Poor Design Research Articles

A multi-objective optimization framework for building performance under climate change

Most building energy simulations utilize typical meteorological year data, overlooking the impacts of climate change. This can lead to inaccurate predictions and suboptimal designs. This study develops an optimization framework to identify robust building designs under varying climate scenarios. A case study is presented for residential buildings in Huangshan, China under 2020, 2050 and 2020–2050 conditions. A general circulation model provides future weather data. Multi-objective optimization maximizes energy efficiency and minimizes life cycle costs. Machine learning models predict heating, cooling and cost as functions of envelope parameters. Optimization is performed using a genetic algorithm. Results reveal the optimum insulation thickness, wall properties and window specifications. Compared to 2020 data, the ideal roof insulation increases from 40 mm to 90 mm by 2050. The optimal heating transmittance decreases from 0.38 W/m2K to 0.19 W/m2K. The approach highlights the significant influence of evolving climate on building design. It provides architects with accurate projections to make informed design decisions for energy efficiency and cost savings over the building lifespan.

The Self-Fulfilling Process of Clinical Race Correction: The Case of Eighth Joint National Committee Recommendations.

There is growing attention to how unfounded beliefs about biological differences between racial groups affect biomedical research and health care, in part, through race adjustment in clinical tools. We develop a case study of the Eighth Joint National Committee (JNC 8)'s 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults, which recommends a distinct initial hypertension treatment for Black versus nonblack patients. We analyze the historical context, study design, and racialized findings of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) that informed development of the guideline. We argue that ALLHAT's racialized outcomes emanated from a poor and artificial study design and analysis weakened by implicit assumptions about race as biological. We show that the acceptance and utilization of ALLHAT for race correction arises from its historical context within the "inclusion-and-difference paradigm" and its indication of the inefficacy of angiotensin-converting-enzyme inhibitors for Black patients, which follows from the enduring, yet, refuted slavery hypertension hypothesis. We demonstrate that the JNC 8 guideline displays the self-fulfilling process of racial reasoning: presuppositions about racial differences inform the design and interpretation of research, which then conceptually reinforce ideas about racial differences leading to differential medical treatment. We advocate for the abolition of race adjustment and the integration of structural competency, biocritical inquiry, and race-conscious medicine into biomedical research and clinical medicine to disrupt the use of race as a proxy for ancestry, environment, and social treatment and to address the genuine determinants of racialized disparities in hypertension.

Studying The Effect of Tourism Revitalization Program : Sustainable Upgrading Slums Settlements of Malang, Indonesia

Consequent of urban poverty is lack of affordable housing in urban areas. It leads to the increasing slum settlements of urban inhabitants living in deprived urban areas. Typically, slum settlements were distress and discomfort aspect on social, economic and environmental. However, policy efforts slum revitalization in Indonesia is observed to have a economic effect on the residents, where revitalization slum area of Tridi subdistrict in Malang become site tourism. Therefore, the purpose of this study is to investigate influence of revitalization slum program refer to Sustainable Development Goals (SDGs) index on development community, community behavior on environmental and ecosystem-based sustainability. This study uses a qualitative fault tree analysis (FTA) approach in sequence. Data were obtained through observation, surveys, and documentation. The results indicate a considerable built environment discomfort was due to lack of social spaces and poor design of the slum revitalization landscape. This study offers the concept of improvement strategy for slum shall not orientate to merely for beautification but also considering to improve the sustainability of the slum wellbeing.

Kajian Kes: Kebocoran Antara Tingkat di Bangunan Kediaman Bertingkat Malaysia

Building defects are a common issue in the construction industry. Defects of high-rise buildings, such as cracks and leaks, are often caused by poor workmanship, and insufficient and low-quality building materials. Other contributing factors to building defects are inadequate cooperation during construction, poor design and improper installation. Inter-floor leakage is a widespread matter in new homes, leaks are detected late and repeated leaks occur even after repairs have been carried out. Inter-floor leakage often occurs in new homes. Leaks are detected late and repeated ones occur even after repairs are carried out. This study aims to diagnose buildings with inter-floor leakage problems by using several diagnostic tools and techniques like visual, destructive and non-destructive tests. Experts use testing equipment to determine moisture and appropriate maintenance or repair. A case study is carried out on a residential unit with a leak in the ceiling due to a crack on the rooftop. The findings of the study can provide knowledge about building diagnosis to property owners and property managers, identifying the cause of leaks and enabling early detection of building defects and suggested repairs to prevent similar leaks from occurring. By utilizing diagnostic tools and techniques, owners and property managers can detect problems early, minimizing damage and expenses in the long run. Based on the study, existing cracks can be converted into expansion joints, white paint can be used on the walls to control heat, installed thermal insulation to control solar energy stress and waterproof membrane can be applied to prevent moisture penetration.

Physician views of artificial intelligence in otolaryngology and rhinology: A mixed methods study.

The study aimed to investigate otolaryngologists' knowledge, trust, acceptance, and concerns with clinical applications of artificial intelligence (AI). This study used mixed methods with survey and semistructured interviews. Survey was e-mailed to American Rhinologic Society members, of which a volunteer sample of 86 members responded. Nineteen otolaryngologists were purposefully recruited and interviewed until thematic saturation was achieved. Seventy-six respondents (10% response rate) completed the majority of the survey: 49% worked in academic settings and 43% completed residency 10 or fewer years ago. Of 19 interviewees, 58% worked in academic settings, and 47% completed residency 10 or fewer years ago. Familiarity: Only 8% of survey respondents reported having AI training in residency, although 72% had familiarity with general AI concepts; 0 interviewees had personal experience with AI in clinical settings. Expected uses: Of the surveyed otolaryngologists, 82% would use an AI-based clinical decision aid and 74% were comfortable with AI proposing treatment recommendations. However, only 44% of participants would trust AI to identify malignancy and 53% to interpret radiographic images. Interviewees trusted AI for simple tasks, such as labeling septal deviation, more than complex ones, such as identifying tumors. Factors influencing AI adoption: 89% of survey participants would use AI if it improved patient satisfaction, 78% would be willing to use AI if experts and studies validated the technologies, and 73% would only use AI if it increased efficiency. Sixty-one percent of survey respondents expected AI incorporation into clinical practice within 5 years. Interviewees emphasized that AI adoption depends on its similarity to their clinical judgment and to expert opinion. Concerns included nuanced or complex cases, poor design or accuracy, and the personal nature of physician-patient relationships. Few physicians have experience with AI technologies but expect rapid adoption in the clinic, highlighting the urgent need for clinical education and research. Otolaryngologists are most receptive to AI "augmenting" physician expertise and administrative capacity, with respect for physician autonomy and maintaining relationships with patients. Level VI, descriptive or qualitative study.

Coordinated design of multi-stakeholder community energy systems and shared energy storage under uncertain supply and demand: A game theoretical approach

Shared energy storage plays an important role in achieving sustainable development of renewable-based community energy systems. In practice, the independent or disordered planning of community energy systems and shared storage systems can lead to suboptimal design without considering the complex interactions between neighboring energy systems. Therefore, a coordinated design approach for community energy systems and shared energy storage is proposed, and a pricing mechanism for storage sharing based on bounded rationality theory is developed. A Stackelberg game is introduced to enable consideration of storage sharing among energy systems at the design phase. The uncertainties of solar irradiation, wind speed, and electrical demand on both the supply and demand sides are also considered. Then, an uncertainty model is formed to optimize the system configurations, operation strategies, and storage sharing strategies of each stakeholder, simultaneously. Furthermore, the influence of the profit margin, storage investment cost, and carbon tax on the storage rental price and system design strategies are discussed. Illustrative examples highlight the feasibility and applicability of the shared storage pricing mechanism and coordinated design approach. This paper provides references for the government with respect to the problem of coordinated design for multi-stakeholder distributed energy systems and storages in a market-oriented environment.

Enhancing quality of life: Human-centered design of mobile and smartwatch applications for assisted ambient living

<p><strong>Background:</strong> Assisted ambient living interfaces are technologies designed to improve the quality of life for people who require assistance with daily activities. They are crucial for individuals to maintain their independence for as long as possible. To this end, these interfaces have to be user-friendly, intuitive, and accessible, even for those who are not tech-savvy. Research in recent years indicates that people find it uncomfortable to wear invasive or large intrusive devices to monitor health status, and poor user interface design implies a lack of user engagement. <strong>Methods:</strong> This paper presents the design and implementation of non-intrusive mobile and smartwatch applications for detecting older adults when executing their routines. The solution uses an intuitive mobile application to set up beacons and incorporates biometric data acquired from the smartwatch to measure bio-signals correlated to the user’s location. User testing and interface evaluation are carried out using the User Experience Questionnaire (UEQ). <strong>Results:</strong> Six older adults participated in the evaluation of the interfaces. Results show that users found the interaction to be excellent in all the parameters of the UEQ in the evaluation of the mobile interface. For the smartwatch application, results vary from above average to excellent. <strong>Conclusions:</strong> The applications are intuitive and easy to use, and data obtained from integrating systems is essential to link information and provide feedback to the user.</p>

Challenge and barriers: Teacher reflection on teaching physical education and sports during Covid-19 pandemic

The covid-19 pandemic in some countries has been declared over. Learning activities began to be transferred face-to-face as before. However, online learning that lasted for almost 2 years certainly left unforgettable memories. During the pandemic, physical education (PE) teachers have become one of those who feel the heavy impact of teaching online. The objective of this study is to explore the online teaching experience of PE teachers. The variable on this research is the difficulties perceived by PE teachers while delivering lesson during pandemic. This research is qualitative research that uses a narrative analysis design. A total of 8 PE teachers from junior and senior high school is being involved in the study. We delivered semi-structured interviews to explore the experiences of teachers during online teaching in the pandemic era. The experience contained in this article is related to problems that are commonly encountered by teachers in Indonesia when implementing online learning. It is argued that most problem are coming from student's side. However, they admitted that teacher also set drawbacks on online learning through limitations on computing skill, poor learning design, and low adaptation on migrating the course from offline to online. This research has the potential to help identify crucial strategies for utilizing ICT and digital technologies in blended teaching settings.

Measuring the Exciton Binding Energy: Learning from a Decade of Measurements on Halide Perovskites and Transition Metal Dichalcogenides

AbstractThe exciton binding energy (Eb) is a key parameter that governs the physics of many optoelectronic devices. At their best, trustworthy and precise measurements of Eb challenge theoreticians to refine models, are a driving force in advancing the understanding of a material system, and lead to efficient device design. At their worst, inaccurate Eb measurements lead theoreticians astray, sow confusion within the research community, and hinder device improvements by leading to poor designs. This review article seeks to highlight the pros and cons of different measurement techniques used to determine Eb, namely, temperature‐dependent photoluminescence, resolving Rydberg states, electroabsorption, magnetoabsorption, scanning tunneling spectroscopy, and fitting the optical absorption. Due to numerous conflicting Eb values reported for halide perovskites (HP) and transition metal dichalcogenides (TMDC) monolayers, an emphasis is placed on highlighting these measurements in an attempt to reconcile the variance between different measurement techniques. It is argued that the experiments with the clearest indicators are in agreement on the following values: ≈350–450 meV for TMDC monolayers between SiO2 and vacuum, ≈150–200 meV for hBN‐encapsulated TMDC monolayers, ≈200–300 meV for common lead‐iodide 2D HPs, and ≈10 meV for methylammonium lead iodide.

What inhibits the progress of early-career women in Karachi? Studying the effects of socio-spatial mobility barriers on women's employment.

There is a widespread acceptance and shift towards sustainable, inclusive and smart mobility solutions around the world. However, in Karachi, poorly coordinated urban planning, lack of effective governance structure and investment in transport, has allowed the growth of an almost unregulated and ungovernable informal transport sector. Women are more severely affected by the poor service since men not only have more space allocated to them on public transport but also have the freedom to use alternative and cheaper private vehicles such as motorbikes and cycles. Poor representation of women in the transport sector further aggravates the situation. The paper aims to highlight the gender-disaggregated effects of poor transport design, provision and lack of personal agency on mobility, for emphasising the social and cultural attitudes faced by female employees. It argues that not integrating the gender-based disadvantages faced by women into planning, reinforces their disadvantaged position and force them to take complex trips. Scenario-based questions were designed for focus group discussion which covered not only the everyday mobility challenges but also their reactions to the potential solutions. For a gender-based comparative analysis, two separate focus group discussions were organised. Adopting a sector-based mapping approach of the issues discussed in the groups helped understand the complexity of female user experience at various levels, starting from planning or discussing the trips with families, to making modal choices. It also helped to tease out the impact of these issues on their employment opportunities as early-career women. The model proposed in this paper can help illustrate where changes can be made in the system considering the social aspects of transport.

Occupational Hazards and Safety Measures Among Medical Laboratories Staff in Eastern Province- KSA

Background: With the increase in interest and awareness about occupational health and safety. However, in Saudi Arabia, few studies have been conducted about the condition of workers in medical laboratories. Objectives: This study attempted to determine the main occupational hazards among medical laboratory staff in Eastern Province- KSA. To assess and evaluate the safety measures undertaken by the medical laboratory staff in Eastern Province- KSA, as well as to identify the factors which hinder the implementation of good occupational safety and health (OSH) practice among medical laboratory staff in Eastern Province- KSA. Method: This was a cross-sectional study research design that entailed the use of a modified structured questionnaire. The study was conducted in 10 medical laboratories out of 105 samples from the respondents. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28, basic descriptive statistical analysis used to perform the following: frequency account, and count percentages. Bar charts and pie charts were used for the presentation of descriptive statistics. Result: The most common types of occupational hazards in medical laboratories are biological hazards are bacteria (39.45%). Meanwhile, the most common chemical hazards include flammable liquids and solids (33%). Whereas, the most common physical hazards the most common were related to electricity (26.32 %). The most contributive control measure to mitigate occupational hazards is providing PPE (94.3%). The most common factors that stymie good practice in medical laboratories included poor laboratory design (61% and lack of awareness about laboratory safety procedures (58.1%). Conclusion: Increasing awareness about safety procedures within medical laboratories and improving the infrastructure and design of laboratories will greatly contribute to the prevention of risks to which medical laboratory staff is exposed.

Usability Evaluation of Two National COVID-19 Registration Systems: A Heuristic Evaluation

Background: Data related to COVID-19 are increasing daily; the data analysis of the COVID-19 registry can provide critical information to policymakers and researchers for planning. The poor user interface design of these systems leads to problems in interacting with them. The present study aimed to evaluate the usability of two national systems to record daily data related to COVID-19 patients throughout hospitals in Iran called the "Medical Care Monitoring Center" (MCMC) and the "Electronic System for Syndromic Surveillance of Infectious Diseases" (ISSS). Methods: The interface of the aforementioned systems was assessed using a heuristic evaluation (HE) method in this descriptive, cross-sectional study. Using Nielsen’s 10 usability principles, three trained evaluators identified problems and determined each system’s severity rates independently. Results: This evaluation identified 164 usability problems, including 59 issues in the "ISSS" system and 105 violations in the "MCMC" system. The highest number of ISSS system problems was related to "Consistency and standard" and "Flexibility and efficiency of use". The average severity of problems in this system varied from 2 concerning "Consistency and standards", "Help users recognize, diagnose, and recover from errors", and "Help and documentation" to 3.6 concerning "Visibility of system status". The highest number of MCMC system problems was associated with "Help and documentation" and "Consistency and standards". The average severity of problems in this system varied from 2 to 3.28 regarding "Help and documentation" and "Recognition rather than recall", respectively. Conclusion: Errors may be decreased, data quality can be raised, and interactions can be enhanced by taking into account standards and guidelines for user interface design, such as the HE utilized in this work.

Vandita Patel in conversation: Entrenched inequities and bad design on the path to a career in UK academia

Vandita Patel in conversation: Entrenched inequities and bad design on the path to a career in UK academia

Augmenting the thermal response of helical coil latent-heat storage systems with a central return tube configuration

Low-temperature stratification, high-volumetric storage capacity, and less-complicated material processing make phase-changing materials (PCMs) very suitable candidates for solar energy storage applications. However, their poor heat diffusivities and suboptimal containment designs severely limit their decent storage capabilities. In these systems, the arrangement of tubes conveying the heat transport fluid (HTF) plays a crucial role in heat communication between the PCM and HTF during phase transition. This study investigates a helical coil tube-and-shell thermal storage system integrated with a novel central return tube to enhance heat transfer effectiveness. Three-dimensional computational fluid dynamics simulations compare the proposed design against a baseline helical coil system without a return tube under equivalent conditions. Outcomes quantify the return tube's efficacy in augmenting heat transfer uniformity and accelerating phase transition. Adding the return tube markedly boosts heat storage and recovery rates, increasing charging by 88% and discharging by 56% versus the baseline. Moreover, total phase transition time reduces by 48% for melting and 36% for solidification with the return tube. The accelerated charging stems from sustained convective heat transfer inside the return tube even as the molten layer thickens. Meanwhile, enhanced solidification results from ongoing cooling of inner regions. Isotherm analysis visualizes the return tube's efficacy in maintaining thermal uniformity throughout the phase transition process. Overall, the return tube significantly improves PCM thermal response, demonstrating a novel but straightforward approach to address heat transfer limitations in latent thermal storage systems.

Investigating the Barriers to EFL Teachers’ Professional Development in Erbil High Schools

The present study entitled, ‘’ Investigating the Barriers to EFL Teachers’ Professional Development in Erbil High Schools”, aims at investigating the barriers to English Language teachers’ professional development in the city Centre of Erbil. To achieve the aims of the study, a questionnaire has been constructed to investigate the barriers to professional development. The tool of the study was exposed to some experts as jury members in the fields of English language, linguistics, and applied linguistics to achieve its validity.The sample of the study is 100 English Language teachers in public high schools. The data was analyzed after being statistically computed by employing SPSS programme to show Percentage, the Mean, and the Standard Deviation of the items of the questionnaire. The findings of this study reveal that there are some outstanding barriers that prevent English Language teachers from participating in professional development activities or training courses. The barriers are: (poor internet infrastructure and teachers’ illiteracy with modern technological tools, the ineffectiveness of teachers’ performance appraisal system, a bad design of professional development programmes, Training venues, financial constraints, teachers’ demotivation, the lack of qualified and professional English language trainers, English language teachers’ excessive workload, administrative routines, personal problems (family problems) and poor economic conditions, teachers’ beliefs and attitudes towards the professionalism of their performance, the effects of colleagues. The study also shows that the variables such as gender, age, marital status, qualification, years of teaching, and teaching hours per week have an impact on teachers’ participation in career-development activities. The contribution of this study can help other researchers in conducting further studies to investigate the barriers that influence teachers’ participation in profession-related activities or training courses among public high school English language teachers. It also helps the education decision makers to plan effective professional development programmes

How states deal with long-term destabilizing risks

Many risks of events with the potential to cause societal collapse either lie far in the future or have a low chance of materializing in any given year. However, optimal mitigation of these long-term destabilizing risks requires state action in the present. We provide a novel framework for understanding why states struggle to formulate a rational response to these risks. In our framework, insights from cognitive psychology, long-term governance and game theory in international relations are integrated. Cognitive biases limit state forecasting accuracy; political incentives and state structures are generally not aligned with tackling the important challenges of the long-term; and global cooperation, a necessary component of mitigation of long-term destabilizing risks, is constrained by suboptimal institutional design in the face of game-theoretical challenges to cooperation. We illustrate this framework by looking at the case of how states fared against epidemic risk in the pre-COVID-19 period. Using 2019 indices of pandemic preparedness, we show that, as a result of the challenges included in our framework, almost all countries failed to take low-cost, high-benefit measures for preventing and mitigating pandemic risk. This underinvestment was widely acknowledged at the time, and occurred in spite of the well-established favorable cost-benefit ratios of such measures. In addition, international cooperation failed to lead to adequate preventive, mitigative and response policies. We argue that, considering the stakes, deepening our knowledge of why states do not adequately mitigate long-term destabilizing risks should be a priority for the study of governance. We conclude with recommendations both for policy makers and researchers.

Living in a hot city: thermal justice through green open space provision

Jakarta's environmental problems, the increasing temperature, and the intensifying urban heat island effect (UHIE) add weight to the deteriorating quality of life in the city. Nevertheless, chronic exposure to heat, especially experienced by inhabitants in tropical cities, receives less attention. It is often seen as a low-onset event that requires no immediate action and is not as noticeable and apparent as other heat events, such as heat waves. This slow onset environmental hazard disproportionately affects the population in the lower socio-economic condition. With their low access to cooling infrastructure, the disadvantaged people of Jakarta live and work in an environment prone to extreme heat exposure. Poor urban planning and design contribute to the intensifying urban heat in Jakarta and exacerbate the impacts of heat by providing mitigating and managing urban heat in the city. Using the Multiple Stream Framework (MSF) lenses, we analyse how and why the issue of urban heat is currently being prioritized in Jakarta and how the provision of green open space contributes to thermal justice in Jakarta. The issue is examined by analyzing urban planning policy through government strategy documents and interviews with key stakeholders. The findings reveal that while there is a growing awareness of urban heat issues in Jakarta, they are often overshadowed by other strategic issues in the policy arena. The research underscores the significance of incorporating urban heat issues into urban policy agendas and promoting equitable distribution of green open space in Jakarta.

Sociodemographic and Workplace Determinants of Quality of Life (Qol) Among Quarry Workers in Nigeria: A Cross Sectional Study

By engaging in one form of works, people earn means of support, establish their identities, perceive life as meaningful and establish social network with others. The quality of life is a product of several factors inherent in the work environment. Quality of life is an important topic in every organization as it determines the future of the organization. This study assessed the sociodemographic and workplace determinants of Quality of life (Qol) among quarry workers in Nigeria. A cross-sectional study was conducted among the respondents. Data were collected using self-administered questionnaires consisting of socio-demographic characteristics, Standard Nordic Musculoskeletal Questionnaire and World Health Organization Quality of life BREF questionnaires (WHOQOL-BREF). A total of 266 quarry workers involved in this study were selected through systematic random sampling technique. The data were analyzed using SPSS version 26. Simple and multiple logistic regression were used to identify the determinants of quality of life among the respondents. The result showed that majority of the respondents (74.1%) had poor quality of life with variation across four domains of physical, environmental, socio relationship and psychological. Following multiple logistic regression modeling, WRMSDs (ORadj 4.24, 95% CI [1.84, 9.77], p-value = .001) and the poor work design (ORadj 3.22, 95% CI [1.52, 6.82], p-value = .002) remained significant determinants of Qol. This study showed poor quality of life among quarry workers in Ebonyi state, Nigeria. Those with WRMSDs and had poor work design were more likely to have poor quality of life compared to those who had no WRMSDs and work in well-designed workplace.

Event-Triggered Distributed State Estimation: A Conditional Expectation Method

This paper mainly focuses on distributed filtering for a discrete time-varying system observed by a sensor network, where each sensor can measure some partial state information of the system and communicate with its neighbours. A novel distributed event-triggered communication mechanism is designed to reduce the communication rate among the sensors and guarantee the performance of the filter. With a data scheduler, the sensor is able to decide whether to transmit data to its neighbours. By applying Gaussian approximation, an evaluation of the effect caused by the non-transmission event is derived, which characterizes the tradeoff between communication rate and state estimation performance. Subsequently, a corresponding sub-optimal filtering gain design protocol is proposed. Compared with the literature, the filtering algorithm proposed in this paper is less conservative. Finally, numerical simulation is provided to illustrate the improvement of performance and the robustness of the approximation.

Lower academic performance among children with perinatal HIV exposure in Botswana.

Studies have reported a higher risk of suboptimal neurodevelopment among children who are HIV-exposed uninfected (HEU) compared to children HIV-unexposed uninfected (HUU). Actual academic performance among school-aged children by HIV exposure status has not been studied. Academic performance in Mathematics, Science, English, Setswana and overall among children enrolled in the Botswana-based FLOURISH study who were attending public primary school and ranging in age from 7.1 to 14.6 years were compared by HIV exposure status using a Cochran-Mantel-Haenszel test. Lower academic performance was defined as a grade of "C" or lower (≤60%). Unadjusted and adjusted logistic regression models were fit to assess for an association between HIV exposure and lower academic performance. Between April 2021 and December 2022, 398 children attending public primary school enrolled in the FLOURSH study, 307 (77%) were HEU. Median age was 9.4 years (IQR 8.9-10.2). Only 17.9% of children HEU were breastfeed versus 100% of children HUU. Among children HEU, 80.3% had foetal exposure to three-drug antiretroviral treatment, 18.7% to zidovudine only and 1.0% had no antiretroviral exposure. Caregivers of children HEU were older compared to caregivers of children HUU (median 42 vs. 36 years) and more likely to have no or primary education only (15.0% vs. 1.1%). In unadjusted analyses, children HEU were more likely to have lower overall academic performance compared to their children HUU (odds ratio [OR]: 1.96 [95% confidence interval (CI): 1.16, 3.30]), and lower performance in Mathematics, Science and English. The association was attenuated after adjustment for maternal education, caregiver income, breastfeeding, low birth weight and child sex (aOR: 1.86 [95% CI: 0.78, 4.43]). In this Botswana-based cohort, primary school academic performance was lower among children HEU compared to children HUU. Biological and socio-demographic factors, including child sex, appear to contribute to this difference. Further research is needed to identify modifiable contributors, develop screening tools to identify the risk of poor academic performance and design interventions to mitigate risk.