Educational Status Research Articles

Maternal feeding practices for sick children under 2 years in Wolkite town, Gurage Zone, Central Ethiopia, 2024: a community-based cross-sectional study

BackgroundOptimal feeding practices for sick children are crucial to prevent morbidity and mortality. Despite global and national policies emphasizing the importance of optimal feeding practices for sick children, studies have revealed varying levels of practice in different regions, including Ethiopia. However, there is a research gap in focusing on community-based contexts to determine sick child feeding practices among mothers with young children.ObjectiveTo assess maternal feeding practices for sick children under 2 years in Wolkite town, Gurage zone, Central Ethiopia: 2024.MethodsA community-based cross-sectional study involving a total of 419 mothers of young children was conducted in Wolkite town, Gurage zone, Central Ethiopia from September 15 to November 15, 2023. Participants were chosen using computer-generated random numbers. Structured, interviewer-administered, and pretested data collection tool were used. The data were coded and entered into EpiData 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing mothers’ practice. Statistical significance was set at p < 0.05 with a 95% confidence interval.ResultsThe study found that 54.4% (95% CI: 50–59%) of mothers demonstrated good feeding practices for their sick children. Significant factors contributing to these practices included mothers having at least a secondary education (AOR: 3.7, 95% CI: 1.5–9.1), delivering their child in a health facility (AOR: 2.3, 95% CI: 1.4–3.8), and receiving support from the father (AOR: 2.3, 95% CI: 1.4–3.8). Additionally, mothers who were counseled on infant and young child feeding had higher odds of practicing good feeding (AOR: 4.1, 95% CI: 2.3–7.03), access to postnatal care (AOR: 3.8, 95% CI: 2.1–6.95) and having a good knowledge of feeding practices (AOR: 2.5, 95% CI: 1.4–4.5) were also strongly associated with effective feeding practices.ConclusionsThe study highlights more than half of mothers in Wolkite town, Gurage zone, Central Ethiopia have good sick child feeding practices. Factors such as the higher educational status of the mother, having the father’s support, place of delivery, receiving PNC services, counseling on infant and young child feeding, and knowledge about sick child feeding were significantly associated with their practice. Implementing targeted education programs, strengthening postnatal care services, counseling on infant and young child feeding, and encouraging the involvement of fathers in childcare and feeding were strongly recommended.

Kidney status and events preceding death in heart failure: A real world data study on 18,456 patients with heart failure

Abstract Background Despite advancements in heart failure (HF) management, kidney dysfunction remains a significant clinical challenge, and is associated with higher mortality rates and other adverse outcomes. However, there are few studies of kidney events preceding death in patients with HF in the real world. Methods Using registry-based data, the prevalence of kidney events preceding death in patients with HF over the period 2014-2018 in Denmark. All deaths in patients with a diagnosis of HF within the previous 10 years were included. Kidney events occurring during within 1 year of death compromised of: acute kidney injury, chronic renal replacement therapy, sustained eGFR&amp;lt;15 mL/min/1.73 m2, or renal transplantation. The prevalence of kidney events preceding death was calculated and different subgroups were compared. Results Among the 18,586 HF patients who died, a total of 3107 (16.7%) experienced kidney events during within 1 year of death. The prevalence of HF patients with kidney events before death was 15.5% for acute kidney injury, 5.8% for chronic renal replacement therapy, 7.4% for an eGFR&amp;lt;15 mL/min/1.73 m2, and 0.18% for renal transplantation (see Figure 1). Acute kidney injury episodes were frequently observed in the last month before death (7.5%) (Figure 2). Age-specific analysis revealed a higher proportion of deaths associated with kidney dysfunction in patients under the age of 65 years compared to those aged 80 years and above (24.3% vs 13.4%). Furthermore, male sex, death in-hospital, reduced pre-existing kidney function, a higher degree of frailty, and lower educational status were associated with higher frequency of death associated with kidney dysfunction. Conclusion In this real-world study, a significant proportion of deaths among HF patients were associated with kidney dysfunction, particularly with acute kidney injury. Further research and awareness of renal complications are necessary to improve outcomes in this population.

Effect of Whole Blood Dietary Mineral Concentrations on Erythrocytes: Selenium, Manganese, and Chromium: NHANES Data.

Selenium (Se), Manganese (Mn), and Chromium (Cr) are dietary minerals ingested from specific grains, vegetables, and animal meats. Prior research showed that these minerals affect animal erythrocyte health but have unknown effects on human red blood cells (RBCs) and hematology. This study evaluated the effects of these dietary minerals on RBC count, hematocrit, and hemoglobin. We conducted a cross-sectional analysis of 23,844 American participants from the 2015-2016 and 2017-2020 National Health and Nutrition Examination Survey. We evaluated sex, age, ethnicity, education, income, and smoking status as covariates. Linear regression analyses were conducted to evaluate the effect of Cr, Se, and Mn on RBC count, hematocrit, and hemoglobin levels. We employed subpopulation-exclusion regressions further to explore the distinct effects of mineral elevation and deficiency. Additional analyses were performed to examine the relationship between Mn and RBC hemoglobin, RBC distribution width, transferrin receptor concentrations, transferrin saturation, and serum iron levels to support the interpretation of our findings. Optimizable ensemble machine learning models were used to corroborate regression results. Adjusting for covariates, Cr was inversely associated with RBC count (Exp(b) = 0.954), hemoglobin (Exp(b) = 0.868), and hematocrit (Exp(b) = 0.668). Conversely, Se was positively associated with RBC count (Exp(b) = 1.003), hemoglobin (Exp(b) = 1.012), and hematocrit (Exp(b) = 1.032). Mn was positively associated with RBC count (Exp(b) = 1.020) but inversely associated with hemoglobin (Exp(b) = 0.945) and hematocrit (Exp(b) = 0.891). Cr was harmful to RBC health in all subpopulations, whereas Se was protective. Mn appears to contribute to the development of microcytic anemia, but only in subjects with clinically elevated Mn levels. Thus, excessive consumption of foods and supplements rich in Cr and Mn may harm human erythrocyte health and hematology.

Does a correlation exist between delayed vaccination and a decreased vaccine confidence?

ABSTRACT Delay in vaccination schedule may result in increased risk of vaccine-preventable outbreaks. Lack of parental confidence in vaccines and sociodemographic factors could be related to those delays. Vaccine Confidence Index (VCI) is an indicator to estimate confidence in vaccines, composed of simple dimensions about it and evaluated using a 5-point Likert scale. Objectives of this study, conducted in the Region of Murcia, Spain, were to determine which sociodemographic factors were associated with delayed administration in measles, mumps and rubella (MMR) vaccine, both first and second doses, and to evaluate if there were differences in parental vaccine confidence of children who were delayed on MMR vaccine schedule compare to vaccinated on time. The 2019–2020 (first dose) and 2016–2017 (second dose) cohorts were divided into four categories: vaccinated on time, slightly delayed, moderately delayed and highly delayed. Online questionnaire was sent to their parents, followed by a telephone questionnaire for non-responders. Regarding MMR first dose, a significant association was found between delay and birth order and intellectual/motor delay of children. Parental educational status, the main source of vaccine information and the social networks more frequently used by parents were also associated with delay. Suffering motor/intellectual delay and the obstacles to vaccination process derived from caring for other siblings were associated with delay in second MMR dose. The VCI decreased significantly in first dose group as delay increases but did not change in the second one. Confidence in vaccines and sociodemographic factors, respectively, were associated with delaying MMR first and second dose.

Parenthood and poverty risk within couples: individual and household poverty risks by gender and education in four European countries

Abstract This study examines how the presence of children is associated with poverty risk within different-sex couples across welfare state regimes, using no- and full-income pooling scenarios. It focuses on whether partners can achieve an adequate living standard without relying on family ties, and how the costs of children shape poverty risk within these scenarios. Using cross-sectional EU-SILC data (2016–2019) on 30,150 coresidential couples from Austria, France, Spain, and Sweden, I use linear probability models (LPM) to estimate household and individual poverty risks among partners with/out children, by education, gender and country. The results indicate that poverty risks vary by gender, income pooling scenario and country. While partners bear household poverty risks together, there is a pronounced gender gap in individual poverty risk across countries. Men, regardless of their education and fatherhood status, have a relatively low individual poverty risk, with little difference between income pooling scenarios. Conversely, women, especially low-educated mothers, have a higher individual than household poverty risk. Observed cross-country variations highlight that the relationship between motherhood and poverty risk is context-specific. Although education is often promoted as a shield against poverty, in some countries, such as Austria, highly educated mothers also face a high individual poverty risk.

Socio-behavioural associates of Early Childhood Caries among preschool children aged three to four years in Gampaha district, Sri Lanka: a cross sectional study

BackgroundEarly Childhood Caries (ECC) is a highly prevalent disease among preschoolers in Sri Lanka, with stagnated prevalence over the decades. Therefore, it is important to determine the socio-behavioural associations of ECC among preschoolers to reduce the country’s ECC burden.MethodsA cross-sectional study with a multistage cluster sampling technique was used to select 3 to 4 year-old preschoolers/mothers dyads in Gampaha district in 2019. Preschoolers who completed third birthday and had not completed fifth birthday on the day of data collection were selected. The dependent variable was the presence (dmft ≥ 1) or absence (dmft = 0) of ECC. Independent variables were sex, monthly family income, mother’s educational and occupational status, child’s birth order, family type, frequency of consumption of sweets and sweetened drinks, time of sweet consumption during the last 24 h, toothbrushing frequency, supervision of toothbrushing, dental visit, and maternal dental caries. A pre-tested validated questionnaire was used. Multiple logistic regression analysis was used.ResultsTotal of 1038 preschoolers were selected. There were 529 females (51.0%) and 509 males (49.0%). The prevalence of ECC was 56.3% (95% CI: 53.1–59.3). Consuming sweets between meals had a higher odds ratio than consuming sweets after main meals (OR = 1.72, 95% CI:1.25–2.35), consumption of sweets every day had a higher odds ratio than consumption of sweets several times a week or less (OR = 2.89, 95% CI: 2.02–4.13), consumption of sweetened drinks every day had a higher odds ratio than consumption of sweetened drinks several times a week or less (OR = 1.73, 95% CI: 1.07–2.79), and the presence of maternal caries had a higher odds ratio than the absence of maternal caries (OR = 1.74, 95% CI: 1.12–2.69). The use of adult fluoridated toothpaste than not using adult fluoridated toothpaste (OR = 0.64, 95% CI:0.48–0.85), tooth brushing twice per day than not brushing twice per day (OR = 0.67, 95% CI:0.51–0.89), and supervised toothbrushing than unsupervised toothbrushing (OR = 0.61, 95% CI: 0.41–0.93) was negatively associated with ECC.ConclusionsECC is highly associated with sweet consumption and oral hygiene behaviours among preschoolers in Gampaha District. Interventions should focus on the oral health behaviours of preschoolers to reduce ECC burden.

Barriers and Facilitators of Management of Type-1 Diabetes in Children: A Socio-Cultural Enquiry of Caregivers’ Perspectives Living in Resource-Constrained Settings

Purpose Caregivers are key stakeholders in management of children with Type 1 Diabetes (T1D), but their perspectives have remained understudied, especially in the developing countries. This study explores their perspectives on the barriers and facilitators of management of a child with T1D in a resource-constrained setting. Methods This qualitative study, conducted in a tertiary level diabetes clinic in India, included parents of children with T1D, selected from subgroups varying in disease duration, education, habitat, and socioeconomic status, who participated in one of the five Focused Group Discussions (FGDs) of 60–90 min duration. The topic guide included questions like "What are the barriers you face related to diabetes care of your child at home or school?" and "What do you think helps you in managing a child with diabetes?" FGDs were audio-recorded, transcribed verbatim, and inductive coding was done independently by two authors. Results Twenty-eight parents (nineteen mothers and nine fathers, mean age: 35.1 years) of children aged between 2–13 years, were recruited till data saturation. Themes related to barriers of management were, ‘balancing nutrition and glycemic control is challenging’, ‘diabetes management involves psychological burden’ and ‘operational challenges’. Parents opined that family support, gaining decision-making and problem-solving attitude and optimal school-time management helped. Conclusion Parents living in resource-constrained circumstances perceive unique challenges during management of T1D in their children like social stigma, illiteracy, financial and logistic issues like procuring and storing essential supplies. A better understanding of these factors can aid healthcare professionals in managing them.

Risk-enhancing factors and social determinants of health in risk assessment for atherosclerotic cardiovascular disease.

The Pooled Cohort Equations (PCEs) do not accurately estimate atherosclerotic cardiovascular disease (ASCVD) risk in certain populations. The 2018 AHA/ACC cholesterol guideline identified risk-enhancing factors as a supplement to PCEs-based risk assessment. However, the role of each risk-enhancing factor in ASCVD risk assessment has not been well quantified. Further, social determinants of health (SDOH) are not included in the PCEs nor considered as risk-enhancing factors in the US cholesterol guideline. We sought to evaluate ASCVD risk associated with each risk-enhancing factor and commonly collected SDOH including education, income, and employment status, and to assess if adding risk-enhancing factors and SDOH to the PCEs improve ASCVD risk prediction. We included individuals aged 40 to 75 years, without ASCVD or diabetes at baseline, and with low-density lipoprotein cholesterol 70-189 mg/dL from two contemporary prospective cohort studies (MESA and REGARDS) and from Kaiser Permanente Southern California (KPSC). The primary endpoint was incident ASCVD defined as nonfatal myocardial infarction, fatal coronary heart disease, or fatal or nonfatal stroke over a 10-year period (median follow-up 10 years). We used Cox proportional hazards models to estimate associations between risk-enhancing factors and SDOH with ASCVD. We also assessed changes in model performance after adding risk-enhancing factors and SDOH to the PCEs. We included 13,863 adults (mean age 60.7 years) from the prospective cohorts and 307,931 adults (mean age 54.8 years) from KPSC. Risk-enhancing factors including hypercholesterolemia, hypertriglyceridemia, metabolic syndrome, and chronic kidney disease were associated with a higher ASCVD risk, independent of 10-year risk estimated by the PCEs. Low education, low income, and unemployment were also associated with higher ASCVD risk. While adding individual risk-enhancing factors or SDOH to the PCEs had limited impact on model performance, adding multiple risk-enhancing factors and SDOH simultaneously led to modest improvements in discrimination (C-index increased by up to 0.07), calibration (integrated Brier score reduced by up to 2.3%), and net reclassification improvement up to 41.4%. These findings suggest including SDOH and risk-enhancing factors may improve ASCVD risk assessment.

Influence of Parents' Economic and Educational Status on Children's Learning

Influence of Parents' Economic and Educational Status on Children's Learning

The Attitudes of Households for Disaster Risk Management in Fogera, Estie and Ebenat Woredas

The underlining disaster risk management practice translates the combination of knowledge, attitude, and action to maximize the effectiveness of responses against disasters. While knowledge and disaster risk management activities move along simultaneously, attitudes are inherent to individuals posing challenges to easily identify issues and then taking extended time to change. Lack of scientific wisdom on the perception of individuals towards disaster management, and the limited understanding of different factors that influence attitudes, complicates the endeavor in response to the increasingly uncertain future. This study assesses the attitudes of households for disaster risk management in the nine kebeles, the lowest administrative unit in Ethiopia, and 32 villages in Fogera, Ebenat and Estie districts (Woredas, the main administrative unit similar to county). Cross-sectional quantitative method was employed, and attitudinal survey was conducted among 412 households selected through probability simple random sampling. Purposive nonprobability sampling technique was used to identify research kebeles based on disaster prevalence, and to collect supplementary attitudinal data from 64 participants representing academia and local stakeholders. Descriptive statistics and parametric test of variance and covariance have been conducted to determine the attitude levels and to assess major factors influencing households’ attitude for disaster risk management. Results indicated that most of the households (53%) have a fairly positive attitude. Households with negative (27%) and extremely negative (20%) perception are concentrated in rural kebeles that are highly affected by recurrent disasters. Therefore, households in disaster affected areas have negative and unconstructive perception for disaster risk management. This is mainly associated with lack of active community participation and ineffective risk management activities. Households’ attitude is also significantly affected by age (p = 0.0001), and within different age groups (p = 0.001), location by kebeles (p = 0.0237), education levels (p = 0.0016), education status (p = 0.004) and experience in indigenous risk management practices (p = 0.00001). In addition, this study revealed a linear relationship within all the identified factors and households’ attitude levels. Considering the situation in Ethiopia where individual perceptions are deeply rooted, coupled with the results of this study that revealed highly negative attitude among disaster affected households, it is recommended to consolidate efforts and influence attitude through maximizing community participation and enhancing the effectiveness of disaster management.

Food purchase and consumption behavior during the COVID-19 pandemic lockdown in Bangladesh: association between sociodemographic composition

BackgroundBangladesh suffered a severe COVID-19 wave from June to August 2021, which forced the government to impose emergency nationwide lockdown measures for three months with discontinuities. The sudden lockdown strongly affected the dietary preferences, financial circumstances, and social interactions of citizens.MethodsIn this comprehensive study, we collected sociodemographic information as well as data on food purchase and consumption behaviors from 1,350 adults in Bangladesh during the weeks of enforced confinement. The association between the sociodemographic factors (viz., gender, age, education status, income, occupation, and household size) and food purchase and consumption behaviors were determined by conducting bivariate and multivariate logistic regression models reporting as odds ratios.ResultsThe descriptive result reveals that 49.63% of the participants experienced wage reductions, with many people enduring reductions of up to 75%; 12.22% lost their jobs. Besides, a decline in the frequency of shopping was observed by 35.04%; and 24.52% avoided outdoor shopping during the pandemic period. Additionally, 28.74% of participants purchased less overall, while 19.48% purchased significantly fewer items per trip compared to the pre-pandemic period. The multivariate analysis shows a prominent increase in online grocery shopping (OR: 4.03, 95% CI: 2.38–6.83, p < 0.001) and meal delivery services (OR = 5.19, 95% CI = 3.21–7.17, p < 0.001) among higher educated individuals compared to the individuals having no institutional education. The personnel having formal jobs purchased 2.34 times more from online grocery sites (95% CI = 0.34–4.08, p = 0.003) compared to the unemployed one. In contrast, a notable increase in panic buying and stockpiling was observed, driven by scarcity and escalating prices of essential food items. The frequency of meals with families, active engagement in meal preparation, and the exploration of novel recipes also increased notably.ConclusionsThe consumption of takeaway food and inter-meal snacks increased significantly with the education level of individuals. These findings highlighted that a prolonged pandemic could magnify economic vulnerability in Bangladesh.

Unveiling Russian Language as a Propaganda Tool

The paper explores how the Russian language has been used as a propaganda tool by the Russian government since the Bolshevik takeover while shedding light on its status before the Russian Revolution. Through a critical analysis of numerous sources, including political speeches, media coverage, and cultural products, this paper examines how language has been used to shape public opinion and promote nationalistic ideals. The paper argues that the Russian language has been used as a powerful tool of propaganda in various ways, such as shaping national identity, creating a sense of pride in the country’s history and culture, and promoting a specific worldview. The paper also discusses the role of language in Russian propaganda efforts abroad, particularly in neighboring countries and regions by concentrating its focus on post-Soviet countries. Particular attention has been paid to the policy measures taken by the Communist governments of both Russia and Union Republics to propel the status of Russian as a lingua franca in the Soviet Union by presenting it as the language of education, culture, and high status. The paper concludes with a discussion of the potential consequences of the use of language as a propaganda tool, including the polarization of societies, the suppression of dissent, and the erosion of democratic values. It argues that a critical examination of the role of language in propaganda is essential for safeguarding the integrity of language and promoting open and democratic discourse.

An assessment of adequate quality antenatal care and its determinants in India

BackgroundAntenatal care (ANC) is an important component in the continuum of care. Providing adequate quality ANC is necessary to prevent maternal and newborn mortality. The coverage of ANC has increased significantly in the last decade in India, but a mere increase in coverage is insufficient if the issue of quality is not simultaneously addressed. This study examines the change in each component of quality ANC between 2015-16 and 2019-21, highlights the factors associated with adequate quality ANC, and observes the state- and district-level distribution of adequate quality ANC during 2019-21.MethodsThis study is based on data from the two most recent rounds of the National Family Health Survey (NFHS), the Indian equivalent of the Demographic and Health Surveys (DHS). These rounds were conducted in 2015-16 and 2019-21 in selected households of India with a total of 190,797 and 176,843 sampled births, respectively. The dependent variable was quality antenatal care, a composite variable consisting of skilled healthcare providers, timeliness, sufficiency, and appropriateness of content. The independent variables were mother’s age, education, wealth quintile, birth order, mass media exposure, health insurance coverage, relationship with the head of household, facility exposure, intended pregnancy, history of adverse pregnancy outcomes, and other socio-demographic variables. Change in each component and dimension of quality antenatal care was assessed using data from both rounds of the survey. A multivariate multinomial logistic regression analysis was employed to identify the determinants of adequate quality ANC using the NFHS-5 data.ResultsThe findings revealed that 32 per cent of mothers received adequate quality antenatal care in 2019–2021, an increase of only 9% points compared to the 2015-16 period. Two significant barriers to achieving adequate quality antenatal care, in terms of appropriateness of content, were the provision of Iron and Folic Acid (IFA) tablets and counselling. The highest utilisation of adequate quality antenatal care was observed in the southern states. The utilisation of quality ANC increased with an increase in women’s education and wealth status; and was more prevalent among those with health insurance coverage and exposure to mass media.ConclusionDespite some improvements in the coverage of antenatal care, the quality of antenatal care continues to be very low and needs urgent attention. Achieving quality antenatal care in both content and experience requires addressing service gaps and developing better measures to capture and improve women’s care experiences.

Parental acceptance of dental treatment with SDF in children with CP.

This study aims to evaluate parental acceptance of dental treatment with silver diamine fluoride (SDF) in children with cerebral palsy (CP). The present study is a case-control study with 80 children in the age range of 6-11 years. Group I consisted of children diagnosed with CP and Group II consisted of children without any Special Health Care Needs and systemic conditions. Preoperative and postoperative behavior assessment was done using Frankl's behavior Rating Scale. 38 % SDF application was done in any one primary molar with occlusal dentinal caries. A well-designed validated structured questionnaire with 10 questions was developed to assess the parental acceptance of dental treatment with SDF. The questionnaire comprised 10 close-ended questions with subdivisions on socio-demographic details, the reason for the previous and current dental visit, and acceptance of dental treatment with SDF. The data were analyzed using SPSS (version 26, IBM, Chicago, USA). Continuous variables were expressed as mean±standard deviation (M±SD). Categorical variables were expressed as frequency (n) and percentage (%). The chi-square test was used for qualitative analysis. The level of significance was set at 5%. The number of children showing positive behavior on Frankl's behavior Rating Scale increased from 55% to 70% after dental treatment with SDF and this difference was statistically significant in Group I (p-value<0.001). 87.5% of parents in Group I had accepted the discoloration caused after dental treatment with SDF compared to 80% in Group II. In Group I, 95% of parents agreed strongly, while in Group II, 82.5% agreed strongly that SDF can be done on un-cooperative and special health care needs children. This difference in agreement seen between parents of Group I and Group II was found to be statistically significant (p-value=0.02). Also, the acceptance of SDF was found to be higher in parents who were educationally more qualified in Group I. This difference in the acceptance level of SDF seen based on the educational status of parents was statistically significant (p-value<0.001). Parental acceptance of SDF for dental treatment was higher in Group I (children with CP) as a greater number of parents accepted dental treatment despite discoloration with the modality being noninvasive and less time-consuming. Improved behavior rating was observed among children in both groups after dental treatment with SDF.

Analysis of medication adherence of chronic hypertensive patients in Pakistani community via open survey method

Aim: Hypertension, a prevalent chronic condition, significantly contributes to cardiovascular diseases worldwide. Effective management of hypertension is highly dependent on patient adherence to prescribed medications, as the correct dose at the right time can lead to desirable therapeutic results. This study aims to analyze medication adherence among hypertensive patients in Islamabad and Rawalpindi through an open survey. Methods: A prospective cross-sectional study was conducted from 17th March 2024 to 30th May 2024, targeting hypertensive populations in Islamabad and Rawalpindi. 246 patients were recruited using a sample size formula, and a General Medication Adherence Scale (GMAS) questionnaire was used to collect data. All the tests were conducted as two-sided, with a significance level of P &lt; 0.05 using Python. Results: Among 246 participants (mean age 57.1 years), most were married, literate, and living with families, 63% were from Islamabad, and 78.9% were employed. The study found high adherence in behavior-related areas but low adherence due to costs. Gender showed a statistically significant correlation (P = 0.03) by independent t-test. At the same time, ANOVA tests revealed that educational level (P = 0.02), monthly income (P = 0.001), family support (P = 0.04), and medication costs (P = 0.001) significantly impacted adherence, while factors like social status, employment status, and smoking did not have a considerable influence. Conclusions: 72.4% of patients adhered to their prescribed therapy, and 27.6% did not highlight a critical issue that requires urgent intervention. Variables like gender, educational status, social status, occupation, and living with family are strongly associated with adherence. Common problems include taking multiple medications, lack of awareness about the importance of adherence, and financial constraints.

86 Sociodemographic and family characteristics of children with and without neurodevelopmental impairment in a Canadian cohort of extreme preterm children

Abstract Background Despite improved survival of extreme preterm infants (&amp;lt;29 weeks’ gestation), neurodevelopmental impairment (NDI) remains high. Certain sociodemographic characteristics (SDC) and limited family resources are known to adversely affect children health and development, particularly those born preterm. There is a dearth of recent data from large cohorts examining the impact of social determinants of health on the neurodevelopment of preterm children. Objectives (1) to describe SDC and family composition in a population-based cohort of extreme preterm children using the Canadian Neonatal Follow Up Network (CNFUN) database; (2) to develop a logistic regression model examining the association of significant NDI (sNDI any of: CP ≥ GMFCS stage 3, Bayley III &amp;lt; 70 in any domain, deafness requiring aids, or bilateral blindness) with SDC using a unique family descriptor. Design/Methods A retrospective review of a national cohort of extreme preterm infants (230 -286 weeks) born between April 2009 and December 2018. We included children who had neurodevelopmental assessment at 18-24 month corrected age at a CNFUN participating Centre. We compared SDC of infants and caregivers and family descriptors (moderating variables) between children with no NDI and those with any NDI and sNDI. Multivariate logistic regression models were developed in two steps to evaluate the effect of SDC (Model 1) and family composition (Model 2) on the primary outcome of sNDI. GEE was used to account for clustering by multiples and within site. Results Out of 10833 eligible infants, 6219 (57%) were included. Of those, 3412 (55%) had no NDI and 2807 (45%) had any NDI. sNDI accounted for 17% of the cohort and 37% of those with NDI. Comparison of the SDC and family descriptors between the three groups are shown in Table 1. On multivariate analysis using SDC, infant’s gestational age and male sex, and primary caregiver’s ethnicity and level of education were independently associated with sNDI. Immigration and employment status were associated with sNDI when family descriptors were added to the first model (Table 2). Conclusion In this national cohort, half of extreme preterm children developed NDI and 1 in 7 had sNDI. There were differences in sociodemographic and family characteristics between those with and without sNDI. The degree of prematurity and caregiver’s education, employment and immigration status were independently associated with sNDI in those children. Future research is needed to determine what interventions and support to benefit those children at risk.

Why do older adults stop cancer screening? Findings from the Medicare Current Beneficiary Survey.

Prostate and breast cancer screening are prevalent among older adults, even among those unlikely to benefit. We aimed to evaluate why older adults stop cancer screening, including the role of physician recommendations. We used nationally representative data from the 2019 Medicare Current Beneficiary Survey (MCBS). We included women aged 76 and older without a history of breast cancer and men aged 71 and older without a history of prostate cancer. The primary outcome was reason for discontinuing screening, categorized as follows: (1) physician recommendation against screening; (2) absence of a recommendation to screen; and (3) patient-driven reason, such as patient preferences or beliefs. We evaluated reasons for screening discontinuation by health status and educational attainment using age-stratified multinomial logistic regression. The sample included 7350 participants representing a weighted population of 22,498,715. Overall, 53% of women underwent screening mammography in the past year or intended to continue screening. Among those who stopped screening, 5% reported a recommendation to stop screening from their doctor, 48% reported no recommendation, and 32% reported a patient-driven reason for cessation. Findings did not differ by educational attainment or health status, including among the oldest patients. For men, 61% were screened with PSA in the past year or intended to continue. Among those who stopped, 3% reported a recommendation against screening, 54% reported no recommendation, and 27% reported a patient-driven reason for cessation. Men with higher educational attainment were more likely to report that their physician recommended against screening (4% vs. 1%, p = 0.01) and that their doctor did not recommend screening (58% vs. 47%, p = 0.01). Reasons for screening cessation did not differ by health status, including among the oldest patients. Cancer screening remains common, even among those with limited potential for benefit, but discussions around screening cessation are rare. Improving communication between patients and physicians may improve screening decision quality.

Slow and Steady or Fast and Furious: An Analysis of Completion Duration in open.uom.lk

The open.uom.lk platform is an open learning platform developed by the University of Moratuwa, Sri Lanka, offering free asynchronous online IT related courses. The platform was developed as an initiative to meet the growing human capital requirement of the IT industry in Sri Lanka, one of the only sectors showing strong growth even during the country’s recent economic crisis. In the two years since the release of its flagship course Trainee Full-Stack Developer, there have been over 270,000 enrolled learners. The course consists of six subjects covering Python programming, web design, and a professional practice module that includes a capstone project. Despite the massive number of enrollments, as in many other MOOCs, completion rates remain low. For instance, for the two beginner courses in programming and web design, into which all participants are enrolled automatically, completion rates stand at 7-10%. Completion rates for subsequent subjects are higher given that enrollment is conditional on completing prerequisites. From a planning perspective, it is not just estimates of how many participants complete the programs but also the time they take to do so that are integral for determining the future growth of the IT industry. As such, this study aims to develop a model for course completion using survival analysis which has the advantage of being able to model censored data (e.g. when duration is unknown due to non-completion) and provide forecasts of completion rates at different points in time. The analysis uses student activity completion reports and demographic information of participants including employment and educational background. The findings suggest that the course interaction variables, particularly the speed of completing early activities, are more important for predicting course completion than the demographic variables, though education and employment status are also significantly correlated with completion. The survival model could then be used for purposes of predicting both the completion probability as well as the timeframe within which the completion may be expected.

Male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia

Male involvement in infant care is an effective intervention to improve infant health outcomes. However, evidence regarding male involvement in infant care and its associated factors is limited in Ethiopia. To assess the male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia. A community-based cross-sectional study was conducted among 606 participants from April 1–30/2023. A systematic sampling technique was used to select each study participant. Data was collected using interviewer-administered questionnaires. Data were entered into Epi data 4.6 and analyzed using statistical Product Service and Solution (SPSS) version 2 5. Both descriptives, mean, frequency and analytical statistics were employed. Variables with a p-value of less than 0.25 in bivariate logistic regression were entered into a multivariate logistic regression to identify associated factors. Statistical significance was declared at p < 0.05. The prevalence of male involvement in infant care was 42.2% with a 95% CI (38.26–46.12). Male who did not attend formal education (AOR = 0.24, 95% CI = 0.14–0.43), having one child (AOR = 5.66, 95%CI = 2.94–10.88), having male infants (AOR = 2.51, 95% CI = 1.60–3.95), first infant order (AOR = 2.70, 95% CI = 1.36–5.39), having adequate knowledge towards infant care (AOR = 5.56,95% CI = 0.12–0.28), and having favorable attitude towards infant care (AOR = 1.70,95% CI = 0.34–0.99) were factors associated with male involvement in infant care. Less than 50% ( 50%) of males are involved in their infant care. Educational status of males, number of infants, male infants, male knowledge, and attitude towards infant care were significantly associated with involvement in infant care. Therefore, efforts should be directed at improving males’ educational status, knowledge, and attitude to improve their engagement in caring for their infants.

Prevalence of Hepatitis E Virus Infection among Blood Donors in a Tertiary Healthcare Facility in Osun State, Nigeria

Hepatitis E virus (HEV) is currently the most common cause of viral hepatitis in developing countries. While prospective blood donors are routinely screened for HIV, Hepatitis B and C globally in endemic areas, HEV is not included in the protocol, despite the increase in global prevalence of HEV. Till date, only a handful of studies exist on the prevalence of HEV in Nigeria. The aim of this study was to fill this knowledge gap by determining the prevalence of HEV among blood donors at the LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria. A total of 102 consenting individuals were enrolled into the study between ages 20 and 55. A volume of 5ml blood sample was collected, and the serum harvested, stored at 20°C until ready for analysis. A double antibody sandwich HEV ELISA was performed to analyze the sera in duplicate for HEV antigen, using an ELISA Kit. Of the 102 samples analyzed, 15 (14.7%) tested positive for HEV antigen, confirming the presence of HEV infection among blood donors in the study population. There was significant association between HEV seropositivity and contact with animals (P=0.010) and alcohol consumption (P=0.000), which means there was a higher chance of donors who consumed alcohol or have had contact with animals to get infected with HEV. However, age, educational status, occupation and gender did not show any statistically significant association with HEV infection. The prevalence of HEV seropositivity was high (14.7%) and a cause for concern as HEV continues to be a major public health issue especially in developing countries.