Higher Educational Attainment Research Articles

Educational Attainment and Later-Life Cognitive Function in High- and Middle-Income Countries: Evidence From the Harmonized Cognitive Assessment Protocol.

Identifying social policies that can promote cognitive health is crucial for reducing the global burden of dementia. We evaluated the importance of educational attainment for later-life cognitive function in various social and geographic settings. Using harmonized data for individuals aged ≥65 years from the United States Health and Retirement Study (HRS) and its international partner studies in England, Mexico, China, and India, and each study's respective Harmonized Cognitive Assessment Protocol (HCAP), we conducted a cross-national comparative study to examine the role of educational attainment in later-life cognitive function across countries (n = 14,980, 2016-2019). We used multivariable-adjusted regression to estimate associations between educational attainment and harmonized global cognitive function scores. In Mexico, China, and India, the general cognitive function scores on average are approximately one standard deviation of the HRS-HCAP cognitive function score distribution lower compared to the United States and England, paralleling patterns of educational attainment across countries. In all countries, higher educational attainment was associated with progressively higher later-life cognitive function scores. Population-level differences in educational attainment explained about 50%-90% of the observed differences in cognitive function scores across countries. The relationship between education and later-life cognitive function across social and geographic contexts underscores the crucial role of education to promote cognitive health and reduce dementia risk. Continual improvement of educational attainment in low- and middle-income settings may yield a significant pay-off in later-life cognitive health.

The Stress of Advancement: A Nurse Practitioner's Exploration in Providing Culturally Competent Obesity Prevention Counseling in Black Women.

Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools. Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes. Black women aged 18-45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5-10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed. Twenty women completed the intervention. Paired sample t-test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p-value of 0.05. Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases.

Health Care Contact Days Among Older Adults in Traditional Medicare : A Cross-Sectional Study.

Days spent obtaining health care outside the home can represent not only access to needed care but also substantial time, effort, and cost, especially for older adults and their care partners. Yet, these "health care contact days" have not been characterized. To assess composition of, variation and patterns in, and factors associated with contact days among older adults. Cross-sectional study. Nationally representative 2019 Medicare Current Beneficiary Survey data linked to claims. Community-dwelling adults aged 65 years and older in traditional Medicare. Ambulatory contact days (days with a primary care or specialty care office visit, test, imaging, procedure, or treatment) and total contact days (ambulatory days plus institutional days in a hospital, emergency department, skilled-nursing facility, or hospice facility); multivariable mixed-effects Poisson regression to identify patient factors associated with contact days. In weighted results, 6619 older adults (weighted: 29 694 084) had means of 17.3 ambulatory contact days (SD, 22.1) and 20.7 total contact days (SD, 27.5) in the year; 11.1% had 50 or more total contact days. Older adults spent most contact days on ambulatory care, including primary care visits (mean [SD], 3.5 [5.0]), specialty care visits (5.7 [9.6]), tests (5.3 [7.2]), imaging (2.6 [3.9]), procedures (2.5 [6.4]), and treatments (5.7 [13.3]). Half of the test and imaging days were not on the same days as office visits (48.6% and 50.1%, respectively). Factors associated with more ambulatory contact days included younger age, female sex, White race, non-Hispanic ethnicity, higher income, higher educational attainment, urban residence, more chronic conditions, and care-seeking behaviors (for example, "go to the doctor…as soon as (I)…feel bad"). Study population limited to those in traditional Medicare. On average, older adults spent 3 weeks in the year getting care outside the home. These contact days were mostly ambulatory and varied widely not only by number of chronic conditions but also by sociodemographic factors, geography, and care-seeking behaviors. These results show factors beyond clinical need that may drive overuse and underuse of contact days and opportunities to optimize this person-centered measure to reduce patient burdens, for example, via care coordination. National Institute on Aging.

Level of Oral Reading Fluency of Learners: Basis for An Intervention Plan

This study aimed to determine the level of oral reading fluency of Grade 4 learners in Culban Elementary School, District 10 in the Division of Himamaylan City during the 3rd grading period of SY 2019-2020. The variables included were sex, parents’ highest educational attainment and size of the family. The study covered the following areas: Speed, Accuracy and Prosody. The result of the study showed that the oral reading fluency of learners’ according showed the following results: Speed – Frustration level, Accuracy – Independent and for Prosody, Approaching Fluency. The oral reading fluency of learners’ when grouped according to aforementioned variables showed these results: Speed – Frustration level, Accuracy – Independent and for Prosody, Approaching Fluency. There was a significant difference in the oral reading fluency of learners when grouped and compared according to sex; there was no-significant difference when grouped according to parent’s highest educational attainment and size of the family.

Impacts of Capital Endowment on Farmers’ Choices in Fertilizer-Reduction and Efficiency-Increasing Technologies (Preferences, Influences, and Mechanisms): A Case Study of Apple Farmers in the Provinces of Shaanxi and Gansu, China

On the basis of data collected from 1208 apple farmers in the provinces of Shaanxi and Gansu, this study utilizes the weighted-frequency method to investigate the priority sequence of farmers’ preferences in choosing fertilizer-reduction and efficiency-increasing technologies. Subsequently, ordered-probit models, a mediating-effect model, and a moderating-effect model are employed to empirically analyze the influence of capital endowment on farmers’ choices related to fertilizer-reduction and efficiency-increasing technologies and their underlying mechanisms. The study further examines how agricultural-technology extension moderates these mechanisms. The main findings are: (1) The priority sequence of farmers’ choices concerning fertilizer-reduction and efficiency-increasing technologies is as follows: organic fertilizer substitution, new efficient fertilizers, soil testing and formula fertilization, green manure cultivation, straw mulching, fertilizer-reduction application, and deep mechanical application. (2) Capital endowment significantly enhances farmers’ choices in fertilizer-reduction and efficiency-increasing technologies. (3) The mechanism analyses indicate that capital endowment can promote farmers’ choices in fertilizer-reduction and efficiency-increasing technologies by improving their information-acquisition capabilities. (4) Moderation effects reveal that agricultural-technology extension methods, such as technical training, financial subsidies, and government publicity, significantly and positively moderate the relationship between information-acquisition capabilities and farmers’ choices in fertilizer-reduction and efficiency-increasing technologies. The moderating effects of educational attainment and generational differences on different agricultural-technology extension methods are heterogeneous. Technical training, financial subsidies, and government publicity can effectively enhance the positive impact of information-acquisition capabilities on farmers with a higher educational attainment. Financial subsidies can effectively strengthen the positive impact of information-acquisition capabilities on the older generation of farmers. Therefore, it is recommended to prioritize the accumulation of farmers’ capital endowment, improve their information-acquisition capabilities, and intensify agricultural-technology extension efforts, especially taking into account farmers’ educational attainment and generational differences.

Early-Life Social Determinants of SCA6 Age at Onset, Severity, and Progression

SCA6 patients with the same size CAG repeat allele can vary significantly in age at onset (AAO) and clinical progression. The specific external factors affecting SCA6 have yet to be investigated. We assessed the effect of early life events on AAO, severity, and progression in SCA6 patients using a social determinant of health approach. We performed a survey of biological and social factors in SCA6 patients enrolled in the SCA6 Network at the University of Chicago. AAO of ataxia symptoms and patient-reported outcome measure (PROM) of ataxia were used as primary outcome measures. Least absolute shrinkage and selection operation (LASSO) regressions were used to identify which early life factors are predictive of SCA6 AAO, severity, and progression. Multiple linear regression models were then used to assess the degree to which these determinants influence SCA6 health outcomes. A total of 105 participants with genetically confirmed SCA6 completed the assessments. SCA6 participants with maternal difficulty during pregnancy, active participation in school sports, and/or longer CAG repeats were determined to have earlier AAO. We found a 13.44-year earlier AAO for those with maternal difficulty in pregnancy than those without (p = 0.008) and a 12.31-year earlier AAO for those active in school sports than those who were not (p < 0.001). Higher education attainment was associated with decreased SCA6 severity and slower progression. Early life biological and social factors can have a strong influence on the SCA6 disease course, indicating that non-genetic factors can contribute significantly to SCA6 health outcomes.

Enrollment Patterns of Medicare Advantage Beneficiaries by Dental, Vision, and Hearing Benefits

Most Medicare beneficiaries now choose to enroll in Medicare Advantage (MA) plans. Racial and ethnic minority group and low-income beneficiaries are increasingly enrolling in MA plans. To examine whether dental, vision, and hearing supplemental benefits offered in MA plans are associated with the plan choices of traditionally underserved Medicare beneficiaries. This exploratory observational cross-sectional study used data from the 2018 to 2020 Medicare Current Beneficiary Survey linked to MA plan benefits. The nationally representative sample comprised primarily community-dwelling MA beneficiaries enrolled in general enrollment MA plans. Data analysis was performed between April and October 2023. Beneficiary self-identified race and ethnicity and combined individual and spouse income and educational attainment. Binary indicators were developed to determine whether beneficiaries were enrolled in a plan offering any dental, comprehensive dental, any vision, eyewear, any hearing, or hearing aid benefit. Mixed-effects logistic regression models were estimated to report average marginal effects adjusted for beneficiary-level demographic and health characteristics, plan attributes, and plan availability. This study included 8139 (weighted N = 31 million) eligible MA beneficiaries, with a mean (SD) age of 77.7 (7.5) years. More than half of beneficiaries (54.9%) were women; 9.8% self-identified as Black, 2.0% as Hispanic, 83.9% as White, and 4.2% as other or multiple races or ethnicities. Plan choices by dental benefits were examined among 7516 beneficiaries who were not enrolled in any dental standalone plan, by vision benefits for 8026 beneficiaries not enrolled in any vision standalone plan, and by hearing benefits for 8131 beneficiaries not enrolled in any hearing standalone plan. Black beneficiaries were more likely to enroll in plans with any dental benefit (9.0 percentage points [95% CI, 3.4-14.4]; P < .001), any comprehensive dental benefit (11.2 percentage points [95% CI, 5.7-16.7]; P < .001), any eye benefit (3.0 percentage points [95% CI, 1.0 to 5.0]; P = .004), or any eyewear benefit (6.0 percentage points [95% CI, 0.6-11.5]; P = .03) compared with White beneficiaries. Lower-income individuals (earning ≤200% of the federal poverty level) were more likely to enroll in a plan with a comprehensive dental benefit (4.4 percentage-point difference [95% CI, 0.1-7.9]; P = .01) compared with higher-income beneficiaries. Beneficiaries without a college degree were more likely to enroll in a plan with a comprehensive dental benefit (4.7 percentage-point difference [95% CI, 1.4-8.0]; P = .005) compared with those with higher educational attainment. The results of this study suggest that racial and ethnic minority individuals and those with lower income or educational attainment are more likely to choose MA plans with dental or vision benefits. As the federal government prepares to adjust MA plan star ratings for health equity, implements MA payment cuts, and allows increasing flexibility in supplemental benefit offerings, these findings may inform benefit monitoring for MA.

Causal effects of educational attainment on temporomandibular disorders and the mediating pathways: A Mendelian randomization study.

As one of the most important indicators of socioeconomic status, educational attainment (EA) exhibits a strong association with temporomandibular disorders (TMDs). Despite this link, there is a lack of evidence regarding the causal role of EA in either facilitating or preventing TMDs. This study aimed to investigate the causal effect of education on TMDs and explore potential mediating pathways. Utilizing summary statistics from genome-wide association studies on years of schooling (N = 766 345) and TMDs (N = 211 023), we conducted Mendelian randomization (MR) to assess the overall effect of education. Additionally, a two-step MR approach was employed to evaluate 30 potential mediators and calculate the mediation proportions in the association. Comprehensive sensitivity analyses were used to verify the robustness, heterogeneity, and pleiotropy. Univariable MR analyses revealed a causal effect of lower EA on an increased risk of TMDs (OR: 0.53, 95% CI: 0.43-0.66, p < .001). Five out of 30 modifiable factors were identified as causal mediators in the associations of EA with TMDs, including feeling nervous (mediation proportion: 11.6%), feeling tense (10.2%), depression (9.6%), feeling worry (7.6%) and daily smoking (8.9%). Meanwhile, no pleiotropy was detected in the analyses (p > .05). Our findings supported that higher EA has a protective effect on the onset of TMDs, with partial mediation by psychological disorders and daily smoking. Interventions on these factors thus have the potential of substantially reducing the burden of TMDs attributed to low education.

Immigration, Educational Attainment, and Subjective Health in the United States.

Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups. While we know more about marginalization due to race and ethnicity, limited information is available on MDRs of educational attainment among US immigrant individuals. This study compared immigrant and non-immigrant US adults aged 18 and over for the effects of educational attainment on subjective health (self-rated health; SRH). Data came from General Social Survey (GSS) that recruited a nationally representative sample of US adults from 1972 to 2022. Overall, GSS has enrolled 45,043 individuals who were either immigrant (4,247; 9.4%) and non-immigrant (40,796; 90.6%). The independent variable was educational attainment, the dependent variable was SRH (measured with a single item), confounders were age, gender, race, employment and marital status, and moderator was immigration (nativity) status. Higher educational attainment was associated with higher odds of good SRH (odds ratio OR = 2.08 for 12 years of education, OR = 2.81 for 13-15 years of education, OR = 4.38 for college graduation, and OR = 4.83 for graduate studies). However, we found significant statistical interaction between immigration status and college graduation on SRH, which was indicative of smaller association between college graduation and SRH for immigrant than non-immigrant US adults. In line with MDRs, the association between educational attainment and SRH was weaker for immigrant than non-immigrant. It is essential to implement two sets of policies to achieve health inequalities among immigrant populations: policies that increase educational attainment of immigrants and those that increase the health returns of educational attainment for immigrants.

Mixed-methods exploration of the knowledge of young adults about blood donation processes; a one-center cross-sectional study in a tertiary institution.

Ghana is a majority youthful population, but is only able to meet 60% of its annual blood donation requirements. Although tertiary students in Ghana may serve as important blood donor resource by virtue of their higher educational attainment, data about their blood donation processes-specific knowledge are scarce. This study therefore explored the perspectives, and experiences of young adults regarding blood donation processes. This exploratory study employed mixed-methods approach (semi-structured questionnaire and focus group discussion, [FGD]). Data collection was sequential; the questionnaire distribution was completed before FGD commenced; themes that emerged from the questionnaire responses guided FGDs. Convenience sampling technique was used to recruit 382 young adults (15-49 years). All statistical analyses were undertaken using the two-tail assumptions; p<0.05 was considered statistically significant. Majority (79.3%) of the participants were in their twenties, with only 1.3% being 40-49 years old. Although two-thirds of participants expressed willingness to donate blood, less than a-third (31.7%; 127/382) had previously donated blood. Overall, less than one-third of participants could correctly identify the minimum weight (26.4%), or the inter-donation interval (14.7%); 37.4% and 58.1% could respectively indicate the required donor age or ≥3 infectious agents screened for prior to blood collection. Among previous donors, 37.2%, 28.1% and 43.0% could identify the required weight, acceptable inter-donation period, and donor age respectively. Two-thirds and a-third of participants preferred voluntary unrelated, and paid donations respectively. Whereas 42.4% of participants indicated intrinsic health benefits of blood donation, 17.0% suggested that blood donation was associated with disease risks. Both previous donors and non-donor groups considered lack of education, fear of post-donation health issues and lack of privacy at blood collection centers as main hindrances to donor recruitment. Targeted intentional blood donation-specific educational campaigns are warranted to address the blood donation processes knowledge gap among the study population.

Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong

The global rollout of COVID-19 vaccines faces a significant barrier in the form of vaccine hesitancy. This study adopts a dynamic and network perspective to explore the determinants of COVID-19 vaccine uptake in Hong Kong, focusing on multi-level determinants and their interconnections. Following the framework proposed by the Strategic Advisory Group of Experts (SAGE), the study used repeated cross-sectional surveys to map these determinants at multiple levels and investigates their interconnections simultaneously in a sample of 15,179 over two years. The results highlight the dynamic nature of COVID-19 vaccine hesitancy in an evolving pandemic. The findings suggest that vaccine confidence attitudes play crucial roles in vaccination uptake, with their importance shifting over time. The initial emphasis on vaccine safety gradually transitioned to heightened consideration of vaccine effectiveness at a later stage. The study also highlights the impact of chronic condition, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviours on vaccine uptake. Higher educational attainment and being married were associated with primary and booster vaccine uptake and it may be possible to leverage these groups as early innovation adopters. Trust in government acts as a crucial bridging factor linking various variables in the networks with vaccine confidence attitudes, which subsequently closely linked to vaccine uptake. This study provides insights for designing future effective vaccination programmes for changing circumstances.

Defining the impact of immune tolerance induction on clinically relevant outcomes in a US cohort of severe hemophilia A

AbstractAlthough the near-term benefit of immune tolerance induction (ITI) for the treatment of people with severe hemophilia A with inhibitor is apparent, the magnitude of the longer-term impact of ITI on clinical outcomes remains undefined. We examined the association between receiving ITI and the success of ITI on clinical outcomes including (1) clinical events, (2) health care use, (3) quality of life/function, (4) socioeconomic status, and (5) death, using the Community Counts (CC) registry of US Hemophilia Treatment Centers between 2013 and 2017. Multivariate logistic regression, negative binomial, and Poisson models were used. Included in this study were 3659 people with severe hemophilia A with median age of 21 years when entering the CC registry. Among 576 participants with inhibitors, 485 had received ITI (84%). ITI was successful in 299 (61.7%) and partially successful or failed in 95 (19.5%) or 91 (18.7%), respectively. Those that received ITI had fewer treated bleeds, less chronic pain, better function, and higher educational attainment than those not receiving ITI. Successful vs partially successful and failed ITI was associated with fewer treated bleeds, less health care use, less chronic pain, better function, and fewer missed days of school or work. Mortality was not associated with ITI, regardless of its success. Those with successful ITI had similar rates of treated bleeds, chronic pain, and health care use as those with no inhibitors. Undergoing ITI, particularly if successful, improved clinical outcomes but not mortality. These findings support decision making regarding initiation of ITI and inform future clinical trials.

Support Mechanism of School Administrators and Work Engagement of Teachers during the New Normal

This study aims to determine the level of support mechanisms teachers received from their school supervisors during the New Normal and its impact on their work engagement. The respondents of this study are 90 teachers in Bacong District, Negros Oriental. The method used in the study is descriptive-correlational and employed a validated self-made questionnaire. Results revealed that the level of mental support teachers receive is high, while instructional and technological support levels are very high. The level of work engagement among the teachers is also high. The teaching position held by teachers is significantly and inversely related to their work engagement, indicating that the higher the teaching position held by the teacher, the lower their work engagement. Additionally, this study reveals that there is no significant relationship between the teachers' highest educational attainment, length of service, or number of training hours and their work engagement. These results underscore the importance of continued support for teachers, especially those in leadership roles, to enhance their engagement and effectiveness in the evolving educational landscape.

The impact of an eco-score label on US consumers' perceptions of environmental sustainability and intentions to purchase food: A randomized experiment.

Front-of-package labels indicating a product's environmental footprint (i.e., eco-score labels) offer promise to shift consumers towards more sustainable food choices. This study aimed to understand whether eco-score labels impacted consumers' perceptions of environmental sustainability and intentions to purchase sustainable and unsustainable foods. US parents (n = 1,013) completed an online experiment in which they were shown 8 food products (4 sustainable and 4 unsustainable). Participants were randomized to a control (n = 503, barcode on product packaging) or eco-score label group (n = 510, eco-score label on product packaging). The eco-score label was color-coded with a grade of A-F based on the product's environmental footprint, where "A" indicates relative sustainability and "F" indicates relative unsustainability. Participants rated each product's environmental sustainability and their future likelihood of purchase. We used multilevel mixed-effects linear regression models and examined moderation by product category and sociodemographic characteristics. The eco-score label lowered perceived sustainability of unsustainable products by 13% in relative terms or -0.4 in absolute terms (95% CI -0.5, -0.3; p<0.001). The eco-score label increased perceived sustainability of sustainable products by 16% in relative terms or 0.6 in absolute terms (95% CI 0.5, 0.7, p<0.001). Effects on purchase intentions were smaller, with a 6% decrease for unsustainable products (p = 0.001) and an 8% increase for sustainable products (p<0.001). For unsustainable products, the effect of eco-score labels on sustainability perceptions was greater for older adults, men, participants with higher educational attainment, and participants with higher incomes. For sustainable products, the effect of ecolabels on sustainability perceptions was greater for those with higher educational attainment. Eco-score labels have the potential to direct consumers towards more sustainable products. Future studies should investigate eco-score label effectiveness on behavioral outcomes.

Health Professionals’ Awareness on Signs and Symptoms of Oropharyngeal Dysphagia among inpatients at a Level – Six Referral Hospital in Kenya

Background: Oropharyngeal dysphagia is a leading risk factor for multiple health complications, including malnutrition, chest infections, and pneumonia. High dysphagia awareness among health professionals may facilitate early identification and treatment. Objectives: This study’s objectives were to (i) determine oropharyngeal dysphagia signs/symptoms awareness levels among healthcare professionals attending to adult inpatients in the acute-care facility of a Kenyan level-six referral hospital and (ii) establish whether their awareness levels vary with selected individual characteristics. Methods: We employed a descriptive, cross-sectional research design, and purposive sampling of 16 health professionals attending to inpatients in the hospital’s acute-care facility. They included five (5) nurses, seven (7) physiotherapists, one (1) speech – language therapists, one (1) oncologist, one (1) neurologist, and one (1) nutritionist. Awareness levels were measured using a 16-item questionnaire. Frequencies, percentages, and means were used to summarize participants’ scores, while the independent samples t-test and one-way ANOVA were used to compare the scores across selected individual characteristics. Results: The mean proportion of correct responses was 73.0% (SD = 17.49), indicating that on average, participants had moderate awareness. Over half (56.3%, n = 9) had either low or moderate OPD signs/symptoms awareness levels. There were significant differences in mean awareness levels due to age (F = 10.13, p = .002) and educational attainment ( F = 7.44, p = .007). Conclusions: Health professionals attending to adult inpatients in the hospital’s medical and surgical units have, on average, moderate awareness of oropharyngeal dysphagia signs and symptoms. High educational attainment is associated with increased awareness. Recommendation: The hospital’s management should implement regular training programs focusing on various OPD management aspects, particularly its signs and symptoms. Priority should be given to nurses, physiotherapists, and HPs without a post-graduate degree. For better client outcomes, and opportunity for continuous professional development

Contraception Crisis in Somalia: Unveiling the Shocking Reality of a Nation Left Behind

Background. Despite global efforts to promote contraceptive use and ensure reproductive health, Somalia continues to face significant challenges in this regard. This study aims to explore the prevalence of contraceptive use in Somalia and identify the determinants influencing its use. Methods. A total of 8,162 reproductive‐aged women’s data were analyzed extracted from 2020 Somali Health and Demographic Survey. The outcome variable was contraception use, classified as any contraception use (yes vs. no), any modern contraception use (yes vs. no), and any traditional contraception use (yes vs. no). The explanatory variables were factors at the individual, household, and community level. The multivariate binary logistic regression model was used to explore associations of outcome variables with explanatory variables. Results. The findings revealed low prevalence of contraceptive use among Somalia women, with only 7% reporting its use. Among them, less than 1% utilized modern contraceptive methods. Several determinants of contraception use were identified, including younger age, higher educational attainment (primary and secondary education), higher parity, exposure to family planning messages through mass media, urban place of residence, and residing in the northwest and northeast regions of Somalia. Conclusion. The results underscore the urgent need for substantial efforts to improve contraceptive use in Somalia. Strengthening healthcare facilities to provide comprehensive sexual and reproductive health services, with a particular focus on promoting contraception uptake, is crucial. Public awareness campaigns and educational programs should also be prioritized to enhance knowledge and understanding of contraception among Somali women.

Disparities in Screening for Adverse Childhood Experiences.

Screening for adverse childhood experiences (ACEs) in the clinical setting is set to become more commonplace with continued efforts to reimburse clinicians for screening. However, an examination of disparities in ACEs screening and related attitudes and beliefs is needed. Using the 2021 California Health Interview Survey (CHIS), this study examined if several measures of socioeconomic status, access to care and identities were associated with 3 outcomes: 1) getting screened for ACEs by a clinician; 2) beliefs about the importance of screening and 3) satisfaction with efforts to address the impacts of ACEs. Logistic regressions were used to estimate odds of the outcomes. Black, Latinx, and Asian individuals had lower odds of being screened for ACEs than non-Hispanic Whites. A recent doctor's visit, higher burden of ACEs, and serious psychological distress were associated with higher odds of being screened. Latinx individuals, women, bisexual individuals, those with a recent doctor's visit and those with serious psychological distress had higher odds of believing clinicians asking about ACEs was very important, relative to their counterparts. Latinx individuals, American Indian or Alaska native individuals, Asian individuals, those with higher educational attainment and those with serious psychological distress had lower odds of being very satisfied with providers' efforts to address the impact of ACEs, relative to their counterparts. Efforts to expand ACEs screening should consider the disparities in screening that currently exist. Given the wide-ranging impacts that ACEs have on health, an equitable approach to screening is necessary.

Sex, age and education of citizens – factors affecting preferential voting? Territorial analysis of the 2023 parliamentary elections in Slovakia

Preferential voting is becoming an increasingly popular tool through which voters can prioritize their preferred candidate within the candidate list of a given political party, thereby influencing the intra-party struggle for public office to some extent. Candidate information is known, but which voters tend to use their preferential vote? Are they men or women, younger or older people, voters with lower or higher educational attainment? The presented study aims to evaluate the relationship between preferential voting and selected socio-demographic variables at the level of Slovakia, its regions and districts. We are analysing the results of the 2023 elections to the National Council of the Slovak Republic alongside socio-demographic data from the 2021 census. In order to identify a possible statistical relationship between the investigated variables, the method of linear correlation analysis was applied, using the Pearson correlation coefficient. The results indicate that at the national level, considering data from more than 2,900 municipalities in Slovakia, no relationship between preferential voting and selected socio-demographic characteristics of the population was demonstrated. Certain patterns were observed within spcecific population groups at a lower spatial-hierarchical level (in the case of the Bratislava region and Žilina region, and in selected districts of the Bratislava, Trnava, Žilina and Banská Bystrica regions), but the informative value of several of them is limited by the low number of cases entering the correlation analysis.

TOWARDS A QUALITY FRAMEWORK ON READING APPROACHES OF ELEMENTARY TEACHERS IN ADDRESSING READING GAPS OF LEARNERS

This study aimed to develop a quality framework on reading approaches used by 200 elementary teachers in addressing reading gaps of learners in Zone III, Schools Division of Zambales. The researcher employed a quantitative descriptive research design and utilized a researcher-made questionnaire as the main data source after it passed validity and reliability tests. Findings revealed that the high WM scores and consistent verbal interpretations of indicators as “Highly Helpful” affirm that guided reading approaches, peer-assisted reading approaches, and technology-aided reading approaches are integral to teachers’ strategies for supporting learner development. The variability indicated by SD values prompts considerations for professional development or clarifications in certain aspects of reading approaches, ensuring alignment in practices across classrooms. There was a significant difference in the extent of reading approaches used by the respondents in addressing learners' reading gaps. The positive VM score indicates that instructional approaches are generally effective in supporting learners’ reading and comprehension development. However, the variability in SD values suggests a need for targeted interventions and differentiated instructional strategies to address varying levels of learner progress in reading and comprehension. There was also a significant difference in the reading performance of learners using these approaches. Furthermore, there was a significant effect of demographic factors, particularly age, gender, and highest educational attainment, on the reading approaches of elementary teachers. The findings affirmed that the reading approaches of elementary teachers significantly affect the reading performance and comprehension of learners, as reflected in the regression analysis. The quality framework established standardized guidelines and evidencebased practices that enhance instructional effectiveness and assessment consistency across classrooms, thereby addressing the reading gaps of learners.

DEMAND DRIVEN UNIVERSITY EDUCATION PROVISION: IMPLICATIONS FOR EQUITY AND QUALITY

The established link between higher education attainment and individual socio-economic prosperity explains to a large extent the continued increase in private and social investment in education. It is the driver of growth in established higher education institutions and in the number of students enrolled. Many research reports on the status of education reveal the intensity in efforts to address issues underlying the poor quality of education. It is generally agreed that universities are entrusted with the task of generating knowledge of appropriate quality, and to making this knowledge availability to a wide population in order to support national economic competitiveness. But the issue of forces driving demand for higher education and their capacity to distort access to opportunities stand out. As nations endeavour to expand access to higher education, challenges of inadequate resource provision constrain access to opportunities for students with certain unique attributes. Overall national socio-economic development requires that education provision be inclusive to cover students with unique characteristics including the marginalised. Participation of those with attributes defined vulnerabilities should be a pre-requisite to quality assessments. This paper therefore examines university education demand trends in Kenya and how they related to students’ characteristics. Descriptive survey designs were used. A sample of 524 respondents was drawn from among the twenty-two public and eighteen private chartered universities. Data was analysed using frequency tables and percentages, and means; hypotheses were tested using ANOVA, with all statistical tests done at α=0.05 level of significance. Results showed that overall demand for education was on the increase in public universities, but declining in private universities. Disparities in demand by gender were observed with more males accessing university places. Consequences of increased demand for university education included high workloads for lecturers, and congested facilities. These findings are important to educators, education planners, institution managers who are charged with devising mechanisms and processes that address issues of quality and equity in demand for university education.