High School Education Level Research Articles

Sexual Violence First Experienced as Childhood or Adolescent: The Effects on U.S. Female Education and Occupation

Previous research generally considers sexual violence as binary, meaning it has been experienced or not, and has yet to identify if the age at which a survivor was first assaulted has differing long-term effects. The primary purpose of this study is to empirically explore the effect of age, specifically the two age ranges of childhood or adolescence, at which sexual violence is first experienced on female survivors’ educational attainment and occupation in the United States (U.S.). Using the National Longitudinal Study of Adolescent Health survey, the empirical results indicate that study participants who first experience sexual violence in childhood are 50.2% less likely to have attained a level of high school education or above compared to those who did not experience sexual violence in childhood. Further, the analysis results suggest those participants who first experienced sexual violence in adolescence are 41.6% less likely to have attained a level of high school education or above compared to those who did not experience sexual violence in adolescence. In reference to occupation, the analysis results indicate that first experiencing sexual violence as an adolescent makes the odds higher that the survivor will be employed in a lower skill occupation (associate professional) relative to the highest skill occupation (professional). Overall, this study concludes that the age at which a survivor was first assaulted impacts the long-term effects of the assault, contributing new information to those researching the effects of sexual violence, those working with survivors, and policy makers developing survivor treatment plans.

The Urgency of Facilities and Infrastructure in Improving the Quality of High School Education

Education is a conscious and planned effort to realize planned and programmed learning, with the aim of developing all the potential of students. Facilities and infrastructure in educational institutions are tools or facilities that have an important role in supporting the success of the educational process in schools. Having adequate facilities directly makes it easier to implement well-planned learning programs. Educational institutions at the high school level must have supporting facilities so that all their potential can be developed. This article uses the type of library research. The data used in this research comes from library sources, documents, journals and articles according to the theme discussed. In this article we will discuss the extent of the urgency of Facilities and Infrastructure to improve the quality of high school level education. Starting from the needs and standards of educational facilities, the role of government and society in accommodating them, and the role of facilities and infrastructure in supporting the quality of education. The hypothesis in this research is that educational institutions ideally have adequate facilities and infrastructure, so that the learning process can run effectively. Regional governments must carry out equal distribution and monitoring in providing assistance so that regional schools can have facilities according to school needs, in an effort to improve students' abilities and achievements in the learning process.

Gambaran Stres Digital pada Remaja Awal

Current use of digital media and the internet can contribute to stress. So this research aims to see how digital stress looks in early adolescents. This type of research is quantitative with descriptive methods. The population in this study were early adolescents at junior high school (SMP) education level. The sampling technique uses Nonprobability Sampling. The research results showed that 107 people (39.3%) had low digital stress and 165 subjects (60.7%) had high digital stress. In conclusion, this research shows that early adolescents have high digital stress.

The characteristics of the elderly with hypertension in Jatimulyo Village

Background: Physical and psychological decline is a sign of aging. In addition, aging also increases the risk of diseases that can lead to death. Hypertension is a non-communicable but chronic disease with a very high prevalence rate in the elderly. Many changes occur during the aging process. These changes need special attention. In the elderly, some problems arise from physical, cognitive, social, and sexual feelings. One of the changes in the cardiovascular system in the elderly is hypertension. 
 Methods: The samples used were ten patients according to the inclusion and exclusion criteria. The research data is primary data obtained from interviews based on questionnaires. Of the ten research subjects, the proportion of hypertension was found in problems with the characteristics of age 60-74 years as much as 70%, female gender (70%), high school education level (60%), and existing housewife occupation (70%). In addition, most of the research subjects had grade 1 hypertension (90%).
 Results: Of the ten research subjects, the proportion of hypertension was found in problems with the characteristics of age 60-74 years as much as 70%, female gender (70%), high school education level (60%), and housewife occupation (70%). In addition, most of the research subjects had grade 1 hypertension (90%).
 Conclusion: Hypertension is also a non-communicable but chronic disease with a very high prevalence rate in the elderly. The prevalence of hypertension at the world level, especially in developed countries, in the elderly population > 60 years is estimated to reach two-thirds or around 60%-80%.

Exploring Social Media Use Integration Based on Educational Level Among Emerging Adults

Objective: Social media has become integral to everyday life, including among emerging adults. Surveys showed that Instagram has become one of emerging adults' most popular social media. Social media could facilitate emerging adult developmental tasks, such as identity exploration. Further, social media uses integration concepts to explore how individuals build emotional connections and involve social media in their daily social routines. Additionally, it is essential to view social media use integration based on educational background. This study explored differences in social media use integration among emerging adults based on education level. Method: A cross-sectional study design was conducted among 305 men and women emerging adults. Participants completed a self-administered questionnaire comprising demographic characteristics and a Social Media Use Integration scale. Data were analyzed using descriptive analysis and one-way ANOVA statistic technique. Results: Descriptive analysis results showed that individuals with a high school education level had the highest social media use integration scores compared to groups from other education levels. Further, education level notably contributed to the score difference in social media use integration among emerging adults. Novelty: This study contributed to exploring further the social media use integration among emerging adults, specifically in the context of educational background.

Soluble urokinase Plasminogen Activator Receptor (suPAR) mediates the effect of a lower education level on adverse outcomes in patients with coronary artery disease.

To investigate whether the adverse impact of lower educational attainment on mortality risk in patients with coronary artery disease (CAD) is mediated by the activation of inflammatory and immune pathways, estimated as elevated soluble urokinase plasminogen activator receptor levels. In 3164 patients undergoing coronary angiography, we investigated multivariable associations between suPAR and educational attainment and assessed the relationship between a lower educational level (defined as a high-school degree or less as the highest educational qualification) and outcomes using Cox proportional hazard and Fine and Gray's subdistribution competing risk models. The potential mediating effect through suPAR and high-sensitivity C-reactive protein (hs-CRP) was assessed using mediation analysis. A total of 1814 patients (57.3%) had achieved a higher (≥college) education level and 1350 patients (42.7%) a lower (≤high school) education level. Soluble urokinase plasminogen activator receptor levels were 9.0% [95% confidence interval (CI) 6.3-11.8, P ≤ 0.0001] higher in patients with lower educational qualifications than in those with higher educational qualifications after covariate adjustment. Lower educational attainment was associated with a higher risk of cardiovascular death after adjustment for demographic, clinical, and behavioural covariates, including CAD severity and heart failure history, medication use, and hs-CRP levels [hazard ratio 1.26 (95% CI 1.02-1.55, P = 0.03)]. However, after adjustment for suPAR levels, the effect of a lower educational level on cardiovascular death became insignificant. Values were similar for all-cause death. Soluble urokinase plasminogen activator receptor levels mediated 49% and hs-CRP levels 17% of the cardiovascular death risk attributable to lower educational attainment. Circulating suPAR levels importantly mediate the effects of lower educational attainment on mortality, indicating the importance of systemic inflammation and immune dysregulation as biologic mediators of adverse social determinants of health.

Practices, perceptions and trust of the public regarding online drug purchasing: a web-based survey from Jordan

ObjectivesOnline purchasing, including drugs, increased dramatically in the last decade especially through the COVID-19 pandemic. The aim of this study was to investigate the frequency and attitudes of consumers concerning...

Association of socioeconomic status with metabolic syndrome and its components among adult population: a community-based cross-sectional study in Nanjing Municipality of China

ObjectivesTo investigate the association of metabolic syndrome (MetS) and its components with socioeconomic status (SES) among general and gender-specific adult population in Nanjing municipality, China.DesignCross-sectional study.Participants13287 participants completed the survey....

Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living With HIV Seeking Medication for Opioid Use Disorder.

People living with HIV and opioid use disorder (OUD) are disproportionally affected by adverse socio-structural exposures negatively affecting health, which have shown inconsistent associations with uptake of medications for OUD (MOUD). This study aimed to determine whether social determinants of health (SDOH) were associated with MOUD uptake and trajectories of substance use in a clinical trial of people seeking treatment. Data are from a 2018 to 2019 randomized trial comparing the effectiveness of different MOUD to achieve viral suppression among people living with HIV and OUD. SDOH were defined by variables mapping to Healthy People 2030 domains: education (Education Access and Quality), income (Economic Stability), homelessness (Neighborhood and Built Environment), criminal justice involvement (Social and Community Context), and recent SUD care (Health Care Access and Quality). Associations between SDOH and MOUD initiation were assessed with Cox proportional hazards models, and SDOH and substance use over time with generalized estimating equation models. Participants (N = 114) averaged 47 years old, 63% were male, 56% were Black, and 12% Hispanic. Participants reported an average of 2.3 out of 5 positive SDOH indicators (SD = 1.2). Stable housing was the most commonly reported SDOH (61%), followed by no recent criminal justice involvement (59%), having a high-school level education or greater (56%), income stability (45%), and recent SUD care (13%). Each additional favorable SDOH was associated with a 25% increase in the likelihood of MOUD initiation during the study period [adjusted HR = 1.25, 95% CI = (1.01, 1.55), P = .044]. Positive SDOH were also associated with a decrease in the odds of baseline opioid use and a greater reduction in opioid use during subsequent weeks of the study (P < .001 for a joint test of baseline and slope differences). Positive social determinants of health, in aggregate, may increase the likelihood of MOUD treatment initiation among people living with HIV and OUD.

LEVEL OF ANXIETY ABOUT COVID-19 IN THE COMMUNITY RT I RW XII KELURAHAN MANYAR SABRANGAN SURABAYA

Anxiety is a judgement and emotional response to something dangerous. Anxiety is strongly instability, decreased income, sudden layoffs, difficulty finding employment, and loss of life in a matter of days after contracting Covid-19 which could cause anxiety. The purpose of this study was to determine the level of anxiety about Covid-19 in the community of RT I RW XII Manyar Sabrangan Village. The sampling technique in this study used an incidental sampling technique with a total of 110 people. The results of this study indicate that people with anxiety levels based on age mostly experience severe anxiety with the highest presentation at the age of 18-25 years (57.15%), while based on education most experience moderate anxiety with the highest presentation in junior high school education (33.3%) and anxiety levels based on work almost all experience moderate anxiety with the highest presentation as self-employed (88.88%). It is expected for every community to continue to discipline themselves in implementing health protocols such as wearing masks, washing hands, maintaining distance and carrying out Covid-19 vaccinations.

Merdeka Curriculum: Strengthening Character Through Assessment At SMP Negeri 17 Pontianak

This research aims to determine the implementation of character strengthening through independent curriculum assessments in junior high school level education units. Curriculum changes require adjustments to the competencies of teachers and students. Especially junior high school students who have just experienced the transition from primary to junior secondary education. In order to find answers to research questions, researchers conducted research at SMP Negeri 17 Pontianak. The research method is descriptive qualitative. The research procedure was carried out starting with preparing the design, implementation and research report. Data collection techniques using observation, interviews and documentation studies. The research results were analyzed according to Milles and Huberman's analysis. Research population of teachers and students of SMP Negeri 2 Pontianak. Meanwhile, the research samples were from social studies teachers and several students. The results of the research show that SMPN 17 Pontianak is still in the adjustment or adaptation stage. Formative assessment is able to provide encouragement to teachers to be more systematic and consistent in assessing students in areas mastered. The assessment at SMPN 17 Pontianak is an evaluation for teachers to review students' abilities, for example what learning needs students need and the obstacles or challenges faced by students. Apart from still not mastering the adaptation process for teachers in the independent curriculum assessment, another obstacle is the limited number of textbooks from the central government which until now has not provided these textbooks to the SMP Negeri 17 Pontianak school. So students are forced to buy textbooks individually and not all students can buy textbooks.

Assessing Depression and Anxiety Levels in English and Spanish-Speaking Patients throughout a Course of Radiation Therapy

An estimated 32.2% and 41.9% of breast cancer patients experience depression and anxiety, respectively. However, distress experienced by patients with breast cancer receiving radiation therapy may vary at different time points and differ in comparison to other patients with breast cancer, potentially due to differences in the understanding of radiotherapy and variability in the severity of side effects. This study sought to describe the changes in levels of depression and anxiety experienced by English and Spanish-speaking patients throughout a course of radiation therapy for breast cancer, along with the impact of different variables on these levels of distress to better understand and quantify potential gaps. Eligibility criteria included English and Spanish-speaking females, ages 18 or older, undergoing radiation therapy treatment for breast cancer at two institutions, including a safety-net hospital. Pre- and post-treatment surveys were completed before and after delivery of radiation therapy. Sociodemographic characteristics collected included: race, ethnicity, marital status, education level, longest residency location, housing, and food security. The survey ended with the standardized PHQ-4 questionnaire, which uses a maximum total score of 12 to assess anxiety and depression. Results were analyzed using the Analysis of Covariance procedure. A total of 160 participants completed pre- and post-treatment surveys. Half of the participants were non-white (50%), primarily married (42.5%), and had a high school or associate's level education (46.9%). The total baseline distress mean (BDM) was 2.96 (Standard deviation, SD = 3.11), and the final distress mean (FDM) was 2.78 (SD = 3.78). English-speaking patients comprised 82.5% (n = 132) of the sample and had a BDM of 2.91 with an adjusted change mean (ACM) decrease of 0.45. Spanish-speaking patients comprised 17.5% (n = 28) of the sample, with a BDM of 3.21 and an ACM increase of 1.03 (P = 0.002). Housing (P = 0.021) and food insecurity (P = 0.002) also showed increasing distress with increased insecurity at baseline. Our study shows that Spanish-speaking patients present with higher levels of distress than their English-speaking counterparts and their distress increased throughout treatment as opposed to English speakers. Other factors, such as housing and food insecurity, are also significantly associated with increased distress. As the number of Spanish speakers in the US continues to increase, it will be important to continue assessing potential differences in cancer care. In addition, understanding the distress changes throughout radiation treatment could help inform future interventions that address these disparities.

Implications and Implementation of Biological Philosophy on Biological Topics: Plant Growth and Development

This article comprehensively discusses growth and development in plants, explaining the differences between these two concepts, as well as their implications in the world of education, especially at the junior high school (SMP), senior high school (SMA) and tertiary education (PT) levels. Growth is explained as an increase in the size and number of cells which is quantitative, while development is a process towards maturity which is qualitative. Growth and development in plants are interrelated and occur continuously. In middle school, students understand the various systems in plant life and the importance of growth and development. In high school, they analyze the relationship between internal and external factors and growth and development processes and carry out experiments related to external factors in plants. The College provides students with the opportunity to conduct in-depth research on plant growth and development, developing their metacognitive abilities. This article highlights the importance of integrating plant growth and development concepts in educational curricula to create deeper understanding and better quality learning.

Development of an Evaluation Model for Islamic Religious Education and Character Education (PAI-BP) at The High School Level: Between Urgency and Effectiveness

The research is aimed to: (1) identify a factual model of learning evaluation of Islamic Religious and Moral Education (PAI-BP); (2) develop the PAI-BP learning evaluation model to suit the needs of the high school education level; and (3) knowing and analyzing the effectiveness of the PAI-BP learning evaluation development model at the high school education level in Karanganyar Regency for the 2020/2021 academic year. The type of the research is development research targetting the evaluation model for Islamic Religious and Moral Education (PAI-BP) for high school level. The data collection method was done using observation, in-depth interviews, document analysis, tests, and questionnaires techniques. Data analysis was carried out by qualitative and quantitative analysis. The research concluded that: (1) The factual model of the evaluation of Islamic Religious Education and Moral Education (PAI-BP) at the high school education level currently done separately between the process of learning and its product; (2) The evaluation model developed has two main components, namely: the learning process and output. The learning process includes four subcomponents, namely: (a) teachers’ performance in the classroom, (b) teachers’ personality, (c) students’ behavior, and (d) learning facilities. Whereas the learning output includes four sub-components, namely aspects: (a) akidah akhlaq, (b) Qur'an-Hadith, (c) Fiqh, and (d) Islamic history; and (3) The effectiveness of the PAI-BP learning evaluation model developed shows that based on the experts, user and practitioner assessments, the model developed is considered as a Good model to evaluate PAI-BP learning at high school level education.

The Impact of Education Level, Access to Transportation, and the Home Environment on Patient-Reported Outcomes after Orthopaedic Trauma Surgery

Objectives It is known that Social Determinants of Health (SDOH) impact a variety of health outcomes. Of these determinants, it remains unclear how education level, access to transportation, and the home environment influence Patient-Reported Outcomes (PROs) following orthopaedic trauma surgery. Methods A cross-sectional survey was conducted at an urban level 1 trauma center to collect data on demographics, education level, access to transportation, and the home environment of 120 patients who underwent fracture fixation surgery. Patient data was correlated with PRO data as measured by Patient Reported Outcomes Measurement Information System (PROMIS) survey scores, including global mental health (GM), global physical health (GP), pain interference (PI), and physical function (PF). A multivariable mixed-effects regression analysis was performed to determine associations between SDOH and PROs. Results Multivariable regression analysis results demonstrated that patients with high school or lower education levels were associated with better PF (P=0.007). Patients with access to transportation were associated with higher GM (P = 0.016), while those who lived greater than 5 miles from the hospital were associated with higher GP (P = 0.0498). Those with difficulty accessing the bathroom were associated with lower GP (P = 0.007) and GM (P = 0.0008), increased PI (P = 0.0002), and lower PF (P = 0.004). People living in apartments had higher GM (P = 0.0008). Navigating stairs inside the home was associated with lower GP (P = 0.030) and higher PI (P = 0.0007), while those who navigated stairs outside of their home reported higher GP (P = 0.038). Conclusion This study found that in our population, education level, access to transportation, and the home environment appeared to be associated with PROs following orthopaedic trauma surgery.

Sometimes Littering Is Acceptable—Understanding and Addressing Littering Perceptions in Natural Settings

The detrimental impact of visitor-induced litter pollution on ecosystems, wildlife, and overall quality of life emphasizes the urgency of mitigating it. This study uniquely focuses on diverse visitors’ perceptions of littering behavior in open spaces, facilitating comprehensive assessment and targeted mitigation strategies. This study aimed to analyze attitudes, willingness to act, and responsibility perceptions, considering diverse demographics in Israel’s multicultural context. It sought insights into littering rationales, potential remedies, and the identification of relatively acceptable littering behaviors for focused attention. This profound comprehension is crucial for conserving ecologically sensitive open areas, necessitating optimized management for interface preservation. Leveraging insights from an online survey involving 401 recent open-space visitors, this research reveals a disparity between self-professed and actual littering practices. Intriguingly, 32% of participants who claimed never to litter described instances of doing so. Furthermore, disparities emerged between anti-litter attitudes, willingness to act, and individual accountability, which were influenced by demographic variables. While individuals from various demographic cohorts attested to littering behavior, young ultra-Orthodox Jews possessing solely a high school level of education exhibited a proclivity for increased littering. Perceptions predominantly attribute purposeful and recreational motives to littering, rather than substantial reasons. Participants conceive a diverse range of effective strategies to address the issue, highlighting its intricate and multifaceted nature. Consequently, this study advocates for a multifaceted approach combining enhanced enforcement, educational campaigns, informative initiatives, and infrastructural enhancements. By acknowledging the complexities of littering behavior and embracing multifarious interventions, policymakers can enhance the likelihood of successfully curbing this pervasive challenge.

Cigarette Smoking Abstinence Among Pregnant Individuals Using E-Cigarettes or Nicotine Replacement Therapy

Smoking cigarettes during pregnancy can impair maternal and child health, and pregnant individuals have increasingly used electronic cigarettes (e-cigarettes) for various reasons, including quitting smoking. To assess smoking abstinence rates among pregnant individuals who used e-cigarettes compared with those who used nicotine replacement therapy (NRT). This cohort study is a secondary data analysis of phase 8 of the US Pregnancy Risk Assessment Monitoring System, conducted between 2016 and 2020. Eligible participants included pregnant individuals who smoked combustible cigarettes within the 3 months before pregnancy and either used e-cigarettes or NRT during pregnancy. Data analysis was conducted from March 2022 to April 2023. Combustible cigarette use within 3 months before pregnancy and use of either e-cigarettes or NRT during pregnancy. The primary outcome was the individual's self-reported smoking abstinence status during the last 3 months of pregnancy. Weighted percentages were reported and weighted multivariable logistic regression models were used to examine the association of e-cigarette use vs NRT with smoking abstinence. A propensity score was used to control for confounding by sociodemographics, pregnancy characteristics, prepregnancy smoking intensity, depression, behavioral support, and hookah use. The cohort included 1329 pregnant individuals (759 ≥25 years [60.2%]; 766 non-Hispanic White individuals [79.8%]) of whom 781 had an education level of high school or lower (61.4%), and 952 had an annual household income of $48 000 or less (81.5%). Of the 1329 individuals, 890 (unweighted percentage, 67.0%) were existing e-cigarette users, 67 (unweighted percentage, 5.0%) were new e-cigarette users, and 372 (unweighted percentage, 28.0%) were NRT users. Compared with individuals who used NRT during pregnancy, individuals who used e-cigarettes had a higher rate of smoking abstinence in late pregnancy (456 individuals [50.8%] vs 67 individuals [19.4%]; propensity score adjusted odds ratio [OR], 2.47; 95% CI, 1.17-5.20; P = .02). In the secondary analysis stratified by the timing of e-cigarette use initiation, existing users of e-cigarettes who initiated before pregnancy had a higher smoking abstinence rate than NRT users (446 users [53.1%] vs 67 users [19.4%]; adjusted OR, 2.61; 95% CI, 1.23-5.51; P = .01). However, new e-cigarette users who initiated use during pregnancy had a similar smoking abstinence rate in late pregnancy when compared with NRT users (10 users [20.6%] vs 67 users [19.4%]; adjusted OR, 1.13; 95% CI, 0.22-5.87; P = .88). These findings suggest that individuals who used e-cigarettes during pregnancy had a higher smoking abstinence rate in late pregnancy than individuals who used NRT, especially for those who initiated e-cigarette use before pregnancy, indicating that replacement of cigarettes with e-cigarettes during pregnancy may be a viable strategy for harm reduction.

Factors Associated with The Incidence of Pulmonary Tuberculosis in Lebak District, Banten Province, Indonesia

Introduction: Pulmonary tuberculosis (TB) is a chronic disease caused by Mycobacterium tuberculosis. The prevalence of pulmonary TB is increasing every year. The previous studies found that knowledge, physical condition of the house, gender and education level are the well-known of factors associated with the TB cases. This study aims to determine the factors associated with the incidence of Pulmonary TB at Puskesmas Maja, Lebak Regency, Banten Province, Indonesia.Methods: Case control study design was used in this study. Total 20 cases and controls were recruited. Cases are individuals aged over 15 years with pulmonary tuberculosis who were confirmed by sputum examination with acid-fast staining (BTA+) showing the presence of Mycobacterium tuberculosis. Controls were individuals with negative sputum examination results. A purposive sampling technique was used to find the defined-case and control groups. A study questionnaire was used to collect the determinant factors and house condition parameter was measured directly. The chi-square test was used to determine the association of each variable related to TB incidence.Results: The demographic data showed that the majority of TB patients in Puskesmas Maja were male who had an elementary to high school education level and had a low level of knowledge and unhealthy physical conditions of the house. The results of bivariate analysis showed that there was a significant relationship between gender, education level, knowledge, and physical condition of the house with the incidence of pulmonary TB at Puskesmas Maja, Lebak Regency.Conclusion: This study concludes that all four variables have a significant relationship with the occurrence of Pulmonary TB at Puskesmas Maja, Lebak Regency. The results of this study can be a source of reference for further research and also become the basis for overcoming pulmonary TB in Banten Province in particular and in Indonesia

Development strategies for creative small and medium enterprises (SMEs): A Quintuple Helix Model approach to support smart city initiatives

This study explores the development of Creative Small and Medium-Sized Enterprises (SMEs) in the food, textile, and handicraft sectors in Jambi City, employing the quintuple helix model to align with the Smart City concept. The research gathered primary data through surveys, interviews, and focused group discussions (FGDs). The study encompassed a diverse range of stakeholders from the specified sectors, with a sample size of 100 individuals. A mixed-method research approach was adopted, integrating both qualitative and quantitative methods. Analytical tools such as the Likert scale, SWOT analysis, and the quintuple helix model were employed for data analysis and interpretation. The findings reveal that many participants in these sectors were women, predominantly with high school-level education. The age group of 46-55 years was most represented among the respondents. Notably, the food sector emerged as the dominant industry among the studied SMEs, attributed to its relative ease of establishment and cost-effectiveness compared to the textile and handicraft sectors. The study also examined the perceptions of the roles of quintuple helix actors (government, academia, industry, society, and social environment) in the development of these SMEs. The findings indicate a generally positive perception, suggesting effective fulfillment of roles by these actors. This collaborative effort within the quintuple helix framework has positively impacted the development of creative SMEs in Jambi City, contributing significantly to the Smart City initiative. The study underscores the importance of such collaboration in fostering the growth and sustainability of creative SMEs in the context of urban development.

Racial/Ethnic Disparities in Prostate Cancer 5-Year Survival: The Role of Health-Care Access and Disease Severity.

Prostate cancer (PCa) exhibits one of the widest racial and socioeconomic disparities. PCa disparities have also been widely linked to location, as living in more deprived regions was associated with lower healthcare access and worse outcomes. This study aims to examine PCa survival across various USA counties in function of different socioeconomic profiles and discuss the role of potential intermediary factors. The SEER database linked to county-level SES was utilized. Five-year PCa-specific survival using the Kaplan-Meier method was performed for five racial/ethnic categories in function of SES quintiles. Multilevel Cox proportional hazards regression was performed to assess the relationship between county-level SES and PCa survival. Multivariate regression analysis was performed to examine the role of healthcare utilization and severity. A total of 239,613 PCa records were extracted, and 5-year PCa-specific survival was 94%. Overall, living in counties in the worst poverty/income quintile and the worst high-school level education increased PCa mortality by 38% and 33%, respectively, while the best bachelor's-level education rates decreased mortality risk by 23%. Associations varied considerably upon racial/ethnic stratification. Multilevel analyses showed varying contributions of individual and area-level factors to survival within minorities. The relationship between SES and PCa survival appeared to be influenced by healthcare utilization and disease stage/grade. Racial/ethnic categories responded differently under similar county-level SES and individual-level factors to the point where disparities reversed in Hispanic populations. The inclusion of healthcare utilization and severity factors may provide partial early support for their role as intermediaries. Healthcare access (insurance) might not necessarily be associated with better PCa survival through the performance of biopsy and or/surgery. County-level education plays an important role in PCa decision making as it might elucidate discussions of other non-invasive management options. The findings of this study demonstrate that interventions need to be tailored according to each group's needs. This potentially informs the focus of public health efforts in terms of planning and prioritization. This study could also direct further research delving into pathways between area-level characteristics with PCa survival.