required if ANC attendance rates are to improve and ultimately redress existing health disparities. Various continuity of care models are well‐placed to address many of the identified barriers and should be made more accessible to women, and particularly those women experiencing disadvantage. Impact: Antenatal care appointments promote the health of women and their babies during pregnancy, but for many women, particularly those experiencing disadvantage, access is delayed or inadequate. ANC providers play a critical role in facilitating timely and adequate care. Health service practitioners and management, and health services policymakers need to understand the complexity of the barriers women encounter. These stakeholders can utilize the findings reported herein to develop more effective strategies for overcoming multiple and multi‐level barriers. Reporting Method: The study is reported in accordance with the relevant EQUATOR guidelines: the standards for reporting qualitative research (SRQR) and consolidated criteria for reporting qualitative research (COREQ). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

This study proposes a family psychobiosocial model on gender differences in cognitive development. Specifically, the aim is to investigate how family biological, socioeconomic, and psychological factors predict child mathematics achievement (MAch) development. The data were obtained from the Millennium Cohort Study. Children's pattern construction scores collected at ages 5 and 7 years worked as MAch (n = 18,497). The predictors were family data collected when the children were 9 months. The results of path analyses for all students indicate that all three factors in the family psychobiosocial model play some roles in children's MAch development. Analyses for the female and male students separately reveal that girls' positive MAch development was significantly predicted by four psychobiosocial factors (fewer mother in-pregnancy alcohol intakes, more family income, higher mother education levels, and more mother cognitive stimulation); boys' MAch development is predicted by only one factor (higher mother education levels). The results support the psychobiosocial model as a whole. Family psychobiosocial factors, especially social factors, impact children's cognitive development more for females than for males. [ABSTRACT FROM AUTHOR]

Given that citizen participation is considered the main pillar of 'Development', the political economy behind its practice (behaviour and utilisation) remains a question. To disentangle the complex web of relationships that the governance shares with the citizens' interface, it would be worthwhile to examine the whole phenomenon at the grass root level. A review of issues surrounding democracy has led different schools of thought to realise the need for adopting a holistic development approach for ensuring citizens' participation in development processes. One such school believes that it is only through addressing governance bottlenecks and ensuring spaces for participation in policy design, programme formulation and implementation supplemented with proper monitoring, that 'real' development can be achieved. It is also universally accepted that governance is an enabler for socio-economic transformation and this can help in the improvement of lives through the eradication of structural inequality. Hence, strengthening the local governments is critical for ensuring citizen empowerment, civic participation and better service delivery. Furthermore, governance is measurable and can be monitored; thus can ensure a measurable implementation, accountability and monitoring framework (Global Thematic Consultation on Governance and the Post-2015 Development Framework, 2013). Against these backdrops, the current study endeavours to unearth plausible factors influencing the health behaviour of rural people examining a case of India's National Sanitation Program—Swachh Bharat Mission in Odisha villages. Analysis of primary data collected from six districts across different regions of the Odisha state shows that various managerial, governance and social factors have a significant effect on the health behaviour of people and present more insightful results. [ABSTRACT FROM AUTHOR]

Although the association between adverse childhood conditions and health in later life has been relatively well established, little is known about how and through which mechanism this association develops. Building on the developmental adaptation model (Martin & Martin, 2002), the present study investigates the effects of distal and proximal influences on successful aging (SA). A cross-sectional survey was conducted of 475 adults aged 50 and above (Mean age = 72.13, SD = 10.46). SA was measured based on Rowe and Kahn's successful aging criteria model (1997) and an SA operationalization based on a number of multidimensional biopsychosocial indicators, including no disease and disability, active engagement with life, high physical and cognitive functioning, psychological well-being, life satisfaction and a one-item subjective SA question. Parental death had no direct effect on SA (β =.03, p =.629), whereas education had (β =.39, p <.001). Furthermore, perceived income level and social conditions were identified as two sequential mediators between both education and SA; and parental death and SA. The findings suggest that both early life and current factors contribute to explaining SA in a variety of ways. [ABSTRACT FROM AUTHOR]

Background: Cancer recurrence is an important care challenge for breast cancer survivors. It is necessary to understand and identify the barriers and facilitators that affect the decision to start retreatment by those facing breast cancer recurrence compared to factors affecting their decision to start the initial treatment, which is different. Objectives: This study is part of a qualitative study with a grounded theory approach, which was conducted to explain the facilitating and inhibiting factors affecting the decision to start retreatment in survivors of breast cancer recurrence, using a qualitative content analysis method. Methods: This study was conducted based on the experiences of 16 patients with breast cancer recurrence and 2 oncologists to confirm the findings of the effective inhibiting and facilitating factors in patients' decisions to start retreatment for breast cancer recurrence in one of the hospitals in Tehran, Iran. The samples were selected, using the purposeful sampling method trying to have maximum diversity. Data were collected through in-depth semi-structured telephone interviews from November 2020 to November 2021 and analyzed, using the conventional content analysis method following the Elo and Kyngas method, which includes 3 phases, including the preparation phase, the organizing phase, and the reporting phase. Credibility, transferability, dependability, confirmability, and authenticity were used for determining the trustworthiness of data. Results: Both groups of inhibiting and facilitating factors were divided into 5 categories, including individual factors, social factors, family factors, illness characteristics, and treatment-related factors. Also, each category included sub-categories in two groups of inhibiting and facilitating factors affecting the decision to start treatment again. Conclusions: Based on the results of the present study, it is necessary to increase the awareness of patients with breast cancer by the treatment staff about the possibility of recurrence and to know the factors influencing their decision-making process to start retreatment. Nurses should play the role of advisors, educators, and supporters of the patients in this field. [ABSTRACT FROM AUTHOR]

Although sentencing recommendations should be based on legal factors, research shows that some juvenile probation officers (JPOs) also consider extra-legal factors. Indeed, research shows that stereotypes about certain demographics (e.g., young Black males) increase the perception of dangerousness and, in turn, result in harsher sentencing recommendations. The purpose of the current study was to identify the legal (seriousness of offense, prior offenses, and record), physical (race, gender, and age), and social factors (socioeconomic status, completeness of the juvenile's family/family arrangement, presence of co-offenders) that the JPO considered the most important when making their sentencing recommendations. Data for the study came from a sample of juvenile probation officers in nine states. Participants were asked questions about sanctioning, disposition, and sentencing. The findings show that while the majority of JPOs rated legal factors (e.g., seriousness of offense) as the most important when making sentencing recommendations, a substantial proportion of the sample rated physical factors (e.g., race) as the most important factor considered when making sentencing recommendations. Implications and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

Climate change is an ongoing public health crisis. Efforts to reverse climate change and protect future generations' physical and mental health are more urgent than ever. Youth are particularly vulnerable to a form of anxiety related to stress or distress caused by awareness of environmental changes, termed eco-anxiety. We conducted a scoping review to better understand the value of youth climate change activism as a strategy to combat climate change and mitigate eco-anxiety. Our review highlights risk factors for eco-anxiety among adolescents and gaps in the literature, considers the benefits and drawbacks of youth activism, and discusses models and strategies to promote youth engagement in climate change activism. To identify relevant literature, we searched a variety of databases, related research suggested by database algorithms, reference lists of resulting literature, and grey literature sources such as global reports and governmental resources. We summarize the findings on eco-anxiety and activism, and we provide recommendations for future research to inform effective public health practices and policy. As we shift our focus to the societal impacts of climate change, it is critical that we elevate the recognition of eco-anxiety as a reality and develop strategies to protect young people and their future. [ABSTRACT FROM AUTHOR]

Purpose in life (PIL) has been linked with numerous health benefits and adaptive aging, yet it diminishes with age, possibly due to loss of social or familial roles through life transitions. Drawing from the longitudinal surveys of the Midlife in the US study (n = 3418), we use time-varying coefficient models to investigate how the trajectory of PIL differs across cumulatively (dis)advantaged, upwardly mobile, and downwardly mobile groups and the role of major life events in shaping these trajectories. We found the upwardly mobile group exhibits higher PIL than the cumulatively disadvantaged and downwardly mobile groups. The consistently disadvantaged group experiences more adverse events at non-normative times. Socioeconomic status disparities in PIL during old age decrease after controlling for life events. We discuss how and why well-being changes and the role of structural and social factors in facilitating or impeding the development or maintenance of PIL over the life course. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a stressful period due to physical, psychological, sexual changes, and presence of disorder such as depression is a matter of concern. Objectives: To study the prevalence of depression among adolescents in urban and rural areas and its socio-demographic correlates. Materials and methods: The PSU consisted all villages (n=29) and mohallas (n=23) in field-practice area. The required number of villages and mohallas, i.e., 10 each, were chosen using the basic random procedure, wherein each village and Mohalla has been assigned a unique serial number. Results: Overall, depression was observed in 110 participants (27.5%) with similar distribution in urban and rural areas. Low maternal and paternal education was a significant risk factor. Adolescents from the upper middle socioeconomic class (42.9%) and those from the lower middle socioeconomic class (33.3%) experienced the most depression. Burden was more among adolescents with low physical activity. Conclusion: This community based study of 400 adolescents residing in the urban and rural areas of Moradabad observed significant burden of depression in adolescent with poor maternal education, living in nuclear families, leading poor lifestyle and affected by any chronic illness at the time of the interview. Positive family history of mental illness was also an important risk factor. [ABSTRACT FROM AUTHOR]

Active aging is important for promoting the health, wellbeing, and participation of older adults. This study investigated the association between active aging and mortality risk among 2 230 respondents aged 60 and older. Principal component analysis extracted a five-factor structure from 15 indicators of active aging. The mean active aging score was 55.57 and the median was 53.33. The Kaplan-Meier curve showed that individuals with active aging scores of 53.33 and above had significantly longer survival than those below the median. Cox regression analysis indicated the significance of active aging in reducing mortality risk by 2.5% after adjusting for sex, marital status, age, ethnicity, chronic diseases, and risk factors. The active aging approach comprising health, economic, and social factors is crucial in improving survival among older adults. Hence, policies and programs that promote active aging should be encouraged to enhance the health and wellbeing of older adults and their engagement in society. [ABSTRACT FROM AUTHOR]

Malnutrition during childhood remains a major public health concern in developing countries. Within the household, the responsibility of the mother in child nutrition is crucial. Their empowerment is recognized by previous research as a social factor associated with low rates of malnutrition in Sub-Saharan Africa. Using data from the Cameroon Demographic and Health Survey of 2018, this study investigates the associations between the dimensions of maternal empowerment and childhood stunting and wasting. A logistic regression model was used to estimate these associations. Considering each dimension of maternal empowerment, the results suggest that mother's economic status was associated with greater odds of childhood stunting (OR = 1.110; 95% CI:1.014, 1.215; p < 0.05), and lower odds of childhood wasting (OR = 0.456; 95% CI: 0.373, 0.557; p < 0.01). Mother's control over financial resources was associated with lower odds of childhood stunting (OR = 0.696; 95% CI: 0.642, 0.756; p < 0.01) and wasting (OR = 0.362; 95% CI: 0.309, 0.424; p < 0.01). Mother's participation in decision-making was related to lower odds of childhood stunting (OR = 0.878; 95% CI: 0.826, 0.933; p < 0.01) and wasting (OR = 0.699; 95% CI: 0.622, 0.786; p < 0.01). Thus, the findings of this study suggest that maternal empowerment dimensions associated differently with childhood stunting and wasting. For a better effectiveness of any policy intervention, it is important to clarify the contribution of each dimension of maternal empowerment when analyzing its relationship with the nutritional status of children. [ABSTRACT FROM AUTHOR]

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To explore the preferences of people with memory complaints (PwMC) and their significant others regarding starting a diagnostic trajectory for dementia. A systematic literature search was conducted in PubMed, PsycINFO, CINAHL, Web of Science, and Embase. Selection of abstracts and papers was performed independently by two researchers. Methodological quality was assessed with the Mixed Method Appraisal Tool. Result sections of the selected papers were thematically synthesized. From 2497 citations, seven qualitative studies and two mixed methods studies published between 2010 and 2020 were included. Overall quality of the studies was high to moderate. A thematic synthesis showed that preferences for starting a diagnostic trajectory arose from the feeling of needing to do something about the symptoms, beliefs on the necessity and expected outcomes of starting a diagnostic trajectory. These views were influenced by normalization or validation of symptoms, the support or wishes of the social network, interactions with health care professionals, the health status of the PwMC, and societal factors such as stigma and socioeconomic status. A variety of considerations with regard to decision-making on starting a diagnostic trajectory for dementia were identified. This emphasizes the need to explore individual preferences to facilitate a timely dementia diagnosis. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the current status of e-health literacy among Chinese older adults, and to summarize and analyze the related influencing factors. Subject and methods: Following the PRISMA Checklist, we searched MEDLINE, CINAHL Complete (EBSCO), PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Science and Technology Journal Database to identify the relevant literature published between January 2000 and December 2020. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of the studies. Results: Five articles were included for the systematic review. The results showed that the e-health literacy of Chinese older adults was low. Based on the social-ecological model, the influencing factors at the individual level included age, gender, educational attainment, socioeconomic status, physical and psychological conditions, frequency of internet use, and credibility perception of online health resources; at the interpersonal level, the influencing factors included marital status, being the family carer and being taught how to use internet to find health resources; at the social/community level, influencing factors included language barriers and cultural barriers. Conclusion: Current e-health literacy among Chinese older adults is low, which is affected by a number of factors. Medical staff should provide detailed health information with guaranteed accuracy and reliability for elderly people. It is necessary to develop intervention programs tailored to varied educational needs of the elderly with different backgrounds (i.e., age, gender, educational attainment, and socioeconomic status) need to be developed in the near future. Family members are encouraged to teach older adults how to use e-health resource in appropriate ways. [ABSTRACT FROM AUTHOR]

Although previous studies showed that warmer temperatures may be associated with increased antimicrobial resistance (AMR) rates, unmeasured factors may explain the observed relationship. We conducted a ten-year ecological analysis to evaluate whether temperature change was associated with AMR across 30 European countries, considering predictors that can determine a geographical gradient. Using four data sources, we created a dataset of: annual temperature change (FAOSTAT database); AMR proportions for ten pathogen–antibiotic combinations (ECDC atlas); consumption of antibiotics for systemic use in the community (ESAC-Net database); population density, gross domestic product (GDP) per capita, and governance indicators (World Bank DataBank). Data were obtained for each country and year (2010–2019) and analyzed through multivariable models. We found evidence of a positive linear association between temperature change and AMR proportion across all countries, years, pathogens, and antibiotics (β = 0.140; 95%CI = 0.039; 0.241; p = 0.007), adjusting for the effect of covariates. However, when GDP per capita and the governance index were included in the multivariable model, temperature change was no longer associated with AMR. Instead, the main predictors were antibiotic consumption (β = 0.506; 95%CI = 0.366; 0.646; p < 0.001), population density (β = 0.143; 95%CI = 0.116; 0.170; p < 0.001), and the governance index (β = −1.043; 95%CI = −1.207; −0.879; p < 0.001). Ensuring the appropriate use of antibiotics and improving governance efficiency are the most effective ways of counteracting AMR. It is necessary to conduct further experimental studies and obtain more detailed data to investigate whether climate change affects AMR. [ABSTRACT FROM AUTHOR]

Background: School bullying causes serious impacts on adolescents' physical and mental health. Few studies have explored the various factors influencing bullying by combining different levels of data. Methods: Based on the database of four Chinese provinces and cities of the Program for International Student Assessment (PISA) in 2018, this study used a multilevel analysis model that combined school-level variables and student-level variables to explore the influencing factors of students being bullied. Results: Students' gender, grade repetition, truancy and arriving late for class, economic, social, and cultural status (ESCS), teacher support, and parent support had significant explanatory power on school bullying on the student-level; on the school-level, school discipline atmosphere and competitive atmosphere among students had significant impacts on school bullying. Conclusions: Boys, students who have repeated grades, truancy and arriving late for class, and students with lower ESCS suffer from more severe school bullying. When developing school bullying interventions, teachers and parents should pay more attention to those students and provide more emotional support and encouragement to them. Meanwhile, students in schools with a lower discipline atmosphere and a higher level of competitive atmosphere experience greater levels of bullying, and schools should create more positive and friendly environments to prevent bullying events. [ABSTRACT FROM AUTHOR]

There has been no research on the trends in early sexual initiation associated with socio-environmental factors in Korea. This study aimed to examine the trends of early sexual initiation with various socio-environmental factors among adolescents. The Korea Youth Risk Behavior Web-based Survey data were used, and two pooled datasets extracted from the 2006–2008 and 2014–2016 waves were conducted and compared. In this study, early sexual initiation was defined as sexual intercourse at the age of 13 years or younger. The weighted percentage and 95% confidence interval reporting early sexual initiation were estimated, and multiple logistic regression was performed for each subgroup of socio-environmental variables with the 2006–2008 pooled data as a reference. Regardless of sex, the weighted percentage of adolescents with sexual experience who reported early sexual initiation increased in 2014–2016 with statistical significance in most cases. Moreover, the possibility of experiencing early sexual intercourse overtime was more prominent among girls than boys. While indifference to adolescent sexual behavior continues, more adolescents become involved in early sexual initiation. Socio-environmental considerations, such as the establishment of safe environments for adolescents' sexual activity, along with systematized monitoring mechanisms, should be administered. [ABSTRACT FROM AUTHOR]

Racial inequities are well-documented across the gynecologic oncology care continuum, including the representation of racial and ethnic minoritized groups (REMGs) in gynecologic oncology clinical trials. We specifically reviewed the scope of REMG disparities, contributing factors, and strategies to improve inclusion. We found systematic and progressively worsening under-enrollment of REMGs, particularly of Black and Latinx populations. In addition, race/ethnicity data reporting is poor, yet a prerequisite for accountability to recruitment goals. Trial participation barriers are multifactorial, and successful remediation likely requires multi-level strategies. More rigorous, transparent data on trial participants and effectiveness studies on REMG recruitment strategies are needed to improve enrollment. [ABSTRACT FROM AUTHOR]

Purpose: While there are a few studies that show the prevalence of blindness and ocular morbidity in children, studies on socioeconomic factors in childhood cataracts are scarce. We aimed to study the socioeconomic status, education and occupation of the parents, consanguinity, and gender inequality among children presenting with cataracts. Methods: This was a hospital-based, prospective, descriptive study of 68 children with cataracts (aged 0–18 years). In addition to the data on clinical parameters and surgical management, we also collected data on age, gender, age at which the chief complaint was noticed, consanguinity of parents, socioeconomic class, and occupation and education of parents. All statistical analyses were performed using MedCalc statistical software (MedCalc Software 2019, Ostend, Belgium). Results: Sixty-eight children with pediatric cataract, out of which 36 were bilateral, were studied. Thirty children (44%) were in the age group of 1–5 years. Out of the 36 bilateral cataracts, 25 (69.44%) were males and 11 (30.56%) were females. Thirty (44.1%) had a delayed presentation. Also, 31% belonged to middle class and 28% belonged to lower middle class. Moreover, 65% of the mothers had an undergraduate education. Conclusion: There is a gender-based inequality and late presentation of childhood cataracts. To improve early detection, red reflex screening should be mandatorily done. Further studies are required to identify barriers to access of eye care specific to girls, in order to plan interventions to improve uptake of treatment. The lower socioeconomic status of the patients should be taken into account in the management of this disease. [ABSTRACT FROM AUTHOR]

Background: Health literacy interventions and research outcomes are not routinely or systematically implemented within healthcare systems. Co‐creation with stakeholders is a potential vehicle through which to accelerate and scale up the implementation of innovation from research. Methods: This narrative case study describes an example of the application of a co‐creation approach to improve health literacy in an Australian public health system that provides hospital and community health services to one million people from socioeconomically and culturally diverse backgrounds. We provide a detailed overview of the value co‐creation stages and strategies used to build a practical and sustainable working relationship between a University‐based academic research group and the local health district focussed on improving health literacy. Results: Insights from our experience over a 5‐year period informed the development of a revised model of co‐creation. The model incorporates a practical focus on the structural enablers of co‐creation, including the development of a Community of Practice, co‐created strategic direction and shared management systems. The model also includes a spectrum of partnership modalities (spanning relationship‐building, partnering and co‐creating), acknowledging the evolving nature of research partnerships and reinforcing the flexibility and commitment required to achieve meaningful co‐creation in research. Four key facilitators of health literacy co‐creation are identified: (i) local champions, (ii) co‐generated resources, (iii) evolving capability and understanding and (iv) increasing trust and partnership synergy. Conclusion: Our case study and co‐creation model provide insights into mechanisms to create effective and collaborative ways of working in health literacy which may be transferable to other health fields in Australia and beyond. Patient and Public Contribution: Our co‐creation approach brought together a community of practice of consumers, healthcare professionals and researchers as equal partners. [ABSTRACT FROM AUTHOR]

PURPOSE Residents of communities facing social vulnerability (eg, poverty) have limited access to clinical trials, leaving them susceptible to experiencing poor health outcomes. We examined the association between North Carolina county-level social vulnerability and available multiple myeloma (MM) trials. METHODS Using a novel data linkage between ClinicalTrials.gov, the 2019 American Community Survey, and the Centers for Disease Control and Prevention's Social Vulnerability Index, we investigated at the county level (1) availability of MM trial sites and (2) the relationship between Social Vulnerability Index and MM trial site availability using logistic regression. RESULTS Between 2002 and 2021, 229 trials were registered across 462 nonunique trial sites in 34 counties. Nearly 50% of trial sites were in academic medical centers, 80% (n = 372) of all trials were industry-sponsored, 60% (n=274) were early-phase, and 50% (n5232) were for patients with relapsed or refractory MM. Counties with low as opposed to high poverty rates had six times greater odds of having ≥1 MMtrial sites (odds ratio [OR], 5.60; 95% CI, 1.85 to 19.64; P = .004). Counties with the lowest percentage of Black Indigenous Persons of Color and non-native English speakers had 77% lower odds (OR, 0.23; 95% CI, 0.07 to 0.69; P = .011) of having ≥ 1 trial sites. The effect remained significant after accounting for the presence of five academic medical centers (n = 95; OR, 0.18; 95% CI, 0.05 to 0.6; P = .008) and adjustment for metropolitan, suburban, or rural status (OR, 0.25; 95% CI, 0.07 to 0.81; P = .025). CONCLUSION Counties with the lowest poverty rates had more MM trial sites, whereas those with the lowest percentage of Black Indigenous Persons of Color populations had fewer MM trial sites. Multilevel efforts are needed to improve the availability and access to trials for socially vulnerable populations. [ABSTRACT FROM AUTHOR]