Low-income Backgrounds Research Articles

Engaging or Deterring the Next Generation? An Analysis of Fees for Cardiac Surgery Conferences

BackgroundConferences are valuable platforms for academic discourse. However, trainees, individuals with lower income backgrounds, and attendees from low- and middle-income countries (LMICs) often face significant financial barriers that may limit accessibility to conferences. This study evaluates fees for attending international cardiac surgery conferences to better understand potential financial barriers. MethodsRegistration fees for 2022-2023 international cardiac surgery conferences were analyzed. Fees were categorized on the basis of the career stage and society member status of the attendee. Other data collected included the meeting’s subspecialty, location, availability of discounts, and virtual components. ResultsSeventeen conferences were identified. Discounts are widely available for students, residents, and fellows attending cardiac surgery conferences in 2022-2023. Society member students’ fees ranged from US $0 to $390 (median, US $15; interquartile range [IQR], $0-$198). Society member residents' and fellows’ fees ranged from US $0 to $795 (median, US $200; IQR, $75-$390). Society member staff’s fees ranged from US $200 to $802 (median, US $545; IQR, $441-$608). Four conferences (23.5%) explicitly mentioned discounts for LMIC attendees, whereas 5 conferences (29.4%) mentioned virtual components. ConclusionsConference fees remain substantial for trainees and LMIC participants, who are respectively burdened with tuition costs and lower incomes and purchasing powers. Conferences should explore avenues to reduce financial barriers to provide more equitable opportunities for current and future generations of cardiac surgeons.

Patient Characteristics and Spending Among Individuals Undergoing Ambulatory Panniculectomy and Abdominoplasty in the US from 2016 to 2019.

Abdominal contouring surgery can provide both functional and cosmetic benefits to patients with abdominal soft tissue laxity. Although these procedures have been studied in the inpatient setting, few studies describe abdominal contouring surgery in the ambulatory setting. The purpose of this analysis was to investigate patterns in patient demographics between functional panniculectomy and cosmetic abdominoplasty using national data from the last four years. Using the Nationwide Ambulatory Surgery Sample, we analyzed outpatient abdominal contouring procedures between 2016 and 2019. Encounters with a CPT 15830 were included. Procedures with ICD Z41.1 or CPT 15847 modifiers were defined as cases of cosmetic abdominoplasty. A weighted estimate of 95,289 encounters were included, with 66,531 (69.8%) functional panniculectomy and 28,758 (30.2%) cosmetic abdominoplasty procedures. Among patients with a history of bariatric surgery (23.8%; 95% CI, 22.3-25.4%), there was a 28.5% (4,866 in 2016 vs 6,254 in 2019) increase in panniculectomy and abdominoplasty. Compared with individuals who underwent cosmetic abdominoplasty, individuals who underwent functional panniculectomy were more racially diverse, had more comorbidities, and were more likely to be from low-income backgrounds. Rates of abdominal contouring surgery in the ambulatory setting have increased in recent years especially among individuals with previous bariatric surgery. There are important demographic and clinical differences between patients who underwent functional panniculectomy and cosmetic abdominoplasty including primary payer, comorbidities, and racial identity. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Kem Anak Hebat and Fun Islami (KAHFI): Program Pelatihan Kreatifitas dan Pembinaan Agama Anak-Anak Indonesia di Kuala Lumpur

The Creative Training and Religious Guidance Program for Indonesian Muslim Children in Kuala Lumpur is important because access to Islamic religious education and Quranic studies in Kuala Lumpur is considered expensive and inaccessible to lower-income Indonesian children. This program aims to provide equal opportunities for children from lower-income backgrounds to obtain quality religious education and develop creative skills. In a diverse environment like Kuala Lumpur, it is important for Indonesian Muslim children to strengthen their religious understanding to maintain their religious identity and practice Islamic values in their daily lives. However, the high costs associated with religious education and Quranic studies can be a barrier for children from families with limited incomes. The Creative Training and Religious Guidance Program for Indonesian Muslim Children in Kuala Lumpur is designed to address this constraint. By collaborating with educational institutions and religious organizations like Fatayat Nahdatul Ulama (NU), the program offers training in creative skills, such as arts and music, while providing religious guidance to the children. This provides an opportunity for children from lower-income backgrounds to access affordable Islamic education and Quranic studies. The program has dual benefits. First, children can access Islamic religious knowledge and learn to recite the Quran without a heavy financial burden, thereby reducing the disparity in access to religious education. Second, by aligning activities with the spirit of Ramadan, the program creates an environment that ignites the enthusiasm of children to participate and enhances their love for Islam. This program offers a new hope for children from lower-middle-class backgrounds in Indonesia to develop a solid understanding of their religion and strengthen their Muslim identity.

COVID-19 Pandemic and Education: Nigerian Parents’ Approach and Perception of Children’s Education Based on Socioeconomic Indicators

This paper, using 201 parents’ reports collected via a descriptive survey, explores (a) how children from different socioeconomic backgrounds (education and income) engage in learning in the absence of inclusive actions to keep learning ongoing in a Nigeria; and (b) the indirect impact of COVID-19 on children’s education (children’s access to learning materials, engagement in learning, and educational achievement). Findings showed that many Nigerian children engaged in learning and parents perceived educational achievement during pandemic school closure as worse. Socioeconomic backgrounds were associated with patterns of engagement. Children from highly educated and high-income backgrounds had significantly higher access to learning resources, which were also associated with their greater engagement in learning, than those children from low socioeconomic backgrounds. Children from low-income backgrounds were more engaged in face-to-face outside the home learning. This could have been due to the low access to online resources and low compliance to COVID-19 rules (driven by mistrust in government) of low-income and less educated families. Implications of findings for informing educational intervention programs, including post-COVID pedagogies, are discussed.

Quality of early childcare and education predicts high school STEM achievement for students from low-income backgrounds.

High-quality early childcare and education (ECE) has demonstrated long-term associations with positive educational and life outcomes and can be particularly impactful for children from low-income backgrounds. This study extends the literature on the long-term associations between high-quality caregiver sensitivity and responsiveness and cognitive stimulation (i.e., caregiving quality) in ECE settings and success in science, technology, engineering, and mathematics (STEM) in high school. Using the 1991 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 1,096; 48.6% female; 76.4% White, 11.3% African American, 5.8% Latine, 6.5% other), results demonstrated that caregiving quality in ECE was associated with reduced disparities between low- and higher-income children's STEM achievement and school performance at age 15. Disparities in STEM school performance (i.e., enrollment in advanced STEM courses and STEM grade point average) and STEM achievement (i.e., Woodcock-Johnson cognitive battery) were reduced when children from lower-income families experienced more exposure to higher caregiving quality in ECE. Further, results suggested an indirect pathway for these associations from caregiving quality in ECE to age 15 STEM success through increased STEM achievement in Grades 3 through 5 (ages 8-11 years). Findings suggest that community-based ECE is linked to meaningful improvements in STEM achievement in Grades 3 through 5 which in turn relates to STEM achievement and school performance in high school, and caregiving quality in ECE is particularly important for children from lower-income backgrounds. This work has implications for policy and practice positioning caregivers' cognitive stimulation and sensitivity in ECE settings across the first 5 years of life as a promising lever for bolstering the STEM pipeline for children from lower-income backgrounds. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Validation of the StimQ2: A parent-report measure of cognitive stimulation in the home.

Considerable evidence demonstrates the importance of the cognitive home environment in supporting children's language, cognition, and school readiness more broadly. This is particularly important for children from low-income backgrounds, as cognitive stimulation is a key area of resilience that mediates the impact of poverty on child development. Researchers and clinicians have therefore highlighted the need to quantify cognitive stimulation; however existing methodological approaches frequently utilize home visits and/or labor-intensive observations and coding. Here, we examined the reliability and validity of the StimQ2, a parent-report measure of the cognitive home environment that can be delivered efficiently and at low cost. StimQ2 improves upon earlier versions of the instrument by removing outdated items, assessing additional domains of cognitive stimulation and providing new scoring systems. Findings suggest that the StimQ2 is a reliable and valid measure of the cognitive home environment for children from infancy through the preschool period.

Factors affecting unmet medical needs of patients with diabetes: A population-based study.

The purpose of this study was to identify unmet medical needs and related factors in patients with diabetes. A cross-sectional study. Participants included 2269 diabetes patients aged >19 years by using data from the National Health and Nutrition Examination Surveys. A complex sample design multiple logistic regression analysis was performed. The study found that 8.7% of diabetes patients experienced unmet medical needs, and it was found to be higher for those who thought their self-assessed health status was unhealthy and often felt stressed in their daily life. Gender and education level had a moderating effect on income level on unmet medical needs experience. These findings have important implications for nursing practice in the management of diabetes. Nurses can develop targeted interventions that address the specific needs of patients who are at risk for unmet medical needs, particularly those from low-income backgrounds. By considering the factors that contribute to unmet medical needs and the moderating effect of income level, nurses can improve patient outcomes and reduce the burden of diabetes.

Mechanisms and pathways linking kindergarten behavior problems with mid-life employment earnings for males from low-income neighborhoods.

Childhood behavior problems are associated with reduced labor market participation and lower earnings in adulthood, but little is known about the pathways and mechanisms that explain these associations. Drawing on a 33-year prospective birth cohort of White males from low-income backgrounds (n = 1040), we conducted a path analysis linking participants' teacher-rated behavior problems at age 6 years-that is, inattention, hyperactivity, aggression-opposition, and low prosociality-to employment earnings at age 35-39 years obtained from tax records. We examined three psychosocial mediators at age 11-12 years (academic, behavioral, social) and two mediators at age 25 years (non-high school graduation, criminal convictions). Our findings support the notion that multiple psychosocial pathways-especially low education attainment-link kindergarten behavior problems to lower employment earnings decades later.

Evaluation of Clinical Profile and Complications Associated with Snake Bite among Such Patients at a Tertiary Care Hospital

Background: Snakebite occurs in Pakistan ofently mostly an occupational infection like farmers, plantation workers, fishers, and even among wildlife park rangers and military personnel. Monsoons are essential to farming, and most farmers are from lower-income backgrounds. Snake bite morbidity and fatality rates are species- and time-specific. The sufferers are often from lower socioeconomic classes, despite the absence of evidence to support their usage in the treatment of snake bite poisoning. Snake bites may be fatal if not treated quickly, thus having accurate data on the frequency and severity of these incidents is crucial for both diagnosis and policymaking. So, the study focuses on the evaluation of clinical profile and complications associated with snake bite among such patients at a tertiary care hospital. Objective: The objective of this study is to identify potential contributors to snake bite occurrences and also to determine the mortality and morbidity rates associated with snakebites and how they vary by snake species, venom type, bite location, and anti-venom use. Study Design: Observational Retrospective Study. Settings: This study is conducted in the department of Forensic Medicine and Toxicology, Sheikh Zayed Medical College, Rahim Yar Khan Pakistan. Duration: One year from Jan 2022 to Dec 2022. Methods: Both sexes from any age group and only suspected of snake bite were included. The poison illness other than snake bite were excluded from the study. Tertiary care facilities located in Pakistan included 150 snake bite cases were studied retrospectively between (study period). Using hospital records, researchers were able to learn specifics about snakebite-related mortality and morbidity, such as the species of snake if known, the method of envenomation, the victim's age, sex, residence, occupation, bite site, bite location, clinical manifestations of snakebite, initial treatment, and antivenom use. The admission and death registry were used to compile the historical record of data. Results: There were 96 male and 57 female enrolled in the study. The afternoon had the highest rate of bites (47% during the day), followed by the morning (28%), for a total of 78.5% during the day and 26.5% during the night. Seventy-five percent of the victims were alert when they were taken to the hospital, and most stayed there for between three and ten days as part of their surveillance, improvement, and recovery. The ages have been divided into different groups and we found that majority were from between 30 to 40 years. Pain, swelling, bleeding, tingling, numbness, and a blackened discoloration of the skin were all seen locally in 92 percent of the cases. Conclusion: Surveillance of envenomation’s is crucial for defining standards, arranging therapeutic supplies, and teaching medical personnel on Snakebite treatment since under-reporting of Snake bite occurrences has led to variances in observed rates of it. In addition, it has been noted that snake bites continue to be a significant occupational (farming) danger for people of working age, particularly men, in rural areas.

In the States: Addressing the Teacher Shortage

In Short States have taken different approaches in addressing the need for increased compensation among teachers by spreading pay increases across multiple years, linking increases to performance, and connecting them to sweeping K–12 policy changes, such as school vouchers. The earn-as-you-learn Registered Apprenticeship model is an increasingly popular policy choice, which helps to close equity gaps for students from low-income backgrounds and students of color who want to enter the profession. Some efforts to reduce the teacher shortage, such as easing requirements to be a teacher, remain controversial and potentially counterproductive when considering education quality.

Some implications of the neoliberal massification of Colombian HE for achieving the sustainable development goals

This article draws on existing research, including publicly available data, to identify changes in Colombian HE which have led to its progressive massification and neoliberalisation. These include the introduction of standardised testing; endogenous and exogenous privatisation (Ball and Youdell, 2007); the expansion of the country’s non-income contingent loan scheme; cost-cutting and cost-sharing; and the Government of Colombia’s prioritisation of technical and technological (T&T) education. The article then explores some implications of this neoliberal massification of Colombian HE for the achievement of the UN’s sustainable development goals in general and more specifically Sustainable Development Target 4.3, which is the only target to explicitly reference inclusion in HE. The analysis suggests that although some neoliberal policies may have broadened access to HE for some Colombians from low-income and rural backgrounds, they are not consistent with a sustainable development agenda. Reasons for this include the large number of student loans recipients who are in arrears; the use of public money to finance students’ courses in private higher education institutions (HEIs); the prioritisation of T&T education which leaves limited room in Colombian HE for the ‘full development of the human personality’ (OHCHR, 2022: article 13.1); and the country’s overreliance on non-renewable resources for its economic prosperity. The paper ends with some proposals for disrupting the ongoing neoliberalisation of higher learning in Colombia such as the replacement of the country’s non-contingent loan scheme with an income-contingent model; improving the efficiency and accountability of state-run T&T programmes; the granting of student loans only for courses at accredited HEIs; the provision of loans to accredited private HEIs only in cases where no public alternative exists; the abolition of tuition fees in public HEIs for the poorest students; the introduction of stipend-supported internships; and the promotion of Civic Education.

The Invisible Hurdle

International students pursuing higher education in the United States incur additional expenses compared to domestic students by spending on foreign credential evaluations and visa applications. These costs are usually not reflected in program fee structures, are non-refundable, and are not covered by financial aid, creating significant, and often unforeseen, financial strains on international students, particularly those from low-income backgrounds. This study compared the costs of two major foreign credential evaluators (Educational Credential Evaluators and World Education Services) and factored in the price of visa processing fees and the I-901 Student and Exchange Visitor Information System fee. It found that First-time, International, Graduate students pay up to $691 for foreign credential evaluations and visa applications. The paper suggests that higher education institutions should provide more transparent fee breakdowns and enhance financial aid packages to better support these students.

Self-Efficacy Buffers Against Belonging Loss for Hispanic Students During the First Semester of College

<p style="text-align: justify;">Hispanic college students typically report a lower sense of belonging than their White peers, citing challenges related to first generation student status, low-income family backgrounds, and academic underpreparedness. The present study asked whether Hispanic students would have a lower sense of belonging than non-Hispanic White students and whether academic self-efficacy would be able to provide a greater buffer against belonging loss for Hispanic students compared to their non-Hispanic White peers. The participants of this study were Hispanic (n = 68) and non-Hispanic White (n = 420) first year students at a predominantly White small liberal arts college. Academic self-efficacy was a significant predictor of change in belonging for Hispanic students but not for non-Hispanic White students. These results suggest academic self-efficacy is a worthwhile target of belonging interventions for Hispanic students. </p>

Weight and disordered eating among adolescents from low-income backgrounds

Disordered eating affects youth from varying socioeconomic backgrounds; however, representation of youth from low-income backgrounds within disordered eating research has been limited. The aim of the current study was to examine the association between adolescent weight and disordered eating among a sample of youth from a low-income background and to examine specific socioenvironmental factors that might moderate this association. Adolescents ages 12–17 (N = 73) from a low-income background and their parents/guardians completed self-report questionnaires. Adolescent height and weight were objectively measured to calculate BMI z-score. Adolescent weight was significantly positively associated with global disordered eating (95 % CI [0.26, 0.54]), after controlling for sex. Parental weight concern moderated the association between weight and global disordered eating, F(4, 68) = 18.44, p < .01, such that the relation between adolescent zBMI and disordered eating was no longer significant at low levels of parental weight concern. Structured family meals moderated the association between weight and global disordered eating, F(4, 68) = 11.99, p < .01, such that more frequent meals weakened the association between adolescent zBMI and disordered eating. Findings suggest that higher weight is associated with greater levels of disordered eating among adolescents from a low-income background. In addition, lower levels of parental weight concern and more frequent family meals significantly buffered the association between weight and disordered eating in this at-risk, yet understudied population. Both parental weight concern and family meals present as factors within the family environment that may serve as targets for intervention.

Effect of HPV self-collection kits on cervical cancer screening uptake among under-screened women from low-income US backgrounds (MBMT-3): a phase 3, open-label, randomised controlled trial

Most cervical cancer in the USA occurs in under-screened women. The My Body, My Test-3 (MBMT-3) trial sought to assess the efficacy of mailed human papillomavirus (HPV) self-collection kits with appointment-scheduling assistance to increase uptake of cervical cancer screening among under-screened women from low-income backgrounds compared with scheduling assistance alone. MBMT-3 is a phase 3, open-label, two-arm, randomised controlled trial. Participants were recruited from 22 counties in North Carolina state, USA, and we partnered with 21 clinics across these counties. Participants were eligible for inclusion if they were aged 25-64 years, had an intact cervix, were uninsured or enrolled in Medicaid or Medicare, had an income of 250% or less of the US Federal Poverty Level, were living within the catchment area of a trial-associated clinic, and were overdue for screening (ie, Papanicolaou test ≥4 years ago or high-risk HPV test ≥6 years ago). Participants were randomly assigned (2:1) to receive a mailed HPV self-collection kit and assistance for scheduling a free screening appointment (intervention group) or to receive scheduling assistance alone (control group). Randomisation was conducted by county using permuted blocks of nine patients and assignment to group was not masked. Participants in the intervention group were mailed HPV self-collection kits to collect a cervical-vaginal sample and return it by mail for testing. Samples were tested with the Aptima HPV assay (Hologic, San Diego, CA, USA), and participants were informed of high-risk HPV results by telephone call. Trial staff made up to three telephone call attempts to provide scheduling assistance for in-clinic screening for all participants. The primary outcome was cervical cancer screening uptake (ie, attending an in-clinic screening appointment or testing negative for high-risk HPV with a returned self-collected sample) within 6 months of enrolment in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02651883, and has been completed. Recruitment occurred between April 11, 2016, and Dec 16, 2019. 4256 women contacted the trial to participate, of whom 899 (21%) were eligible for inclusion and 697 (78%) returned consent forms. Of those who consented, 461 (66%) women were randomly assigned to the intervention group and 236 (34%) women were randomly assigned to the control group. We excluded 32 ineligible women post-randomisation, leaving 665 for primary analysis. Screening uptake was higher in the intervention group (317 [72%] of 438) than control group (85 [37%] of 227; risk ratio 1·93, 95% CI 1·62-2·31). Among intervention participants, 341 (78%) of 438 returned a self-collection kit. Three participants reported hurt or injury when using the self-collection kit; no participants withdrew due to adverse effects. Among under-screened women from low-income backgrounds, mailed HPV self-collection kits with scheduling assistance led to greater uptake of cervical cancer screening than scheduling assistance alone. At-home HPV self-collection testing has the potential to increase screening uptake among under-screened women. National Cancer Institute.

Inclusivity in transitioning to medical school.

Inclusivity in transitioning to medical school.

Evaluation of Early and Late High School Student Science Research and Mentorship Programs: Virtual Gateway to Science Curricula and Mentorship During the COVID-19 Pandemic.

People from racial and ethnic minoritized groups, those with disabilities, and those from low-income backgrounds are underrepresented in biomedical careers. Increasing diversity in the biomedical workforce, particularly health care providers, is imperative to address the disparities faced by minoritized patients. The COVID-19 pandemic highlighted disparities experienced by minoritized populations and emphasized the need for a more diverse biomedical workforce. Science internship, mentorship, and research programs, which have historically been conducted in person, have been shown to increase interest in biomedical fields for minoritized students. During the pandemic, many science internship programs pivoted to virtual programming. This evaluation focuses on two such programs for both early and late high school students and evaluates change in scientific identity and scientific tasks pre- and post-program. Additionally, early high school students were interviewed to obtain more in-depth information on the program experiences and effects. Early and late high school students reported increased scientific identity and comfort with scientific tasks compared pre- to post-program in several domains. Desire to pursue biomedical careers was maintained pre- to post-program for both groups. These results highlight the importance and acceptance of developing curricula for online platforms to help boost interest in biomedical fields and desire for biomedical careers.

The Lasting Benefits of Multiyear Camp Programming for Youth from Low-Income Backgrounds

Summer camps are a common youth development setting in North America; however, youth from lowincome backgrounds often cannot attend because of financial barriers. Subsequently, although a robust camp literature exists, little is known about the lasting benefits for youth from low-income backgrounds. Even less is known about how these outcomes may differ based on the number of years youth attend a multi-year camp. The purpose of this study was to examine the long-term outcomes camp alumni reported as attributable to camp and that remain important in their life today. Eighteen outcomes examined via a cross-sectional retrospective survey completed by 449 camp alumni between the ages of 18 and 40 (mage = 22.1, SD = 5.17) were analyzed using repeated-measures analysis of variance to examine the within-subject and between-subject associations between years attended camp and alumni reported outcomes. Alumni of multi-year camps for youth from low-income backgrounds reported that camp was important to the development of many outcomes that are useful to their lives today. The more years that alumni attended a multi-year camp program, the greater the impact they reported that camp had on outcomes important to them today and the more likely they were to have completed post-secondary education. The results of this study provide evidence that practitioners and policy makers may use to advocate for funding to make camp programs more accessible and supportive for youth from low-income backgrounds, and to support youth year-round to stay engaged with camp programs.

Updating normative cross-sectional values and secular trends in body mass, body height and body mass index among Québec children and adolescents.

The main objective of this study was to examine secular trends in body mass, body height and body mass index (BMI) from measured rather than self-reported values between 1972 and 2017. A total of 4500 students (males = 51%) were selected from a stratified sampling. The age range varied between 6.0 and 17.9years. The sample came from 24 elementary schools and 12 high schools located in six urban cities from the province of Québec. All the tests selected were based on standardized procedures that are recognized as valid and reliable. Standardization and modeling of smoothed percentile curves for each variable for both sexes were produced. Regional variations between youth from the province of Québec and those from all other Canadian provinces confirm the relevance of using data specific to the target population. Comparisons with the 1972 and 1982 data show an important increase in body mass (~ 7kg, i.e. 16.4%) and BMI (~ 1.4kg·m-2, i.e. 19.9%) with minor change in body height (~ 1.8cm, i.e. 3.9%). Youth from low-income backgrounds (p=0.001) as well as those living in large urban cities (p = 0.002) see their probability of developing overweight or obesity greatly increase (low-income = 2.1 times; large urban cities = 1.3 times). However, overweight and obesity rates seem to have stabilized at around 21% since 2004. This study provides up-to-date data on factors that contribute to the prevalence of overweight and obesity in youth in urban settings of Québec, and will be instrumental in guiding public health strategies designed to optimize growth outcomes.

Latent trajectories of learning- and teacher-context behavior problems across the primary school transition

This study explores children's development of behavior problems in specific classroom situations characterized by meaningful teacher interactions (teacher contexts) and structured learning activities (learning contexts) during the first four years of schooling. Multidimensional growth mixture modeling was employed to detect unobserved subpopulations (latent classes) with common trajectories of teacher- and learning- context behavior among a US national sample (N = 3872) of children from low-income backgrounds. Analyses revealed three subpopulations with distinct behavior trajectories that were differentially associated with first-grade academic skills and social-emotional outcomes. Children with ‘Optimal’ and ‘Difficult’ school transitions had similar patterns of behavior problems in both Teacher and Learning contexts, whereas children with ‘Moderate’ school transitions had more divergent trajectories of behavior problems across context domains. Results are discussed in light of developmental theory and implications for practice.