The joint and interactive effects of household income, delivery mode with prenatal BPA exposure on offspring early postnatal growth trajectories: A prospective cohort study.

A cross-sectional online study was conducted with 368 Brazilian university students aged 18-30 years. Ultra-processed food intake was assessed using a score based on the Nova classification, reflecting the number of ultra-processed food subgroups consumed on the previous day. Food addiction was measured with the modified Yale Food Addiction Scale 2.0 and operationalized as diagnostic severity (none, mild, moderate, severe) and symptom presence (zero vs. one or more symptoms). Household income was categorized into four classes (A-D/E). Associations were examined using negative binomial regression, with multivariable models adjusted for body mass index and additional models including gender, race, and perceived stress related to the COVID-19 pandemic. Lower household income was consistently associated with higher intake of ultra-processed foods. Compared with the highest income class, participants in income classes C and D/E showed expected intakes 39% and 42% higher, respectively. When food addiction was analyzed using diagnostic criteria, only the mild diagnosis group differed from the non-food addiction group, showing lower expected intake after adjustment for body mass index. In contrast, symptom-based analyses revealed that participants with one or more food addiction symptoms had an approximately 18% higher expected ultra-processed food intake than asymptomatic individuals. Lower income and symptom presence were particularly associated with consumption of ultra-processed foods that replace or accompany meals, as well as ultra-processed beverages. Household income and food addiction symptoms jointly influence ultra-processed food intake among Brazilian university students. Symptom-based measures appear more sensitive than diagnostic categories for identifying population-level vulnerability. These findings highlight the need for public policies that address both socioeconomic inequalities and addictive-like eating behaviors to reduce excessive ultra-processed food consumption.

Anticipated living arrangement plans in later life: Interplay of health, childlessness, and income in South Korea.

Food insecurity and verbal aggression toward children: Income-differentiated pathways through parental psychological distress.

The National School Lunch and Breakfast Program, a US program that addresses food insecurity, requires children with higher household incomes to pay for meals. It is unclear whether universal school meals (USM) policies, which make all meals free, further alleviate food insecurity, particularly for students who would otherwise pay. This study estimates the association between statewide USM policies and food insecurity. A difference-in-differences study using a nationally representative sample of US households with 6- to 17-year-old children from 2012 to 2021 and 2023 to 2024. The exposure was maintaining statewide USM policy after 2022, determined based on state of residence. The primary outcome was household food insecurity; the secondary outcome was child food insecurity. Analyses were stratified by household income. The sample included 75 122 households. Households with the highest incomes in USM-maintaining states experienced a 1.3-percentage-point (95% CI: -2.1, -0.5) differential decrease in household food insecurity and a 0.9-percentage-point (95% CI: -1.4, -0.5) differential decrease in child food insecurity. Households with low-middle income in USM-maintaining states experienced a 3.2-percentage-point (95% CI: -6.1, -0.3) differential decrease in household food insecurity but no differential change in child food insecurity. Households with lowest income in USM-maintaining states experienced no differential change in household food insecurity and a 3.8-percentage-point (95% CI: -6.2, -1.5) decrease in child food insecurity, although caution is required because the parallel trends assumption was violated. Implementing statewide USM policies could contribute to decreased food insecurity among households with school-aged children.

Using household survey data on expenditures and incomes, we construct an objective measure of corruption in the public sector for a broad spectrum of countries. Specifically, we focus on the consumption-income gap for public sector workers relative to private sector workers to gauge the extent of hidden income (bribes) in the government. After validating our data and documenting properties of the consumption-income gap, we compare our measure with popular corruption perception indices. We find that i ) the relationship between our measure and the alternatives is nonlinear; ii ) available indices appear to be only weakly (and sometimes “wrongly”) correlated with the consumption-income gap at high frequencies; iii ) the available indices appear to have a low weight on the relative consumption-income gap in the public sector. • The paper proposes an objective measure of corruption by focusing on the consumption-income gap of public sector workers relative to private sector workers, interpreting the gap as a gauge of hidden income (bribes). • Using household survey data from a diverse set of 57 countries over the 1995-2023 period, the authors construct the first cross-country analysis of this market inference method. • The analysis finds that popular corruption perception indices do not correlate strongly with the consumption-income gap, suggesting existing indices may provide a distorted or noisy picture of actual, experienced corruption. • The consumption-income gap offers a timely, scalable, and quantifiable measure that can be used to validate existing indices, providing a valuable component for a more credible anti-corruption toolkit.

Association between full-scope practice, schedule balance, and burnout among nurses in health professional shortage areas: A cross-sectional study.

The Role of Geography in United States Retinoblastoma Care.

Associations between the built environment and body mass index among a residentially stable cohort of mid-older aged adults in Brisbane, Australia (2007-2016).

To assess the socioeconomic consequences of critical illness by quantifying changes in household income level and unemployment among ICU survivors in a universal health coverage setting. This nationwide retrospective cohort study used the Korean National Health Insurance Service database. Adult ICU survivors between January 1, 2020, and December 31, 2022, were included. Patients who died within 1 year or had missing data were excluded. The final cohort consisted of 582,341 survivors. None. The primary endpoint was the change in household income level (scale 0-20) between pre-ICU and post-ICU years, analyzed using generalized estimating equation models. The most salient finding was a profound financial polarization among survivors. While the overall cohort experienced a significant and progressive decline in income rank (1-yr ratio of means [RoM], 0.994; 2-yr RoM, 0.976; both p < 0.001), this average masked a severe impact on the highest income quartile (Q4), which exhibited a substantial 6.5% relative drop in mean rank (RoM, 0.935). In contrast, the lowest quartile (Q1) showed relative stability (RoM, 2.198) due to a "floor effect" and transitions into the social safety net. Descriptively, 160,682 survivors (27.6%) experienced income decline, 60,432 (10.4%) suffered catastrophic decline, and 12.3% of 326,125 previously employed survivors were no longer employed within 1 year. Critical illness is associated with progressive socioeconomic deterioration characterized primarily by financial polarization. Even with universal health coverage, the economic burden hits previously high-earning households most severely, while lower income groups face potential asset depletion before transitioning to social safety nets. Policies integrating sustained financial protection and vocational rehabilitation into post-ICU survivorship care are essential.

Participation in sports contributes substantially to children's physical health, psychological well-being, and cognitive development. Despite national initiatives to increase youth sports participation, inequities remain. Socioeconomic disadvantage, racial and ethnic minority status, and other social determinants of health (SDOH) are associated with lower engagement. However, most research addresses isolated factors rather than cumulative neighborhood-level SDOH. This study identified neighborhood SDOH profiles and examined their associations with sports participation. Baseline data of 9400 children from 9 to 10 yr in the Adolescent Brain Cognitive Development Study were analyzed. Eighty-two neighborhood indicators spanning seven SDOH domains were aggregated into domain scores, with higher scores reflecting more advantaged conditions. Hierarchical agglomerative clustering identified neighborhood SDOH profiles. Associations between cluster membership and sports participation were examined using regression models adjusted for age, sex, race and ethnicity, parental education, and household income. Outcomes included the total number of sports and qualitative indices by sport skill type (open vs closed) and context (team vs individual). Four neighborhood profiles were identified, ranging from high affluence to urban high-risk environments. Children from disadvantaged clusters participated in fewer sports. Those in the most deprived neighborhoods played approximately 1.5 fewer sports than peers in affluent areas ( P < 0.01) and had reduced odds (open-skill or team sport participation odds ratios approximately 0.35-0.37, P < 0.01). Associations were attenuated after adjustment for individual- and family-level socioeconomic factors, with disparities remaining significant primarily in moderately advantaged and highly socioeconomically deprived neighborhoods. Distinct neighborhood social conditions are associated with differences in youth engagement in organized sports. These findings underscore the importance of considering structural and community-level factors when examining disparities in youth sports participation.

Factors associated with employment and hospitalizations in early-onset psychosis: a clinical study with register-based follow-up.

Understanding household economic influences on child stunting: A cross-sectional study in Eastern Uganda.

This study investigates the degree of the perceived risk of intravenous thrombolysis in acute cerebral infarction among surrogate decision-makers and the factors influencing their propensity to make decisions about thrombolysis. An investigation was conducted on a cross-sectional basis. We recruited participants using a purposive sampling technique. All participants were recruited from the Advanced Stroke Centre in a tertiary care general hospital from January 2022 to December 2022. A total of 201 Surrogate Decision-Makers completed the survey. Using a self-designed questionnaire, the instrument of this survey contains three aspects of general information including risk perception level survey, propensity for thrombolysis, and consisting of 18 questions. Risk perception consists of three dimensions: economic risk perception, psychosocial risk perception, and physical functioning risk perception, and each dimension is scored in the range of 3-15 points. Higher scores indicate stronger risk perception. The mean risk perception score of acute ischemic stroke surrogate decision-makers was (11.26 ± 2.72). The average score of psychosocial risk perception was (10.71 ± 2.34); the score of physical function risk perception was (11.00 ± 2.37). The highest proportion of those choosing conservative treatment was 46.8%. The percentage of those willing to thrombolize was 27.4%, and those who were unsure about it was 25.9%. The degree of perceived economic risk, perceived psychosocial risk, and perceived physical function risk all had a significant negative effect on the propensity to make decisions about thrombolysis after excluding the confounding interference of different ages, education levels, and monthly per capita household income. This study found a significant effect of risk-perception of the surrogate decision-maker on treatment propensity. Healthcare professionals should pay attention to guiding surrogate decision-makers to establish correct disease perception and risk-perception through effective communication during thrombolysis communication in acute ischemic stroke to relieve their decision-making pressure, shorten decision-making time and reduce Door-to-Needle time to improve patient prognosis and increase the rate of thrombolytic therapy. This study is a questionnaire survey conducted by the investigator and no patient or public participation is required. The risk perception of surrogate decision-makers is likely to play an essential role in the decision-making process. However, increased risk perception and prolonged thrombolysis are due to a lack of knowledge about thrombolysis among surrogate decision-makers. Generalizing the need for intravenous thrombolysis may improve the rate of thrombolysis and thus provide clinical benefit to patients.

Type 2 diabetes mellitus (T2DM) increases the risk of developing periodontal disease, and severe periodontal disease leads to poor diabetic control based on blood levels of glycated hemoglobin (HbA1c). However, less is known about diabetic control and caries. The authors aimed to compare HbA1c levels in a cohort of All of Us Research Program study participants with T2DM who had received a diagnosis of caries, gingivitis, or periodontitis. Included in this cross-sectional study were people who received a diagnosis of T2DM; a mutually exclusive diagnosis of caries, gingivitis, or periodontitis; and an HbA1c laboratory value within plus or minus 90 days of receiving the dental diagnosis. The primary outcome was the level of diabetic control dichotomized into controlled (HbA1c ≤ 64 mmol/mol [8%]) and uncontrolled (HbA1c > 64 mmol/mol [8%]). Covariates included demographic charactersitics, body mass index, smoking history, and self-reported general health. Differences between exposure groups were tested using t tests and χ2 tests and logistic regression modeled diabetic control at the time of dental disease diagnosis. The analytic data set included 2,421 participants. Mean (SD) age at diabetes diagnosis was 52.3 (12.0) years; 50.8% of participants were women, 27.7% were Black, 35.6% were White, 29.2% were Hispanic, and approximately 50% reported annual household income less than $25,000. Participants who received a diagnosis of caries had higher mean HbA1c levels. Participants who received a diagnosis of gingivitis or periodontitis were more likely to have controlled T2DM than those who received a diagnosis of caries. The study results underscore the need for further research to clarify the association between caries and diabetes. Although it is widely accepted that a bidirectional association exists between T2DM and periodontal disease, increased awareness among health care professionals of other oral-systemic associations is warranted.

Socioeconomic status (SES) is associated with adolescents' cognitive and academic outcomes, yet most research has focused on household SES in high-income countries. This study examined linear and canonical associations between family- and school-level disadvantage and cognitive-academic performance in 1296 Chilean adolescents (aged 10-14). Linear mixed models estimated associations between SES and continuous cognitive and academic scores, while canonical correlation analysis (CCA) characterized multivariate SES-cognition-achievement patterns. Findings showed that attending schools with a mid- or low School Vulnerability Index (SVI) was associated with higher scores in memory and problem solving (β = 4.3-7.4), whereas SVI was not related to grades; in contrast, parental university education and higher household income were linked to higher cognitive scores (β = 2.9-5.0) and better grades across subjects (β = 0.12-0.45). CCA identified two globally significant covariation modes. The first mode (r = 0.40) captured a broad socioeconomic dimension, driven primarily by family income and parental education, which correlated with generalized cognitive and academic performance. A second mode (r = 0.25) captured secondary variance in selected academic subjects and inhibitory control. However, individual SES indicators did not reach statistical significance on this component. These findings suggest a shared socioeconomic gradient driven predominantly by family resources underlies adolescent cognitive and academic outcomes. Alongside this global trend, school vulnerability is primarily linked to specific cognitive functions and family socioeconomic status is pervasively associated with academic achievement. Mitigating educational disparities would therefore benefit from multi-level policies targeting both environments. SUMMARY: A shared socioeconomic gradient driven by family resources underlies adolescent cognitive and academic outcomes. School vulnerability associates specifically with targeted cognitive functions. Family socioeconomic status pervasively associates with broad academic achievement. Effective mitigation of educational disparities involves targeting both home and school contexts.

Do demographic and socioeconomic factors influence the management of nasal bone fractures?

Men are more likely to die from cancer than women, which may partly be explained by differences in diagnosis stage. This pan-cancer analysis examined sex differences in cancer stage at diagnosis for nonreproductive solid organ tumors across 30 cancer sites. We used data from the Surveillance, Epidemiology, and End Results 21 database (2015-2022, excluding 2020). We conducted multiple polytomous logistic regression to assess the association between sex and stage of disease (localized vs. regional and localized vs. distant) for each site, adjusted for age and diagnosis year. We further conducted stratified analyses based on race and ethnicity and county-level median household income. Of the 30 sites examined, males had greater odds of being diagnosed at regional and/or distant stages compared with the localized stage for 20 sites, while having lower odds of being diagnosed at the later stages for four sites, compared with females. When examining distant stage, the site with the largest adjusted odds ratios (aOR; i.e., male predominance) was the tongue [aOR = 2.34; 95% confidence interval (CI), 2.16-2.53]; the smallest aOR (i.e., female predominance) was for the bladder (aOR = 0.69; 95% CI, 0.66-0.72). For most sites we examined, males were significantly more likely to be diagnosed at regional or distant staging than localized staging when compared with females. Further investigation is warranted to elucidate the mechanisms driving sex-based differences in stage at diagnosis and to identify effective, targeted intervention strategies aimed at reducing diagnostic disparities, particularly among males.

Depressive symptoms trajectories among Chinese menopause transition women and their subsequent impact on life satisfaction: A longitudinal study based on the CHARLS database.

Lyme disease is a growing public health concern in the United States. Despite higher rates of infection among children and disseminated disease among racial minorities, few studies have investigated the role of health care inequities on tick-borne disease knowledge among parents. We conducted a single-center, cross-sectional, anonymous survey of tick-borne disease recognition and prevention strategies among English- and Spanish-speaking parents/caregivers in a region of high Lyme disease incidence (Long Island, New York). Survey questions consisted of demographics, knowledge assessment, and tick bite prevention practices. Survey responses were analyzed with descriptive statistics and a multivariable logistic regression model to identify associations between participant characteristics and a calculated knowledge score. In total, 120 participants completed the survey, including 95 (79.2%) English speakers and 25 (20.8%) Spanish speakers. Of these, 72 participants (60%) answered all 4 knowledge questions correctly, and 94 (78.3%) answered 75% of the knowledge questions correctly. English language preference was associated with higher knowledge scores on univariate but not multivariable analysis. Multivariable analysis identified Hispanic or Latino race/ethnicity, lower household income, and fewer years of residence on Long Island as predictors of lower Lyme disease knowledge scores. Our findings highlight the role of adverse social determinants of health on Lyme disease risk, underscoring the need for focused educational interventions on high-risk populations.