Complete Primary Education Research Articles

Motivation and Intergenerational Educational Mobility

Abstract: This study aimed to identify whether motivation to learn has a statistically significant effect on intergenerational educational mobility among Brazilian university students. Although qualitative studies have proposed the existence of this relationship, quantitative evidence still needs to be discovered. We sought to identify the characteristics that might be fostered to enable students to complete primary education and pursue higher education. To answer the research question, we used data from a sample of 1,031 individuals collected via a structured questionnaire and estimated an ordered logistic regression model with intergenerational educational mobility as the dependent variable and motivation as the key independent variable. The results showed that more motivated individuals were more likely to be educationally upwardly mobile in relation to their parents. However, such cases were more likely to occur when there was low mobility, with the father or mother having completed high school. This study’s findings would help public policymakers seeking to promote intergenerational educational mobility and reduce inequality. The results suggest motivation can be fostered and developed in children and adolescents, and the mechanisms for doing so, be they extrinsic or even intrinsic, need to be considered.

Socio-Cultural Factors Influencing Community Participation in the Joint Forest Management: A Case of Uzungwa Scarp Nature Forest Reserve, Tanzania

This study emphasizes the critical role of participatory approaches, particularly joint forest management (JFM), in addressing the escalating threat to forests posed by human activities. Focusing on the socio-cultural aspects, the research explores the factors influencing community participation in joint forest management within Tanzania's Uzungwa Scarp Nature Forest Reserve (USNFR), employing the Socio-Ecological System theory to underscore the potential of community-driven resource management. The study employed a cross-sectional research design, collecting data through questionnaires, focus group discussions, and interviews involving 190 respondents from five villages spanning Kilolo, Mufindi, and Mlimba Districts. Quantitative data underwent descriptive statistical analysis, while qualitative data were subjected to thematic analysis. The majority of the respondents were relatively young, likely due to their physical fitness and heightened environmental commitment. Conversely, older individuals were underrepresented, likely due to age-related limitations. Gender imbalances were observed, reflecting deeply ingrained gender-related barriers in societal norms. Education levels varied, with a significant portion having completed primary education, while higher levels of education were less represented. The respondents were predominantly married, indicating a probable tie to family responsibilities. Farming was the main occupation for the majority, highlighting their dependence on forest resources. Effective communication emerged as pivotal during village assemblies and workshops, fostering awareness and empowerment for successful joint forest management. Cultural factors significantly influenced community participation in JFM within the USNFR. Ritual activities, local knowledge, and power dynamics played key roles, creating taboos and restrictions that reinforced cultural ties to conservation, leveraging the influence of community elders. To enhance community involvement, the current influential factors should be preserved and enforced. Also, to ensure tailored conservation training programs, context-specific communication tools, promotion of cultural integration, and ensuring inclusivity in all JFM aspects. Future research should focus on assessing the impact of training programs on forest conservation

Comprehensive Knowledge of HIV and AIDS and Related Factors in Angolans Aged between 15 and 49 Years.

A comprehensive knowledge of HIV and AIDS among men and women in Africa is reportedly low. To the best of our knowledge, no studies using any definition of comprehensive knowledge of HIV and AIDS have been conducted in Angola. To address this gap, we aimed to describe the comprehensive knowledge held by individuals aged between 15 and 49 years regarding HIV and AIDS and some associated factors, using the most recent Angolan demographic and health survey (DHS). Using an observational, cross-sectional design, we analyzed data collected from 19,785 individuals aged between 15 and 49 years for the 2016 DHS in Angola. We conducted a logistic regression analysis of descriptive and complex samples to examine the data and to unravel possible factors associated with having a comprehensive knowledge of HIV and AIDS. Almost half of the respondents (47.7%) had a general comprehensive knowledge of HIV and AIDS. Individuals who watched television (adjusted odds ratio [aOR]: 2.40; 95% CI: 2.11, 2.72) or read newspapers and magazines (aOR: 1.99; 95% CI: 1.72, 2.30) more than once a week had higher odds of having a comprehensive knowledge of HIV and AIDS compared to those who did not. Similarly, having completed primary education and above (aOR: 1.83; 95% CI: 1.67, 2.00) or living in urban areas (aOR: 1.51; 95% CI: 1.34, 1.71) increased the likelihood of individuals having a comprehensive knowledge of HIV and AIDS compared to their counterparts. These results reflect inequalities that require further attention at either a research or a political level. Nevertheless, we consider that these results can assist decision-makers in advocating for continuous investment in HIV health literacy and in adapting global solutions to local Angolan contexts.

Unraveling the Complexity of Atypical Serological Profiles in Chronic Hepatitis B: Insights Into Disease Dynamics and Clinical Implications.

Introduction Chronic hepatitis B (CHB) continues to be a significant global public health problem. Conventional serological markers play a pivotal role in diagnosing and prognosticating CHB, but atypical serological profiles deviating from established norms pose challenges. Methods A cohort of 35 CHB patients who did not receive an antiviral treatment with atypical serological markers was followed for five years (2017-2022). Demographics, serological parameters, and changes were documented. Serological parameters and serum viral loads (hepatitis B virus (HBV)-deoxyribonucleic acid (DNA) levels) were assayed at the central laboratory during their routine follow-ups. Three groups of atypical serological markers are defined: hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) positivity; hepatitis B e antigen(HBeAg) and anti-hepatitis B e-antigen (anti-HBe) positivity; and isolated core (anti-hepatitis B core (anti-HBc) immunoglobulin G (IgG)) positivity. Patients with concomitant HBsAg and anti-HBs were also stratified into seroreversion groups. Changes in serological markers and HBV-DNA levels across the study period were documented and evaluated at the end of the study period. Statistical analysis was conducted using the Kruskal-Wallis test and IBM SPSS Statistics software for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA). Results In a cohort of 35 patients with atypical hepatitis B serology, demographic analysis revealed that 51.4% (n=18) were female and 48.6% (n=17) were male, with a mean age of 45.7 years. Educational distribution showed that 45.7% (n=16) completed primary education, 22.8% (n=8) had a high school education, and 31.5% (n=11) held university degrees. Among these patients, 10 displayed the concurrent presence of HBsAg and anti-HBs, with 60% (n=6) being female. Serum HBV-DNA was detectable in all cases. After five years, 60% (n=6) exhibited seroconversion from HBsAg to anti-HBs, particularly notable in females (66.7%). These patients showed lower HBsAg titers and serum HBV-DNA levels (p = 0.048, p = 0.036). A subset of 15 patients demonstrated simultaneous HBeAg and anti-HBe positivity. The HBeAg seropositivity waned over time, with 40% (n=6) and 26.7% (n=4) females and males, respectively, retaining positivity by the fifth year. During this period, serum HBV-DNA levels decreased. The remaining five patients sustained HBeAg and anti-HBe positivity. Among 10 patients solely positive for anti-HBc IgG, three had concurrent HBV-DNA positivity. Strikingly, three patients with negative HBV-DNA developed anti-HBs positivity after five years. Conclusion The complexity of CHB infection demands a comprehensive understanding. Atypical serological profiles suggest distinct disease stages, immune response variations, and viral mutations. This study enhances comprehension of viral replication, immune responses, and disease progression, potentially guiding tailored therapeutic strategies.

Effectiveness of Suicide Prevention Training Package on the Level of Knowledge about Suicide Risk Management

Introduction: Suicide is the intentional action taken by a person to end his or her own life. It is a major public health and mental health problem. This study was an attempt to find out the effectiveness of suicide prevention training package on the level of knowledge about suicide risk management among general population at Thrissur. Objectives: To assess the level of knowledge on suicide risk management before and after intervention, to compare the pretest and posttest level of knowledge of the people about the suicide risk prevention and management after giving suicide prevention training package and to associate the level of knowledge of the people in selected socio- demographic characteristics about the suicide risk prevention and management. Methodology: The study was conducted among 50 selected samples from 15 houses. The research design of the study was pre-experimental one group pre-test post-test design and samples were selected using purposive sampling method. The knowledge regarding suicide risks, warning signs and risk management were assessed with help of questionnaire consisting 3 sections and a total of 25 questions and the socio-demographic variables were assessed with help of demographic profile. The tool and interventions were validated by 5 experts including one psychiatrist. Results: The findings show that out of 50 samples 21 samples (42%) were belongs to the age group of 18 to 34 years. 14samples (28%) belong to the age group of 35 to 49 years. 11 samples (32%) belongs to the age group of 50- 64 years and only 4 samples (8%) belong to >65 years. Most of the 21 persons were samples were females (32%), married (24%) and living in a nuclear family (46%). Majority of them were graduated (42%), about 34% completed secondary/higher secondary education, 20% completed primary education and 4% were illiterate. Most (44%) of them were unemployed, 26% were having a professional job and 22% were having a non- professional job and about 8%of them were retired. Majority (88%) of them was above poverty level and living in rural area (60%). 66% of them were suffering from medical related diseases, 10% were suffering from psychiatric illness and 18% were suffering from other illnesses. About 4% of them were having a family history of suicide. Among them 31 samples (62%) had moderate knowledge and only 2 of them (4%) had adequate knowledge and 12 of them (34%) had poor knowledge. Discussion: At the end of the study, investigator found that there is a significant increase in the level of knowledge of people after giving suicide prevention training package. And also found that there is no significant association exist between demographic variables and knowledge level of sample.

Józef Jakubowski (1899–1984) – activist in scout, community, and émigré organisations in the light of Polish and French archival resources

The main purpose of this paper is to provide an insight into the life, activities, and preserved archival documents concerning Józef Jakubowski (1899–1984), whose work in support of Polish emigrants residing in France during the Second World War deserves highest recognition and respect. Jakubowski was born in Warsaw, where he spent his childhood, completed primary and secondary education, and began his studies at the Warsaw University of Technology in 1917. He was was actively involved in the scouting movement. His participation in the Polish–Soviet War forced him to leave the university . It was only in 1924 that he completed his higher education at another university, the Higher School of Commerce. His professional life also started in Warsaw, where he worked for the Association of Polish Merchants until 1939. His life was interrupted by the Second World War, and he decided to emigrate first to Switzerland and then to France. At that time of his life, he became involved with the Polish Red Cross. He was primarily involved in developing forms of aid and organising support for Poles in France. Once the Polish Red Cross was banned from further activities, he worked in the Welfare Society for the Poles in France. He cooperated with the Polish Resistance Movement in France and with military authorities on the evacuation of the Polish armed forces to England, as well as with many institutions, including the French Red Cross, the Department of Social Welfare for Foreigners, the International Refugee Organisation, and the Association of Polish Veterans. The archival documents concerning Jakubowski, surviving at the Central Archives of Modern Records in Warsaw and at the Polish Library in Paris, make it possible to reconstruct not only the facts of his life but also the events related to the functioning of the institutions, organisations, and associations he worked for.

KECICIRAN PENDIDIKAN DALAM KALANGAN ANAK-ANAK ASNAF: KAJIAN KES SEKOLAH RENDAH DI NEGERI PERLIS

Education is something very important to every person. Every child deserves an opportunity to learn. The Malaysian government has emphasized access to education for all and has proposed various educational guidelines and goals to bridge the gap in education, production and skills across all sectors since the establishment of Malaysia. Government action is to ensure that all children, regardless of gender, ethnicity, socio-economic background, or location, have access to and complete primary education. Problems in education, especially dropout problems among students often occur. Therefore, this study tries to look at the problem of dropping out of education among the poor and the poor. Case study research is used in this research. Data is obtained through interviews, observations and research of certain relevant documents. Data were analyzed descriptively. The findings of the study show several reasons for dropping out among students from the poor asnaf group, among them are family factors, personality, external factors and teaching and learning at school. A significant effect of this problem is the lack of opportunities for them to continue their studies. Measures to provide assistance by agencies such as Baitulmal are able to develop all these groups.

Abstract 67: Perceived Factors for Late Diagnosis in Women With Advanced Breast Cancer in Northern Tanzania

Abstract Purpose: In Tanzania, women often present with advanced stage breast cancer leading to treatment delays and poor outcomes. Factors influencing late hospital presentation of breast cancer have not been investigated. In this study, we aimed to explore patient perception of factors contributing to the late diagnosis of breast cancer. Methods: Women diagnosed with late- stage breast cancer in an outpatient cancer care center were identified by clinic nurses and recruited for study participation. Semi-structured interviews were conducted by a single proctor. Interviews were recorded, transcribed verbatim, and coded by three independent reviewers using NVivo 12. Themes were identified using a grounded theory approach. Results: Twenty patients (10 rural and 10 urban) participated in the interviews. The average age was 56; 11 (55%) completed primary education, 10 (50%) were unemployed, and 5 (25%) were married. Fourteen (70 %) of the patients had stage 4 breast cancer, 3 (15%) had stage 3, and 3 (15%) had stage 2. Nineteen (95%) of our respondents misunderstood the etiology of breast cancer as well as its causes, signs, and symptoms. Misconceptions led to experiences of stigma in 19 (95%) participants. One participant stated: “…I failed to tell people because… once I tell them that I have problem they will start to run away from me and even if you ask for assistance they think that I cannot pay them back because they think they might help me today and I die tomorrow before I pay them back…” Fifteen (75%) of the participants experienced rejection from their partners. Thirteen (65%) participants expressed financial concerns and eighteen (90%) participants were initially treated by a traditional healer, both of which lead to delays in hospital presentation. Conclusion: Lack of knowledge about breast cancer among patients, societal stigma, lack of spousal support, financial barriers, and initial treatment by traditional healers all contribute to delays in diagnosis and treatment of breast cancer in Northern Tanzania. Stigma reduction and educational interventions may reduce these delays, and further research is needed to improve access to cancer care in this population. Citation Format: Elizabeth Msoka-Bright, Mackenzie Abraham, Polina Zmijewski, Furaha Serventi, Perry Cyril, Brenda Kitali, Vivian Saria, Jackline Kwayu, Adelide Kavishe, Gileard Masenga, Blandina Mmbaga, Lily Gutnik. Perceived Factors for Late Diagnosis in Women With Advanced Breast Cancer in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 67.

Abstract 83: The Perceived Relationship Between Nutrition and Cancer Among Breast Cancer Patients in Northern Tanzania

Abstract Purpose: Modifiable risk factors, including nutrition, are of particular interest in cancer research. There are limited studies establishing associations between dietary patterns and breast cancer risk. The purpose of this qualitative study is to explore the nutritional practices and perceptions of nutrition and cancer among breast cancer patients in northern Tanzania. Methods: Participants with confirmed diagnosis of breast cancer were identified in an outpatient setting and included in a larger qualitative study regarding patient breast cancer experiences and reasons for advanced stage at time of diagnosis. Semi-structured interviews were conducted by trained interviewers and transcribed verbatim, then translated from Swahili to English. Thematic coding using a grounded theory approach was done by two independent researchers. Results: Twenty patients (10 rural and 10 urban) participated in the interviews. The average age was 56; 11 (55%) completed primary education, 10 (50%) were unemployed, and 5 (25%) were married. Fourteen (70%) of the patients had stage 4 breast cancer, 3 (15%) had stage 3, and 3 (15%) had stage 2. Food access varied with 6 (30%) patients identifying as farmers or growing up on coffee plantations. Within this group, two-thirds mentioned pesticide use. Cancer causes perceived by patients included animal products (n = 5, 25%), cooking oil and fried food (n = 5, 25%), toxins or chemicals in food (n = 6, 30%), alcohol use (n = 5, 25%), smoking (n = 2, 10%), and being overweight/obese (n = 1, 5%). After receiving the cancer diagnosis, 55% (n = 11) modified their diet: decreased or ceased alcohol intake (n = 4, 20%), stopped consuming soda (n = 2, 10%), prepared food by boiling instead of frying (n = 2, 10%), and increased vegetable intake (n = 3, 15%). Conclusions: Many participants perceived cancer to be caused by dietary factors with some correctly identifying risk factors including smoking, alcohol use, and being overweight/obese. These beliefs were impactful enough to lead many to change their dietary habits after cancer diagnosis. Further research is needed to elucidate the impact of dietary habits on cancer outcomes in Sub-Saharan Africa and provide educational interventions to promote healthier lifestyles in patients. Citation Format: Garrett Barnes, Sindhu Dwarampudi, Elizabeth Msoka-Bright, Lily Gutnik. The Perceived Relationship Between Nutrition and Cancer Among Breast Cancer Patients in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 83.

Factors associated with fathers' involvement in infant and young child feeding and nurturing care in the urban slums of Bangladesh: A cross-sectional study.

Optimal infant and young child feeding (IYCF) and nurturing care during the first years of children's lives are crucial for ensuring their growth and development. The IYCF and nurturing practices are associated with a multifaceted interplay of context-specific factors where fathers' involvement is necessary. The aim of this study is to explore the current scenario of fathers' involvement in IYCF practices in the urban slums of Bangladesh. A cross-sectional survey among the residents of the Sat Tola slum in Dhaka, the capital of Bangladesh was conducted. To avoid social desirability bias, 361 mothers of children aged <24 months were interviewed regarding fathers' involvement. An operational definition of father's involvement was developed based on 11 criteria and then scoring was applied to classify 'Good Involvement' and associated factors were identified using multivariable logistic regression. Fathers' mean age was around 31 (SD ± 6.09) years and the majority of them (44.32%) completed primary education. Fathers had diversified occupations such as day laborer (32.41%), garment worker (22.71%), and business (14.96%). Factors that were significantly associated with the father's involvement in IYCF practices include educational status (aOR = 3.98, 95% CI = 1.91, 8.26, p < .00) and theiroccupational status (aOR = 0.34, 95% CI = 0.16, 0.70, p = .00). Fathers were more active for their first child (aOR: 1.99, 95% CI = 1.04, 3.79, p = .03). Having child in the age group of 14-20 months (aOR = 2.73, 95% CI = 1.32, 5.64, p = <.01) and wife in the age group of 21-30 years (aOR = 2.34, 95% CI = 1.20, 4.58, p = .01) were significantly associated. The study finding explored that fathers' education and occupation as well as mothers' age and education were significantly associated factors for fathers' involvement in the IYCF practices. Further longitudinal studies are recommended to establish the causal relationship between fathers' involvement with IYCF and their impact on child growth and development.

Farmer perception of impacts of fall armyworm (Spodoptera frugiperda J.E. Smith) and transferability of its management practices in Uganda

BackgroundThe Fall armyworm (FAW) Spodoptera frugiperda (Lepidoptera: Noctuidae) is now established across the African continent and is a highly polyphagous and destructive pest of many crops. In Uganda, FAW has become the major maize pest, causing heavy damage especially on shoots and growing points. The objectives of this study were to: (i) document local farming practices that have been useful to manage FAW, (ii) establish farmers’ perspective on the time of FAW’s arrival to their localities, (iii) investigate the economic impact (yield) of FAW to maize farmers, (iv) establish the farmers’ perception on the current status of the FAW, and (v) document alternative practices used to manage the FAW and the perceived efficacies.MethodsA questionnaire survey was undertaken in November 2020 in Kamuli and Namutumba districts of Uganda and 99 farmers were interviewed to understand their profiles and perceptions about the FAW. A descriptive analysis of this data was undertaken to establish the socio-economic profiles and perceptions of the farmers.ResultsFarmers’ education levels in the two districts ranged from basic (completed primary education) to advanced (completed University degree), with most farmers having 10–30 years experience in growing maize (F = 20.8; df = 3,7; P = 0.0067), and with mainly small- and mid-sized production scales (F = 436.2; df = 2,5; P = 0.0002). Famers in Kamuli (98%) and Namutumba (96%) reported 25–50% yield losses due to FAW infestation that negatively impacted their income. We found a significantly higher percentage of farmers (84% and 92% in Kamuli and Namutumba districts, respectively), could correctly identify the FAW by its appearance (P < 0.0001). While FAW was officially reported in Uganda in 2016, farmers confirmed noticing damage symptoms similar to those caused by FAW as early as 2013 and 2014 in Namutumba and Kamuli districts, respectively. 98% of the farmers in Kamuli and 96% of those in Namutumba strongly agreed that FAW infestation reduced their income, while 74% in Kamuli and 86% in Namutumba also strongly considered the FAW as a threat to maize production (P < 0.0001). The majority of farmers (64% in Kamuli, 82% in Namutumba) still considered the FAW to be a very serious challenge to maize production in their localities, six years since officially being reported in Uganda. To manage the FAW, 84% and 90% of Kamuli and Namutumba respondents respectively, predominantly use chemical control methods. Other methods used also included cultural control practices (i.e., by regular weeding and handpicking), while the use of biological extracts (pepper, tobacco, Aloe-vera, Lantana, sisal) was evident though not common. Pheromones and biological control methods to manage FAW were not reported, although a farmer in Kamuli district reportedly observed weaver birds (Ploceus spp.) predating on the FAW in maize. A small number of farmers (ca. 4%) in both districts reportedly took no intentional action against FAW.ConclusionsThe farmers believe they can manage FAW if they have the appropriate and efficacious chemical insecticides as they are able to correctly apply them and follow recommended procedures. The farmers advocated for an area-wide approach as one of the best alternatives to manage this invasive pest.

Challenges Facing Women Vegetable Vendors in Arusha, Tanzania: A Case of the Tengeru Market

The study aimed to analyse the challenges that women vegetable vendors face in Arusha, Tanzania, with a focus on Tengeru market. A cross-sectional research design was adopted in this study. A case study, as opposed to a broad statistical survey, focuses on a specific circumstance. It refers to the process of getting an understanding of a topic without including the entire population. The survey's findings showed that the majority of respondents were female due to the nature of the study, were in their 21s to 25s, and had only completed primary education. The study's findings again showed that the majority of respondents sold vegetables in their local community markets to generate revenue. Also, the majority of these people were participating in vegetable vending activities due to persuasion from their families, spouses, local government officials, societal seminars, and other groups. Furthermore, it was found that a few individuals claimed that the income they were generating from their activities was insufficient to satisfy their households' requirements or other socioeconomic activities.&#x0D; The study discovered that vegetable vendors faced numerous challenges, including a lack of assistance from the government or their families, a lack of confidence, a lack of skills and knowledge, and work interruptions due to violence against women. According to the study, the government should assist them by providing loans, enacting laws and regulations, raising awareness, and developing useful materials.

Škole u seoskoj sredini i inkluzivno obrazovanje - stanje i mogućnosti

The paper discusses the context of rural schools, and the current state and possibilities for the development of inclusive education in them. The law of the Republic of Serbia stipulates that all children must have access to and complete primary education, which implies, among other things, inclusive education, whereby each school must develop its own construct that matches the social and cultural circumstances in which the school operates, and the different needs of its students. The paper examines the presence of inclusive characteristics of education and the possibilities for improving inclusive education from the standpoint of teachers, on the sample of 160 teachers from 25 rural schools in Zlatibor district. A descriptive method and a survey method were applied. A special questionnaire for teachers, created for the purposes of this research, was used as the instrument. The results show that teachers estimate most of the characteristics of inclusive education as being present in their school, with the exception of inclusive teaching resources and assistive technologies. They see providing professional support and additional training for working with students who need support as the most important opportunity for improving the process of inclusive education.

Padrões de síndrome metabólica e fatores associados em mulheres do ELSA-Brasil: uma abordagem com análise de classes latentes

Abstract: This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.

Educational inequalities and premature mortality: the Cuba Prospective Study

Although socioeconomic status is a major determinant of premature mortality in many populations, the impact of social inequalities on premature mortality in Cuba, a country with universal education and health care, remains unclear. We aimed to assess the association between educational level and premature adult mortality in Cuba. The Cuba Prospective Study (a cohort study) enrolled 146 556 adults aged 30 years and older from the general population in five provinces from Jan 1, 1996, to Nov 24, 2002. Participants were followed up until Jan 1, 2017, for cause-specific mortality. Deaths were identified through linkage to the Cuban Public Health Ministry's national mortality records. Cox regression models yielded rate ratios (RRs) for the effect of educational level (a commonly used measure for social status) on mortality at ages 35-74 years, with assessment for the mediating effects of smoking, alcohol consumption, and BMI. A total of 127 273 participants aged 35-74 years were included in the analyses. There was a strong inverse association between educational level and premature mortality. Compared with a university education, men who did not complete primary education had an approximately 60% higher risk of premature mortality (RR 1·55, 95% CI 1·40-1·72), while the risk was approximately doubled in women (1·96, 1·81-2·13). Overall, 28% of premature deaths could be attributed to lower education levels. Excess mortality in women was primarily due to vascular disease, while vascular disease and cancer were equally important in men. 31% of the association with education in men and 18% in women could be explained by common modifiable risk factors, with smoking having the largest effect. This study highlights the value of understanding the determinants of health inequalities in different populations. Although many major determinants lie outside the health system in Cuba, this study has identified the diseases and risk factors that require targeted public health interventions, particularly smoking. UK Medical Research Council, British Heart Foundation, Cancer Research UK, CDC Foundation (with support from Amgen).

Willingness to work in rural areas and associated factors among graduating health students at the University of Gondar, northwest Ethiopia, 2021.

Many of the rural areas in developing countries are still in need access to quality healthcare services. To ensure the fair distribution of a high-quality health workforce and the availability of health services, there is a need to assess the background barriers that explain why healthcare providers are not interested to work in rural areas, thereby setting strategies to achieve universal health coverage. Therefore, this study is aimed to assess the willingness to work in rural areas and associated factors among health students at the University of Gondar. An institution-based cross-sectional study was conducted at the University of Gondar from August 15 to 25, 2021. A total of 422 study participants were selected using a stratified random sampling technique. A pretested self-administered questionnaire was employed to collect the data. Data were entered into EPI DATA 4.6 and exported to SPSS 25 for further analysis. Multivariable logistic regression analysis was performed to identify factors associated with students' willingness to work in rural areas. The level of significance was decided based on the 95% confidence interval at a p-value of ≤ 0.05. In this study, it was found that health students' willingness to work in rural areas was 78.4% (95% CI: 74.3, 82.4). Being male (AOR = 2.15; 95% CI: 1.17, 3.94), having intention to continue with their profession (AOR = 2.5; 95% CI: 1.28, 4.86), having a favorable attitude towards working in rural areas (AOR = 7.32; 95% CI: 5.71, 18.65), and having a mother with no formal education (AOR = 2.23; 95% CI: 1.02, 4.85) and completed primary education (AOR = 2.69; 95% CI: 1.1, 6.61) were significantly associated with willingness to work in rural areas. The willingness of students to work in rural areas was optimal. This calls for concerned bodies to create a conducive environment for male and female students to engage in rural areas without hesitation. It is also important to ensure that students are willing to work in the rural areas voluntarily, instead of working in rural areas due to a lack of employment.

A Clinico-Epidemiological Study among Burn Injury Patients in a Tertiary Care Hospital of Eastern India

Background: Every year in India about 7 million people suffer from burn injury, which is a leading cause of not only mortality, but morbidity and disability among the burn patients, leading to emotional trauma and stigma. Objectives: The present study was conducted in a peripheral medical college of West Bengal to describe the epidemiology, clinical presentation, and outcome in burn patients and also to identify contributing factors influencing the outcome in burn patients. Methodology: In this descriptive cross-sectional study, all consecutive burn patients admitted in Dept of surgery in 2018 were included. Data was collected regarding socio demographic profile, mechanism, type and degree of burn, total body surface area involved, time taken to reach health facility and outcome. Results: Out of 514 burn patients, majority were 20 to 60 years age group, females, Muslim in religion, from rural background, completed primary education, homemaker and having monthly income of the family below Rs 5000. Most of the burns were accidental, thermal in nature occurred at household level. About one third had burns involving dangerous areas of body. Average length of stay in hospital was 6.104 days with 20% case fatality and directly proportional with body surface area involved. Conclusion: Safety measures and building awareness can prevent burn injury at household level. Early initiation of treatment, infection control and following standard management protocol can avert mortality in tertiary setting. Rehabilitation and psychosocial care are urgently needed to combat disability. Keywords: Burn, Clinico-epidemiology, Length of stay, Outcome

Adherence to healthy lifestyle recommendations in Brazilian cancer survivors.

We aimed to describe the adherence to healthy lifestyle recommendations (regular consumption of fruits, vegetables, and salad greens; limit the consumption of red and processed meat, fast food, sugary and alcoholic beverages; keeping a healthy body weight, being physically activity, and not smoking) of 2314 cancer survivors and 86,517 adults without cancer diagnosis (general population) from the Brazilian National Health Survey, 2019. We developed a score including eight healthy lifestyle recommendations proposed by the World Cancer Research Fund (i.e., the score ranged from 0 to 8; being 0 did not follow any recommendation and 8 followed all recommendations). Cancer survivors had higher healthy lifestyle score than the general population. In contrast, they presented similar adherence to the recommendations of physical activity, healthy body weight, and quitting smoking. Among cancer survivors, women (OR 1.52; 95%CI 1.12 to 2.06) and widows (OR 1.49; 95%CI 1.02 to 2.18) had greater odds of adherence to healthy lifestyle recommendations, adjusted for other sociodemographic characteristics. However, cancer survivors with complete primary education (OR 0.64; 95%CI 0.44 to 0.94) and higher education (OR 0.58; 95%CI 0.40 to 0.83) had lower adherence to the recommendations. Our findings may be useful to support counseling and interventions aimed at promoting healthy lifestyles for Brazilian cancer survivors. Healthy lifestyle may reduce mortality and cancer recurrence, and improve quality of life in cancer survivors. Identifying factors associated with the adherence to healthy lifestyle in cancer survivors may be useful to support actions and interventions.

The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana.

Background:According to the World Health Organization/United Nations International Children’s Fund Joint Monitoring Program, people practice open defecation globally. After achieving open defecation-free (ODF) status through efforts such as Community-Led Total Sanitation (CLTS), communities (particularly vulnerable households) may revert to open defecation, especially when toilet collapse is common and durable toilets are unaffordable. Accordingly, there is increasing interest in pro-poor sanitation subsidies.Objectives:This study determined the impacts of a pro-poor sanitation subsidy program on sanitation conditions among the most vulnerable households and others in the community.Methods:In 109 post-ODF communities in Northern Ghana, we conducted a cluster randomized controlled trial to evaluate a pro-poor subsidy program that identified the most vulnerable households through community consultation to receive vouchers for durable toilet substructures. We surveyed households to assess toilet coverage, quality, and use before and after the intervention and tracked program costs.Results:Overall, sanitation conditions deteriorated substantially from baseline to endline (average of 21 months). In control communities (not receiving the pro-poor subsidy), open defecation increased from 25% (baseline) to 69% (endline). The subsidy intervention attenuated this deterioration (open defecation increased from 25% to only 54% in subsidy communities), with the greatest impacts among voucher-eligible households. Noneligible households in compounds with subsidized toilets also exhibited lower open defecation levels owing to in-compound sharing (common in this context). CLTS followed by the subsidy program would benefit more households than CLTS alone but would cost 21–37% more per household that no longer practiced open defecation or upgraded to a durable toilet.Discussion:Sanitation declines, often due to toilet collapse, suggest a need for approaches beyond CLTS alone. This subsidy program attenuated declines, but durable toilets likely remained unaffordable for noneligible households. Targeting criteria more closely aligned with sanitation inequities, such as household heads who are female or did not complete primary education, may help to generate greater and more sustainable impacts in Northern Ghana and, potentially, other contexts facing toilet collapse and limited market access. https://doi.org/10.1289/EHP10443

Evaluation of occupational health management status and safety issues of the small-scale fisheries sector in Bangladesh.

Small-scale fishing is one of the most precarious occupations, with high rates of threats and hazards. The present study was undertaken to evaluate the health hazards and safety issues of fishers involved in small-scale fisheries (SSF). Fifty SSF fishers (n = 50) were surveyed by using a pre-tested questionnaire between October 2019 and March 2020 at the lower Meghna River in the northern tip of the Bay of Bengal, Bangladesh. Results revealed that 56% of SSF fishermen belong to a nuclear family, and 42% completed primary education. Forty per cent had an annual income of between 1,000 and 1,500 USD. Seventy-six per cent of fishermen were found to suffer from fever, and 72%, and 60% from diarrhoea and skin diseases over the last 5 years (2015-2020), respectively. During fishing, 78% of fishermen also suffered from red-eye problems, dizziness, and headache, and 68% struggled with musculoskeletal complaints during the last 5 years. Extreme cyclonic occurrences and sudden storms were experienced by 66% and 32% of fishermen, respectively, during the last 5 years. Local pharmacies were visited by 46% of fishermen for treatment due to ease of access. Sixty-four per cent of participants applied their local indigenous knowledge to treat health-related problems. Twenty-eight per cent and 32% of fishermen used a first aid box and stored medicine on board, respectively. Most of the fishers are in great risk of medium- to high-range danger while fishing in the SSF sector in Bangladesh. Many countries have developed protocols for safe and responsible fishing. In Bangladesh, adequate attention is needed for the sustainable development of the SSF sector.