Nobility and bourgeoisie in Baltic German narrative prose (1860–1914)

Background: In addition to physical welfare, reproductive health is also vital for psychological well-being. All stages of reproduction can take place safely if reproductive health is well cared for, and it ultimately leads to the formation of healthy new offspring. The aim of this study is to know about reproductive health-related knowledge and practices in women of reproductive age in an underdeveloped area in Pakistan and to identify the associated factors that give a meaningful impact on reproductive health.Methods: A cross-sectional study was carried out among women of childbearing age in underdeveloped areas in the province of Punjab, Pakistan. A sample of 400 was taken on a random basis. All the relevant data were collected from February 1, 2022, to August 30, 2022, with the help of a structured questionnaire, designed specifically for the study, informed consent was taken from all of the participants before data collection. Questions were asked about their menstrual cycles, use of contraceptives, knowledge about sexually transmitted diseases, screening of cervical cancer, pap test, human papillomavirus vaccine, and related to home or hospital deliveries. Socioeconomic classes were defined by different income ranges per month as lower class, upper lower class, middle class, upper middle class, and upper class.Results: Ten percent of participants with education up to fifth grade have never used any method of contraception while 70% of participants who studied up to eighth grade never used the same. In lower class and upper lower class, the prevalence is 33.3% and 41.7%, respectively. The prevalence of screening for cervical cancer is 50% in married women and 60% in the upper middle class. Of women with education up to eighth grade, 65% answered with No, and the prevalence is 50% for lower-class women. Regarding the human papillomavirus vaccine, 41.7% of married women, 33.3% of women in upper class, and 50% of women in the middle class mentioned that they know about it, while 68.4% of women have education up to eighth grade and 47.4% of lower-class women answered with No. Of women with education up to eighth grade, 92.5% had one to two deliveries at home, and 68.8% of women with education up to fifth grade had three to four deliveries at home. Fifty percent of women from both lower and upper lower classes had one to two deliveries at home. Twelve women from the upper middle class had all of their deliveries at home and 20 had five to six deliveries at home. Of women with education up to fifth grade and eighth grade, 64.3% and 28.6%, respectively, had their all deliveries at a hospital; 22.9% of women from the upper class and 20% of the upper middle class also had all deliveries at the hospital, Thirty-three women who graduated from college had one to two deliveries in the hospital. All of these results are found to be significant with a p-value <0.05.Conclusion: Knowledge about reproductive health is less prevalent in women with low education and the same is for lower and lower middle socioeconomic class. The education level of women and their socioeconomic class is one of the major factors that have a meaningful impact on their reproductive health and practices.

ABSTRACT. This article focuses on the analysis of some of the main concepts of social stratification, such as class and status. The paper then examines the particularities of social stratification in the US, including factors leading to the stratification of society (e.g. wealth, income, education, occupation) and the three types of social classes in this country: upper class, middle class and lower class. In comparison, social stratification in Romania is influenced by historic circumstances (e.g. ex-communist elite members identified in the upper class). There are three social classes in Romania, too, but the upper and middle class are still coagulating, while the lower class is well established.JEL Codes: A14; Z13Keywords: social stratification; class; status; US; Romania1. IntroductionThe analysis of social inequality is one of the most important concerns of sociologists, economists, scholars and many others. Inequalities have always existed and will continue to exist in human societies. Even in the most primitive communities, where wealth and property are minimal, there is inequality among individuals, men and women, young and old, and the list can go on. How certain groups in a society have became richer or more powerful than others, how unequal modem societies are, what chance someone coming from a less privileged background would have to reach the top of the economic hierarchy and for what reasons poverty still exists in developed countries - are questions that sociologists are attempting to answer in order to clarify the ways in which societies were stratified and the processes through which status was achieved.In order to draw attention to the unequal positions occupied by individuals in society, sociologists speak of social stratification - structural inequalities between different groups of people. Societies are composed of several layers in a hierarchy, the most privileged on top and the less privileged at the bottom.2. StratificationThere are four major types of stratification systems: slavery, caste, estates and class (Giddens, 2010: 263-309). Slavery is an extreme form of inequality in which some individuals are actually owned by others. Caste is associated with the cultures of the Indian subcontinent. The term caste is not of Indian origin; it comes from the Portuguese word casta, meaning race or purebred. The caste system is highly complex and structurally varies so much from one area to another, that it is not basically a single system, but a diversity of insufficiently linked beliefs and practices. Estates were part of European feudalism and consist of social strata with different obligations and rights, some of these differences established by law (the nobility, the clergy and the commoners).Class differs in many respects from slavery, caste or estates. It can be defined as a large-scale group of people who share common economic resources which strongly influence their lifestyle (Giddens, 2010:267). Unlike other stratification systems, class membership is not based on a position specified by law or by custom. Class systems are more fluid than other types of stratification, and the boundaries between classes are not clearly defined. Class membership is at least partially acquired. Classes depend on economic differences between groups of individuals (inequalities in the possession and control of material resources). Class systems mainly operate through large-scale impersonal links (e.g. unequal working conditions).Specialists in various domains consider that society is made up of a certain number of classes. According to Giddens (2010), in a society we distinguish the upper class, the old middle class, the upper middle class, the lower middle class, the upper working class, the lower working class and the underclass.The Goldthorpe class scheme is more intricate: 1) higher-grade professionals, administrators, and officials; managers in large industrial establishments; large proprietors; 2) lower-grade professionals, administrators, and officials, higher-grade technicians; managers in small industrial establishments; supervisors of non-manual employees; 3a) routine non-manual employees, higher grade (administration and commerce); 3b) routine non-manual employees, lower grade (sales and services); 4a) small proprietors, artisans, etc. …

The Present study was conducted in the Department of Pediatrics of Lala Lajpat Rai &amp; Associated Hospital GSVM Medical College, Kanpur. All the children aged between 1-5 years, admitted in Department of Pediatrics were asked to participate in this study. Information regarding vaccination, socio-demographic factors was collected from their parents and care takers. Accuracy and validity of information were confirmed by immunization card in possible situation and inspection for BCG scar. Hospital based descriptive cross-sectional study.In upper class, 100% of children were completely immunized. In upper middle class, 80.8% children had complete and 19.1% partial immunization status. No one remained unimmunized in upper middle class. In lower middle class, 33.9% of children were completely immunized, 59.6% partially immunized and 6.4% remained unimmunized.Children who were 1stin birth order, had maximum immunization coverage (44.8%). Minimum immunization coverage was in birth order &amp;#62;4 (3.2%). P value is &amp;#60;0.001, indicates the significant relation between birth order and immunization status. As birth order increased, immunization coverage decreased. In this present hospital based descriptive cross –sectional study, we found that 51.2% children were fully immunized, 45.6% were partially immunized and 3.2% children were unimmunized as per National immunization schedule. Children belonging to upper class were 100% completely immunized. In upper middle class 80.8% children in lower middle class 33.9%, in upper lower class 55.7% and in lower class 50.9% children were completely immunized respectively. In lower class immunization coverage was higher than lower middle class. Droprate for BCG to pentavalent 1 was 10.64%, similarly dropout from BCG to measles was 12.7%. Dropout rate of pentavalent 1 to pentavalent 2 was 1.4%, pentavalent2 to pentavalent3 was 2.6%. It indicates that system is not able to hold the child once registered. Steps for improvement should focus on reducing the drop rate from BCG to pentavalent and measles.

This study was conducted to understand the infant (0-12 month) feeding practices among different classes' mothers in Dhaka city. The study was carried out among the 183 mother-infant pair of the upper, middle and lower socio-economic classes in Dhaka city and purposive sampling method was applied. The study was conducted at following areas in Dhaka city which were selected purposively. The mean age of upper class, middle class and lower class were 35±4, 25±3 and 21±7 in years. Regarding first feeding it was observed that upper (75%), middle (85%) and lower class (48%) first gave colostrum. It also observed that 18% of upper class mother first gave powder milk, while in case of middle class it was 5%. In lower class preference of giving honey and sugar water were 21% and 12% respectively. The starting time of breast feeding indicated that in upper classes (74%) breast feeding initiated within one hour, while in middle (75%) and lower classes (84%) it was given within 12 hours. It was highlighted that 44% upper and 36% lower class mothers started complementary feeding at 3 month of the baby respectively, while in middle class 61% mother started complementary foods at 5 month of their baby. In case of duration of breast feeding practices, middle and lower classes breast-feed continued longer time than upper class. Majorities of the upper class prefered egg, soup, fruit juice while middle class liked meat-fish, egg, khichuri, fruits. On complementary feeding the lower class choiced mainly rice-potato, dal, khichuri or vegetables. The study result should not be generalise and need further large scale research. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21124 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 5-8

This study aimed at establishing the determinants and distribution of the health-seeking behaviours of Port Harcourt residents, and comparing them between the upper and lower socio-economic classes. A descriptive crosssectional study using 204 respondents was carried out. The socio-economic classification used occupation and average monthly income. Multi-staged sampling technique was used; stage one being by stratified sampling using socio-economic classes for stratification; stage two involved clustered sampling; following which five-sectioned structured questionnaires were administered. Differences (P&lt;0.05) in Health facility used existed: the upper class used mostly Government and Private Hospitals; the lower class additionally used health centres and un-orthodox health facilities. Reasons for using a health facility was similar (P&gt;0.05) as both classes mostly go for treatment or medical check-ups. Health facility preference was mostly for good treatment outcome and accessibility; cost also, for the lower class. Commonly and last used health-care giver differed (P&lt;0.05); upper class mostly saw a doctor, the lower saw the doctor, pharmacist and nurse. Competence; the major reason for health-care giver selection by the upper class differed (P&lt;0.05) from the lower that had previous good treatment outcome and illness severity. The upper socioeconomic classed have better health-seeking behaviours because they use more competent Health facilities and health-care givers.

This study aimed at establishing the determinants and distribution of the health-seeking behaviours of Port Harcourt residents, and comparing them between the upper and lower socio-economic classes. A descriptive cross-sectional study using 204 respondents was carried out. The socio-economic classification used occupation and average monthly income. Multi-staged sampling technique was used; stage one being by stratified sampling using socio-economic classes for stratification; stage two involved clustered sampling; following which five-sectioned structured questionnaires were administered. Differences (P<0.05) in Health facility used existed: the upper class used mostly Government and Private Hospitals; the lower class additionally used health centres and un-orthodox health facilities. Reasons for using a health facility was similar (P>0.05) as both classes mostly go for treatment or medical check-ups. Health facility preference was mostly for good treatment outcome and accessibility; cost also, for the lower class. Commonly and last used health-care giver differed (P<0.05); upper class mostly saw a doctor, the lower saw the doctor, pharmacist and nurse. Competence; the major reason for health-care giver selection by the upper class differed (P<0.05) from the lower that had previous good treatment outcome and illness severity. The upper socioeconomic classed have better health-seeking behaviours because they use more competent Health facilities and health-care givers.

On the Updating and Reformulations, Added by Adam Smith and J M Keynes, to Aristotle's Universal, General Theory of Economics, Politics, Civics, and Institutions

This paper tries to investigate the use of directive speech acts in different social class. Using the six types of directive speech acts proposed by Ervin-Tripp (1976), which are need statement, imperative, imbedded imperative, permission directive, question directive and hint, this paper focuses on the main male characters’ utterances from two novels; Crazy Rich Asians written by Kevin Kwan which represents upper class society and I am the Messenger written by Markus Zusak which represents lower class society. The results show that both upper and lower social classes mostly use imperative directive (42 utterances or 80%). Lower class male character uses more ‘need statement directive’ than upper class male character. Meanwhile, upper class character uses more ‘question directive’ than lower class character. Generally, upper class people use the directive as commands to their employees while the lower class character uses directive in his work as a cab driver which required him to be more direct in asking and offering the customers

IntroductionTobacco use in recent times has been identified to be the single biggest cause of morbidity and mortality. The epidemic of tobacco use has increased among young adults, which has changed the equation of the prevalence. The contribution of tobacco use to socioeconomic inequalities in health is increasing in India. Adolescent’s tobacco use may play an important role in increasing social inequalities related to smoking and smokeless tobacco use. The objective of this research was to study the association between socioeconomic status and tobacco use among college students of Mangaluru, South IndiaMethodsTo analyze the association between the socioeconomic status and tobacco use, the study was conducted among 18 to 24-year-old college students (n = 802) in different colleges of Mangaluru, South India. A subset of key questions from the Global Adult Tobacco Survey (GATS) was used. The socioeconomic status of the participants was recorded using Kuppuswamy socioeconomic scale (for India) to categorize them into upper class and lower class. Descriptive statistics were applied to assess the factors related to tobacco use and socioeconomic status using SPSS ver. 24.0.ResultsApproximately 29.7% males and 70.3% of females completed the interview. Among 802 subjects, 69.9% belonged to the upper class and 30.04% belonged to the lower class. The current smokers who smoked daily 1.7% were from the upper class and 1.7% were from the lower class; no statistically significant difference was observed as well (p = 0.97). Approximately 3.4% from the upper class smoked less than daily and 3.1% from lower class smoked less than daily (NS). Among the upper class, 1.8% used daily and 2% subjects from the lower class used smokeless tobacco. A statistically significant difference was observed with subjects between the upper and lower class in noticing cigarette promotions in various forms during the last 30 days of interview.ConclusionSocioeconomic disparities on tobacco use need to be explored to ensure the initiation of new tobacco control activities and monitor the existing tobacco control policies. The current study finding demonstrates a significant but varied role of socioeconomic status on current and past tobacco use.

Objective: The main aim of this paper was to examine the relationship between life skills and the socioeconomic status of the students enrolled in different disciplines of study in universities and colleges of Punjab State. Method: 600 students who were majoring in science, the arts, or business programs in the universities and colleges of Punjab State, India served as the sample. Modified Kuppuswamy (2022) Socio-economic scale (SES) was used. As per scale- families are placed into one of five categories: upper class, upper middle class, lower middle class, upper lower class, and lower class. A family’s total score can range anywhere from three to twenty-nine points, and it can only be determined by combining information about the members of the family’s education level, occupation level, and income level. Life skills were measured by self-developed tools. This test measures 10 life skills, including critical thinking, self-awareness, creativity, decision-making, problem-solving, effective communication, interpersonal relationships, empathy, stress management, and dealing with emotions. Each dimension has five statements, and a 5-point scale is used to rate each. Findings: It has been found in the present study that students of science disciplines have higher life skills in comparison to Commerce and Social science Streams. Similarly, students from higher SES backgrounds tend to have better Life Skills compared to those from lower SES backgrounds. Novelty: This research uniquely compares socio-economic status, academic discipline, and students' life skills within the NEP-2020 framework. It stands out by examining how these variables collectively impact life skills development, providing a nuanced understanding of their interdependence. By focusing on the diverse socio-economic backgrounds and varied academic disciplines, the study offers novel insights into tailoring educational strategies that foster essential life skills. In this research paper, an analytical approach has been applied to analyze the data as per NEP-2020's holistic and inclusive vision, aiming to bridge educational disparities and enhance student outcomes in a comprehensive manner. Keywords: Life Skills, Socio-Economic Status, Science, Social Science and Commerce Disciplines of study, NEP 2020

BackgroundCOVID-19 has restricted the education of students on a global scale. With the nationwide stay-at-home directives, schools, colleges and universities have been shut down. Online education is a measure for continuing the learning of the students in times of pandemic. However, the school-going children of urban slum areas face challenges in attending online classes. Through this study, we have tried to highlight the problems and challenges faced by the students and their parents from an urban slum area of Mangalwarpeth, Pune for attending online education in times of COVID. The urban slum area mainly consists of people from low socioeconomic backgrounds lacking the necessary resources and supportive environment for an online mode of education. We have observed and recorded the response of the participants in the context of online education in times of COVID and challenges faced by the lower socio-economic strata due to reasons like non-availability of resources, poor internet connectivity, poor understanding, and distractions while classes leading to low attendance.MethodsA cross-sectional qualitative study was conducted in an urban slum area of Mangalwarpeth, Pune. Data was collected over four months after receiving consent from the parents of the children from the metropolitan slum area of Mangalwarpeth. A structured questionnaire was used. Data was coded on an excel sheet and was transferred to SPSS software version 21 (IBM Corp., Armonk, NY) and was represented in frequency and percentage.ResultAfter the data collection and analysis, we found that (according to the modified Kuppuswamy scale for socioeconomic status) around 53% of the study population were from the lower middle class followed by the upper lower class (27.16%), upper middle class (9.87%), lower class (8.64%) and upper class (1.23%). Sixteen percent of participants do not have smartphones available, and 95.5% do not have a laptop required for online classes. A total of 19.5% of the students do not have access to internet services. Eighty-four percent of parents agreed on increased expenses of the internet.ConclusionStudents from urban slum areas belong to lower socioeconomic classes and face problems while attending online classes like the nonavailability of resources and lack of a supportive environment. There are increased expenses of the internet as a result of the online mode of education, with increased distractions from the surroundings, concentration problems, and less understanding of the subjects. The students cannot interact with their teachers and friends and as a result, their social interaction is reduced. A supportive environment and proper resources are essential for the learning of students to continue education in times of emergencies like pandemics.

The role of high socioeconomic status (SES) as an established risk factor for melanoma has been well documented in Western countries and regions. However, research on the association between melanoma and SES in China remains limited. This study aimed to investigate the association between SES and melanoma incidence and stage in China. Five measures of SES were accessed, including education level, ethnic background, per capita household income, occupation, and medical insurance coverage. A scoring system based on the Kuppuswamy Socio-Economic Scale was used to create a quantitative assessment of SES. To improve clarity and precision, we refined the language in the original text. Clinical stage at diagnosis was classified according to the Chinese Society Oncology Melanoma Guidelines. A total of 122 patients with pathologic melanoma were enrolled in this study from January 2013 to December 2017. Of these patients, 58 (48%) were male and 64 (52%) were female, with a mean age of 59.23 ± 9.91 years. Patients in the age groups of 45-59 and 60-73 had a higher incidence of melanoma compared to other age groups. Acral lentiginous melanoma was the most commonly observed subtype, accounting for 48% of cases. Patients with a low level of education (middle school and below) and a low level of monthly household income (<3000 CNY) had a higher risk of developing melanoma, as did those who were unemployed. Interestingly, a higher proportion of melanoma diagnoses were made in patients with medical insurance than those without. However, no significant differences in melanoma staging were found based on education level ( P = 0.153), monthly household income ( P = 0.507), occupation ( P = 0.687), or insurance status ( P = 0.537). According to the Kuppuswamy Socio-Economic Scale, there were 0 in upper class, 50 in upper middle class, 44 in lower middle class, 28 in upper lower class, 0 in lower class. The mean K-score was 13.85. No statistically significant interaction was observed between K-score and tumor stage. Patients with lower SES have a higher risk of developing melanoma. However, no significant differences were found in melanoma staging based on SES.

This study analyzed a novel written by Hebert George Wells, The Time Machine.The author talked about the different classes based on society’s economic status, namely upper class and lower class that might cause the class struggle. There were three objectives that were formulated by the writer, 1) to discuss the characterization of the Eloi and Morlock, 2) to present the conflict between Eloi and Morlock, 3) to discuss the class struggle between the upper and lower class in accomplishing their desire as represented by character Eloi and Morlock. In analyzing this novel the writer used the socio-cultural-historical and biographical approach and also the library research to analyze this novel. There were two main character in the novel that represented the upper and lower classes in nineteenth century. They had conflict since hundreds years ago that was the lower class were oppressed by the upper class. It made them bare and did the struggle. This struggle came from the economical, ideological and political background. Since the economical struggle that was increasing the wage and shorting the work hours was not approved, they made the ideological struggle. This struggle found the perfect way to control the upper class. After that, they did the political struggle that served the upper as the cattle and prey them. They also changed the rule which was oppressed to oppress. It recommended for the next researcher to use the same approach and for the teacher to use this novel as learning material.

&lt;p&gt;The purpose of this research is to analyze the self-positioning and social class phenomenon of &lt;em&gt;The Doll’s House&lt;/em&gt;. It tells about social oppression create by upper to dominate lower class. Upper class takes part as dominant while lower class takes part as minority in society. This research uses qualitative research. The researcher needs postcolonial theory to identify the self-positioning between upper and lower class in the short story. The analysis reveals that upper class treats lower class to be the other, subaltern and create social discrimination. The conclusion is the upper class founds powerful, otherwise the lower class is found surviving not fighting from injustice.&lt;/p&gt;

Impact of Social Determinants of Health on Survival Outcomes in Multiple Myeloma Patients at a Major Cancer Center