Higher Income Research Articles

Investigating knowledge and attitudes toward genetic testing and counseling among palestinians

Genetic testing is important in the diagnosis of genetic disorders. Genetic counseling integrates the interpretation of the results of genetic testing to reach informed decisions concerning genetic disorders. Palestine has an increased incidence of genetic disorders primarily due to the continued practice of consanguineous marriage. Nevertheless, limited research has been conducted to explore public awareness regarding genetic testing and genetic counseling. The current study aimed to assess the public knowledge, attitudes, and practices of Palestinians toward genetic testing and genetic counseling. A cross-sectional study was performed using an online questionnaire that gathered information from Palestinians whose ages were 18 years or older between April and July 2024. The questionnaire gathered demographic information about the participants and assessed their genetic test usage patterns and their knowledge, practices, and attitudes toward genetic testing and counseling. A total of 1056 participants (408 males and 648 females) completed the questionnaire. The mean age of participants was 31.18 years. Sixty-seven point 6% of the participants reported their knowledge about the term genetic testing; however, only 35.5% of them knew the term genetic counseling. Knowledge of genetic testing was significantly associated with younger ages, higher levels of education, and higher income (p < 0.05). Knowledge of genetic counseling was significantly associated with higher income and was more familiar among married participants and those who underwent routine check-ups. Only 9% indicated that they underwent genetic testing which was higher among older ages, married participants, among those undergoing routine check-ups, and among participants who had hereditary disorders in their families. Among the 95 participants who had genetic tests, 52.6% of them performed it for marriage. Other reasons for undergoing genetic testing were diagnosis (22.1%), followed by carrier testing (17.9%), and predictive and pre-symptomatic testing (10.5%). Sixty-point-6% of respondents reported they would like to perform genetic testing as a predictive test for cancer risk. Participants with higher levels of education were more likely to perform cancer-predictive genetic testing (p < 0.05). Participants who were undergoing routine check-ups, those who had reported their health status as poor, and those who had hereditary disorders in their families were more likely to perform predictive cancer genetic testing. In conclusion, there is insufficient knowledge about genetic counseling among Palestinians. Despite the relatively good knowledge of genetic testing, this has not translated into appropriate practice. Genetic testing is still not widely practiced and the most common for performing it is pre-marriage testing rather than medical reasons. It is strongly recommended to increase awareness about genetic testing and genetic counseling among Palestinians. In particular, these programs should be directed toward people with lower levels of education, and toward families with a high degree of consanguinity and consequently a high incidence of genetic disorders.

Are Soft Skills Enough? Experimental Evidence on Skill Complementarity for College Graduates

The authors study how complementarities in skill may affect the returns to vocational training using a randomized controlled trial in Cairo, Egypt. Participants, who were college-educated, were given either a four-week training in soft skills (e.g., grooming, time management), technical skills (e.g., Microsoft programs, English language), or a mix of the two (half of each). Findings show large differences in outcomes between the three treatments. The technical and mixed treatments do best in the short term, raising first-job income by about 15%, relative to the soft skill treatment. In the longer term, the mixed-skill treatment significantly outperforms the other two treatments, giving participants 20–27% higher income. The high returns for this group may come from increased access to jobs that require speaking English, which may be at higher-quality employers. Overall, the results suggest that curriculum details play an important role in the outcomes of vocational training programs and that leveraging skill complementarity can yield tangible benefits.

Athletes’ Education for Their Successful Future Career After Sports—Perspective of Former Athletes and Potential Employers

Although sports are a dream career for many young people, only a small percentage of athletes can make a living from this. Moreover, even elite athletes with high incomes must find other employment after sports. This justifies the development of their human capital via education valued by employers. Our article originally approaches this issue with recommendations for the effective education of athletes. The aim is to identify and analyze the key skills that former athletes use in the work environment and that help them successfully integrate into employment outside sports. Our robust scientific approach, described in the methodology, combines relevant secondary and primary data and corresponding analytical methods. The secondary data analysis identified the skills required by employers as well as the employment of former athletes in areas outside of sports. Based on quantitative primary data (questionnaire on a sample of 237 young athletes), the skills perceived as important by young athletes were revealed. The qualitative component is represented by interviews with selected former athletes and employers from the corporate environment. The main findings include the alignment of the perceived importance of certain skills by young athletes and employers. The high perceived importance of education during sports careers was supported by all stakeholders.

Willingness to pay for green buildings post COVID-19 pandemic outbreak: differences between high- and low-income areas and high- and low-price settlements

This paper examines whether city residents’ willingness to pay (WTP) for green buildings changed after the outbreak of the COVID-19 pandemic. It aims to provide evidence showing whether COVID-19 affected people’s residential choices. Based on past literature, this paper proposes that the pandemic’s impact on the demand for green buildings may have two different directions: the effect of increasing demand for physical and mental health and the effect of decreasing income. This paper further infers that in areas with higher incomes and properties with higher total prices, the effect of increasing demand for physical and mental health will be more significant, making green premiums more likely to appear in these markets. Data from Taiwan’s largest metropolitan area, Taipei City, is used to verify these inferences. Based on the estimation results of different income and housing price regions, the study finds regional differences in the impact of the pandemic on the WTP for green buildings, which supports the inferences of this paper. Although opportunities for greener construction industries and green recovery have emerged, the results of this paper also imply that the greener effect caused by COVID-19 might be less significant in areas with lower incomes and housing prices. It is suggested that the government invest more in green construction in these areas to balance the green differences between housing markets in the city.

Risk factors for mortality and financial burdens in patients with colon cancer.

300 Background: Colon cancer remains one of the most common cancers of the digestive system and continues to rank high among the leading causes of cancer-related deaths, despite the increased prevalence of screening. In this study, we aimed to investigate risk factors for mortality and health care costs in hospitalized patients diagnosed with colon cancer. Methods: Patients admitted to the hospital in 2019 and 2020 were identified using the Nationwide Inpatient Sample database and categorized into two groups based on the presence of colon cancer (with relevant ICD-10 codes). To account for confounding factors, multivariate regression analysis was applied to calculate mortality. Statistical analyses were conducted to assess mortality rates, length of stay, and hospital charges. Results: A total of 169,805 patients were admitted with a primary diagnosis of colon cancer, with a mean age of 67.6 years. The majority were White (69.9%), and 50.2% were male. Age over 60 (OR: 1.67, p &lt; 0.001) and sepsis (OR: 16.01, p &lt; 0.001) were associated with increased in-hospital mortality among colon cancer patients, while higher household income (76th to 100th percentile, OR: 0.71, p = 0.011) and treatment at an urban teaching facility (OR: 0.54, p &lt; 0.001) were linked to a lower risk of in-hospital mortality. Female gender (OR: 0.88, p = 0.080) and having inflammatory bowel disease (OR: 0.67, p = 0.055) did not significantly affect in-hospital mortality, nor did Black race (OR: 1.1, p = 0.348) or Hispanic race (OR: 1.15, p = 0.287) compared to White patients. Sepsis (+11.8 days, p&lt;0.001; +$192,699, p&lt; 0.001), age over 60 (+0.99 days, p&lt;0.001; +$6,134, p&lt;0.001), and care at urban teaching hospitals (+0.54 days, p&lt; 0.001; +$32,230, p&lt; 0.001) were associated with longer hospital stays and higher total charges. Conversely, female gender (-0.21 days, p=0.001; -$5,529, p&lt;0.001) and higher income (-0.69 days, p&lt;0.001; -$1,565, p=0.466) were linked to shorter hospital stays and lower total charges. Conclusions: Early recognition of sepsis in colon cancer patients could potentially reduce in-hospital mortality rates, as well as significantly decrease costs and length of stay. The higher mortality rates observed in patients with sepsis may be attributed to the immunocompromised state associated with cancer. Implementing targeted interventions to address the higher risks in older patients and those with sepsis could improve outcomes and reduce the overall burden of colon cancer-related hospitalizations. Impact of patient demographics, socioeconomic factors, and clinical conditions on mortality, length of hospital stay, and total hospital charges. Data Mortality Length of Hospital stay Total Charge Age&gt;60 1.67 (p&lt; 0.001) 0.99 days, p&lt;0.001 $6428, p&lt; 0.001 Race (Hispanic compared to White race) 1.15 (p=0.287) 0.38 days, p= 0.004 $14,127, p&lt;0.001 Race (Black compared to White race) 1.1 (p=0.348) 1.4 days, p&lt; 0.001 $5370, p=0.002 Female gender 0.88 (p=0.08) -0.21 days, p= 0.001 -$5529, p&lt; 0.001 High house hold income 0.71 (p= 0.011) -0.69 days, p&lt;0.001 -$1565, p= 0.466 Treatment at urban teaching facility 0.54 (p&lt;0.001 0.54 days, p&lt;0.001 $32230, p&lt; 0.001 Sepsis 16.01 (p&lt;0.001) 11.8 days, p&lt;0.001 $192699, p&lt; 0.001 IBD 1.05 (p=0.888) 0.67 days, p=0.055 $5348, p=0.293

Tooth loss explains income inequalities in dementia.

Socioeconomic inequalities in oral health and dementia exist worldwide. This study investigated the mediating effects of tooth loss on the association between income and dementia. This study used data from the Japan Gerontological Evaluation Study, which targeted people aged ≥65 years. The explanatory variable was equivalent income in 2010. The outcome variable was dementia incidence between 2010 and 2022. Cox proportional hazard regression was used to examine the association between income and dementia incidence, adjusting for confounders. We performed causal mediation analyses to evaluate the extent to which the number of natural teeth mediates the association. Among the 21,306 participants, the mean age was 73.4 years, and 53.5 % were females. The cumulative incidence of dementia was 19.7 % for people with higher incomes and 24.0 % for those with lower incomes. People with lower incomes had fewer teeth (the prevalence of having ≥20 teeth: 42.2 % in higher incomes and 31.1 % in lower incomes). Lower income was associated with dementia after adjusting for confounders (Hazard ratio (HR) [95 % confidence interval (CI)]: 1.18 [1.10; 1.26]), which was partially attenuated by controlling for the number of teeth (HR [95 % CI]: 1.17 [1.09; 1.25]). Causal mediation analysis demonstrated that the proportion mediated by the number of teeth was 6.6 %. Our study found that tooth loss partially mediated the association between income and dementia. Preventing tooth loss appears to reduce inequalities in dementia among older people. Tooth loss has mediating effects on the association between income and dementia. Strategies for maintaining natural teeth seem effective in reducing the socioeconomic inequalities of dementia.

Abstract WP257: Persistent Racial Disparity Despite Higher Income in Odds of Receiving Mechanical Thrombectomy and Thrombolysis for Acute Ischemic Stroke Admissions 2006-2021

Abstract WP257: Persistent Racial Disparity Despite Higher Income in Odds of Receiving Mechanical Thrombectomy and Thrombolysis for Acute Ischemic Stroke Admissions 2006-2021

Telemedicine in Coeliac Disease: In-Person Appointments Are Favoured by Patients With a Lower Education Attainment and Lower Household Income.

A gluten-free (GF) diet, the only treatment for people living with coeliac disease (CD), is challenging, and international guidelines highlight the valuable role of healthcare professionals in enabling self-management. The study aimed to explore the acceptability of telephone and online video consultations for adults with CD. A cross-sectional study consisting of an online and paper survey was promoted to adults with CD. Data from 496 adults with CD (87% female, 96% White) are presented, and 44% were adhering to the GF diet. Over half (58%) were very confident in understanding food labels from supermarkets, whereas only 38% were very confident when shopping online. The largest proportion of patients preferred in-person healthcare appointments for CD (44%), with 20% reporting no preference and 21% preferring telephone appointments. Only 15% preferred online video consultations; of these, 97% were confident with online technology. A higher proportion of patients from a lower household income requested 'in-person' appointments compared with those with a higher income (65% vs. 45% (p < 0.01)). Likewise, 58% of patients without a degree qualification requested 'in-person' appointments compared with 45% of degree-educated patients (p = 0.027). We highlight a significant proportion of adults with CD prefer an in-person appointment. The paper survey enabled the views of a broader range of digitally confident patients to contribute to the study. With a global shift towards telemedicine and online resources, access and digital literacy is an important consideration for equitable healthcare to optimize patient self-management of the GF diet.

EHealth, digital information and technology use of men with prostate cancer.

The investigation of digital information sources and technologies specifically used by men with prostate cancer is scarce. This study seeks to address current gaps in the literature by investigating prostate cancer-specific internet and technology use by men with prostate cancer and factors associated with this use. Cross-sectional surveys were conducted in three Australian urology clinics (local in Sydney, Western Sydney and Murrumbidgee) in 2023. Data analysis included descriptive and bivariate analysis. Chi square tests of independence, Mann-Whitney U tests and Fischer exact tests were used to assess demographic, prostate cancer-specific and psychometric variables with prostate cancer-specific usage of each website, social media and technology type. A total of 349 men responded. Mean age of respondents was 69.6 years (SD 7.8). 74.5% (n = 260) had undergone radical prostatectomy, while 10% (n = 35) reported locally advanced/metastatic disease. Information websites were used by 77.7% (n = 271) of men. Social media was used by 37% (n = 129), and total internet use was 79.1% (n = 276). Younger age, higher education and higher income were commonly associated with a greater extent of use of information source and technology types. High variability in usage and factor association was demonstrated between and within analysed group categories. Men with prostate cancer use a broad variety of digital information sources and technologies to access prostate cancer information at a higher rate than ever before. This work stresses the significant variability in the extent of use which men demonstrate among these resources and the factors which may play a role in this behaviour.

Incidence, case fatality, and functional outcome of intracerebral haemorrhage, according to age, sex, and country income level: a systematic review and meta-analysis

Intracerebral haemorrhage (ICH) accounts for approximately 28% of all strokes worldwide. ICH has a high case fatality, and only few survivors recover to independent living. Over the past decades, demographic changes, and changes in prevalence and management of risk factors may have influenced incidence. Widespread implementation of stroke units and improved care in general may have affected case fatality and outcome. We aimed to update the evidence on incidence, case fatality, and functional outcome of ICH, according to age, sex, and country income level. We systematically searched PubMed and Embase from 2008 to April 2023 for prospective population-based studies on incidence, case fatality, or functional outcome of first-ever ICH. We excluded studies in which less than 80% of cases was confirmed with imaging or autopsy. Quality of the studies was assessed based on the used case finding methods. We used inverse variance-based random-effects meta-analyses to pool the crude incidence, case fatality at 1 month, and the percentage of patients with good functional outcome after 3, 6, or 12 months, as defined by the authors of the individual studies. Time trends were assessed using weighted linear meta-regression. Funnel plots were constructed to study publication bias. The review was registered on PROSPERO (CRD42023413314). We identified 70 eligible studies, describing 19,470 ICH patients from 26 different countries. Of these, 62studies reported on crude incidence, 41 on case fatality, and 10 on functional outcome. Overall crude incidence was 29.2 per 100,000 person-years (95% CI 23.3-36.4; I2=100%). Incidence was lower in women than in men and increased with age. Incidence was highest in lower-middle income countries, followed by high and upper-middle income countries. Case fatality at 1 month was 35.5% (95% CI 32.3-38.9; I2=90%). The percentage of patients with good functional outcome (mRS 0-2 in nine studies, mRS 0-3 in one) after 3-12 months was 31.2% (95% CI 24.7-38.6; I2=76%). We found no time trends in incidence, case fatality, or functional outcome. Our results demonstrate the persistently high burden and devastating consequences of ICH, stressing the need for better preventive strategies and acute treatments. None.

Prenatal exposure to heat and humidity and infant birth size in Ghana.

Previous studies - primarily in high income countries - have shown that high prenatal temperatures are associated with adverse birth outcomes. However, these studies are mostly focused on average exposure across the full gestational period or short-term exposure immediately prior to delivery and may miss important sensitive windows of exposure in utero. Further, nearly all use ambient air temperature data, which neglect physiologically important interactions between air temperature and humidity. The Ghana Randomized Air Pollution and Health Study (GRAPHS) recruited pregnant individuals from 2013 to 2015 from communities in the Kintampo North Municipality and Kintampo South District of Ghana. We estimated daily maximum shaded wet bulb globe temperature (WBGTmax) and heat index (HImax) during pregnancy and examined associations with birth weight, birth length, head circumference, and incidence of low birth weight, preterm birth, and small for gestational age. Using linear regression analyses, trimester average models identified that higher WBGTmax in the first trimester was associated with larger head circumference; second trimester was associated with shorter birth length, lower birth weight and higher odds of preterm birth, and third trimester was associated with shorter gestational age and larger head circumference. Time-varying analyses using distributed lag nonlinear models find that, compared to the median, lower WBGTmax and HImax (25th percentile) during the first half of pregnancy was associated with higher birth weight and longer birth length. Compared to the median, lower WBGTmax and HImax (25th percentile) in the second half of pregnancy was associated with smaller head circumference while higher wet bulb globe temperature (75th percentile) was associated with larger head circumference. Overall, our study identified that higher WBGTmax and HImax are associated with pregnancy duration and newborn size. Given the overall trend in our study area of rising temperatures, these data suggest that adaptation strategies are urgently needed to protect child health.

Medication adherence, depression levels, and quality of life among young people with depression in Indonesia: a mixed method study.

Limited information is available on medication adherence, depression levels, and quality of life (QoL) among young individuals with depression in Indonesia. This study examined factors associated with medication adherence, depression severity, and QoL in young Indonesians with depression. It also explored (1) reasons for good or poor adherence and (2) participants' perceived QoL. A mixed-methods sequential explanatory design was employed from January to June 2022. A national cross-sectional survey of 681 participants was conducted, followed by qualitative interviews with 40 participants. Low medication adherence was observed in 76.2% of participants. Higher adherence was associated with a bachelor's degree. Lower depression levels were linked to older age, female gender, longer treatment duration, and a family history of psychiatric disorders (p < 0.05). QoL significantly declined among people with higher income, the presence of family psychiatric disorders, lower adherence, and more severe depression level. Qualitative findings highlighted inadequate mental health literacy, marital status, low income, lack of support, and side effects as barriers to adherence. Financial stability and positive social support were critical for better QoL. Key factors influencing medication adherence among young Indonesians with depression included income, national health insurance coverage, mental health literacy, and social support. Strengthening communication between patients and mental health providers, particularly psychiatrist, is essential to optimize treatment plans and improve outcomes.

The awareness, attitudes and knowledge of pediatricians in Tamil Nadu India of sudden unexpected death in epilepsy (SUDEP) and epilepsy related risks: A cross-sectional study.

Sudden Unexpected Death in Epilepsy (SUDEP) in epilepsy is recognised to be equally common in adults and in children and young people (CYP). There is higher prevalence of epilepsy in lower- and middle-income countries (LMICs) compared to high income countries (HIC) however research in SUDEP is limited in LMICs such as India particularly in CYP. To explore SUDEP awareness and attitudes to communication to CYP and their carers/parents by pediatricians in Tamil Nadu, India, one of the 28 states, with 80 million population. A cross-sectional online survey of Likert response questions using validated themes, was circulated among the paediatric doctors fraternity in Tamil Nadu, India. Non-discriminatory exponential snowballing technique leading to convenience non-probability sampling was used. The inquiry involved SUDEP-related topics including the awareness, knowledge, need for and importance of counselling. Descriptive statistics were used for analysis. Out of the 150 consenting participants, a majority were males (60.0%), had more than 10years of practice (80.7%), were private practitioners (51.3%) and working in urban areas (94%). Over a third (35%) did not know of SUDEP, while less than half of the participants (40.7%) had ever counseled CYP and/or their carers on SUDEP. Nearly three quarters (73.3%) recognised the need for training on SUDEP risk and communication. There is a significant lack of SUDEP awareness and knowledge among pediatricians in Tamil Nadu India which is likely to be the case across much of India. Virtual training and education could help bridge the knowledge gap.

The impact of pandemic experiences on future similar situations: analysis of latent variables and trip purposes in ride-hailing choice

ABSTRACT Due to the experience and knowledge of individuals since COVID-19, this study aims to study how people would choose ride-hailing for different trip purposes under similar conditions in the future. Data was collected through a stated preference questionnaire and the choice of ride-hailing is then analyzed separately for daily, mandatory, and discretionary trips using three binary logit models. The importance of variables related to health concerns like Perceived Threats is evident in all models. Results indicate that individuals who prioritize the health of their families are less likely to use these services both on mandatory and discretionary trips. Additionally, ride-hailing systems is preferred by students for mandatory trips as well as women on shopping trips, while people with high incomes do not use them for work trips. The findings suggest that companies offering ride-hailing services should focus more on health measures to increase their usage in times of crisis.

Patriotism and All-Russian Civic Identity in the Value System of Modern Russian Students (Based on the Materials of a Survey of Students of the Far Eastern Federal District)

The article presents the results of a sociological study of the peculiarities of the formation and strengthening of civic identity and patriotic sentiments among students of educational institutions of higher education in the Far Eastern Federal District. The subject of the study was the values, career aspirations and difficulties of students studying at universities in the Far Eastern Federal District. The work examines various aspects of civic identity, including attitudes towards family, health, material well-being, as well as common symbols and ideals. Special attention is paid to the role of historical and cultural memory in the formation of the all-Russian civic identity. The results of the study are discussed in the context of the current social and political situation in Russia. The analysis of the data showed that the main value remains a strong family, and the leading position is occupied by the standard of living and high income. The youth of the Far Eastern Federal District are characterized by a high level of patriotism (up to 70%), self-identification with all-Russian, national values and symbols of identity as opposed to ethnic, regional and supranational ones.

Impact of the COVID-19 pandemic on routine immunization coverage of children and teenagers in Ontario, Canada.

To assess immunization coverage for routine vaccinations in children (aged 4-7years) and teenagers (aged 14-17years) during the COVID-19 pandemic compared to the pre-pandemic period, in Ontario, Canada. Retrospective cohort study using primary care electronic medical records data from the University of Toronto Practice-Based Research Network database from January 2018 to June 2022. Monthly estimates of vaccine up-to-date (UTD) coverage (defined as 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap)-containing and 1 dose of measles, mumps and rubella-containing vaccines received after the 4th birthday for children; and 1 dose of Tdap-containing vaccine received after the 14th birthday for teenagers) and time series regression analysis were used to compare changes in mean coverage before and during the pandemic. We also examined if changes in coverage estimates over time were associated with sociodemographic factors. 30,010 children and 31,624 teenagers were included. Mean monthly UTD coverage for children decreased significantly from 48.7% (SD 2.1) pre-pandemic (January 2018 - February 2020) to 44.3% (SD 1.3) in mid-pandemic period (July 2020-June 2021), and remained significantly lower in later pandemic period (July 2021 - June 2022). Mean monthly UTD coverage for teenagers was 34.6% (SD 0.9) pre-pandemic and decreased to 16.7% (SD 0.6) in later pandemic period. When adjusted for baseline differences, teenagers from neighborhoods with higher income, lower proportions of racialized and newcomer populations and from rural areas experienced larger decreases in UTD coverage during the pandemic. No significant differences were found in UTD coverage among children across the various sociodemographic factors. Significant declines in immunization coverage for children and teenagers in Ontario were still observed by June 2022, highlighting the need to further study the long-term impact of the pandemic and implement effective catch-up interventions to increase immunization coverage and prevent outbreaks of vaccine-preventable diseases.

P-29. Recombinant Zoster Vaccine Uptake Among Immunocompromised US Adults

Abstract Background In January 2022, ACIP recommended 2 doses of recombinant zoster vaccine (RZV) for herpes zoster (HZ) prevention in adults ≥ 19 years who are or will be immunodeficient or immunosuppressed because of disease or therapy. While this decision served to address an unmet medical need, its impact on vaccination is not fully understood as RZV uptake and series completion estimates among immunocompromised (IC) adults are lacking.Figure 1.RZV Uptake (&amp;gt;1 dose) by Patient Age and Autoimmune Disease, Immunocompromising Condition, or TreatmentAbbreviations: AID: autoimmune diseases, IC: immunocompromised, HIV: human immunodeficiency viruses, RZV: recombinant zoster vaccine. Methods This retrospective cross-sectional analysis used IQVIA open-source medical and pharmacy claims (10/20/2021 to 06/30/2023) to describe RZV uptake and series completion among adults ≥ 19 years old with evidence of an autoimmune disorder (AID) or immunocompromising disease. RZV uptake, series completion, and dosing schedule compliance were assessed descriptively, and Kaplan-Meier analyses estimated time to series completion. Generalized estimating equations, controlling for patient demographics, clinical characteristics, and social determinants of health, predicted the odds of both RZV uptake and series completion.Figure 2.RZV Series Completion by Patient Age and Autoimmune Disease, Immunocompromising Condition, or TreatmentAbbreviations: AID: autoimmune diseases, IC: immunocompromised, HIV: human immunodeficiency viruses, RZV: recombinant zoster vaccine. Results Cumulative RZV uptake was 8.2%, increased considerably starting at age 50 years, and ranged from 6.6% to 10.4% by IC condition (Figure 1). Series completion was 62.1% (6 months post-initial dose), increasing to 70% by 12 months, with a median completion time of 4.23 months (95% confidence interval: 4.20-4.23) and 88.5% of completers complied with the recommended dosing schedule. Both series completion and dosing schedule compliance varied by age and IC condition (Figures 2 &amp; 3). The odds of RZV uptake varied by AID/IC condition and were higher among females, those with higher incomes, minorities, and adults with more years of education. Few differences in the odds of RZV series completion by IC condition were observed; however, the odds were lower among younger and Black or Hispanic patients but increased among those with higher household incomes (Figure 4).Figure 3.RZV Series Dosing Schedule Compliance by Age and Autoimmune Disease, Immunocompromising Condition, or TreatmentNumbers reflect the proportion of series completers (2 doses) that did so within 6 months of the initial dose.Abbreviations: AID: autoimmune diseases, IC: immunocompromised, HIV: human immunodeficiency viruses, RZV: recombinant zoster vaccine. Conclusion RZV uptake among the adult IC population in the United States is suboptimal despite ACIP guidance, yet series completion is likely among those initially vaccinated. Given the elevated risk of HZ in these patients, concerted efforts across the care team are needed to address an ongoing unmet medical need. Funding: GSK (VEO-000679)Figure 4.Odds of RZV Uptake among Immunocompromised AdultsAbbreviations: CI: confidence interval. Disclosures Justin Gatwood, PhD, MPH, AstraZeneca: Grant/Research Support|Genentech: Advisor/Consultant|GSK: Employment|GSK: Stocks/Bonds (Public Company)|Merck &amp; Co.: Advisor/Consultant|Merck &amp; Co.: Grant/Research Support Catherine B. McGuiness, MA, MS, GSK: Advisor/Consultant Marie Yasuda, PharmD, MS, Amgen: Grant/Research Support|Bayer: Grant/Research Support|BMS: Grant/Research Support|GSK: Advisor/Consultant|Novartis: Grant/Research Support|Sandoz: Grant/Research Support|Servier: Grant/Research Support Chi-Chang Chen, PhD, MSPharm, Amgen: Grant/Research Support|Bayer: Grant/Research Support|BMS: Grant/Research Support|GSK: Advisor/Consultant|Novartis: Grant/Research Support|Regeneron: Grant/Research Support Nikita Stempniewicz, MSc, GSK: Employment|GSK: Stocks/Bonds (Public Company)

Knowledge and Practices Among Mothers in Detection, Treatment and Prevention of Acute Respiratory Tract Infections in Children Under Five Years in Kandy Municipal Council Area

Introduction: Acute Respiratory Tract Infections (ARTI) cause childhood morbidity and mortality worldwide. Mothers play a crucial role, identifying early symptoms and obtaining proper medical advice. It was the aim of this study to assess the knowledge and practices regarding symptoms, treatment and prevention of ARTIs among mothers of children less than five years of age in the Kandy Municipal Council.Materials and Methods: A cross-sectional study was conducted with the participation of mothers having one or more children less than five years of age living in the Kandy Municipal Council Area. A questionnaire was used to assess the knowledge level regarding detection, prevention and treatment of ARTIs and values were compared with demographic factors.Result: Total of 424 mothers were recruited age range 22-35 years. The majority of mothers (83.73%) identified pneumonia as a severe ARTI. The majority (74.23%) gathered health information from public media. Many children suffered from several episodes of ARTI during the previous year. A cold was the commonest symptom and 68.87% identified viruses as the cause. Half the mothers (50.24%) sought medical advice immediately, while 33.96% gave home remedies. Family members with ARTI were separated from the child (66.04%), and 86.79% tried to improve the immunity as preventive measures. A significant relationship was found between the knowledge score and educational level, income, and employment, but not the age, and number of children.Conclusion: Overall knowledge of the mothers regarding ARTIs was not satisfactory. Mothers with a high income, high level of education and employment had better knowledge.

P-1405. Drivers of Unplanned Pregnancy among Women with HIV in the Northern and Southern United States

Abstract Background National estimates from 1986-2015 show that the proportion of unplanned pregnancies among women with HIV (WWH) is high at 78% and that Black/African American women are disproportionately impacted. We aimed to evaluate the prevalence of unplanned pregnancy using a contemporary cohort of pregnant and postpartum WWH (2019-2024), and identify the individual, interpersonal, community and societal factors associated with pregnancy planning.Table 1.Sociodemographic, sociocultural, and psychosocial variables in a cohort of pregnant and postpartum women (2019-2024)Footnote: social support (Likert scale 1=never 5=always), HIV provider trust (Likert scale 1=strongly disagree 5=strongly agree), self-efficacy (additive scale 0=cannot do at all 10=completely certain can do), HIV related stigma (additive 0=never experienced 9=heavily experienced) Methods We performed a secondary data analysis of cross-sectional surveys from an on-going randomized controlled trial testing a peer-led behavioral intervention to improve postpartum retention in HIV care. WWH were recruited from six sites in the northeast and southern US. We used unadjusted and adjusted logistic regression to estimate the association between study outcome, pregnancy planning (“Were you planning to get pregnant?” Yes/No) and individual/interpersonal (self-efficacy, social support, HIV provider trust, HIV related stigma) and community/societal (race, ethnicity, marital status, income, employment) factors.Table 2.Factors associated with pregnancy planning among women with HIV Results To date, a total of 137 women (83% Black, 7% White, 10% Asian, American Indian/Alaska Native, Native Hawaiian/Pacific Islander categorized as other race; 14% Hispanic ethnicity) enrolled in the trial and were included in this analysis. The proportion of unplanned pregnancy was high at 73%. Among WWH with unplanned pregnancy, 90% were Black, 4% were White, 6% were women of other race (p=0.002). While Black women had significantly reduced odds of pregnancy planning (OR 0.18, 95% CI 0.046-0.68), married women (OR=3.33, 95% CI 1.26-8.85), women with higher income (OR=1.27, 95% CI 1.03-1.57) and those with employment (OR 2.33, 95% CI 1.08-5.03) had higher odds of pregnancy planning. In the fully adjusted model, Black race (aOR 0.11 95% CI 0.02 -0.48) was the only factor negatively associated with pregnancy planning. Conclusion Unplanned pregnancy among women with HIV and its disproportionate burden on Black women continues to be an area we have yet to make significant progress. Interventions addressing social determinants of unplanned pregnancy and racial disparities are needed to improve reproductive health care for WWH. Disclosures William R. Short, MD, Gilead: Grant/Research Support|Janssen: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Honoraria Rachel Scott, MD,MPH,FACOG, DHHS Perinatal Guidelines: Board Member|UW STD Prevention Training Center (UW STD PTC): Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|Vindico CME: Honoraria

Macroscopic Stochastic Model for Economic Cycle Dynamics

We present a stochastic dynamic model which can explain economic cycles. We show that the macroscopic description yields a complex dynamical landscape consisting of multiple stable fixed points, each corresponding to a split of the population into a large low and a small high income group. The stochastic fluctuations induce switching between the resulting metastable states and excitation oscillations just below a deterministic bifurcation. The shocks are caused by the decisions of a few agents who have a disproportionate influence over the macroscopic state of the economy due to the unequal distribution of wealth among the population. The fluctuations have a long-term effect on the growth of economic output and lead to business cycle oscillations exhibiting coherence resonance, where the correlation time is controlled by the population size which is inversely proportional to the noise intensity. Published by the American Physical Society 2025