Higher Education Level Research Articles

Positivity and Follow-up Testing of Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Universally Screened Female Basic Military Trainees.

Follow-up testing is recommended three months after patients initially test positive with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Follow-up testing adherence in the United States has been reported below one third of women, even in universally insured populations. We assessed both the positivity of CT and GC infections in female basic military trainees and the rates of follow-up testing for those who tested positive. Between January 1, 2006-December 31, 2021, female Air Force Basic Military Trainees were universally screened with urinary nucleic acid amplification testing for CT and GC. Those who tested positive were evaluated to determine demographic information as well as follow-up testing rates. Patients who were evaluated with a repeat CT/GC NAAT test within 12 months after a positive CT/GC test result were considered to have received appropriate follow-up. 5,022 (5.2%) of 97,168 trainees tested positive for only-CT (4,749 (4.8%)), only GC (138 (0.1%)) or both CT/GC (135 (0.1%) during the study period. Those at increased risk of infection were those <24 years of age, Hispanic and Black individuals, high school education level, and single women. Of the 4,687 still in the military at three months after diagnosis, 3,268 (69.7%) had repeat testing within 12 months. There was no significant difference in follow-up testing by age, race, educational level, marital status, or organism causing original infection. Follow-up testing among female USAF basic military trainees is higher than in other universally insured populations. This study demonstrates remaining barriers to adherence to recommended guidelines.

The impact of the COVID-19 pandemic on overweight and obesity: the case of NEET in Türkiye

The study aims to investigate how COVID-19 pandemic affects the probability of being overweight or obese in the case of NEET in Türkiye. This study delves into the comprehensive dataset provided by the Turkish Health Research Surveys from 2014 to 2022. The primary focus is on individuals aged 15–29, with a specific exploration of the repercussions of the COVID-19 pandemic on health conditions. The investigation centers on deciphering the intricate connections between NEET (Not in Education, Employment, or Training) status, pandemic ramifications, and the likelihood of being overweight or obese. Leveraging probit models and meticulous control for variables such as age, gender, regional fixed effects, and completed education levels, our findings indicate significant associations. Notably, the NEET subgroup demonstrates a 5.8% increase in the probability of being obese or overweight. We find suggestive evidence that the pandemic contributes to a marginal increase of 1.2%. A particularly intriguing revelation surfaces as being NEET significantly amplifies the likelihood of overweight or obesity in young females. Education plays a vital role in preventing overweight or obesity, as higher education levels correlate with a lower likelihood of obesity. Moreover, we analyze different age groups, our results show that being NEET is positively associated with the probability of overweight or obesity for females aged 19–24 and 25–29 in the post-pandemic period, indicating higher sensitivity to the pandemic among NEET females.

Một số yếu tố ảnh hưởng đến thời gian nhập viện ở bệnh nhân nhồi máu não cấp

Object: Some factors affect hospitalization time in patients with acute cerebral infarctionMethod: Cross-sectional, retrospective descriptive study including 150 patients with acute cerebral infarction treated at the Neurology Center and Stroke Center, Bach Mai Hospital from January 2023 to December 2023.Result: The average hospital admission time was 661.5 minutes (11 hours); Only 26 patients were hospitalized early before 4.5 hours, accounting for 17.3%; Factors affecting the early hospitalization time of patients are high educational level (OR: 2.362; 95% CI [1.002-5.565]), daytime onset time (OR: 3.787; 95% CI [ 0.081-0.996]), having a witness at the time of symptom onset (OR: 5.928; 95% CI [1.336-26.308]), using ambulance transportation (OR: 32.445; 95% CI [9,916-106,223]), history of stroke or TIA (OR: 5.9; 95% CI [1.73-20,121]), recognition of symptoms of stroke (OR: 256.82; 95% CI [31] ,69-2081.44]) and knowledge of fibrinolytic drugs (OR: 83.18; 95% CI [16.81-411.69]); Factors affecting the patient's late hospitalization time include: distance to the hospital &gt;15km (OR: 0.33; 95% CI [0.117-0.931]), admission to a front-line medical facility (OR: : 0.165; 95% CI [0.054-0.507]).Conclusion: Factors affecting the patient's early hospitalization time include: high educational level, time of illness onset during the day, presence of witnesses at the time of symptom onset, use of public transport ambulance, history of stroke or TIA, recognition of stroke symptoms and knowledge of thrombolytic drugs.

What’s behind the Attitudes of the Ethnic Bulgarians in Reproductive Age towards Interethnic Marriages with Members of Bulgaria’s Turkish Community?

This piece of research investigates the determinants of ethnic Bulgarians’ attitudes towards interethnic marriages with members of Bulgaria’s Turkish community. A statistical analysis was conducted to examine the role of socio-demographic factors in shaping these attitudes. It discusses many factors but focuses on the statistically significant educational attainment, settlement type, family status, and net income. Higher levels of education do not necessarily lead to more tolerant attitudes towards interethnic marriages. Settlement type and family status emerge as influential determinants. Income is important in shaping attitudes, with the better-off households exhibiting higher approval rates to interethnic mixed marriages. These and other findings contribute to understanding interethnic attitudes and provide valuable insights for policymakers and stakeholders working towards fostering social cohesion and inclusion.

Influenza Vaccination Coverage and Influencing Factors in Type 2 Diabetes in Mainland China: A Systematic Review and Meta-Analysis

Background: Influenza has many harmful effects on people with type 2 diabetes mellitus (T2DM), such as hyperglycemia and increasing incidence of cardiovascular and cerebrovascular diseases. Epidemiological evidence shows that influenza vaccinations can effectively prevent deterioration in T2DM patients. At present, there is a lack of nationwide studies on the vaccination status of influenza vaccines for patients with certain chronic diseases. This study aimed to evaluate the influenza vaccination status of T2DM patients in mainland China and the factors affecting their influenza vaccination. Methods: Data were sourced from PubMed, Embase, Web of Science, the China Biology Medicine Disc (CBMdisc), the China National Knowledge Infrastructure (CNKI), and the Wanfang Database. The keywords used in the literature search included “diabetes”, “diabetes mellitus”, “DM”, “diabetic”, “T2DM”, “influenza vaccine”, “flu vaccine”, “China”, and “Chinese”. A total of 249 articles were retrieved through the searches; 7 articles met the inclusion criteria. The fixed-effects model was used when heterogeneity was low and a random-effects model was used when the heterogeneity was high. Results: The influenza vaccination coverage rate was 1.46% in diabetic patients and 9.99% in elderly diabetic patients. The influenza vaccination rate of type 2 diabetes patients with a high education level is higher than that of patients with a low education level. (OR: 1.462 [1.123, 1.903]). Meanwhile, gender (OR: 1.076, 95%CI: 0.893–1.295), marriage (OR: 1.283; 95%CI: 0.931–1.766), and occupation (OR: 1.049; 95% CI: 4.422–2.606) have no significant impact on influenza vaccination in patients with type 2 diabetes. Conclusions: This study found that the coverage of influenza vaccination in patients with T2DM in Chinese mainland was low, and there were few relevant research articles. In China’s mainland areas, education background is an important factor affecting the influenza vaccination of T2DM patients. China should continue to improve the influenza vaccination rate of patients with type 2 diabetes.

Awareness of Family Planning Services among Pregnant Women in Arumeru District, Tanzania: Implications for Public Health Interventions

The demand for health literacy in family planning continues to be a global issue, particularly in developing regions. It is also estimated that over 225 million women in developing countries face challenges accessing and utilizing family planning services. Sub-Saharan Africa has the lowest family planning prevalence, at 24%, with high unmet needs, despite global efforts to improve access and knowledge. This study aimed at assessing the family planning services among pregnant women in Arumeru District, Tanzania. Using a sample size of 269 respondents, data was collected through questionnaires and interviews with healthcare officers between February and March 2024. Data were then analyzed using descriptive statistics techniques for quantitative data whereas qualitative data were analyzed using content analysis approach. Results reveal that 92.9% of respondents were aware of family planning services, with varying levels of understanding. Education and occupation played significant roles in awareness, with younger, educated individuals showing higher knowledge. Improving awareness about maternal and child health can lead to better healthcare practices, timely interventions, and increased utilization of services, ultimately reducing mortality rates and contributing to broader public health goals of improved health equity and universal health coverage. However, cultural, religious, and literacy barriers continue to hinder full understanding. The study concludes that respondents in the study area have high level of awareness regarding family planning, particularly among younger individuals and those with higher education levels. The study recommends targeted awareness programs, especially for underserved populations, and emphasizes the importance of involving men in family planning education to improve reproductive health outcomes.

Risk of Discontinuance in Contraceptive Uptake Among Kenya Women: A Survival Analysis Using the Cox Proportional Hazard Model

A problem of equal importance is the substantial challenge posed by the discontinuance of contraceptive use in family planning programs, particularly for developing countries such as Kenya. Investigating the determinants of contraceptive discontinuation using demographic factors can provide insights to enhance the efficacy of family planning. Using data from the Performance Monitoring for Action (PMA) survey, this study examined the demographic and contraceptive method-related covariates associated with the risk of discontinuation of contraception among Kenyan women. The study employed Cox proportional hazards models to analyze sampled data of Kenyan women from the PMA survey. Two separate models were used: a standard model which included demographic characteristics with a baseline contraceptive variable (Ever use contraceptive) and an extended model showing how specific contraceptive methods impact the likelihood of the risk of discontinuing contraception. Older age (Coefficient of -0.268 with a hazard ratio of 0.765) was associated with a decreased risk of contraceptive discontinuation. At the same time, women with higher educational levels (Coefficient of 0.015, with a hazard ratio of 1.015) were related to an elevated hazard and were more likely to discontinue their current method of contraception. The extended model showed that subcutaneous injectable contraceptives (Coefficient of -2.040 with a hazard ratio of 0.130) and male condoms (Coefficient of -1.137 with a hazard ratio of 0.321) were conditionally related to a significantly decreased hazard of discontinuation. The results highlight the importance of contraception choice and the significance of age and education in maintaining continuous contraception. To support Kenyan women in maintaining continuous contraception in achieving their reproductive health goals comprehensive education on emergency contraception and the provision of long-acting reversible contraceptives should be provided by health and family planning organizations. There is a call for a longitudinal study to offer an understanding of the dynamic behavior of contraception over time and the need for time-varying analyses to capture the evolving nature of contraception and its discontinuation.

Predictive accuracy of the logit model to determine factors affecting delivery and postnatal care services utilization in Tanzania

PurposeThis paper examines factors affecting the delivery care (DC) and postnatal care (PNC) services utilization in Tanzania using the predictive accuracy of the binary logit model by including DC as among the predictors of PNC utilization.Design/methodology/approachThe study used secondary data from the Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022) based on a sample of 13,266 women aged 15–49. Binary logit was used to analyze the association between independent variables and each binary dependent variable, followed by a stepwise likelihood ratio test for binary logistic regression analysis to select the most important predictors associated with DC and PNC. Odds ratios were used to predict the likelihood of the occurrence of significant explanatory variables in explaining the outcomes.FindingsThe results showed that the type of place of residence, wealth index, region, highest educational level, husband/partner’s level of education and respondent’s occupation were significant predictors of DC utilization. In contrast, the woman’s age, region, highest educational level, wealth index, DC and husband/partner’s educational level were significant predictors of PNC utilization. Public health interventions are needed to promote and increase the utilization of delivery and postal care services. The targets should be poor women and those residing in rural or remote areas.Originality/valueIncluding DC as a predictor variable (which was not used before) in PNC utilization improved the predictive power of the model and the robustness of the results.

Subjective Well-Being and Corruption in Latin America

This study explores the impact of corruption on subjective well-being in Latin American countries, focusing on Chile, Ecuador, Argentina, Uruguay, Venezuela, Bolivia, Colombia, and Peru during the period 2017-2021. The research examines how perceptions of corruption affect key indicators such as education, health, income, and life satisfaction. Utilizing secondary data from the World Values Survey, a descriptive and explanatory methodology was employed, incorporating statistical analysis and ordinal logistic regression models. Findings reveal a complex relationship between corruption and subjective well-being, indicating that higher levels of education are associated with increased awareness of corruption, while economic stability, political trust, and life satisfaction show varied associations with perceived corruption. The study highlights regional differences and contextual factors influencing these dynamics, providing insights into the multifaceted effects of corruption on human development and overall well-being in Latin American populations. Received: 2 August 2024 / Accepted: 24 September 2024 / Published: 05 November 2024

Telehealth utilization among patients with chronic disease: Insights from the 2022 Health Information National Trends Survey.

Telehealth has been effectively used for managing chronic disease conditions; however, utilization patterns vary across populations. This study aims to examine the prevalence of telehealth utilization, the associated factors of telehealth modality (e.g., audio, video) among patients with chronic diseases, and the role of health literacy. Participants with at least one diagnosed chronic disease from the 2022 Health Information National Trends Survey (HINTS 6) data (n=3686) were analyzed. Differences in participant characteristics between telehealth users and non-users were compared using χ² statistics. Multinomial logistic regression models were employed to investigate factors associated with telehealth modality. About 52% of participants reported using telehealth in the past 12 months, with 34.7% using audio-only modality. Telehealth use was highest among participants with depression (61.6%) and lowest among those with high blood pressure (47.6%). Participants over 75 years old (OR, 3.11 [95% CI, 1.99-4.85]; P < 0.001) were more likely to use audio-only modality compared to the youngest group (18-34 years). Respondents with a higher educational level (bachelor's degree: OR, 0.77 [95% CI, 0.59-1.00], P = 0.049; post-baccalaureate degree: OR, 0.60 [95% CI, 0.43-0.82]; P < 0.001) and higher health literacy (OR, 0.81 [95% CI, 0.66-0.99]; P =0.04) were more likely to use audio-video modality compared to their counterparts. Telehealth use varied across demographics and chronic diseases, revealing significant disparities. Elderly individuals, those with lower socioeconomic status, and those with lower health literacy tended to use the audio-only modality. Providing support for digital platforms and health literacy can empower patients with chronic diseases to effectively use telehealth for self-management.

Professional values, ethical climate and job satisfaction of nurses and their selected sociodemographic and occupational characteristics

AimTo explore the relationship of selected socio-demographic and occupational characteristics of nurses and their level of professional values, hospital ethical climate and job satisfaction.MethodsCross-sectional study was conducted among 388 Polish nurses from the spring of 2021 to winter of 2023, in the eastern part of Poland; and followed by Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Four research tools were used to collect data together with questionnaire for socio-demographic and occupational characteristics.ResultsProfessional values such as activism correlate negatively with religious beliefs (Z = −1.789; p = 0.044), this means that nurses who are more involved in professional change activities are likely to be less associated with religious beliefs. A positive correlation was observed between the Ethical Hospital Climate Survey subscale—peer relations and nurses’ education level (H = 5.638; p = 0.048), indicating that a higher education level was associated with better relationships with colleagues at work. A negative relationship was identified between nurses’ external job satisfaction and their marital status (Z = −1.958; p = 0.040), that is, married nurses feel less satisfaction with the external aspects of their jobs than their single colleagues.DiscussionThese findings underscore that medical staff management should take into account both sociodemographic factors [e.g., age, education, place of residence, marital status, religious beliefs, as well as professional factors (working hours, qualification course, etc.)] that affect nurses’ professional values, job satisfaction and the ethical climate of the hospital. These underscore the need to adapt management strategies to the individual needs of employees, which can contribute to improving working conditions in healthcare facilities.Data collection toolThe data collection tool consists of four sections.DemographicsCollected background and demographic information.Nurses’ professional values scale (NPVS-3)Assessed professional values among nurses.Hospital ethical climate survey (HECS)Assessed hospital ethical climate among nurses.Minnesota satisfaction questionnaire-short form (MSQ-SF)Assessed job satisfaction levels among nurses.

The use of complementary and alternative medicine (CAM) during pregnancy.

Approximately one-third of the global population uses complementary medicine, as yoga and meditation, not endorsed by evidence-based conventional medicine and, with more difficulties in case of pregnancy. Our study investigates the prevalence of Complementary and Alternative Medicine (CAM) usage in Novara (Italy) and its province through a survey to pregnant women at 36 gestational weeks. The sample consisted of 70 women, average age of 33 years, most Caucasian, highly educated, mostly employed, under private gynecological care, with a prevalence of CAM use of 24.3 % [95 % CI 14.83; 36.01]. Six women (35.3 %) did not inform their healthcare provider of using these medicines, 15 women (88.2 %) express willingness to use complementary medicine in their next pregnancy, while 2 (11.8 %) are uncertain. The study found a significant association between higher education and CAM usage among pregnant women. Other factors, including nationality, occupation, choice of private practice, parity, physical activity, diet, smoking, pregnancy complications, and vaccination status, did not show significant relationships with CAM usage. Our objective is to delineate the characteristics of CAM users, explore the methodologies and motivations of their usage, and ascertain any correlations with the rejection of conventional vaccination practices. The analyzed population consists of 70 women aged 32.9 years in mean, mostly Caucasian, with a high level of education. Most women are under private gynecological care (84.3 %), half of the participants are experiencing their first pregnancy. Physical activity levels vary, with 34.3 % reporting high activity levels. Regarding diet, 77.1 % consider their eating habits moderately healthy, with a notable portion of smokers women (24.3 %); 20.0 % have experienced pregnancy complications. 17 participants utilized non-conventional or alternative medicine, with a prevalence of 24.3 [95 % CI 14.83; 36.01]. Six women (35.3 %) did not inform their healthcare provider about using CAM. Seven women (46.7 %) claim significant beneficial effects in most cases, while 8 (53.3 %) state this occasionally. Based on their experiences, 15 women (88.2 %) express willingness to use complementary alternative medicine in their subsequent pregnancy, while 2 (11.8 %) are uncertain. Only one person (11.1 %) used this type of therapy as a substitute for conventional treatment, but they informed their attending physician. The study seeks to enhance our understanding of CAM utilization in pregnancy, informing more comprehensive and evidence-based healthcare practices for expectant mothers.

Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review

Background: Extensive research has been devoted to ICDs, but there is still a significant gap in the literature regarding phantom shocks (PSs). Understanding the frequency, predictors, risk factors, management and health implications of PSs is essential. This review aimed to comprehensively investigate PSs in patients with ICDs up to the present day. Specifically, the review explores the incidence of PSs, identifies risk factors that may increase their likelihood and determines predictive factors to help anticipate their occurrence. By addressing these points, the study aimed to enhance the understanding and management of PSs in ICD patients. Methods: This study reviewed central databases from their inception up to March 2024. The primary objective was to examine the occurrence of PSs in patients with ICDs. Data were gathered on patient demographics, incidence rates, and various risk factors and predictors that might affect the occurrence of PSs. Then, a detailed analysis of the collected data was conducted to identify significant associations between these risk factors, predictors and the incidence of PSs. Results: This review identified a significant association between prior ICD shocks, defibrillation threshold testing, the presence of depression and anxiety for the occurrence of PS in patients with ICDs. This underscores the importance of thoroughly evaluating and managing these factors to improve the care of individuals with ICDs. Conclusion: PSs are often associated with various factors, such as previous shock therapy, defibrillation threshold testing, depression, anxiety and higher levels of education. It is crucial for healthcare providers to acknowledge these correlations and provide personalised care to patients experiencing PSs.

Temporal Trends in Knowledge of Human Papillomavirus and Associated Oropharyngeal Cancer Following Expanded Vaccination Eligibility.

Human papillomavirus (HPV) is a significant driver of elevated risk for oropharyngeal squamous cell carcinoma (OPSCC). In 2018, HPV vaccination eligibility was expanded to men and women aged 27 to 45. We evaluated changes in awareness of HPV, its association with OPSCC, and HPV vaccination among all US adults between 2018 and 2020, focusing on those aged 27 to 45. Cross-sectional survey cycles. The Health Information National Trends Survey (HINTS). The HINTS, a nationally representative survey of US adults, was queried. A total of 3504 adults in 2018 and 3865 adults in 2020 were assessed for knowledge of HPV, its vaccine, its association with OPSCC, and changes in awareness between 2018 and 2020. Statistical significance was set at P < .05. Most respondents were aware of HPV (2018: 60.8%; 2020: 64.8%) and its vaccine (2018: 60.8%; 2020: 61.6%). A significant decrease in awareness of the association between HPV and cervical cancer was seen between 2018 and 2020 (75.0% vs 70.2%, P = .028). Knowledge of HPV+ OPSCC was poor and did not change over time (2018: 27.0%, 2020: 29.5%). Statistically significant increases in HPV awareness between 2018 and 2020 were found for individuals who reported completing high school as their highest level of education (P = .009), Caucasians (P = .013), males (P = .024), and those making more than $200,000 annually (P = .022). Knowledge of the association between HPV and OPSCC remained poor despite expanded vaccine eligibility. Public health education on the association may increase awareness for groups likely to benefit from vaccination.

Assessment of childhood vaccination hesitancy among syrian parents under temporary protection

Background and AimVaccination programs become increasingly crucial during migratory movements driven by conflict and other disruptions. This study aims to determine the prevalence of childhood vaccination hesitancy among Syrian parents under temporary protection and identify areas for targeted interventions.MethodA total of 227 Syrian parents attending three Immigrant Health Centers in Sultangazi were assessed using the Arabic version of the Parent Attitude about Childhood Vaccines (PACV) survey, conducted between October and December 2023.ResultsThe prevalence of vaccine hesitancy among these parents was found to be 10.6%. An inverse correlation was observed between maternal education level and vaccine hesitancy, indicating that higher education levels were associated with lower levels of hesitancy.ConclusionThe observed rate of vaccine hesitancy among Syrian parents under temporary protection underscores the urgent need for targeted interventions. Tailored vaccination strategies for immigrant populations are essential to improve immunization rates and ensure the health and well-being of these communities.

Rural versus urban healthcare through the lens of health behaviors and access to primary care: a post-hoc analysis of the Romanian health evaluation survey

BackgroundWorldwide, rural populations are recognized to be exposed to increased health challenges due to their living and working environment, socioeconomic status, and access to health services. According to the Romanian Country Health Profile 2023, approximately 46% of all deaths recorded in Romania in 2019 could be attributed to behavioral risk factors such as tobacco smoking, dietary risks, alcohol consumption and low physical activity. No data on rural versus urban areas are available to date, and research is needed to document health inequalities, identify barriers to health services, and explore solutions.MethodsThis study is an analysis of data collected during the Health Evaluation Survey carried out by the National Institute of Public Health in 2022 and aimed to reveal differences in health risk factors between rural and urban areas. The analysis was carried out under the methodological framework of the Health Evaluation Survey 2022, which is coordinated by the National Institute of Public Health.ResultsOur study’s objectively measured data revealed that the overall health profile of rural communities is characterized by lower education levels, lower incomes, and higher binge drinking rates than those of their urban counterparts. Additionally, rural inhabitants more often have high blood pressure, are more overweight and obese (per body mass index measurements) and have higher fasting plasma glucose. The health profile of the urban population revealed higher education levels and greater proportions of people with adequate monthly income, people with daily alcohol consumption, people who smoke, and people with hypercholesterolemia. Access to primary health care evaluated through proxy indicators was lower in rural areas but was relatively good overall.ConclusionsOur analysis of the health profile of rural communities revealed a greater prevalence of obesity and overweight, especially among women, and an increased prevalence of heavy drinking among men. Access to primary health care evaluated through proxy indicators is lower in rural areas but is relatively good overall. Lower education levels and the possibility of lower health literacy underpin the need for targeted health education campaigns. Sustainable strategies for rural health need to be identified, especially in the field of health promotion and disease prevention programs.Trial registrationThis study is observational research involving human participants where no interventions were applied to the study population.

Pendapatan dalam Hubungannya dengan Perencanaan Ekonomi Kabupaten Muaro Jambi dilihat dari Sisi Perkembangan Indeks Gini Kabupaten Muaro Jambi

Analysis of the Gini index based on education level shows significant inequality in the distribution of education in society. Higher levels of education tend to be accessed by groups with higher incomes, while groups with lower incomes often face barriers to obtaining quality education. This is reflected in the Gini index, which shows that the gap between groups with good and limited access to education is widening. This inequality has an impact on economic opportunities and social mobility, suggesting that improvements in a more inclusive education system and equal access to education across all levels of society are essential to reducing inequality and achieving greater social justice. The secondary sector in Muaro Jambi also shows significant levels of inequality. In the manufacturing and processing industries, large companies that produce goods on a large scale often make substantial profits, while small and medium enterprises struggle to compete. Inequality is also reflected in the construction sector, where the income gap between skilled and unskilled construction workers, and between large and small contractors, is quite striking. This contributes to the high Gini index in this sector, reflecting income inequality among workers and employers. In the tertiary sector, which includes services, retail, finance, and insurance, income inequality tends to be higher. In the service sector, the difference in income between workers in customer service and managers or professionals is very large. In the finance and insurance sector, income inequality is also significant because wages in this sector are often very high compared to other sectors, creating a large gap between workers in these fields and those in lower-wage sectors. This unequal distribution of income leads to a high Gini index in the tertiary sector. The quaternary sector in Muaro Jambi, which includes technology, information, and research and development, shows high levels of inequality. This inequality is caused by the large differences in wages between technology professionals and workers in non-technology sectors, as well as between workers in large technology companies and small businesses. Specialized skills and high levels of education in this sector are often directly related to high incomes, while those in less skilled or educated positions earn much lower wages. This creates a clear inequality in the distribution of income in this sector.

Associations between sociodemographic and clinical characteristics and adherence to self-management behaviours among community-dwelling older adults with mild cognitive impairment.

Self-management is vital for individuals with mild cognitive impairment (MCI) to enhance cognitive health and mitigate the risk of dementia. However, maintaining consistent engagement in self-management strategies can be challenging for older adults with MCI. This study aimed to explore the associations between sociodemographic and clinical characteristics and adherence to self-management behaviours among community-dwelling older adults with MCI. A cross-sectional study involving 467 community-dwelling older adults with MCI was conducted from July to November 2022 across Nanjing, Xuzhou, and Lianyungang in Jiangsu Province, China. Data on sociodemographic and clinical characteristics, as well as self-management behaviours for MCI, were collected. Multiple linear and binary logistic regressions were employed to identify factors influencing self-management behaviours. Among the four recommended self-management behaviours for MCI, participants adopted an average of 1.37 ± 1.202 behaviours. Physical exercise (n = 239; 51.2%) was the most prevalent behaviour, followed by modifiable risk factors management (n = 156; 33.4%), cognitive training (n = 144; 30.8%), and cognitive function monitoring (n = 103; 22.1%). Higher education level (B = 0.286, P < 0.001), urban employee medical insurance (B = 0.621, P < 0.001), and non-smoking status (B = 0.389, P = 0.002) positively correlated with aggregate MCI self-management behaviours, while older age (B = -0.295, P < 0.001) had a negative association. Marital status, monthly income, employment status, gender, residence, and family history of cognitive disorders were also found to be associated with specific self-management behaviours for MCI. Enhancing adherence to self-management among community-dwelling older adults with MCI is critical. Sociodemographic and clinical factors should be considered to pinpoint at-risk populations and accordingly tailor support strategies.

What determines the accessibility of early childhood education in Bangladesh?

This paper aims to understand the potential factors influencing the accessibility of early childhood education (ECE) in Bangladesh. Utilising data from the Multiple Indicator Cluster Survey (MICS) 2019, this study explored the influence of individual, household, socio-economic as well as geographical variables on ECE enrollment. It employed a comprehensive approach, which involved using descriptive statistics for univariate analysis, chi-square and t-statistics for bivariate analysis, and the logit model for multivariate analysis. The findings revealed that a child’s likelihood of attending an ECE program increases with their age, while those with functional difficulties and larger household sizes exhibit lower odds of attendance. Children with mothers possessing higher education levels demonstrated increased odds of ECE enrollment. Wealthy households and urban or Mymensingh division residency were associated with higher odds of ECE enrollment, while Barishal, Rajshahi, and Sylhet divisions indicated lower odds. To enhance ECE accessibility, the study recommends implementing a roadmap for ensuring universal early childcare and early education with an emphasis on socioeconomically underprivileged children, particularly in rural areas. Proposed strategies may include providing financial assistance to poor households and fostering public–private partnerships for ECE provision in remote regions like Barishal, Rangpur, Rajshahi, and Sylhet divisions. Moreover, it is crucial to make parents and communities aware about the significance of ECE in order to make sure that children ages 3–5 years are involved in ECE programs.

Investigating the risk factors of cardiomyopathy in pregnant mothers

BackgroundCardiomyopathy during pregnancy significantly impacts maternal health, contributing to high morbidity and mortality. Identifying risk factors for this condition is crucial for enhancing prenatal care and preventing adverse outcomes. Study designThis population-based case-control study investigates the risk factors associated with cardiomyopathy in pregnant women. MethodsWe analyzed data from 5133 pregnant women (1686 cases with cardiomyopathy and 3447 controls without cardiomyopathy) who received care at healthcare facilities affiliated with Mashhad University of Medical Sciences between March 1, 2017, and June 20, 2024. Risk factors were assessed through logistic regression models, which calculated adjusted odds ratios (AORs) with 95 % confidence intervals (CIs) for various demographic, medical, and pregnancy-related variables. ResultsSignificant risk factors for cardiomyopathy in pregnancy included obesity (AOR = 2.11, 95 % CI: 1.43–2.02), higher education level (AOR = 1.84, 95 % CI: 1.25–1.86), mental health issues (AOR = 2.07, 95 % CI: 1.7–2.5), domestic violence (AOR = 2.02, 95 % CI: 1.08–3.6), twin pregnancy (AOR = 2.6, 95 % CI: 1.57–4.6), and preeclampsia (AOR = 6.9, 95 % CI: 2.78–17.4). Additional risk factors included lack of physical fitness (AOR = 1.5, 95 % CI: 1.13–2.007), history of infectious disease during pregnancy (AOR = 1.4, 95 % CI: 1.11–1.76), anemia (AOR = 1.57, 95 % CI: 1.15–2.09), and hypertension (AOR = 1.55, 95 % CI: 1.18–2.02). Smoking increased risk but was not statistically significant (AOR = 1.29, 95 % CI: 0.69–2.4). ConclusionAddressing modifiable and non-modifiable risk factors in prenatal care is crucial to reducing cardiomyopathy incidence and improving maternal cardiovascular health.