Effects Of Socioeconomic Status Research Articles

Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study

BackgroundPrevious research has shown that socioeconomic status (SES) is a strong predictor of chronic disease. However, to the best of our knowledge, there has been no studies of how SES affects the risk of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that has not been based upon self-reporting or retrospectively screening of symptoms. As far as we know, this is therefore the first study that isolate and describe socioeconomic determinants of ME/CFS and calculate how these factors relate to the risk of ME/CFS diagnosis by utilizing individual level registry data. This allows for objective operationalization of the ME/CFS population, and makes it possible to model SES affect the risk of ME/CFS diagnosis, relative to control groups.Data and methodsWe conduct a pooled cross-sectional analysis of registry data from all adult patients diagnosed with ME/CFS from 2016 to 2018 in Norway, coupled with socioeconomic data from statistics Norway from 2011 to 2018. We operationalize SES as household income and educational attainment fixed at the beginning of the study period. We compare the effects of SES on the risk of ME/CFS diagnosis to a population of chronically ill patients with hospital diagnoses that share clinical characteristics of ME/CFS and a healthy random sample of the Norwegian population. Our models are estimated by logistic regression analyses.ResultsWhen comparing the risk of ME/CFS diagnosis with a population consisting of people with four specific chronic diseases, we find that high educational attainment is associated with a 19% increase (OR: 1.19) in the risk of ME/CFS and that high household income is associated with a 17% decrease (OR:0.83) in risk of ME/CFS. In our second model we compare with a healthy population sample, and found that low educational attainment is associated with 69% decrease (OR:0.31) in the risk of ME/CFS and that low household income is associated with a 53% increase (OR: 1.53).ConclusionWe find statistically significant associations between SES and the risk of ME/CFS. However, our more detailed analyses shows that our findings vary according to which population we compare the ME/CFS patients with, and that the effect of SES is larger when comparing with a healthy population sample, as opposed to controls with selected hospital diagnoses.

Metacognition as a mediator of the relation between family SES and language and mathematical abilities in preschoolers

The effect of family socioeconomic status (SES) on academic achievement in literacy and numeracy has been extensively studied with educational inequalities already witnessed in preschoolers. This is presumably explained by the effect of family SES on cognitive and socioemotional abilities associated with academic achievement. Metacognition which refers to knowledge and regulation skills involving reflexivity about one's own cognitive processes is one of these abilities. However, most of the studies investigating the association between metacognition and academic achievement have focused on school-aged students and studies with younger students are only emerging. Meanwhile, the association between family SES and metacognition abilities has surprisingly received little attention regardless of participants’ age. The aim of this study was to explore the associations between family SES, metacognition, language and mathematical abilities in preschoolers aged 5 to 6. We provide the first evidence that the effect of family SES on preschoolers’ language and mathematical abilities is mediated by the effect of family SES on their metacognitive abilities. The implications for future research, education and policies aiming at reducing educational inequalities are discussed.

Longitudinal effects of socioeconomic status on first and second language reading development: evidence from Chinese children learning English

AbstractWhile it has been shown that socioeconomic status (SES) is important for children’s literacy development in their first language (L1), less is known about its association with reading in a second language (L2). The present study examined the different effects of SES on the acquisition of reading in Chinese as L1 and English as L2 from ages 7 to 11, among 291 Chinese children. The results showed that the contribution of SES to Chinese word reading was not significant. In contrast, SES significantly predicted English word reading. Mediation analyses revealed that SES had direct and indirect effects on English word reading, through phonological awareness and letter name knowledge, but only an indirect effect on Chinese word reading through phonological awareness and vocabulary knowledge. These findings highlight the importance of SES for reading acquisition in L2, and the influence of language-specific characteristics on the cognitive/linguistic skills required to master reading in a specific language.

The effect of childhood socioeconomic status on youth investment risk tolerance: Based on the life history theory perspective

This study based on the life history theory discusses how childhood socioeconomic status (SES)11Socioeconomic status is referred as SES hereafter. affects youth investment risk tolerance and proposes a moderated mediation model to examine the mediating role of life history strategies and the moderating effect of financial literacy. Based on a survey of Chinese youth, we found that childhood SES has a significant positive effect on youth investment risk tolerance and life history strategies mediate the relationship between childhood SES and investment risk tolerance. Furthermore, financial literacy not only moderates the positive relationship between childhood SES and investment risk tolerance but also moderates the indirect effect of childhood SES on investment risk tolerance through life history strategies. Specifically, the positive effect of childhood SES on investment risk tolerance through life history strategies is weakened in youth with greater financial literacy.

Age at peak height velocity in Polish adolescents: Effect of socioeconomic factors.

Age at peak height velocity (APHV) is an indicator of maturity timing which is applicable to both sexes, and which is influenced by environmental factors. The objective of this study was to assess variation in APHV associated with several indicators of socioeconomic status (SES) in a longitudinal sample of Polish adolescents. The sample included 739 boys born in 1983 and followed annually from 12 to 16 years, and 597 girls born in 1985 and followed annually from 9 to 13 years. The height records were fitted with the SITAR model to estimate APHV. SES was estimated using principal component analysis of indicators of familial status based on parental education, family size, living conditions and household possessions. Statistical analyses included analysis of variance (one-way for general SES and three-way for parental education and family size) and Tukey post-hoc tests for unequal samples. General SES (p <.001) and family size (p < .05) significantly influenced APHV among boys, while only maternal education (p < .05) significantly influenced APHV among girls. Among youth from families of higher SES, as defined by the respective indicators, APHV was attained significantly earlier, on average, than in peers from families of lower SES. Overall, the results showed a sex-dependent effect of SES on APHV, and highlighted the influence of favorable socioeconomic conditions for optimal growth and maturation during adolescence.

Gender and Socioeconomic Influences on Ten Pro-Environmental Behavior Intentions: A German Comparative Study

Pro-environmental behaviors (PEBs) such as climate-friendly mobility and eating habits hold great promise in terms of reducing greenhouse gas (GHG) emissions and, thus, are important goals for addressing climate change from a population perspective. Yet, sociodemographic correlates and differences in PEB intentions have to be considered in designing messages and behavior change interventions. This study implemented a quota-sampling survey (N = 979, 511 women, 468 men, age M = 50.4, SD = 17.2) of the German population and found that, overall, participants exhibit strong intentions to engage in various PEBs, with the exception of cycling and adopting a vegetarian diet. Moreover, women displayed higher intentions to engage in PEBs compared to men, particularly in adopting a vegetarian diet. The relationships between socioeconomic status (SES) and PEB intentions, as well as the combined effects of gender and SES, were inconsistent for different PEB intentions. We conclude that on a population level, intention-building interventions are necessary for vegetarianism and cycling, while for the other PEBs, interventions may focus on closing the intention–behavior gap. There is a need to further research the interplay of different PEBs in diverse groups and for interventional studies targeting the discrepancy in eating habits across genders.

English skills of Puerto Rican students: the effect of gender, SES and school socioeconomic composition

Abstract This study evaluates the effects of gender, socioeconomic status (SES), and school of origin on students’ language performance. We used data from the test Measurement and Evaluation for Educational Transformation (META, for its acronym in Spanish). We analyzed the results of 21,425 eleventh-grade students from 194 public schools in Puerto Rico. The results suggest that there is a significant relationship between students’ gender and their English skills. Female students achieved higher levels of language performance than male students. There was also a significant relationship between SES and language performance. Students with a more advantaged socioeconomic status showed better language outcomes than students from disadvantaged socioeconomic backgrounds. The socioeconomic composition of the school was found to play an important factor in the linguistic performance of students: a diverse socioeconomic composition is related to better school performance and the narrowing of language disparities. We propose that the composition of schools’ student bodies is a factor that educational linguistic policy makers in Puerto Rico should give more consideration to, as it could have a key role in ameliorating English language attainment and education in general in Puerto Rico’s public schools.

Life course socioeconomic status, chronic pain, and the mediating role of allostatic load: findings from the midlife in the United States.

Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear. This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (N=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis. Results indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136, P < 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP. The present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP.

Interplay of socioeconomic status, cognition, and school performance in the ABCD sample

Coming from a disadvantaged background can have negative impact on an individual’s educational trajectory. Some people however seem unaffected and cope well with the demands and challenges posed by school education, despite growing up in adverse conditions, a phenomenon termed academic resilience. While it is uncertain which underlying factors make some people more likely to circumvent unfavorable odds than others, both socioeconomic status (SES) and cognitive ability have robustly been linked to school performance. The objective of the present work is to investigate if individual cognitive abilities and SES interact in their effect on grades. For this purpose, we analyzed SES, cognitive, and school performance data from 5001 participants from the Adolescent Brain Cognitive Development (ABCD) Study. Ordinal logistic regression models suggest similar patterns of associations between three SES measures (parental education, income-to-needs ratio, and neighborhood deprivation) and grades at two timepoints, with no evidence for interaction effects between SES and time. Parental education and income-to-needs ratio were associated with grades at both timepoints, irrespective of whether cognitive abilities were modeled or not. Neighborhood deprivation, in contrast, was only a statistically significant predictor of reported grades when cognitive abilities were not factored in. Cognitive abilities interacted with parental education level, meaning that they could be a safeguard against effects of SES on school performance.

Impact of Race, Socioeconomic Status, and Geography on Healthcare Outcomes for Children With Sickle Cell Disease in the United States: A Scoping Review.

A large proportionof patients with sickle cell disease (SCD) identify as Black or African American (AA). Social bias and stigma in healthcare outcomes for children with SCD are impossible to explore without considering the impact of racial/cultural identity, socioeconomic status (SES), and geography. It is important to understand the current influences of social movements, expanded health insurance coverage, and telehealth on these variables when considering healthcare outcomes for patients with SCD. The objective of this study was to determine the roles of racial identity, SES, and geography in healthcare outcomes for the pediatric population of children with SCD in the United States (US). This study is a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases utilized included Cochrane, CINHAL, Medline, and Nursing and Allied Health Collection, all accessed through the EBSCO Information Services. Studies met the following inclusion criteria: published in English, pediatric patients residing in the US, and published between 2017 and 2022. Search terms included "sickle cell" AND "pediatric", which were then combined with "minority" OR "racial" OR "rural" OR "urban" OR "poverty" OR "income" OR "socioeconomic status". The initial search yielded 635 unique articles, with 17 articles meeting full inclusion criteria. Overall, it was clear that there are examples of positive effects of race, low SES, and rural geographic location on positive health outcomes, though a large number of studies oscillated between showing negative associations or no association at all. Barriers to care for patients with SCD are multifaceted, making it difficult to isolate and analyze the impact of individual variables. Many studies demonstrated the significance of family, community, and institutional relationships as positive support for patients with SCD. This review highlights the need for additional research on the healthcare outcome benefits of patient/familial support groups aiming to bring together patients who share racial experience and SCD diagnosis regardless of SES and geography.

The Impact of Morphological Intervention on Literacy Knowledge and Reading Motivation: A Cluster-Randomized Comparison Trial in Diverse Socioeconomic Status Kindergartens.

This study investigated the effectiveness of a storytelling-based morphological intervention program on the language and literacy knowledge and reading motivation of kindergarten children from low and mid socioeconomic status (SES) backgrounds. It also explored how these groups compared in change scores against a non-intervened high SES group. Employing a cluster randomization approach, this study included 158 kindergarten children, comprising intervention and comparison groups from low and mid SES backgrounds, as well as a non-intervened high SES group. Assessments were conducted on morphological awareness (MA), print concepts, vocabulary, and reading motivation. Children in the intervention groups showed better performance in MA and print concept scores than those in their respective comparison groups. The mid SES intervention group also displayed significant improvement in vocabulary and motivation scores compared to its counterpart. When examining the effects of SES on change scores, the low SES intervention group achieved superior results in vocabulary and print concept scores compared to both the mid SES intervention and the non-intervened high SES groups. For reading motivation, the mid SES group outperformed the low SES group. The morphological intervention program using storytelling positively impacts both the literacy skills and reading motivation of kindergarten children, especially those from low and mid SES backgrounds. This study emphasizes the significance of designing interventions that cater to the distinct educational needs of children from different SES backgrounds.

Socioeconomic status is associated with pediatric adenotonsillectomy outcomes: A single institution study

ObjectiveOur institution serves a diverse patient population across a large metropolitan city. Literature has shown pediatric otolaryngology patients with lower socioeconomic status (SES) have higher rates of sleep-disordered breathing, delays in treatment time, and greater risks of complications post-tonsillectomy. This study aims to examine the effects of SES on adenotonsillectomy outcomes performed at our institution. Study designA retrospective chart review including 1560 pediatric patients (ages 0–18) who underwent adenotonsillectomy between January 2015 and December 2020. SettingLarge metropolitan hospital, level 1 trauma center. MethodsOutcome variables included postoperative hospital admission, phone calls, 30-day follow-up, and persistent obstructive sleep apnea (OSA). Descriptive statistics using Wilcoxon Signed Rank Tests and univariate and multivariate logistic regression modeling were used to determine statistically significant covariates at α = 0.05. ResultsThe cohort included Non-Hispanic White (n = 488, 31 %), Non-Hispanic Black (n = 801, 51 %), Hispanic (n = 210, 13 %), and other (n = 61, 4 %) groups. Using multivariate regression, privately insured patients were less likely to have moderate-to-severe OSA before surgery (0.65 95 % CI 0.45, 0.93 p = 0.017) and be admitted postoperatively (0.73, 0.55–0.96, p < 0.01), while more likely to have postoperative follow-up phone calls (1.57, 1.19–2.09, p < 0.01) and visits (1.53, 1.22–1.92, p < 0.01). Increased income was associated with decreased rehospitalizations within three months of surgery (0.98, 0.97–1.00, p < 0.01). ConclusionThis study suggests SES significantly affects adenotonsillectomy outcomes. Further studies are warranted to provide better care for all pediatric patients.

The Relationship between Socioeconomic Status and Academic Achievement is Mediated and Moderated by Executive Functions.

Executive function is an underlying mechanism linking family socioeconomic status (SES) and academic achievement. Previous studies mainly investigated either the mediating or moderating role of executive function within this relationship, which either overlook the individual differences that are independent of the environment or neglect the influence of the environment on shaping personal factors. To avoid a piecemeal approach to theory, the current study aimed to test the mediating and moderating roles of executive function in a single analytic model. Two hundred and thirty-six Chinese fifth graders (Mage = 10.70 years, SD = 0.49, range = 10.23-11.75 years, and 40.30% girls) were recruited. Their executive function performance was measured using eight different tasks, and their Chinese literacy skills and mathematics achievement were assessed by routine school evaluations. One year after the initial assessment, children's academic achievements were evaluated again. Results demonstrated that parental SES positively predicted children's academic achievement when controlling for prior academic achievement, and children's executive function mediated this relationship. Also, executive function moderated the association between SES and academic achievement in that, the negative predictive effect of low SES on academic achievement was only significant for children with lower levels of executive function, which is not shown in children with higher levels of executive function. By demonstrating the dual roles of executive function in the SES-achievement link, this work provides evidence for supporting the optimal development of children from diverse socioeconomic backgrounds and emphasizes the significance of developing individualized intervention strategies on executive function to mitigate the negative effect of low SES on children's academic achievement.

Investigating the individual and joint effects of socioeconomic status and lifestyle factors on mild cognitive impairment in older Italians living independently in the community: results from the NutBrain study

ObjectivesDespite extensive research, a clear understanding of the role of the interaction between lifestyle and socioeconomic status (SES) on cognitive health is still lacking. We investigated the joint association of socioeconomic factors in early to midlife and lifestyle in later life and Mild Cognitive Impairment (MCI). DesignObservational cross-sectional study. SettingNutBrain study in northern Italy. Participants773 community-dwelling adults aged 65 years and older (73.2 ± 6.0 SD, 58.6% females) participating in the NutBrain study (2019–2023). MeasurementsThree SES indicators (home ownership, educational level, occupation) and five lifestyle factors (adherence to Mediterranean diet, physical activity, smoking habits, social network, leisure activities) were selected. Each factor was scored and summed to calculate SES and healthy lifestyle scores; their joint effect was also examined. The association with MCI was assessed by logistic regression controlling for potential confounders. Sex-stratified analysis was performed. ResultsIn total, 24% of the subjects had MCI. The multivariable logistic model showed that a high SES and a high lifestyle score were associated with 81.8% (OR0.182; 95%CI 0.095−0.351), and 44.1% (OR0.559; 95%CI 0.323−0.968) lower odds of having MCI, respectively. When examining the joint effect of SES and lifestyle factors, the cognitive benefits of a healthy lifestyle were most pronounced in participants with low SES. A healthier lifestyle score was found to be significantly associated with lower odds of MCI, only in females. ConclusionsAccording to our findings, SES was positively associated with preserved cognitive function, highlighting the importance of active lifestyles in reducing socioeconomic health inequalities, particularly among those with a relatively low SES. Trial registrationTrial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

The Urban-Rural Heterogeneous Effect of Family SES on Achievement: The Mediating Role of Culture.

Previous studies have fully discussed the relationship between family socioeconomic status (SES) and achievement, but few of them regarded urban-rural differences as the moderating factor, which is an essential issue in urban-rural educational equalization in terms of educational outcomes. This study discusses the urban-rural heterogeneous effect of family SES on achievement and manifests the mediating role of education-related cultural factors. Based on the China Education Panel Survey data of 18,672 junior high school students, this study found the following: (1) family SES had a weaker positive effect among rural children than among urban children; (2) the urban-rural heterogeneous effect could be mediated by education-related cultural factors, i.e., learning environments and beliefs; and (3) in this regard, contemporary China is experiencing cultural reproduction rather than a cultural mobility mode. In Conclusion, although the urban-rural achievement gap will be maintained or even expanded in China, improving rural children's learning environments and beliefs opens up the possibility of alleviating disadvantages in achievement resulting from family socioeconomic disadvantages. Therefore, narrowing down the urban-rural achievement gap from a cultural perspective provides policy implications for educational development in rural areas.

Effects of socioeconomic status and greenspace on respiratory emergency department visits under short-term temperature variations: An age-stratified case time-series study

IntroductionNeighborhood socioeconomic status (SES) and greenspace can affect respiratory health. However, it is unclear whether effects of neighborhood SES and greenspace on respiratory health still exist regardless of temperature variations. MethodsThis paper conducted a two-stage, age-stratified case time-series study. The first goal is to examine the associations between two temperature metrics (daily mean temperature [DMT] and diurnal temperature range [DTR]) and respiratory emergency department (ED) visits among four age groups in New York City. The second goal is to evaluate whether neighborhood SES and greenspace would be determinants of respiratory ED visits independent from temperature varying factors. A distributed lag nonlinear model was applied on ED data from 135 zip codes (October 2016 - February 2020). ResultsOur first-stage analysis indicated that older adults aged 65+ had higher risk of ED visits (RR=2.78, 95% eCI: 2.41, 3.22; with 7 days of lag) on days with low DMT (-10°C), followed by adults aged 18-64 (RR=2.48, 95% eCI: 2.32, 2.65), children and youth aged 5-17 (RR=1.38, 95% eCI: 1.24, 1.53), and young children aged 0-4 (RR=1.04, 95% eCI: 0.96, 1.13). However, no excess respiratory ED visits were observed on days with high DMT (30°C). Higher DTR was associated with higher risk, with children and youth more susceptible when DTR was high (DTR 20°C; RR=5.70, 95% eCI: 3.42, 9.49; with 7 days of lag). The second-stage analysis indicated neighborhood SES and greenspace had significant associations with respiratory ED visits regardless of temperature variations. Specifically, Higher income and greenspace exposure were negatively associated with ED visits among all age groups. ConclusionsNeighborhood SES and greenspace could affect respiratory morbidity regardless of weather conditions. Daily temperature variations accelerated the short-term risk among population subgroups under different weather conditions (e.g., higher risk of days with low DMT among older adults, higher risk of days with high DTR among children and youth aged 5-17), which could create co-effects with neighborhood SES and greenspace on respiratory health.

How are socioeconomic inequalities in preterm birth explained by maternal smoking and maternal body mass index: A mediation analysis.

Preterm birth affects between 7% and 8% of births in the UK and is a leading cause of infant mortality and childhood disability. Prevalence of preterm birth has been shown to have significant and consistent socioeconomic inequalities. To estimate how much of the association between socioeconomic status (SES) and gestational age at birth is mediated by maternal smoking status and maternal body mass index (BMI). Retrospective cohort study of a maternity hospital in the UK. The analysis included all singleton live births between April 2009 and March 2020 to mothers 18 years old and over, between 22 weeks and 43 weeks gestation. We estimate two measures of mediation for four low gestational age categories: (i) The proportion eliminated the percentage of the effect of SES on low gestational age at birth that would be eliminated by removing the mediators, through the Controlled Direct Effects estimated using serial log-binomial regressions; and (ii) The proportion mediated is the percentage of the effect removed by equalising the distribution of the mediators across socioeconomic groups, estimated using Interventional Disparity Measures calculated through Monte Carlo simulations. Overall, 81,219 births were included, with 63.7% low SES. The risk of extremely (0.3% of all births), very (0.7%) and moderately preterm birth (6.3%) was 1.71 (95% Confidence Interval [CI] 1.29, 2.31), 1.43 (95% CI 1.18, 1.73) and 1.26 (95% CI 1.19, 1.34) times higher in the low SES, compared to higher SES respectively. The proportion of this inequality eliminated by removing both maternal smoking and BMI was 43.4% for moderately preterm births. The proportion mediated for smoking was 33.9%, 43.0% and 48.4% respectively. Smoking during pregnancy is a key mediator of inequalities in preterm birth, representing an area for local action to reduce social inequalities in preterm birth.

Positive math attitudes are associated with greater frontal activation among children from higher socio-economic status families

Math learning is explained by the interaction between cognitive, affective, and social factors. However, studies rarely investigate how these factors interact with one another to explain math performance. This study aims to fill this gap in the literature by using functional magnetic resonance imaging (fMRI) to understand the neurocognitive mechanisms underlying the interaction between parental socioeconomic status (SES) and children's math attitudes. To this aim, 57 children solved multiplication problems inside the scanner. We measured parental SES by creating two groups based on parents' occupations and measured children's math attitudes using a questionnaire. We ran a cluster-wise regression analysis examining the interaction between these two variables while controlling for the main effects of SES, math attitudes, and full IQ. The analysis revealed a cluster in the left inferior frontal gyrus (IFG), which was due to children with positive math attitudes from high socio-economic status families showing greater IFG activation when solving large multiplication problems as compared to their negative attitudes high SES peers, suggesting that they exhibited more retrieval effort to solve large multiplication problems. We discuss how this may be because they were the only ones who fully engaged in math opportunities provided by their environment.

Socioeconomic status as a predictor of post-operative mortality and outcomes in carotid artery stenting vs. carotid endarterectomy.

The association between low socioeconomic status (SES) and worse surgical outcomes has become an emerging area of interest. Literature has demonstrated that carotid artery stenting (CAS) poses greater risk of postoperative complications, particularly stroke, than carotid endarterectomy (CEA). This study aims to compare the impact of low SES on patients undergoing CAS vs. CEA. The National Inpatient Sample (NIS) was queried for patients undergoing CAS and CEA from 2010 to 2015. Patients were stratified by highest and lowest median income quartiles by zip code and compared through demographics, hospital characteristics, and comorbidities defined by the Charlson Comorbidity Index (CCI). Primary outcome was in-hospital mortality. Secondary outcomes included acute kidney injury (AKI), post-operative stroke, sepsis, and bleeding requiring reoperation.Multivariable logistic regression was used to determine the effect of SES on outcomes. Five thousand four hundred twenty-five patients underwent CAS (Low SES: 3,516 (64.8%); High SES: 1,909 (35.2%) and 38,399 patients underwent CEA (Low SES: 22,852 (59.5%); High SES: 15,547 (40.5%). Low SES was a significant independent predictor of mortality [OR = 2.07 (1.25-3.53); p = 0.005] for CEA patients, but not for CAS patients [OR = 1.21 (CI 0.51-2.30); p = 0.68]. Stroke was strongly associated with low SES, CEA patients (Low SES = 1.5% vs. High SES = 1.2%; p = 0.03), while bleeding was with high SES, CAS patients (Low SES = 5.3% vs. High SES = 7.1%; p = 0.01). CCI was a strong predictor of mortality for both procedures [CAS: OR1.45 (1.17-1.80); p < 0.001. CEA: OR1.60 (1.45-1.77); p < 0.001]. Advanced age was a predictor of mortality post-CEA [OR = 1.03 (1.01-1.06); p = 0.01]. While not statistically significant, advanced age and increased mortality trended towards a positive association in CAS [OR = 1.05 (1.00-1.10); p = 0.05]. Low SES is a significant independent predictor of post-operative mortality in patients who underwent CEA, but not CAS. CEA is also associated with higher incidence of stroke in low SES patients. Findings demonstrate the impact of SES on outcomes for patients undergoing carotid revascularization procedures. Prospective studies are warranted to further evaluate this disparity.

Foreign language learning motivation and the socioeconomic status of Czech lower secondary students: An analysis of mediating factors

The relationship between socioeconomic status (SES) and students’ English as a foreign language (EFL) learning motivation is an under-researched topic. However, with growing concerns about how SES affects students’ academic behaviors and educational outcomes, an investigation of this topic is needed. Applying the L2 motivational self-system theory, we explore, on a sample of 664 Czech lower secondary students, the effect of SES on students’ EFL learning motivation and examine whether this effect can be explained by students’ attendance at elite schools and their families’ use of English while traveling abroad. Structural equation modeling was used to analyze the data. The findings suggest that SES plays an important role in both students’ L2 learning experience and ideal L2 self. We found that children of parents with higher SES levels are more likely to attend elite schools and experience trips abroad with their family where English is used to communicate, which can largely explain the effect of SES on students’ L2 learning experience and L2 ideal self. Future research into the factors that contribute to language learning motivation among students from different SES levels could further shed light on how the motivation gap can be closed.