Lower Socioeconomic Groups Research Articles

Mobile Health Solutions for Prostate Cancer Diagnostics-A Systematic Review.

Prostate cancer, the most common cause of cancer in men in the UK and one of the most common around the world to date, has no consensus on screening. Multiple large-scale trials from around the world have produced conflicting outcomes in cancer-specific and overall mortality. A main part of the issue is the PSA test, which has a high degree of variability, making it challenging to set PSA thresholds, as well as limited specificity. Prostate cancer has a predisposition in men from black backgrounds, and outcomes are worse in men of lower socioeconomic groups. Mobile targeted case finding, focusing on high-risk groups, may be a solution to help those that most need it. The aim of this systematic review was to review the evidence for mobile testing for prostate cancer. A review of all mobile screening studies for prostate cancer was performed in accordance with the Cochrane guidelines and the PRISMA statement. Of the 629 unique studies screened, 6 were found to be eligible for the review. The studies dated from 1973 to 2017 and came from four different continents, with around 30,275 men being screened for prostate cancer. Detection rates varied from 0.6% in the earliest study to 8.2% in the latest study. The challenge of early diagnosis of potentially lethal prostate cancer remains an issue for developed and low- and middle-income countries alike. Although further studies are needed, mobile screening of a targeted population with streamlined investigation and referral pathways combined with raising awareness in those communities may help make the case for screening for prostate cancer.

Intersections of informal work status, gender and tuberculosis diagnosis: Insights from a qualitative study from an Indian setting.

There is evidence that more than one third of tuberculosis (TB) cases in India go undiagnosed each year and it is more pronounced among female patients. While there are studies available on the socioeconomic, cultural and gender-related dimensions of TB diagnosis delays among female patients in India, intersections of gender, informal work and diagnosis delays are not sufficiently studied. The present study aims to fill this gap by examining the TB diagnosis delay that are linked to the contingencies of working in informal arrangements for women from lower socio economic background. The study draws on 80 qualitative in-depth interviews conducted among female patients from lower socio-economic background, who were working or recently stopped working in informal arrangements and undergoing Directly Observed Therapy, Short-course (DOTS) treatment in Bengaluru (India) city and 60 willing significant others of the patients. The participants were identified through a scoping survey that covered 188 female patients from 18 DOTS centres in the city. Other than the already known reasons for the delay in TB diagnosis for women such as normalisation of symptoms, stigma and the gender-related discrimination leading to low prioritisation of women's illness, the present study identifies reasons related to work informality. These are normalisation of symptoms as workplace health problems; work related concerns that restricted formal help seeking; non TB specific narratives of symptoms, often incorrectly assumed to be work related health issues or comorbidities and thus confounding the early accurate diagnosis by the medical personnel and shifting between formal and informal systems of help-seeking. Further, the study found that mere knowledge of TB symptoms did not always translate to early diagnosis for patients from the lower socioeconomic groups working in informal arrangements due to the fear of losing work and wages owing to hospital visits. The workplace focus, especially the informal sector where a huge majority of India's workforce is employed, is notably absent in the TB elimination programme. The study indicates the need to adopt a comprehensive approach in the ongoing TB elimination programme in India in which family, living environment and workplace should be integral parts.

Analyzing the Frequency of Premalignant Lesions and Oral Malignancy in Indian Subjects Attending Outpatient Department From the Low Socioeconomic Group.

Oral cancer is a rapidly growing disease among Indian subjects mainly in the low socioeconomic group. Socially and economically marginalized subjects are at high risk for oral cancer because of smoke and smokeless tobacco consumption. To evaluate the prevalence of precancerous lesions and oral cancerand evaluate tobacco as a causative factor in Indian subjects visiting the outpatient department of the institute. Around 658 subjects were analyzed forfrequency of premalignant lesions and oral malignancy in Indian subjects from the low socioeconomic group. Patientsvisited for pain, burning, or ulceration in the oral cavity were clinically assessed for any tissue growths, leathery alterations, ulcerative changes,and white or red lesions in the oral cavity. Results:The overall prevalence of smokeless and smoking tobacco was 78.8% (n=518) and 65.2% (n=429) respectively in the present study. Around 39.8% (n=262) of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 36.2% (n=238) subjects and 6.1% (n=40) for labial mucosa. Oral cancer is highly prevalent in Indian subjects owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. More tobacco cessation centers areneededto stop the habit and early diagnosis will prevent dysplastic changes.

An Investigation into Implications of Tuberculosis Control Efforts in Pakistan: A Comparative Approach

Objective: To investigate the difference of Tuberculosis (TB) related information in diagnosed TB patients and healthy individuals in relation to the implications of National Tuberculosis Program (NTP) control efforts. Study Design and Setting: This comparative case-control study was conducted from May to December 2022 in public sector tertiary care setups of Karachi. Methodology: In this case control study, 100 hospitalized diagnosed patients of TB were compared with 155 healthy individuals from May to December 2022. We analyzed sociodemographic characteristics of both groups related to the information for transmission and prevention of TB, as a basic element for the disease control. Result: TB patients were more likely to be uneducated, have low household income and positive family history of TB as compared to non-TB (OR 0.52, 0.30, 0.40). 18% of TB patients believed that TB infected person cannot be a source of spread to cause TB disease (OR=4.7; P=0.006). There was a statistically significant association among both the groups deemed to malnutrition and multiple households as the risk factors of tuberculosis (P=0.002 and <0.001 respectively Conclusion: TB related information with respect to its cause, preventive and treatment was insufficient in both study groups leading to delay in TB treatment and increase mortality from the disease. Health education interventional strategies, focused on primitive and advanced TB related information are needed in general population with special attention on low socioeconomic groups of community, and the population living in isolated and remote areas.

Outreach of the programmatic components of National Health Mission in India: An inter‐ and intra‐state analysis using nationally representative data

In 2005, India launched the National Health Mission (NHM) to achieve equity in access to primary and secondary healthcare, with special focus on maternal and child healthcare (MCH). Studies have shown that NHM has increased access to MCH services; however, the access is still low among low socioeconomic population groups. Since outreach among target population is crucial to improve access to MCH, we analyzed the level and the inter‐ and intra‐state socioeconomic inequity in the outreach in two major NHM components: conditional cash‐transfer program‐JSY, and community health workers‐ASHAs and ANMs. We used administrative records and nationally representative cross‐sectional sample surveys in the early‐ and after the targeted full‐implementation phases of NHM, and employed descriptive and multivariate methods. We found that the NHM had covered only less than one‐half of the eligible women, with considerable inter‐state variations. For instance, in the high‐focus states in 2015–16, the receipt of JSY benefits, ASHAs services, and ANMs services among eligible women was 41.5%, 40.6%, and 48.8%, respectively, whereas the respective outreach among the bottom wealth quintile was 39.8%, 45.1%, and 44.4%. However, there was attenuation in inequity overtime, favoring the poor in the outreach of JSY benefits and ASHAs services. Furthermore, underscoring the importance of program outreach, we find that district with higher level of program outreach was associated with increased uptake of MCH services among target population. Our findings imply for implementing policy measures for wider program outreach so that the NHM could serve as pathway to attain universal health‐care coverage for India.

A Prospective Study of Comparison between Open Trendelenburg Operation, Radiofrequency Ablation, EVLA, and Glue Technique for the Management of Varicose Veins

Background: Varicose veins are a subset of Chronic Venous disorders, including spider, reticular, varicose, and leg oedema. In our country, varicose veins are common surgical problems most commonly seen in low socio-economic groups and associated with certain occupation(s). Varicose veins have been known to affect the quality of life (QoL) leading to changes in occupation. Surgical treatment methods such as Saphenofemoral Junction (SFJ) Ligation and Great Saphenous Vein (GSV) stripping with spinal or general anaesthesia, Radio Frequency Ablation (RFA), Endovascular Laser Ablation (EVLA) and GLUE Technique within the operating room are considered in patients who remain refractory to conservative management and continue being symptomatic. Aim & Objectives: The study aimed to compare the outcome and associated post-operative complications, including Deep Venous Thrombosis, Pulmonary Embolism or Paresthesia, and Ecchymosis, with various modalities in the management of varicose veins. Material and Methods: The study was performed at a tertiary care centre which included 200 patients over a period of one year and was evaluated in the basis of VCSS & VDS scores. Results: We observed that all treatment protocols demonstrated results which improved the general physical condition of patients with the least number of complications. Treatment for varicose veins encompasses open surgeries and Endovenous techniques (EVLA and RFA), which show comparative results in clinical improvement, complications and postoperative hospital stay. Both VCSS and VDS are sensitive tools for measuring clinical outcomes of treatments of venous disease. However, the choice of appropriate tool is dependent upon the type of treatment, the Surgeon ‘s personal experience, availability of resources, durations of hospital admission and cost of treatment.

Work Adaptation Experience of Vietnamese Workers in Korean Workplaces: Constructivist Grounded Theory

Purpose: The purpose of this study is to find a nursing intervention plan by classifying the body pain areas of the Korean aged and analyzing related factors. Methods: This study performed the latent class analysis, cross-analysis, and one-way ANOVA using the SPSS 25.0, M-plus 7.0 program on 4,388 older adults aged 65 or over using the data from the 2020 Aging Research Panel. Results: As a result of the Latent Class Analysis, participants divided into four groups. Group 1 was the 'shoulder and low back pain group' with high shoulder and back pain, group 2 was the 'upper body pain group' with severe pain in the arms, wrists and fingers and chest, group 3 was the 'lower pain focused group' with high pain in the legs and knees, and finally, group 4 was the 'general low pain group' with low pain overall. The result of the study shows that the group that did not exercise regularly, the female group, and the low socioeconomic status group have more pain in general. The upper body central pain group showed a low level of life satisfaction. Conclusion: This study discusses various nursing interventions for the prevention of chronic pain, especially for the aged female group who has diverse body pain areas, the aged with low socioeconomic status, and the aged who do not exercise.

Firearm Assaults in Communities: The Impact of COVID-19 Lockdown.

Firearm violence has increased nationwide, with recent surges linked to the COVID-19 pandemic. We measured traumatic assault trends at our urban Level I trauma center and assessed rates of firearm violence over time and pre/post local COVID-19 lockdown based on levels of socioeconomic disadvantage. We conducted a retrospective review (2016-2022) of assault patients 16years and older. Demographics and hospital outcomes were assessed by assault mechanism (firearm, knife, blunt). Patient address was correlated to Area Deprivation Index (ADI), a measure of socioeconomic disadvantage. COVID-19 lockdown onset was defined as initial date of lockdown (3/19/2020). Trend and time-series analyses compared all assault mechanisms and firearm-specific assaults pre/post-lockdown. Poisson regression assessed firearm assault risk. Of the 1583 total assaults, firearm patients (n = 335) were younger (median 29years), had longer hospital stays (median 2days), and greater mortality (12%) than other mechanisms. The 2years post-lockdown had significantly more firearm assaults (27% vs 15% pre-lockdown, P < .001) and time-series analysis found this abrupt and significant increase in firearm assaults occurred at lockdown onset (P = .01). Also post-lockdown, the rate of firearm assaults increased by 10% for every unit increase in socioeconomic deprivation (P < .01). There was no change in assault type by race/ethnicity. Firearm assaults increased dramatically immediately post-COVID lockdown at our center and have maintained higher rates through 2022. Greater ADI was associated with increasing firearm assaults and has magnified post-lockdown, demonstrating lower socioeconomic groups are disproportionately and increasingly affected by firearm violence.

The Impact of the No Jab No Play and No Jab No Pay Legislation in Australia: A Scoping Review

Australia has a long history of population-based immunisation programs including legislations. This paper reports on a review of evaluations of the impact of the federal No Jab No Pay (NJNPay) and state implemented No Jab No Play (NJNPlay) legislations on childhood immunisation coverage and related parental attitudes. Five databases were searched for peer-review papers (Medline (Ovid); Scopus; PsycInfo; ProQuest; and CINAHL). Additional searches were conducted in Google Scholar and Informit (Australian databases) for grey literature. Studies were included if they evaluated the impact of the Australian NJNPay and/or NJNPlay legislations. Ten evaluations were included: nine peer-review studies and one government report. Two studies specifically evaluated NJNPlay, five evaluated NJNPay, and three evaluated both legislations. Findings show small but gradual and significant increases in full coverage and increases in catch-up vaccination after the implementation of the legislations. Full coverage was lowest for lower and higher socio-economic groups. Mandates are influential in encouraging vaccination; however, inequities may exist for lower income families who are reliant on financial incentives and the need to enrol their children in early childhood centres. Vaccine refusal and hesitancy was more evident among higher income parents while practical barriers were more likely to impact lower income families. Interventions to address access and vaccine hesitancy will support these legislations.

Understanding the Spectrum of Esophageal Cancer Disparities

Esophageal cancer carries an immense burden of disease. Despite advances in cancer care, the survival rate of esophageal cancer has not significantly improved over the last 30 years. The burden of disease is greater on minorities, immigrants, and lower socioeconomic groups in the United States. Research has consistently shown that these communities suffer from persistently worse outcomes. Minorities are noted to have increased risk of developing esophageal cancer, have worse stage at presentation, and limited access to the newest advancements and best treatment options. The reason for these disparities is multifactorial and the US health system must address and correct the underlying reasons to ensure just health care for all.

Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalisation or death: Danish nationwide cohort study.

Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. We followed 3 721 810 Danish residents aged ≥30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter ≤2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual- and area-level socioeconomic status, and population density. 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg·m-3) and NO2 (per 3.59 μg·m-3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. Long-term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.

Comparative Study of Clinical and Audiological Outcome between Autologus and Prosthesis in Ossicular Chain Reconstruction

Abstract Introduction: Ossiculoplasty is one of the commonly done and challenging surgery in otology and has been done using various graft materials. Materials such as autologous cartilage (tragal or conchal) or allograft (homograft) of the same tissue and synthetic materials like polyethylene TORP, ceramic and hydroxyapatite PORP or Titanium prosthesis have been used. But the latter synthetic materials are expensive and have high extrusion rates. Autologous cartilage grafts are selected for Ossiculoplasty as they are easy to harvest at the same site of operation, non-toxic, has less extrusion rate, minimum shrinkage and lateralization. Aims and Objective: The aim of this study is to know the efficacy of autologous graft and prosthesis in ossicular reconstruction and to evaluate hearing outcome along with extrusion rate among them. Methodology: It is a prospective study done on patients attending ENT outpatient department in civil hospital Ahmedabad affiliated to BJ medical college Ahmedabad. 60 patients were included in the study who underwent ossicular reconstruction either with canal wall up or down mastoidectomy with tympanoplasty. Conclusion: On follow up of 60 patients over six month we followed there is significant air bone gap reduction with prosthesis but there is risk of extrusion which cancel out beneficial effect of prosthesis. Whereas cartilage and incus remodelling give good result in air bone reduction and better take up compare to prosthesis with less extrusion rate. Also, autologous grafting in ossicular chain reconstruction is economical in developing countries like India with disease prevalent among low socioeconomic group. Keywords: PORP/TORP, Ossicular chain reconstruction, incus remodelling, CSOM, Mastoidectomy

Formulation of fortified instant weaning food from Musa paradisiaca (banana) and Eleusine coracana.

Weaning food is a soft, easily digestible type of food other than breast milk for infants aged 6 to 24 months. The present study was conducted to develop cereal-fruit-based complementary foods for infants and evaluate the nutritional quality of such types of foods. Few researchers have focused on formulating weaning foods from locally available, nutritious, and rich ingredients without nutrient loss to reduce malnutrition and infant morbidity rates. In this study, the formulated infant food was prepared from Musa paradisiaca (Nendran banana) and Eleusine coracana (ragi). Formulated weaning food was analyzed using various standard methods, demonstrating that it could provide adequate nutrients to growing infants for their proper growth and development. The shelf life of the weaning food was also studied for a period of 3 months at ambient conditions in two different packaging materials: aluminum and plastic (low-density polyethylene or LDPE), with the aluminum foil pouch exhibiting the best shelf life. This ready-to-serve food, which is formulated and fortified with natural ingredients containing essential macronutrients and micronutrients, could be regarded as highly effective supplementary food for infants. Furthermore, this development has the potential to introduce an affordable weaning product specifically targeted at low socioeconomic groups.

Protecting the built environment in a barrier beach and marsh system: A case study of the Hampton-Seabrook Estuary, New Hampshire

Many barrier beaches in the U.S. are areas of high socioeconomic activity that some stakeholders want to maintain despite being increasingly vulnerable to tidal and storm surge coastal flooding due to climate change and associated sea level rise (SLR). Here we examine how this can be accomplished using a hybrid of nature-based solutions and grey infrastructure under present and short-term future climates. Our case study site of the Hampton-Seabrook Estuary in New Hampshire has a barrier beach that is densely developed with residential, tourist, and commercial facilities and buildings; it is a major economic engine for the state. It also has extensive back-barrier tidal wetlands. Given the few options available for flood protection with present land uses, it was found that at least in the short term primarily gray approaches would have to be used to maintain the socioeconomic activities of this barrier beach system, such as elevating key roads and fortifying (but greening) existing seawalls. In some locations, however, dune maintenance programs could be expanded, and in other locations living shorelines could be constructed to increase resilience to storm flooding. In addition, many assets would have to rely upon purely site-specific protection measures such as elevating and flood proofing. Socioeconomically vulnerable residents would be afforded some benefits due to the built environment and anchor institutions being protected, but the costs of flood-proofing individual homes (or choosing to relocate) would likely be borne by individual homeowners. Adding public greenspace and walkable areas may afford the greatest health benefits to people in lower socioeconomic groups who typically have the least access. The reduction in flood risk can be accomplished with minimal environmental impacts compared to those the region will face from SLR alone. In the longer term, more consideration may need to be given to the concept of managed retreat. Unfortunately, the environmental benefits of retreat would not be recognized if short-term gray actions were successfully implemented.

TO EVALUATE THE VARIOUS RISK FACTORS RESPONSIBLE FOR ROAD TRAFFIC ACCIDENTS IN PUNJAB – A DESCRIPTIVE STUDY

Objective: Evidence from research suggests that human factors and the road environment are among the most frequent contributors to the occurrence of road traffic accidents (RTAs). Hence, traffic rule and various policies, alike have strengthened their efforts to cope with this public health burden. Yet, still little is known about the factors contributing to the high number of RTAs. In this study, we tried to find out the various risk factors responsible for road accidents in the Punjab region. Methods: The present study was conducted in Guru Nanak Dev Hospital, Amritsar, involving 1425 patients who were admitted to the Emergency Department from January 1st, 2012, to December 31st, 2012, due to injuries in RTAs. Results: In our study, it seems that most of the cases were in the age group of 15–44 years. In all the age groups, males were the predominant victims with male-to-female ratio of 5.72:1. Majority of cases belonged to an upper–lower socioeconomic group, according to the Kuppuswamy scale and the major proportion of accidents occurred during the morning and evening busy hours of the day hours. Out of a total of 893 drivers, 858 (96.08%) had no knowledge about the speed limit prescribed for the road or speed. Conclusion: There appears to be a large number of behavioral issues and a lack of knowledge that contributes significantly to the road accident rates in the Indian states. Hence, there is a need for policy intervention. Most effective measures used to reduce the number of accidents, in descending order of magnitude, are how strictly the traffic police enforce the law, more levels of penalties, and more traffic police, including more speed measuring devices.

Medical Students' Socioeconomic Status and Academic Performance in Medical School.

Background Students from lower socioeconomic groups tend to underestimate their chances of acceptance to medical school and their likelihood of success once admitted. Objective The objective of this study is to determine if socioeconomic disadvantage status is linked to lower medical college admission test (MCAT) scores and academic performance in medical school. Methods Using the Association of American Medical Colleges (AAMC) education/occupation (EO) indicator, we compared economically disadvantaged students to students with no financial disadvantage on the MCAT, Phase 1 National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE) Step 1, Phase 2 NBME, and USMLE Step 2 test scores. Results Medical students in the disadvantaged group scored significantly lower on the MCAT than students with no financial disadvantage. The disadvantaged group showed a non-significant lower trend in performance until USMLE Step 2. Conclusions Applicants from lower socioeconomic backgrounds may perform lower on their MCAT and early medical school benchmark exams, but they appear to catch up with and even surpass their peers on their USMLE Step 2 examination.

Efficacy and safety of a vitamin-mineral intervention for symptoms of anxiety and depression in adults: A randomised placebo-controlled trial “NoMAD”

BackgroundAnxiety and depression are increasingly burdening society. We investigated whether micronutrients (vitamins and minerals), improve anxiety and depression symptoms in an adult community setting. MethodsParticipants (n = 150) describing functionally-impairing symptoms of anxiety/depression randomly received micronutrients or placebo for 10 weeks. Primary outcome measures were Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder Scale-7 (GAD-7), and Clinical Global Impression-Improvement scale (CGII). They were monitored online with regular phone contact with a clinical psychologist. ResultsLinear mixed-effects modelling showed significant improvements in both groups, with the micronutrient group improving significantly more quickly on both the PHQ-9 (t = −2.17, p = 0.03) and the GAD-7 (t = −2.23, p = 0.03). Subsequent models with covariates showed that participant characteristics moderated time-by-group interactions; micronutrients provided fastest improvement relative to placebo for younger participants, those from lower socioeconomic groups and those who had previously tried psychiatric medication. On the CGII, there were no group differences at end-point ((F1,148) = 1.36, p = 0.25, d = 0.19, 95 % CI [−0.13 to 0.51]), with 49 % of the micronutrient and 44 % of the placebo groups being identified responders. Participants on micronutrients had significantly increased bowel motions compared with placebo. There was no increased suicidal ideation, no serious adverse events and the blind was adequately maintained. Drop out was low at 8.7 %. LimitationsThe improvement under placebo and lack of formal diagnoses limit generalizability. ConclusionsDespite limited clinician contact, all participants improved significantly, though improvements were faster with micronutrients. Participants in some subgroups demonstrated a lower response to placebo, identifying where micronutrients may offer greatest potential as an intervention.

Dysfunctional schema modes as determinants of psychiatric comorbidities: a study in a cohort of people with epilepsy.

Symptomatology of epilepsy and its' associated alteration in brain processes, stigma of experiencing seizures, and adverse sequelae of anti-epileptics have been demonstrated to impact behaviour and exacerbate psychopathology. This study examines the role of dysfunctional schema modes in People with Epilepsy (PWE) and their association with psychiatric symptoms. Semi-structured interviews were conducted with 108 PWE treated with anti-epileptics for at least one year and with no history or mental disorder or psycho-active substance use. Clinical symptoms were measured utilising the Symptom Checklist-90 (SCL-90) with schema modes measured utilising the Schema Mode Inventory (SMI). Maladaptive coping and child schema modes were significantly higher in individuals from lower socio-economic status group (p < 0.01), with several maladaptive schema modes more prevalent in males. Hostility symptoms were increased in individuals from lower socio-economic classes and were more prevalent early in disease course. Several psychological symptoms including somatisation, interpersonal, obsession, depression, paranoia, hostility, phobia, anxiety, and psychoticism, were predicted by various maladaptive schema modes (p < 0.001). This study highlights the impact of maladaptive schemas, suggesting that PWE might benefit from the introduction of appropriate psychotherapeutic interventions such as schema-focused therapy, particularly if from lower socio-economic classes or in the early stages of theirdisease course.

Nutritional significance of finger millet and its potential for using in functional products

Finger millet (Eleusine coracana L.), ragi or mandua, is one of essential minor millets extensively grown in the Indian and African subcontinents. It is a staple food in India, particularly for people belonging to low-socioeconomic groups. Finger millet is highly valued for its content of macro- and micronutrients. It is rich in carbohydrates, protein, and fat. Its micronutrients include calcium (0.38%), dietary fiber (18%), and phenolic compounds (0.3–3%), such as catechin, epicatechin, as well as ferulic, salicylic, protocatechuic, cinnamic, and hydroxybenzoic acids, etc. Finger millet is also recognized as a source of vital amino acids, including isoleucine, leucine, methionine, and phenylalanine, which are otherwise deficient in starchy meals. In addition, finger millet is well appreciated for its pharmacological properties such as anti-diabetic, anti-tumorigenic, anti-atherosclerogenic, antioxidant, and antimicrobial effects. To improve its nutritional and sensory properties, this grain can be processed by various traditional and advanced methods (soaking, malting, cooking, fermentation, popping, and radiation). These processing techniques equally assist in the reduction of anti-nutritional factors (tannins, phytic acid, oxalic acid, protein inhibitors, glucans) and their inhibitory effects. In this review, we highlighted the nutritional composition, health attributes, and uses of finger millet for the development of functional food products.&#x0D; Researchers and producers can further explore the opportunities and scope for utilizing finger millet and develop more products in the same line to solve the current issues of food and nutrition security.

Exploring Education Differences in the Parental Well‐Being Gap

Increasing evidence suggests that raising minor children is a “mixed bag” of emotions. Parents with minor children report more positive emotions, but also more negative emotions than adults without children. Little attention, however, has been paid to how this mixed bag varies by one's education level: a key socioeconomic indicator connected to family life and well‐being. Drawing on data from the American Time Use Survey Subjective Well‐being Module (2010, 2012, 2013; N = 17,481 respondents) and random effects models, we explored this question. Results revealed that parents of all education levels (vs. non‐parents) reported greater levels of positive emotions (happiness, meaning) and less sadness, but only higher educated parents reported greater levels of negative emotions (stress, fatigue). Among lower educated women, however, we observed no parental well‐being gap. These findings provide new knowledge of, and challenge several prevailing arguments about, how parenting is associated with the well‐being of higher and lower socioeconomic groups.