Disadvantaged Backgrounds Research Articles

The Effect of AI‐Based Systems on Mathematics Achievement in Rural Context: A Quantitative Study

ABSTRACTBackgroundDespite educational advances, poor mathematics achievement persists among K‐12 students, particularly in rural areas with limited resources and skilled teachers. Artificial Intelligence (AI) based systems have increasingly been adopted to support the diverse learning needs of students and have been shown to enhance mathematics achievement through personalized learning experiences by adapting to student's needs. Existing studies have documented the positive impact of AI‐based systems on mathematics achievement. However, there is a lack of research that has studied AI‐based systems on students' mathematics achievement and engagement in rural settings. The present study addresses the existing literature gap by focusing on the AI‐based Edmentum Exact Path, analyzing its effectiveness in enhancing mathematics achievement and engagement among 8th‐grade students in rural schools in the Southern United States. By examining both cognitive and affective engagement, along with students' mathematics achievement, this research explores the role of AI‐based systems in student learning.ObjectiveThis study aims to explore the effectiveness of Edmentum Exact Path, an AI‐based system, in improving 8th‐grade students' mathematics achievement and affective and cognitive engagement in the Southern United States.MethodsThis study utilized a quasi‐experimental design involving 78 students from socioeconomically disadvantaged backgrounds, comparing those receiving supplemental Edmentum Exact Path‐led instruction and traditional teacher‐led methods to a control group receiving only the teacher‐led instructions. Mathematics achievement was measured through pre‐tests and post‐tests, while student engagement was assessed using the 5‐point Student Engagement Instrument (SEI). Statistical analysis was performed using t‐tests and ANOVA.Results and ConclusionsThe findings revealed statistically significant improvements in mathematics achievement for both the experimental and control groups. However, the group using teacher‐led instruction showed a statistically significant improvement in affective engagement, while no statistically significant differences were observed in cognitive engagement between groups.ImplicationsThe findings suggest that integrating AI‐based systems like Edmentum Exact Path may enhance affective engagement in mathematics among students from rural areas. However, the impact on cognitive engagement remains unclear, indicating a need for further research. These results support the potential for integrating AI‐based systems to enhance mathematics achievement in rural settings.

Parental Warmth of Non-Offending Primary Caregiving Fathers Rearing Children in the U.S. Child Welfare System: Associations with Children’s Socioemotional Development

SYNOPSIS Objective. Fathers who are impacted by the child welfare system are often examined through a deficit lens. This cross-sectional study aims to assess paternal warmth as a positive dimension of non-offending, primary caregiving men’s fathering and examine the links between paternal warmth and children’s socioemotional development among families impacted by the U.S. child welfare system. Design. Data came from a subsample (N = 192) included in the National Survey of Child and Adolescent Well-Being-Second Cohort. Primary caregiving fathers were from socioeconomically disadvantaged backgrounds, with biological fathers making up the largest group followed by foster fathers and grandfathers. Children’s internalizing symptoms, externalizing symptoms, and social competence were regressed on paternal warmth assessed using the Home Observation for Measurement of the Environment-Short Form. Results. Paternal warmth did not differ by father type. Greater paternal warmth was associated with lower levels of children’s externalizing symptoms and higher levels of children’s social competence. Conclusions. Non-offending, primary caregiving fathers engage in positive fathering—in the form of paternal warmth—despite the multiple disadvantages they face, and such fathering is associated with beneficial socioemotional outcomes for their children. Family and child welfare practitioners should provide father-inclusive services to support fathering, especially within the often complex system of child welfare.

Leveraging epidemiological data for the development of interventions to promote healthy nutrition and physical activity among adolescents from disadvantaged backgrounds

Abstract ePro-Schools is a public health initiative designed to promote healthy nutrition and physical activity among adolescents from socially disadvantaged backgrounds using a targeted e-health intervention to be deployed in the school context. A central theme of ePro-Schools is its robust cross-sectoral collaboration, involving stakeholders from academia, healthcare, education, and local communities. This cooperative approach not only enhances the intervention’s relevance and efficacy but also ensures its cultural, social, and economic adaptability to the needs of the target population. The project embodies a truly interdisciplinary effort, integrating insights from epidemiology, behavioural science, public health, and digital technology to innovate and improve health promotion strategies. This presentation will explore how data from epidemiological studies, such as the Health Behaviour in School-aged Children (HBSC) study, are used to support the development of the ePro-Schools intervention. Utilizing high-quality epidemiological data, the project identifies key determinants of physical activity, dietary habits, and sedentary behaviour amongst adolescents growing up in low-SES contexts, allowing to craft tailored strategies to promote healthier lifestyles within this vulnerable population.

Stressors and suicidal ideation in low-income adults in Malaysia: A serial mediation analysis of social support and mental health symptoms.

Studies have documented a heightened risk of suicidal ideation in response to stressors, especially among people from socioeconomically disadvantaged backgrounds. However, the mechanisms of this association remain elusive. Drawing on the social deterioration and counteractive models, this study aims to elucidate the pathways linking stressors to suicidal ideation through serial mediation of social support and mental health symptoms in Malaysia. Data were collected from 404 low-income adults (33.2% male and 66.8% female) receiving monthly financial assistance from Malaysia's social welfare department. We employed stressor measures (i.e. financial, family and work), the Oslo Social Support Scale, the Patient Health Questionnaire and the Suicidal Behaviour Questionnaire-Revised. A total of 46.8% of participants reported mild-to-severe anxiety and depressive symptoms, with 11.1% classified as high risk for suicide. Direct and indirect effects were found. After controlling for age and gender, social support and mental health symptoms mediated the link between stressors and suicidal ideation. The serial mediation analysis indicates that stressors are connected to heightened suicidal ideation through a sequence involving insufficient social support, followed by elevated levels of mental health symptoms. Understanding the multifaceted relationships among stressors, social support, mental health symptoms and suicide ideation expands the potential for developing targeted interventions and preventive strategies tailored for vulnerable populations. Clinical work with low-income individuals may include implementing early systematic efforts to develop accessible mental health and integrated care services.

The Impact of Meritocracy on Higher Education: A Perspective from College Admissions Policies in Mainland China

This study examines the impact of meritocracy on higher education in mainland China, focusing on university admission policies. Since the reform and opening-up period, Chinas economic and educational advancements have increasingly emphasized elitism, particularly in allocating university admission slots through mechanisms like the Gaokao. The analysis, conducted from historical and contemporary perspectives, reveals that while elitism has optimized the distribution of educational resources, it has also deepened social inequalities. Despite their intent to promote fairness, policies such as the provincial quota system and independent admissions have widened regional and urban-rural disparities in educational resources. Furthermore, government initiatives like targeted poverty alleviation and regional preferential policies have had limited success in addressing these disparities. The study concludes that while elitism has centralized high-quality educational resources, it has hindered upward social mobility, especially for students from rural and disadvantaged backgrounds, highlighting the need for comprehensive reforms to achieve educational equity and social justice.

The Revolution of Artificial Intelligence in Nursing Education and Practice

As a grade 11 student studying in Modern School, Barakhambha Road, New Delhi, I have been fortunate enough to witness the effects of government policies aimed at integrating children from economically weaker sections (EWS) into mainstream education. While the inclusion of EWS children in schools like ours has been a significant stride towards social equity, there are still several challenges to overcome. Our batch (2011) was the first batch where the EWS quota was implemented by the government. All throughout junior school, I kept hearing from my family that it was the noblest idea to integrate children who come from slightly disadvantaged backgrounds into the mainstream, and how it was only through education and equal opportunities that the children of this country would grow to become fine human beings who could lead the world of the future. I was always taught to treat them with kindness and compassion, but also, at the same time, in an effort to be inclusive, was taught to be careful about not hurting them by making them feel different or pointing out the differences between our upbringings. The presence of EWS children in our school is a testament to the success of policies such as the Right to Education (RTE) Act, which mandates private schools to reserve a percentage of their seats for underprivileged children. This initiative has provided EWS children with access to quality education, creating opportunities for their future. However, the social aspect of integration is an area that still requires attention. One of the most glaring challenges is the lack of interaction between children belonging to higher socio-economic strata and those belonging to the EWS. I have myself been a witness to unequal treatment, even though it was largely inadvertent. This is because schools ask children to engage in activities that may not necessarily be within the means of an EWS household. Activities such as domestic field trips and international exchange programmes challenge even affluent households at times. It is not uncommon to see students from different socio-economic backgrounds form separate social circles. This social divide can have a profound impact on the EWS children, making them feel isolated and unwelcome. Such feelings can further affect their academic performance and emotional well-being. As a student, I believe it is crucial to explore ways to foster better relationships between students from diverse backgrounds.

An exploration of parents’ engagement with learning about climate change through science education: learnings for future practice

Climate change education is crucial to addressing the climate crisis. Studies show that parents and guardians can play an important role in transmitting knowledge, competencies, and a pro-environmental orientation to their children. Whilst climate change education can span many disciplines, it has been effective within science education. In this paper we embrace evidence-based effective approaches to science education, with parents. Climate change education research literature published to date focusses on school-based interventions and there is a dearth of literature on parental involvement. This paper describes the development of, and outcomes associated with, a programme to promote engagement with climate change education for families from socioeconomically disadvantaged backgrounds. Data were gathered through post semi-structured interviews and reflections on posters and photos created and collected throughout the programme. Findings indicate that this approach engaged parents in climate change education with their children and successfully addressed various misconceptions. The programme presents a real opportunity to engage parents in their children’s formal education.

Multiphase optimization strategy to establish optimal delivery of nutrition-related services in healthcare settings: A step towards clinical trial

BackgroundMinorities living in the Southern US generally have greater incidence and prevalence of cardiometabolic diseases compared to other groups. Cardiometabolic disease prevalence and risk can be reduced by focusing on diet and lifestyle modifications. There is need for holistic and integrated care models for community-based healthcare organizations who are already working with minorities. This research aimed to select and optimize essential psychosocial and structural components to address diet behaviors among racial/ethnic minorities, and/or disadvantaged background young to middle aged adult populations in Mississippi. MethodsNutrition360 was guided by a community-academic team using a participatory approach and included a preparation and two optimization phases to examine different approaches to dietary interventions utilizing the multiphase optimization strategy. Each intervention arm included three different modalities to identify the most feasible delivery method. The intervention was conducted at a community-based, outpatient healthcare center located in Jackson, MS. Eligible participants were between 25 and 50 years old, residents of Jackson metropolitan area, at risk for cardiovascular disease-related premature mortality, and had internet access. Individuals who completed baseline surveys were randomly assigned to an intervention group and then to modality order. Co-primary outcomes were research participant burden and cost-effectiveness and secondary outcomes were attendance, and dietary measures. ResultsThirty-one, African American individuals with a mean age of 40.5 years completed baseline surveys and were randomized to an intervention program. ConclusionThe two most feasible and cost-effective interventions will be combined to further test this model's delivery in the real-world setting as part of the next optimization phase. RegistrationClinicalTrials.gov, NCT06286618. https://clinicaltrials.gov/study/NCT06286618

Perspectives of Caregivers on Access to Health Care for Children with CKD

BackgroundInequitable access to health care based upon demographic factors such as ethnicity, socioeconomic status (SES) and geographical location has been consistently found in children with chronic kidney disease (CKD). However, little is known about the perspectives of caregivers on accessing healthcare. We described caregivers’ perspectives on accessing healthcare for children with CKD from socioeconomically disadvantaged backgrounds and/or rural or remote areas. MethodsCaregivers of Australian children aged 0-16 years, across all CKD stages, from low SES backgrounds, and/or residing in rural or remote areas, purposively sampled from five centers, participated in semi-structured interviews on accessing healthcare. Transcripts were analyzed thematically. ResultsFrom 32 interviews, we identified 6 themes: lack of agency undermining ability to seek care (obscurity of symptoms, uncertain and confused about care processes, vulnerable and unable to advocate), losing trust in clinicians (confused by inconsistencies and ambiguities in advice, distressed by lack of collaborative care), exasperated by organizational rigidity (frustrated by bureaucratic roadblocks, lack of access to specialist care in rural and remote settings, inadequacies of support programs), compounding burden of caregiving (unsustainable financial pressure, debilitating exhaustion, asymmetry of responsibility), intensifying strain on family (uprooting to relocate, sibling stress and neglect, depending on family support), building resilience and stability (empowerment through education, confidence in technical and medical support). ConclusionsCaregivers of children with CKD from disadvantaged backgrounds feel disempowered and vulnerable when accessing care for their child. Strategies are needed to improve access to healthcare for families who are socioeconomically or geographically disadvantaged.

Impacts of a Summer Transition Program on Kindergarten Readiness for Children from Disadvantaged Backgrounds

ABSTRACT Kindergarten transition programs support successful school transitions for families and may reduce disparities in academic readiness upon school entry. Yet, access and participation in high-quality summer transition programs are lower among children from disadvantaged backgrounds. This study examined the impact of a summer kindergarten transition program on children’s readiness in language and literacy, mathematical thinking, and social foundations and the strength of their home-school relationships. Assessment scores of 416 kindergartners within 30 classrooms in 28 elementary schools in one southeastern state were analyzed. Children who participated demonstrated significantly more readiness in their language and literacy, mathematical thinking, and social foundation skills compared with children who were eligible but did not participate in the program. Further, children who participated in the program had significantly stronger home-school relationships compared to children who were eligible but did not participate and those who were not eligible to participate in the program. The findings provide preliminary evidence that summer transition programs are an equitable strategy to reduce achievement gaps upon kindergarten entry. School administrators should consider implementing summer transition programs to support academic readiness and develop strong home-school relationships in communities with a high population of children who are at risk for later school difficulties.

S02-4: How does the Hungarian Active Lifestyle Strategy address social inclusion?

Abstract Purpose The purpose of Sarolta MONSPART Active Lifestyle Strategy is to raise proportion of physically active people with a healthy lifestyle in Hungary. There is special focus on the engagement of senior citizens and people with disadvantaged background. Project description The Strategy is the first ever national policy document dedicated to the field of overall promotion of health-enhancing physical activities. Methods The development of the Strategy had been initiated by the State Secretary for Active Lifestyle. The University of Sport Sciences had been invited for the coordination of the Strategy’ development, which is based on outcomes of international policy document analysis and national stakeholder consultations. The Strategy identifies ten priority target areas and eight horizontal priorities. “Active seniors” and “Activation of socially disadvantaged groups”, which includes people with disabilities and people with unfavourable socio-economic background are also priority areas. The implementation of the Strategy is planned to happen on the base of the proposed actions in all priority target areas. Respective governmental and non-governmental organisations have been involved into the drafting of the Strategy. Based on their proposals for implementing actions, an action plan has been drafted. Respectively these organisations are also important actors during the delivery of the proposed initiatives. The evaluation of the implementation of the Strategy will be based on the proposed indicators, that are part of the Strategy in relation to each proposed action, also reflecting on the number of successfully implemented actions and number of participants. Dissemination of the strategy has already started during the drafting phase, by the involvement of ca. 50 organisations as consultative partners. After the official approval of the Strategy, communication will be ensured by the State Secretariat for Active Lifestyle and the implementing partners. Conclusions The State Secretariat for Active Lifestyle will monitor the implementation of the action plan and collect the well-functioning methods and practices. It is expected that a relevant network of professional organisations will be created in all priority target fields and those networks will be able to provide data and feedback on the proposed actions.

A critical view: Examining disparities regarding timely cholecystectomy

BackgroundImplicit bias may prevent patients with abdominal pain from receiving optimal workup and treatment. We hypothesized that patients from socially disadvantaged backgrounds would be more likely to experience delays in receiving operative treatment for cholecystitis. To study this question, we examined factors related to having a prior emergency department presentation for abdominal pain (prior emergency department visit) within 3 months of urgent cholecystectomy. MethodsWe performed a retrospective analysis of consecutive patients who received an urgent cholecystectomy at an urban safety net public hospital between July 2019 and December 2022. The main outcome of interest was prior emergency department visit within 3 months of index cholecystectomy. We examined patient age, sex, race, ethnicity, preferred language, insurance, and employment status. Bivariate comparisons and logistic regression were used to determine the relationship between patient factors and prior emergency department visit. ResultsOf 508 cholecystectomy patients, 138 (27.2%) had a prior emergency department visit in the 3 months preceding their surgery. In bivariate analysis, younger age, Black race, Hispanic ethnicity, non-English preferred language, and type of insurance (P < .05) were associated with prior emergency department visit. In regression, younger age, Black race, Hispanic ethnicity, and having Medicare or being uninsured were associated with higher odds of having a prior emergency department visit. ConclusionMore than 1 in 4 patients had an evaluation for abdominal pain within 3 months of having an urgent cholecystectomy, and these patients were more likely to be from socially disadvantaged backgrounds. Standardized evaluation pathways for abdominal pain are needed to reduce disparities from institutional or implicit bias.

Diversity, Equity, and Inclusion in Plastic Surgery: Where Do We Stand? Highlighting Overlooked Issues in Efforts to Improve Representation

The lack of diversity among applicants successfully matching into integrated plastic surgery residency continues to be a topic of significant discussion, yet substantial improvements in representation remain elusive. This article aims to highlight the systemic barriers contributing to the decline in diverse plastic surgery trainees. This perspective summarizes current and existing challenges in improving recruitment efforts of underrepresented in medicine (URiM) trainees and those from socioeconomically disadvantaged backgrounds. While acknowledging current DEI initiatives, the authors point out those underappreciated modifiable and nonmodifiable obstacles that perpetuate the lack of equity and inclusivity in the match process. We emphasize the importance of continued commitment from program directors and chairs to these initiatives and its generational augmentative effects on achieving true and lasting diversity and equity.

Effects of the comprehensive school reform program Success for All on students’ reading skills in Dutch schools

ABSTRACT Success for All (SfA) is a comprehensive school reform program designed to support schools serving many students of disadvantaged backgrounds to increase students’ achievement. SfA includes daily 90-min reading lessons with extensive use of cooperative learning, tutoring for struggling readers, and an emphasis on parental involvement. School teams receive coaching and training, and each school has a facilitator appointed who supports program implementation. SfA has shown positive results in the US, and has been translated to the Dutch context. Effects on students’ reading achievement were evaluated with a total sample size of 1,011 students from three cohorts. We found a significant positive effect on reading fluency of first-grade students (Cohen’s d = +0.40). The effect for the subgroup of low-socioeconomic-status students was even somewhat higher (Cohen’s d = +0.63). We did not find significant effects in Grade 2 and Grade 3. We also found no effects of SfA on reading comprehension.

Consultations about randomised controlled trials are shorter and less in-depth for socioeconomically disadvantaged patients compared to socioeconomically advantaged patients: qualitative analysis across three trials

BackgroundPatients from socioeconomically disadvantaged backgrounds are underserved in randomised controlled trials, yet they experience a much greater burden of disease compared with patients from socioeconomically advantaged areas. It is crucial to make trials more inclusive to ensure that treatments and interventions are safe and effective in real-world contexts. Improving how information about trials is verbally communicated is an unexplored strategy to make trials more inclusive. This study examined how trials are communicated verbally, comparing consultations involving patients from the most and least socioeconomically disadvantaged areas.MethodsSecondary qualitative analysis of 55 trial consultation transcripts from 41 patients, sampled from 3 qualitative studies embedded in their respective UK multi-site, cancer-related randomised controlled trials. Patients living in the most and least socioeconomically disadvantaged areas, defined using English Indices of Multiple Deprivation decile scores, were purposively sampled. Analysis was largely thematic and drew on the constant comparison method.ResultsRecruiters communicated clinical uncertainty in a similar way for patients living in different socioeconomic areas. Consultations with disadvantaged patients were, on average, half the duration of those with advantaged patients, and tended to involve recruiters providing less in-depth explanations of trial concepts, used phrasing that softened trial arm risks, and described trial processes (e.g. randomisation) using informal or metaphorical phrasing. Disadvantaged and advantaged patients differed in the concerns they expressed; disadvantaged patients voiced fewer concerns and asked fewer questions but were also less likely to be invited to do so by recruiters.ConclusionInteractions about trials unfolded in different ways between patients living in different socioeconomic areas, likely due to both patient- and recruiter-related factors. We present considerations for recruiters when discussing trials with patients from socioeconomically disadvantaged backgrounds, aimed at enhancing trial communication. Future research should examine disadvantaged patients’ and recruiters’ experiences of verbal trial communication to inform guidance that addresses the needs and preferences of underserved groups.

Access to and equity in cancer clinical trials in Oregon.

e23100 Background: Approximately 20,000 people per year are diagnosed with cancer in Oregon. The OHSU Knight Cancer Institute is the only academic cancer center in the state, with the nearest center located almost 200 miles away. Clinical trials (CT) are essential for cancer care but only a small proportion of eligible people participate due to multiple factors. In this retrospective study, we identified the association between sociodemographic factors and cancer CT participation at OHSU. Methods: Adult patients referred to OHSU for evaluation and treatment of a new cancer 2019-2022 were included. Data collected included age, gender, race/ethnicity, zipcode, insurance, type of cancer and CT participation. Zip-codes were used to estimate poverty level as defined by the American Community Survey, rural vs. urban location and distance to the cancer center. Multivariate analysis was conducted to identify factors associated with CT participation. Results: A total of 14,261 patients with median age 65 (18-101) years were treated at OHSU from 2019-2022 (86% for solid tumors, 14% hematologic malignancies). Of these, 53% were &gt; 65yrs, 51% male and 8.5% self-identified as non-White (including Hispanic). These numbers are similar to those reported in the statewide cancer registry. About 61% of those &lt; 65 yrs were privately insured, 84% of those &gt; 65 yrs had Medicare, and 31% were from areas at or below the national poverty level. About 40% lived &gt; 30 miles from OHSU (29% &gt; 60 miles, 14% &gt; 120 miles) and 31.5% lived in rural areas. A total of 2134 patients (15%) participated in cancer CT (8% interventional, 6% interventional therapeutic and 10% noninterventional). Factors independently associated with decreased CT participation on multivariate analysis included age &gt; 65yrs regardless of type of insurance, &lt; 65yrs with public insurance, female, racial/ethnic minority, solid tumor diagnosis and cancer care at a community-based clinic (Table 1). Conclusions: Patient with cancer treated at OHSU are representative of the population in our catchment area and region. However, there is room to improve access and CT participation for older adults and persons from racial/ethnic minorities and disadvantaged backgrounds. Our study highlights the importance of understanding the catchment area and accounting for social determinants of health when implementing community outreach strategies for CT participation. [Table: see text]

From Extreme Ideas to Violent and Nonviolent Outcomes: An In-Depth Analysis of Probation Files on Terrorist Suspects in the Netherlands

ABSTRACT How do individuals who commit violent terrorist crimes differ from those who commit nonviolent terrorist crimes? In this study, we compare characteristics and pathways of violent (VTS) and nonviolent (NVTS) individuals prior to being suspected or convicted of crimes with terrorist intent (e.g. planning an attack, financing terrorism) in the Netherlands through an analysis of probation files. Departing from a social control and life-course perspective, we examine possible signs and triggers leading up to the terrorist suspicion, various life domains (socio-demographic characteristics, social network, and personality related variables), mental health, criminal histories, and online activities. Findings demonstrate primarily resemblances between both groups. Nonetheless, compared to NVTS, VTS showed more indications of signs of acting in accordance with extreme ideological beliefs and feelings of injustice, had a more disadvantaged socioeconomic background, were more often involved with other radicals (e.g. in groups and/or online), had more substance abuse problems, and were more active online in relation to their terrorist suspicion. NVTS, on the other hand, had more regularly a turbulent youth, more commonly ever showed indications of aggressive behavior, had more often mental health problems, and, consequently, received more social care compared to VTS. Implications and avenues for future research are discussed.

How do adolescents end open-ended psychoanalytic psychotherapy? Exploring dropout in a community-based clinic

ABSTRACT Dropout from psychotherapy among adolescents is a common occurrence. Adolescents’ need for independence can be in direct conflict with therapeutic relationships, particularly in open-ended psychotherapy where endings need to be negotiated. The present study was a service evaluation, which aimed to identify how open-ended once-weekly psychoanalytic psychotherapy ends with adolescents, and whether dropout could be predicted from a range of adolescent and treatment factors. The sample comprised 443 adolescents, aged 14–24, who had received psychoanalytic psychotherapy in a community-based clinic. Logistic regression was used to estimate the effects of predictors on the odds of dropout. Adolescents were categorised based on how treatment ended: adolescents’ unilateral decision (43%), mutually agreed between adolescent and therapist (27%), initiated by changed external circumstances such as relocation (23%) or a referral to another service (6%). Younger adolescents and those from more disadvantaged backgrounds were most at risk of dropout. Missed sessions early in treatment were also predictive of dropout. Neither therapist change nor the number of services was significantly associated with dropout. This study shows that dropout is a frequent occurrence in open-ended psychoanalytic psychotherapy. Further research is needed to explore how young people at risk of dropout can be better supported to attend treatment to ensure they receive the maximum benefits. Moreover, research is required to identify how therapists can optimally respond to missed sessions, to avoid subsequent dropout and to facilitate positive and appropriate treatment endings.

Growing up in discomfort: Exploring energy poverty and thermal comfort among students in Portugal

Energy poverty is a growing multidimensional concern worldwide, with children and young people particularly vulnerable. This age group spends a significant amount of time in both their houses and school buildings. To date, there has been little research on the dual vulnerability to inadequate thermal comfort conditions in these two environments. In Portugal, the exposure to inadequate thermal comfort in school buildings varies due to disparities in renovation efforts. This work aims to assess upper secondary school students' perception of energy poverty at home and thermal comfort inside classrooms. A survey method was employed comparing a sample of students from one renovated and one non-renovated school located in the Lisbon district. Surveys were complemented with interviews and surveys completed by other school stakeholders. The results indicate that between 4.2 and 14 % of students live in permanent discomfort (i.e., uncomfortable both at school and home). Despite the discomfort levels observed in students from the renovated school, it is possible to say that the renovation alleviated levels of discomfort. Students with health conditions and disadvantaged backgrounds were more likely to report discomfort than those who did not. This study raises awareness of an underexplored vulnerable group and provides valuable insights into the issue of energy poverty among young people. It addresses the need to incorporate this age group in energy-related school policies and future renovation programs.

Nonsuicidal self-injury in sexual minorities in Korea: the mediating role of intrapersonal functions and depression

A growing body of literature indicates that individuals belonging to sexual minority groups are at an increased risk of severe nonsuicidal self-injury (NSSI) behaviors. This study aimed to examine the potential factors mediating sexual minority status and more severe NSSI behaviors. A total of 296 self-identified sexual minorities and 206 heterosexuals who reported engaging in at least five-lifetime NSSI episodes were recruited online. The participants completed an online survey that included demographics, measures of depressive symptoms, and the frequency and functions of NSSI behaviors. Serial mediation analyses indicated that the association between sexual minority status and more frequent NSSI behaviors was mediated by depressive symptoms and intrapersonal functions of NSSI. Further analyses revealed that NSSI functions may vary by minority status, with individuals reporting a sexual minority status showing more frequent endorsements of intrapersonal functions. This study’s findings contribute to the literature by elucidating the complex role of clinical factors that mediate the relationship between sexual minority status and increased risk of engaging in more frequent NSSI behaviors. Our findings underscore the importance of developing a comprehensive perspective on NSSI behaviors, including the characteristics of NSSI functions and current clinical symptoms, as well as disadvantaged backgrounds, such as minority status.