High School Education Research Articles

Development of an older adult Nutrition Equity Index (NEI) and association with the Healthy Eating Index (HEI) in older Black and White U.S. adults

ObjectivesWe developed a novel measure for older U.S. adults called the Nutrition Equity Index (NEI), which includes functional ability. We compared both the NEI and food insufficiency with Healthy Eating Index (HEI) scores. DesignThe Health, Aging, and Body Composition Study is a prospective, longitudinal cohort of Medicare-eligible, community-dwelling Black and White men and women. SettingPittsburgh, PA and Memphis, TN. ParticipantsParticipants (N = 2468, aged 74.7 ± 2.9 years) had baseline (1997−98) and 1-year follow-up NEI data; and 1 year follow-up for food insufficiency, key covariates, and the HEI (diet quality measure) from a 108-item interviewer-administered food frequency questionnaire. MeasurementsFood insufficiency was defined from a modified validated question on ample food amount/variety from the U.S. Department of Agriculture. NEI was constructed from 8 questions in three subdomains: food insecurity (food insufficiency, hunger, anxiety about limited food, limited money for food), food access (groceries), and food acquisition (difficulty shopping, preparing meals, carrying groceries). Final NEI categories were low nutrition equity (0), moderate nutrition equity (1), and high nutrition equity (2). Multivariable linear regression compared both NEI and food insufficiency with HEI, adjusted for sociodemographic, lifestyle and comorbidity factors. ResultsOf participants, 13.5% had food insufficiency, 12.1% had low NEI, and 32.5% had moderate NEI. Participants with food insufficiency (vs. food sufficiency) or low NEI (vs. high NEI) were more likely to be Black and have < high school education (both p < 0.0001). In minimally adjusted models, food insufficiency was associated with 2.2 point lower HEI score (p = 0.001), low NEI with 2.6 point lower HEI score (p = 0.001), and moderate NEI with 1.0 point lower HEI score (p < 0.05). Adjusting for race attenuated NEI associations with HEI to non-significance. After multivariable adjustment, food insufficiency was associated with 1.5 point lower HEI score (p = 0.03). ConclusionFood insufficiency was associated with lower dietary quality in this sample of older Black and White U.S. adults. NEI performed similarly to food insufficiency for HEI associations prior to multivariable adjustment and identified more older adults with nutrition inequity, who may be at risk for poor health outcomes.

Intrinsic capacity loss rates and protective factors among individuals aged 80 years and older in Chinese nursing homes: A latent class analysis

Prior to this cross-sectional study, the intrinsic capacity (IC) loss rates and protective factors in nursing homes for individuals aged 80 and older remained unexplored. Analysing 434 participants, this study found 86.9 % of individuals experienced the loss of at least one IC domain, with detailed losses in locomotion, vision, vitality, hearing, psychological, and cognitive capacities at rates of 83.2 %, 52.8 %, 50.9 %, 46.5 %, 44.9 %, and 44.0 %, respectively. Following latent class analysis (LCA), five distinct IC impairment patterns were noted, with locomotor impairment emerging as a central component across most classes. IC protective factors for persons aged 80 years and older included financial stability, being male or younger within the cohort, junior high school or higher education, being married, no smoking history, manageable comorbidity levels, minimal medication use, good sleep, and not using assistive devices. Based on these five classes, this study provides a potential practical framework alongside recommendations for IC care strategies in the oldest-old, emphasising the importance of locomotor function in maintaining the overall IC.

Risk for Financial Precarity From Hospitalization: Implications for Targeting Financial Assistance in Medicare.

High out-of-pocket costs in Medicare may leave many beneficiaries in financial precarity. Beneficiaries with modest incomes are often ineligible for Medicaid (which covers most out-of-pocket Medicare costs) and may have insufficient resources to pay an unexpected health care bill. This has prompted calls to improve financial protections, but the target population remains uncharacterized. To identify beneficiaries who would face financial precarity if exposed to the Medicare Part A hospital deductible ($1600). Cross-sectional study of the 2018 wave of the Health and Retirement Study. United States. Community-dwelling Medicare beneficiaries with incomes greater than 100% to 400% or less of the federal poverty level. Nationally representative estimates of financial precarity, defined as having insufficient funds to pay the deductible, examined across 4 scenarios that considered checking and savings account balances, total liquid assets (with a reserve for future living costs), and supplemental insurance. Among 4881 beneficiaries (population weighted n = 26 619 823), 45.0% had insufficient funds in checking and savings accounts to pay the Medicare hospital deductible. Financial precarity was more prevalent among Black and Hispanic versus White beneficiaries (73.5% and 76.2% vs. 36.2%), those with less versus more than high school education (70.0% vs. 37.1%), and those with 3 or more versus 2 or fewer chronic conditions (49.2% vs. 39.1%). In defining financial precarity to include beneficiaries with insufficient liquid assets to pay the deductible while maintaining a $5000 reserve for future living expenses, 50.7% were financially precarious. Building off this definition to assume supplemental insurance covered the deductible, 39.0% remained financially precarious. Cost-sharing exposure is limited to hospitalization. Many Medicare beneficiaries with modest incomes are at risk for financial hardship from costs of a single hospital stay. National Institute on Aging.

Educational attainment and cardiovascular outcomes in prostate cancer: observations from 3700 men in 6 countries in the RADICAL PC study

Abstract Background Educational attainment has been associated with improved cardiovascular outcomes in individuals with or at high risk for cardiovascular disease (CVD). There is little information on the relationship between education and CVD outcomes in individuals with cancer. Also, we have limited understanding of what mediates the relationship between education and these outcomes. Purpose To evaluate the relationship between educational attainment in patients with PC and CVD event (CVE) or all-cause mortality. Methods We prospectively studied 3,778 men with PC from 55 sites in 7 countries (median age 69 years), 46% on ADT. Inclusion criteria were one of: PC diagnosed in the past 12 months; started ADT within the past 6 months; or plan to start ADT in the next month. Educational attainment was classified as those who attained primary school education vs. those who attained high school education vs. those who attained greater than high school education. Participants were followed for a median of 2.5 years from enrolment to document CVE: myocardial infarction, angina, stroke, cerebrovascular disease, peripheral arterial disease, arterial revascularization, heart failure, venous thromboembolism, and atrial fibrillation. The primary outcome for this analysis was CVE or death. All outcomes were evaluated by Cox proportional hazards models adjusted sequentially for age, race, physical activity levels, tobacco use, and alcohol use. Results Among 3,778 participants, 726 (19%) achieved primary school education, 1,001 (27%) high school, and 2,051 (54%) greater than high school education. On univariate analysis, as compared with participants with greater than high school education, those with high school education and primary school education had respective HR (95% CI) of 1.33 (1.05-1.69) and 2.19 (1.71-2.83). Adding age, race, tobacco, and alcohol use to the Cox model progressively attenuated the association between education and the primary outcome. Eventually, after adjustment for these characteristics and physical activity levels, the relationship between education and the primary outcome was no longer significant (Table). Conclusion This finding suggests that patterns of tobacco and alcohol use and physical activity, which are modifiable behaviors, account for the relationship between education and death or CVE in patients with prostate cancer.Table

Sociodemographic Factors Associated with the Utilization of Digital Health Technologies Among Informal Caregivers: A Nationwide Study in the USA, 2022.

Informal caregivers can leverage digital health technologies to support their own health while also assisting patients, particularly those with mental or physical challenges. This study investigated the sociodemographic factors associated with the use of digital health technology among informal caregivers. Data from the 2022 Health Information National Trends Survey (HINTS) were examined for this cross-sectional study. The survey identified key outcomes related to the use of online medical records, health apps, digital wearable health devices, and the digital sharing of health information with professionals, on social media, or with others facing similar health issues. Sociodemographic factors (gender, race/ethnicity, feelings of one's household income, education, and census division) were also analyzed. Weighted multivariable logistic regression models were employed. A total of 831 individuals were included, representing about 36,960,385 national informal caregivers in 2022. Caregivers with a high school education or less (vs. those with at least some college education) and non-Hispanic Black caregivers (vs. non-Hispanic White caregivers) were significantly less likely to be offered access to online medical records by their healthcare providers. Additionally, online medical record usage was lower among caregivers with high school education or less, but higher among caregivers aged 50-64 (vs. those aged 35-49). Caregivers with a high school education or less were less likely to use health apps and digital wearable health devices, but more likely to share personal health information on social media. Men caregivers, those aged 50-64 and over 65 (vs. the 35-49 age group), and caregivers who were dissatisfied with their income were less likely to use digital wearable health devices. The findings underscore disparities in the utilization of caregivers' digital health technology, particularly in digital wearable health devices. Recognizing and addressing these disparities are crucial for tailoring interventions to enhance equitable access to digital health technology among diverse informal caregiver populations.

Does perceived usability of a multi-component mobile device intervention improve health-related quality of life?

Abstract Background Good health-related quality of life (HRQL) is essential to healthy aging. Prior studies have demonstrated that mobile device technologies can promote HRQL in older adults. However, evidence of technology acceptance in older adults is often inconsistent and poorly understood. Purpose This study aims to 1) describe technology acceptance using efficiency, learnability, user experience (i.e., acceptability), and perceived control from the USABILITY survey of a multi-component mobile device intervention consisting of a wearable activity tracker (Fitbit Versa), access to Lose It app, and text messages (for experimental group only) in older adults at risk for cardiovascular disease, and 2) examine the correlation between technology acceptance and changes in HRQL before and after using each component of the digital intervention. Methods Data were collected using a purpose-built technology usability survey, and HRQL was assessed using the 12-Item Short Form Survey (SF-12), which measured perceived physical and mental health. Correlations were used to identify associations between technology acceptance and HRQL. Results The mean age of participants (n=54) was 65.4 ± 6.0 years; a majority were females (60%), married (53%), Hispanic (66%), and had a high school education or higher (76%). Table 1 shows that the experimental group had considerably higher HRQL at three months, but no differences in technology acceptance were noted. Fitbit technology adoption was found to be correlated with physical HRQL (r=304, p=0.027). The Lose It app showed no correlation with HRQL. Despite receiving higher usability ratings, SMS messages were not correlated with physical or mental HRQL. Conclusion Our findings demonstrate that older persons at risk for cardiovascular disease find mobile device intervention components acceptable. However, each component affected physical and mental health differently. These findings inform more complete technology acceptance models for older individuals' technology design, education, and deployment. Older persons prefer personalized communication, such as customized text messages, as the most favored aspect of the multi-component mobile device intervention. It warrants a larger clinical trial to determine its efficacy on HRQL.

Race/Ethnicity, Education, and All-Cause Mortality in US Adults: Mediation by Telomere Length

Abstract Background Racial/ethnic inequities in mortality risk are pervasive in the United States even after controlling for socioeconomic status indicators such as educational attainment. Although the mechanisms underlying these inequities remain unclear, telomere length (TL) has emerged as a potential mediator. We aimed to investigate the joint association of race/ethnicity and education with all-cause mortality risk, and the contribution of TL to this relationship. Methods We used data from the U.S. National Health and Nutrition Examination Survey, 1999 to 2002, and 2019 Linked Mortality File (n = 6,526 non-institutionalized adults aged 25 years or older, including 2,166 deaths), a retrospective cohort study with a follow-up period to December 31, 2019. Cox proportional hazards regression and causal mediation analysis were used to address these aims. We reported hazard ratios (HR) and 95 % confidence intervals (CI). Furthermore, for the mediation analysis, we reported the total, direct, and indirect effects measured as HR and 95 % CI. Results After adjusting for age and sex, among White individuals, those with less than a high school education had a 2.26 times higher (95% CI: 1.93, 2.65) rate of all-cause mortality compared to those with some college or higher education. When compared with White adults with at least a college degree, Black adults with at least a college degree had a 1.38 higher rate of dying (95% CI: 1.04, 1.84). There was no significant joint association of race/ethnicity and education on all-cause mortality in Mexican Americans. In the mediation analysis, TL did not significantly contribute to the joint association of race/ethnicity and education with all-cause mortality risk. Discussion These findings underscore the need for a better understanding of the joint relationship of race/ethnicity and education on mortality risk inequities and their potential mechanisms to improve population health ultimately. Key messages • Lower educational attainment was associated with higher mortality rates among White individuals, disparities persisted among the Black population, despite higher education levels. • Our analysis did not find a significant mediation effect of telomere length on the joint effect of race/ethnicity and education-mortality relationship.

Factors Influencing Suicidal Ideation in Young and Middle-aged Adults in Korea: A Nationwide Study

Abstract Objectives This study aims to analyze various factors influencing suicidal ideation among young (19-39 years) and middle-aged (40-64 years) adults using nationwide longitudinal data in South Korea, which has the highest suicide rate among OECD countries for more than 20 years. Methods An analysis was conducted using the WAVE II data (2016-2017) from a nationwide longitudinal study on the mental health of suicide survivors (LoSS). The sample included 2,002 participants (1,290 young adults, 712 middle-aged adults) recruited through stratified proportional quota sampling. Multiple regression analysis was performed to identify factors influencing suicidal ideation in each age group. Results In young adults, being female, having a high school education or lower, being unmarried/divorced/widowed, and having higher levels of depression were positively associated with suicidal ideation. Higher levels of social support and better subjective physical health were negatively associated with suicidal ideation. In middle-aged adults, being unemployed, living alone, drinking alcohol more than once a week, and having higher levels of depression were positively associated with suicidal ideation, while higher levels of social support were negatively associated with suicidal ideation. Conclusions Factors influencing suicidal ideation differ between young and middle-aged adults. Age-specific suicide prevention strategies considering these factors are needed to promote social health and stability in South Korea. Key messages • Different factors influence suicidal ideation in young and middle-aged adults in South Korea. • Age-specific suicide prevention strategies are necessary to effectively address suicidal ideation and promote social health and stability in South Korea.

Barriers to finding and maintaining pet-inclusive affordable housing: Tenant experiences in Houston, Texas

The city of Houston, Texas has a growing deficit of available and affordable rental units for low-income residents. Due to pet policies, the shortage of affordable housing potentially puts renters who own pets at greater risk of housing insecurity. In this qualitative study, we use a community-engaged approach to document the lived experiences of finding and maintaining affordable housing among 24 current, former, and aspiring pet owners. The majority of the participants identified as female, were aged 44–60 years, identified as Black, had a high school education, and were employed full-time or on disability or government assistance. Many expressed having experienced homelessness in the past and/or having lived in several different types of affordable housing over their lifetime. Participants highlighted challenges in finding pet-inclusive affordable housing, emphasized its importance, and discussed issues faced, such as high pet charges, size and breed restrictions, and confusion surrounding pet policies. Landlord relationships and living conditions varied, with safety concerns prevalent. Having one’s pet designated as an Emotional Support Animal made tenants feel safe and secure, knowing they could not be refused, evicted, or otherwise charged extra. Participants shared what is working well and what could be improved. This study concludes with recommendations for fair application and awareness of pet policies in affordable housing, drawing on participating tenants’ experiences and existing efforts for policy and practice improvements.

Determinants of adherence among patients with hypertension

Abstract Background Poor adherence to pharmacological treatment among patients with hypertension (HTN) is common. Approximately half of HTN patients do not use their medications as prescribed. Multiple barriers can influence adherence to antihypertensive medications. HTN patients may be characterized by the presence of frailty syndrome (FS) and cognitive impairment (CI). FS and CI may adversely affect the course of the disease and adherence to therapeutic recommendations. Purpose To assess the adherence and its determinants among patients with hypertension. Methods The study included 129 patients diagnosed with hypertension (81 men, 48 women; mean age M±SD=69.98±11.67) hospitalized in the Department of Occupational Diseases and Hypertension. Medical record analysis, the author's sociodemographic questionnaire, the Tilburg Frailty Idicator (TFI) to determine the presence of frailty syndrome, the Montreal Cognitive Assesment (MoCa) questionnaire to assess cognitive function, and the Adherence to Medication Scale (ARMS) to assess adherence were used. Results The majority of respondents were male (62.79%), living in large cities (31.78%), in a relationship (61.24%), with a high school education (68.22%), and retired (67.44%). Analysis of medical records among comorbidities showed diabetes (59.69%) and other cardiovascular diseases (58.91%) to be the most common. Hospitalizations due to hypertension within the past year in the range of 1-2 were reported in 72.09% of the subjects, 3-5 hospitalizations in 17.05%, and more than 5 hospitalizations in 10.85% subjects. The surveyed patients mostly kept self-monitoring diaries (61.24%), measured their blood pressure values 2-3 times a day (58.15%) with an upper arm blood pressure monitor (64.34%). In terms of self-care behaviors, respondents most often indicated following a diet with a restriction of unhealthy fats (52.71%), following a low-sodium diet (44.19%) and being physically active (33.33%). The mean blood pressure values in the study group were M±SD=139.73±16.73 mmHg for SBP and M±SD=81.48±13.25 mmHg for DBP, respectively. On the basis of the TFI, 99.22% of patients showed the presence of FS (M±SD =10.66±2.82), the MoCa questionnaire indicated abnormal values in cognitive function in 79.07% (M±SD =18.16±8.3). The average adherence ARMS score was M±SD 17,6±6,72 pcts. (higher the ARMS score the worse adherence). Univariate analysis as determinants of adherence showed unemployment (b=9.391;p=0.001), smoking (b=6.701;p=0.001), duration of illness (b=-0.153;p=0.003), 3-5 hospitalizations in the past year (b=3.891;p=0.014). Multivariate analysis among determinants of adherence showed unemployment (b=7.556;p=0.022), duration of illness (b=-0.167;p=0.002) and 3-5 hospitalizations (b=5.011;p=0.001). Conclusion Hypertensive patients are characterized by optimal adherence. Despite expectations, cognitive impairment and frailty syndrome did not determine adherence to medications.

Impact of park renovation on children’s quality of life in New York City

Abstract Background Despite increasing interest in the role of parks on children’s health, research on the impact of park interventions is limited. This study uses a quasi-experimental pre-post design with matched controls to evaluate the effects of park redesign and renovation on children’s quality of life (QoL) in underserved New York City (NYC) neighborhoods with predominantly Hispanic and Black populations. Methods Utilizing longitudinal data from the Physical Activity and Redesigned Community Spaces (PARCS) Study, we examined the parent-reported QoL of children aged 3-11 years living within a 0.3-mile radius of 13 renovated parks (N = 201) compared to 11 (N = 197) control parks before and after the park intervention. QoL was measured using the modified KINDL questionnaire, a health-related QoL scale that assessed children’s physical and emotional well-being, self-esteem, and well-being in home, peer, and school settings. A difference in difference (DID) linear mixed model was used to compare QoL between intervention and control groups. Results We found a significant improvement in the physical well-being subscale of KINDL in the intervention vs. control group (DID=6.35, 95% CI = 0.85-11.85, p = 0.024). The differential improvement was strongest among girls (DID=7.88, p = 0.023) and children with parents in the lowest socioeconomic background (education high school or less DID=8.38, p = 0.024; Not employed DID=7.53, p = 0.048; Single/Widowed/Divorced DID=8.67, p = 0.025). No significant differences were found in other subscales. Conclusions Our study indicated a beneficial impact of improving park quality on the physical well-being of children residing in underserved neighborhoods. These findings support investments in neighborhood parks to advance health equity.

Independent associations of educational attainment and its joint associations with LE8 score for risk of cardiovascular disease incidence and mortality among Chinese people

Abstract Background/Introduction Educational attainment is a social determinant of health. Quantifying its associations with risk of cardiovascular disease (CVD) incidence and mortality has public health importance. Recently, the American Heart Association introduced the Life’s Essential 8 (LE8) score to evaluate CVD risk. However, it remains unclear how educational attainment and the LE8 score interact in their joint associations with CVD and mortality. Purpose To examine the associations of educational level with the incidence of CVD, including coronary heart disease (CHD) and stroke, and total mortality. Also, we examined the joint associations of educational level and the LE8 score with CVD incidence and total mortality. Methods We prospectively followed 91,744 Chinese adults from the Kailuan Study (2006-2021), who were free of CVD at baseline. Information on educational level, diet, lifestyle, and health conditions was collected every 2 years. LE8 score was calculated based on eight components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. We used time-dependent Cox models to assess the associations of educational level with the outcomes as well as the joint associations of educational level and LE8 score, with adjustments for demographics, dietary and lifestyle factors, and medical history. Results During a mean follow-up of 13.1 years, there were 12,916 incident CVD cases and 13,090 deaths. Compared with the participants who only received illiteracy or elementary education, those who received high school education and above had a lower risk of CVD incidence (HR = 0.82, 95% CI = 0.76, 0.88), stroke incidence (0.72, (0.66, 0.79)), and total mortality (0.73, (0.68, 0.77)). Educational level was not associated with risk of CHD. Furthermore, significant additive interactions between educational attainment and LE8 score on the risk of CVD and mortality were observed (all p values for additive interactions &amp;lt;0.01). Compared with the participants who only received illiteracy or elementary education and had a low LE8 score, those who only received illiteracy or elementary education but had a high LE8 score still had a 27%-47% lower risk of CVD and total mortality, while those who received high school education and above and had a high LE8 score had a 51%-74% lower risk of CVD and total mortality. Conclusions Higher educational level was associated with a lower risk of CVD and mortality. These inverse associations were most apparent among participants with both a high educational level and a high LE8 score, while the participants with a low educational level but with a high LE8 score still had a significantly lower risk. These findings highlight the importance of improvement in educational attainment in preventing CVD events and deaths, and suggest that CVD events and deaths attributable to lower levels of education may be reduced by improving LE8 score.

Sleep quality and associated factors in older outpatients with hypertension in Vietnam: A cross-sectional study

Background &amp; Aim: Sleep plays a crucial role in controlling blood pressure. Older adults commonly suffer from poor sleep quality which results in several negative health outcomes, such as cognitive impairment, depression, and increased risk of falling. However, limited research exists on sleep quality in older Vietnamese adults. This study aimed to investigate sleep quality and its associated factors in older adults with hypertension in Central Vietnam. Methods &amp; Materials: A cross-sectional study was conducted at a tertiary hospital in Central Vietnam with 235 outpatients who were aged 60 years or older, diagnosed with hypertension, and without cognitive impairment. The Pittsburgh Sleep Quality Index was utilized to assess the participants' sleep quality. Multiple binary logistic regression was computed to identify factors associated with sleep quality with a P value less than 0.05. Results: The mean sleep quality score was 8.2 (±3.9), with 71.9% of participants reporting poor sleep quality. Participants with a high school education or less were more likely to report poor sleep quality than those with higher education (OR = 1.91; 95% CI: 1.05 - 3.46; p= 0.034). Additionally, the presence of musculoskeletal disease increased the risk of poor sleep quality (OR= 2.26; 95% CI: 1.04 - 4.87; p= 0.038). Conclusion: The majority of participants suffered from poor sleep quality, which was strongly associated with educational level and the presence of musculoskeletal diseases. Strategies for early detection, prevention, and treatment of poor sleep quality are essential for improving health outcomes in this population.

DESCRIPTIVE STUDY THE CHARACTERISTICS OF MOTHERS WITH POSTPARTUM DEPRESSION SCREENING RESULTS ON THE SEVENTH DAY PUERPERIUM

Postpartum depression is a psychological disorder that occurs during the postpartum period. The incidence of postpartum depression in Indonesia is between 50-70%. The development of the baby and the mother’s social life can be severely affected by postpartum depression. Screening is necessary to anticipate the incidence of postpartum depression. The purpose of this study was to describe the characteristics of mothers with postpartum depression screening results on the seventh day of postpartum women. The design of this study was a quantitative descriptive with a cross-sectional approach. The population of 38 people used the total sampling technique so that the total sample was 38 people. The research instrument used a general data questionnaire and EPDS. The results of the study showed that postpartum mothers who experienced a risk of postpartum depression were 21.1%. Based on the characteristics, namely mothers aged 20-35 years (18.4%), primiparous (13.2%), spacing of children &lt;2 years (8.7%), mothers who do not work (15.8%), and mothers with senior high school education (15.8%). The risk of depression experienced by postpartum mothers in Blimbing, Malang is thought to be caused by factors such as parity, distance between children and education level. Although in small numbers. Postpartum depression can have a negative impact on the mental health of the mother and the development of the child in the future, so depression screening needs to be tried so that the coverage of early detection of postpartum depression increases.

Using data fusion with multiple imputation to correct for misclassification in self-reported exposure: a case-control study of cannabis use and homicide victimization

BackgroundCannabis use has been causally linked to violent behaviors in experimental and case studies, but its association with homicide victimization has not been rigorously assessed through epidemiologic research.MethodsWe performed a case-control analysis using two national data systems. Cases were homicide victims from the National Violent Death Reporting System (NVDRS), and controls were participants from the National Survey on Drug Use and Health (NSDUH). While the NVDRS contained toxicological testing data on cannabis use, the NSDUH only collected self-reported data, and thus the potential misclassification in the self-reported data needed to be corrected. We took a data fusion approach by concatenating the NSDUH with a third data system, the National Roadside Survey of Alcohol and Drug Use by Drivers (NRS), which collected toxicological testing and self-reported data on cannabis use for drivers. The data fusion approach provided multiple imputations (MIs) of toxicological testing results on cannabis use for the participants in the NSDUH, which were then used in the case-control analysis. Bootstrap was used to obtain valid statistical inference.ResultsThe analyses revealed that cannabis use was associated with 3.55-fold (95% CI: 2.75–4.35) increased odds of homicide victimization. Alcohol use, being Black, male, aged 21–34 years, and having less than a high school education were also significantly associated with increased odds of homicide victimization.ConclusionsCannabis use is a major risk factor for homicide victimization. The data fusion with MI method is useful in integrative data analysis for harmonizing measures between different data sources.

Pre-vocational education as a factor in the development of human resources in the healthcare system

Pre-professional medical education in high school provides not only a more in-depth study of individual subjects of general education programs, but also expands the opportunities for self-determination of students, ensures continuity of the educational process, allows boys and girls to adapt more successfully mastering higher medical professional education programs and is the basis for a successful career.Aim. To evaluate the results of the introduction and implementation of the model of pre-professional medical and pharmaceutical education using the example of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) (hereinafter referred to as the Pre-University) as a means of developing the human resources potential of the healthcare system on the territory of the Russian Federation.Materials and methods. During the work, a theoretical analysis of domestic and foreign literature on the problem of developing the human resources potential of the healthcare system was carried out. A study was conducted in the comparative aspect of the basic readiness of students in grades 8-11 at the Pre-University and specialized medical and biological classes of regional educational institutions to the choice of medical specialties using a test questionnaire with the identification of three key aspects: readiness to master medical specialties; self-assessment of capabilities and erudition in the field of modern medicine. 1465 people took part in the survey. The reliability of the results was carried using the Mann-Whitney U test. Assessment of the statistical significance of differences between the means was carried out at a critical level of p = 0.05.Results. Studying at the Pre-University of Sechenov University allowed the majority of adolescents to achieve higher levels of formation of the main indicators of basic readiness to choose medical specialties. The share of students with a high level of readiness to master medical specialties at the Pre-University is 13.8 % higher compared to students of specialized medical and biological classes, with high erudition – 13.8 % and 6.7 % higher those who highly assess their prospects for entering a medical university.Conclusion. Pre-professional education based on close interaction between the Pre-University and Sechenov University allows students to develop motivation to choose a medical profession, as well as a clear understanding of the learning process in the chosen profession and is an important link in the system of continuous educational trajectory «pre-university–university–clinic».

ASSOCIATION BETWEEN RELIGIOSITY AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER UNDERGOING CHEMOTHERAPY - RELIGIOSITY AND QUALITY OF LIFE IN WOMEN WITH CANCER

Objective: To verify the correlation between religiosity and health-related quality of life in women with breast cancer. Method: Analytical longitudinal, prospective study, conducted between January 2019 and March 2020, on a public hospital in Maranhão. A sociodemographic questionnaire and the instruments EORTC-QLQ-C30, EORTC-QLQ-BR23 and DUREL Scale were applied. The data were verified by the Shapiro-Wilk test, Pearson correlation coefficient and Spearman. Results: Eighty women, mean age 52 years, married, with high school education, white, Catholic participated in the research. A positive correlation was observed between religiosity and quality of life in all stages of chemotherapy treatment. Conclusion: The positive association between religiosity and quality of life in women with breast cancer undergoing chemotherapy was the conclusion of our study. Religiosity is an essential factor of quality of life in oncological diseases.

Comparison of Large Language Models in Generating Machine Learning Curricula in High Schools

With the rapid advancement of artificial intelligence technologies, the integration of AI concepts into educational curricula represents an increasingly important issue. This paper presents a comparative analysis of four AI large language models, ChatGPT (now GPT-4o), Bard (now Gemini), Copilot, and Auto-GPT, in the last year, progressing from the previous into the newer versions, thus also revealing the progress over time. Tasks were selected from the Valence project, which aims to advance machine learning in high school education with material designed by human experts. The four LLMs were assessed across 13 topics, 35 units, and 12 code segments, focusing on their code generation, definition formulation, and textual task capabilities. The results were analyzed using various metrics to conduct a comprehensive evaluation. Each LLM was allowed up to five attempts to produce outputs closely aligned with human-written materials, with experts providing iterative feedback. This study evaluated the effectiveness and accuracy of these LLMs in educational content creation, offering insights into their potential roles in shaping current and future AI-centric education systems.

Biblical Perspective and Educational Domains in Sex Education: Addressing Gaps in Indonesian Sex Education

In Indonesia, sex education is delivered in public high schools as part of the biology curriculum and under the topic of reproductive health. According to the government’s view, when schools teach students properly about reproductive health, they will have a good understanding of their sexuality. Therefore, there is no need to have any further sexual education outside of the school curriculum. However, about half of the teenagers living in major cities are involved in premarital sex, and the rate of teen abortion and HIV infections is high. This article examined the implementation of sexual education in public high schools in Indonesia using a combination of qualitative and quantitative research. The survey was done on a sample of 416 students from 30 provinces and 66 cities in Indonesia. The finding support a particular approach to sex education that incorporates cognitive, affective, and psychomotor learning aspects of educational taxonomy. We find that it is essential to develop a separate sex education module in addition to the current reproductive health topic taught in biology to encourage students to practice abstinence, rather than just teaching reproductive health.

Association of Racial Residential Segregation and Other Social Determinants of Health with HIV Late Presentation.

Understanding social determinants of HIV late presentation with advanced disease (LPWA) beyond individual-level factors could help decrease LPWA and improve population-level HIV outcomes. This study aimed to examine county-level social determinants of health (SDOH) with HIV late presentation. We aggregated datasets for analysis by linking statewide HIV diagnosis data from the South Carolina (SC) Enhanced HIV/AIDS Reporting System and multiple social contextual datasets (e.g., the American Community Survey). All adult (18 years and older) people with HIV diagnosed from 2014 to 2019 in SC were included. Linear mixed models with forward selection were employed to explore the association of county-level SDOH with the county-level three-year moving average percentage of LPWA and average delay time from HIV infection to diagnosis. Around 30% of new HIV diagnoses were LPWA in SC, and the mean delay time for people with LPWA was approximately 13 years. Counties with more racial residential segregation had longer average delay time (Adjusted beta = 5.079, 95% CI: 0.268 ~ 9.889). Regarding other SDOH, the increased percentage of LPWA was associated with fewer Ryan White centers per 100,000 population (Adjusted beta = -0.006, 95% CI: -0.011~-0.001) and higher percentages of the population with less than a high school education (Adjusted beta = 0.008, 95% CI: 0 ~ 0.015). Reducing county-level disparities in LPWA requires multifaceted interventions addressing multiple dimensions of SDOH. Targeted interventions are needed for counties with more Black residential segregation, fewer Ryan White centers, and higher percentages of less than high school education.