Low Education Group Research Articles

Association between maternal body mass index and congenital anomalies: A case-control study in Tuscany (Italy).

To investigate the relationship between prepregnancy maternal body mass index (BMI) and congenital anomalies (CAs). Case-control study on data collected by the registry of CAs of Tuscany (Italy) and birth certificates from 2005 to 2017. Maternal prepregnancy BMI. Any major CAs and groups of organ-specific anomalies. Odds ratios (ORs) were estimated using logistic regression models adjusted for maternal factors. Maternal BMI ≥25 was significantly associated with all nervous system anomalies (OR=1.61, 95% confidence interval [95% CI] 1.13-2.29) and with neural tube defects (OR=2.03, 95% CI 1.00-4.12); maternal underweight was significantly associated with orofacial clefts (OR=1.67, 95% CI 1.12-2.48). After stratification by education, in the low education group, mothers with BMI ≥25 had an increased risk of nervous system anomalies (OR=2.19, 95% CI 1.01-4.76), whereas underweight mothers had an increased risk of nervous system anomalies (OR=3.89, 95% CI 1.44-10.53), orofacial clefts (OR=2.59, 95% CI 1.24-5.42), and urinary anomalies (OR=1.74, 95% CI 1.07-2.82). In the medium/high education group, the only significantly increased risk was found in mothers with BMI ≥25 for nervous system anomalies (OR=1.50, 95% CI 1.00-2.25). Main results have shown a positive association of maternal BMI ≥25 with nervous system anomalies and maternal underweight with orofacial clefts. The study has also evidenced the impact of social status and provided clues to the role of maternal ethnic background.

Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002\u20132015

BackgroundAtrial fibrillation (AF) is a common heart rhythm disorder and a risk factor of adverse cardiovascular diseases. Established causes do not fully explain the risk of AF and unexplained risk factors might be related to the environment, e.g. magnesium in drinking water. Low magnesium levels in drinking water might be associated with higher risk of cardiovascular diseases including AF. With detailed individual data from nationwide registries and long-term magnesium exposure time series, we had a unique opportunity to investigate the association between magnesium in drinking water and AF.ObjectiveWe evaluated the association between magnesium concentration in drinking water and AF risk.MethodsA nationwide register-based cohort study (2002–2015) was used including individuals aged ≥30 years. Addresses were linked with water supply areas (n = 2418) to obtain time-varying drinking water magnesium exposure at each address. Five exposure groups were defined based on a 5-year rolling time-weighted average magnesium concentration. AF incidence rate ratios (IRRs) between exposure groups were calculated using a Poisson regression of incidence rates, adjusted for sex, age, and socioeconomic position. Robustness of results was investigated with different exposure definitions.ResultsThe study included 4,264,809 individuals (44,731,694 person-years) whereof 222,998 experienced an incident AF. Magnesium exposure ranged from 0.5 to 62.0 mg/L (mean = 13.9 mg/L). Estimated IRR (95% CI) compared to the referent exposure group (< 5 mg/L) was 0.98 (0.97–1.00) for the second lowest exposure group (5–10 mg/L), and 1.07 (1.05–1.08) for the two highest exposure groups (15–62 mg/L). Strongest positive associations were observed among those aged ≥80 years and with lowest education group. An inverse association was found among individuals with highest education group.ConclusionThere might be a small beneficial effect on AF of an increase in magnesium level in drinking water up to 10 mg/L, though an overall positive association was observed. The unexpected positive association and different associations observed for subgroups suggest a potential influence of unaccounted factors, particularly in vulnerable populations. Future research on magnesium in drinking water and cardiovascular diseases needs to focus on contextual risk factors, especially those potentially correlating with magnesium in drinking water.

Relationship between obesity and psychosocial risk factors in hypertensive patients

Abstract Introduction: Unhealthy lifestyle habits, including sedentary behaviour and improper diet are major risk factors for obesity. Overweight is very frequent in hypertensive and type 2 diabetic patients. Psychosocial factors are associated with multiple health behaviors related to overweight/obesity. The aim of the study was to evaluate the relationship between obesity and psychosocial risk factors in hypertensive patients having different levels of education. Material and methods: 623 hypertensive patients, admitted to the Cardiovascular Rehabilitation Clinic in Tîrgu Mureș were evaluated by weight, height, waist circumference, laboratory analyses and psychosocial risk based on a validated questionnaire on nine topics. Non-paired Student t test was used for statistical evaluation of the obtained data. Results: Obesity or overweight affected 86.9% of the studied hypertensive patients. Obesity was more frequent in subjects having type 2 diabetes as comorbidity. Mean BMI was significantly higher in the lower education group (p=0.007) compared to those with higher level of education. Average triglyceride and uric acid levels were significantly higher in obese subjects compared to those having lower BMI (p&lt;0.0001). Patients living alone had significantly lower mean BMI (p=0.006) and waist circumference values (p=0.001) compared to those living with their spouse. Conclusions: Weight excess in very frequent in the studied hypertensive patients, especially in those with type 2 diabetes as comorbidity and having lower educational level. Hypertriglyceridemia and hyperuricemia occurred more frequently in obese subjects compared to non-obese ones. Overweight is less frequent in patients living alone.

Promoting Postsecondary Education in Low-Income Youth: The Moderating Role of Socio-Behavioral and Academic Skills in the Context of a Major Educational Reform.

Governments around the world are pressed to invest in postsecondary education. However, little research exists to document whether large-scale educational reforms aimed at increasing rates of postsecondary attendance benefit youth's developmental outcomes. This study tested whether an educational reform occurring in Québec, Canada, in the 1960s increased educational levels, and whether it benefitted some youth more than others. In the 1970's, 4109 low-income youth (50% females) aged 7-13 years old were recruited at Time 1 from first, fourth, and seventh grade classes (Mage = 10.6, SD = 2.5). Socio-behavioral characteristics and academic skills at Time 1 were examined as predictors of educational attainment at Time 2, three decades later, on 3883 of the same participants. Multinomial logistic regressions were used to examine the likelihood of youth obtaining a diploma from the newly created, accessible, and affordable colleges ("cégeps"). Low-educated groups (high school dropouts and high school graduates) presented a higher early risk profile than did college graduates. Interactions revealed that social withdrawal protected youth from disadvantaged neighborhoods, helping them graduate from college. Likeability helped academically weaker girls go beyond college and access university, and helped academically competent boys graduate from college. Aggressive behavior decreased the odds of university attendance for academically competent boys. Policies promoting higher education for disadvantaged youth should be supplemented with early interventions integrating academic and socio-behavioral objectives.

The Role of Education in Sustainable Dietary Patterns in Slovenia

The most sustainable dietary patterns involve the consumption of plant-based (vegan) foods, excluding or reducing animal products, including meat, fish, and dairy, yet there is a lack of research on determinants of sustainable dietary patterns in central European countries. The present article aimed to examine the prevalence of sustainable dietary practices and attitudes among the Slovenian public and to investigate the role of education in fostering sustainable dietary patterns. We analyzed a representative national sample of Slovenians, with data gathered in 2019 (ISSP/Slovenian Public Opinion; N = 1079; 51.2% females). The results indicate that most Slovenians do not have sustainable dietary practices or attitudes with regard to health, the environment, animals, and dietary minorities. One in four Slovenians consume meat at least once per day and one in two consume meat three to six times per week. In addition, 78.2% of Slovenians consume milk at least three times per week; more than half consume milk daily or more often. Fish consumption is the least frequent among the three food groups. At least two-thirds of Slovenians also hold attitudes that are low in sustainability. Results also show that, after controlling for confounding variables, higher educational level emerged as an independent predictor of lower meat consumption, but not of lower fish or milk consumption. Furthermore, those in the lowest educational group are significantly less likely to hold sustainable attitudes than those in the higher educational group. Finally, current student status only decreases meat consumption. Since our results show an educational gradient in meat consumption and attitudes, public health and environmental campaigns should focus on the less-educated groups, encouraging them to reduce meat intake and fostering more sustainable attitudes.

Risk and Preventive Factors for SUDI: Need We Adjust the Current Prevention Advice in a Low-Incidence Country.

Background: The incidence of Sudden Unexpected Death in Infancy (SUDI) is low in the Netherlands, with an incidence rate of 0.18 per 1,000 live births. Therefore, prevention advice may receive less attention, potentially leading to increasing incidence rates. It is currently unknown whether the risks for SUDI changed in the Netherlands, and if other risk factors might be present. The aim of this study was to examine the current risks and preventive factors for SUDI in Dutch infants, in order to determine if it is necessary to adapt the prevention advice toward the current needs.Methods: A case-control study was conducted comparing SUDI cases aged <12 months from 2014–2020 in the Netherlands (n = 47), to a Dutch national survey control group from 2017 including infants <12 months of age (n = 1,192).Results: Elevated risks for several well-known factors were observed, namely: duvet use (aOR = 8.6), mother smoked during pregnancy (aOR = 9.7), or after pregnancy (aOR = 5.4) and the prone sleeping position (aOR = 4.6). Reduced risks were observed for the well-known factors: room-sharing (aOR = 0.3), sleep sack use (aOR = 0.3), breastfeeding (aOR = 0.3), and the use of a pacifier (aOR = 0.4). For infants <4 months, the risk for SUDI was higher when bed-sharing (aOR = 3.3), and lower when room-sharing (aOR = 0.2) compared to older infants. For older infants, the sleep sack was found to be more protective (aOR = 0.2). A high risk for SUDI when bed-sharing was found when mother smoked, smoked during pregnancy, or if the infant did not receive any breastfeeding (respectively aOR = 17.7, aOR = 10.8, aOR = 9.2).Conclusions: Internationally known factors related to the sudden unexpected death of infants were also found in this study. Relatively new findings are related to specific groups of infants, in which the strengths of these risk factors differed. In a low-incidence country like the Netherlands, renewed attention to the current prevention advice is needed. Furthermore, additional attention for prevention measures in low educated groups, and additional advice specifically targeting high-risk groups is recommended.

Parental socioeconomic status and asthma in children: Using a population-based cohort and family design.

The observed association between the parental socioeconomic status (SES, measured as education/income) and asthma or wheezing in offspring may be explained by confounding of unmeasured factors (shared genes and family environment). We aimed to study the association between parental SES and asthma/wheeze using cousin comparison. Data were collected on individuals born in Sweden 2001-2013. Parental SES (education and income) was gathered from Statistics Sweden. Asthma/wheeze was identified using national health registers. The association between parental SES at birth and incident asthma/wheeze was estimated using Cox regression also comparing differently exposed cousins. The association between parental SES at 5years and current asthma was estimated using logistic regression. Included were 955,371 individuals. Mothers with compulsory school only (lowest education group) compared with those with further education (highest education group) was associated with incident asthma/wheeze below 1year of age HRadj=1.45 (1.38-1.52) and over 1year of age HRadj=1.17 (1.13-1.20). The corresponding estimates for the lowest income group were HRadj=1.61 (1.54-1.69) and HRadj=0.94 (0.92-0.97), respectively. In maternal cousin comparisons, the associations for asthma/wheeze over 1year of age was HRadj=1.21 (1.05-1.40) for compulsory school only and HRadj=0.94 (0.84-1.07) for the lowest income group. The ORadj for current asthma at 5years was 1.05 (1.00-1.11) for mother's compulsory school only and 0.98 (0.94-1.02) for mother's lowest income group. Results for estimates were similar for father's SES. We confirm an association between low parental SES (measured as education) and asthma/wheeze. Cousin comparison suggests that this association is not wholly due to confounding of unknown familial factors, therefore supporting a causal relationship. The relationship between parental income and asthma/wheeze is less clear. This study is important for understanding risk factors for asthma/wheeze and for future prevention strategies. Further research is warranted to investigate the possible mechanisms for association between parental education and asthma/wheeze.

Socio-economic position and burden of ischemic heart disease in Finland in 2017

Abstract Background Ischemic heart disease (IHD) caused every fourth death in the European region in 2017. Furthermore, it accounted for about 12% of total disease burden estimated with disability adjusted life years (DALYs). DALYs summarize premature mortality (years of life lost, YLL) and morbidity (years lived with disease, YLD) in a specific cause. These disease burden estimates are customarily used to examine time trends or differences between countries or regions. However, they have seldom been calculated by socio-economic position (SEP), especially using individual-level SEP indicators. Methods We calculated DALYs for the Finnish 30+ year-old population in 2017. For YLL, we used Statistics Finland database for total population. For YLD, we used individual level data from the cross-sectional health examination FinHealth 2017 survey (n = 6538), which was linked with administrative register data. Population attributable fractions (PAFs) for selected IHD risk factors (smoking, blood pressure, total cholesterol and body mass index, BMI) were also calculated. Methodology published by the Global Burden of Disease study, such as disability weights for YLD and relative risks for PAFs, was applied where applicable. Results DALYs for IHD per 1000 population were 61.1 for men and 31.0 for women. Premature mortality (YLL) caused over 80% of DALYs. Burden of IHD morbidity (YLD) was higher in low education groups. In the total population, PAFs for IHD risk factors for men and women, respectively, were as follows: 17% and 8% for smoking, 56% and 58% for elevated systolic blood pressure, 25% and 28% for high cholesterol, and 27% and 24% for high BMI. Conclusions IHD morbidity was higher among low education groups. A large part of IHD burden was attributable to major cardiovascular risk factors, most markedly to elevated systolic blood pressure. In the future, the burden of disease could be increasingly assessed also by SEP. Key messages The burden of IHD in Finland was especially high among men, and majority of the burden was due to premature mortality. Over 50% of the IHD burden was attributed to elevated systolic blood pressure. Assessing the burden of diseases by socio-economic position provides a new perspective for examining socio-economic differences in health.

Vaccination willingness and educational level

SamenvattingVaccinatie is een belangrijk onderdeel in de bestrijding van het COVID-19-virus. Een voorspeller van het aandeel mensen dat daadwerkelijk een vaccinatie zal nemen is de vaccinatiebereidheid onder de bevolking. Uit buitenlandse literatuur blijkt dat de vaccinatiebereidheid onder mensen met een lagere sociaaleconomische status lager ligt dan onder andere groepen. In deze bijdrage beschrijven we in hoeverre dit ook in Nederland het geval is en laten we zien hoe risicoperceptie, vertrouwen in de werking en veiligheid van het vaccin en gezondheidsvaardigheden hier mogelijk mee samenhangen. Tot slot belichten we een aantal interventiestrategieën die positief aan de vaccinatiebereidheid onder laagopgeleiden kunnen bijdragen.

Impact of sociodemographic factors on children’s immunization in Bulgaria

Abstract Introduction Vaccinations have been touted as one of the “greatest public health achievements”, but the rate of under-vaccination in child population is steadily declining, especially in low-income groups. Many studies show, that country-specific parental socio-demographic factors may influence on children's immunization coverage. Aim To assess which family socio-demographic factors influence parental vaccine hesitancy. Methods A survey was conducted among 1195 parents of children under the age of 7y., between 2015-2017, mean age of 30.9±6.4y., of Bulgarian or other ethnic groups, living in Eastern Bulgaria. Questions about family socio-demographic factors, attitude, beliefs and fears were included. Results The share of parents who state that they would not have vaccinated their children if the vaccination program was not compulsory is 20.9%. They are mainly in the age range 30-39(42,4%;Spearman's ρ = 0,13;р&amp;lt;0,0001), with higher education(57.6%; Pearson's r=- 0,13;р&amp;lt;0,001), of Bulgarian ethnicity (73,7%;Pearson's r=-0,12;р&amp;lt;0,0001%), living in a larger town, mainly gathering information about vaccines from the Internet(29.9%), mass media(30%) and/or relatives and friends(25.5%). Even of compulsory vaccination programs, these parents tend to have children with missed or postponed vaccinations. Insufficient knowledge and/or shortcomings of the health system are the leading factors for parents with lower education and Roma ethnic group living in relatively smaller settlements, who do not to have a full-scale vaccination program of their children. Conclusions Socio-demographic differences in parental attitudes towards compulsory vaccination require a differentiated approach. Preventive health care work is needed to overcome the growing anti-vaccine attitudes. Education and proper evidence-based proofs about vaccines and their benefits is needed for one types of a population group while increased knowledge and improved access to medical services for another population group. Key messages A large-scale study, characterized as a representative to the country, about the parents' attitudes towards immunization as a whole in the Republic of Bulgaria was carried out. Some socio-demographic factors that might have affected the readiness of parents to vaccinate their children have been analyzed.

(Un)married with children? Exploring marriage between parities in Hong Kong

ABSTRACT Births outside of marriage are comparatively rare in East Asia, but numbers appear to be rising. Such fertility tends to be concentrated among lower educational and socioeconomic groups which can entrench pre-existing inequalities in systems where such ‘non-traditional' family forms are penalised. Most research in this area, however, has focused on the relationship between marriage and first birth. Using a large microdataset from Hong Kong, we explore the relationship between marriage and childbearing across the life-course. In particular, we examine the frequency of marriage between parities, and the various predictors of marrying (or not). Rather than ‘life-long’ cohabiters, we find roughly half of all couples who have a first birth outside of marriage do, in fact, marry before having their second child. The study concludes with some exploratory reasons for the apparently strong continuation of the relationship between marriage and childbearing in Hong Kong and in East Asia more generally.

How Does Urban Sprawl Affect Public Health? Evidence from Panel Survey Data in Urbanizing China.

This study takes urbanizing China as the research object, employs data from three follow-up surveys conducted by the Harmonized China Health and Retirement Longitudinal Study, and examines the effects of urban sprawl on public health from physical and mental health perspectives. Although urban sprawl does not necessarily increase the risk of each specific type of disease or psychological feeling, it has a significant impact on overall physical and mental health. Further analysis reveals significant heterogeneity in the effects of urban sprawl on the physical and mental health of different groups. Specifically, urban sprawl is detrimental to the physical health of males and females, but only has negative impact on the mental health of females. Younger groups are more vulnerable to physical and mental health damage from urban sprawl relative to middle-aged and older groups. In addition, urban sprawl has a significant negative impact on the health of the low-education group but a very limited impact on the health of the high-education counterpart. From an income perspective, however, the preference for suburban housing among middle- and high-income groups makes their health more vulnerable to the negative effects of urban sprawl than low-income groups living in urban centers.

Is the Association Between Education and Sympathovagal Balance Mediated by Chronic Stressors?

BackgroundThis study investigated whether raised chronic stress in low education groups contributes to education differences in cardiovascular disease by altering sympathovagal balance.MethodsThis study included cross-sectional data of 10,202 participants from the multi-ethnic, population-based HELIUS-study. Sympathovagal balance was measured by baroreflex sensitivity (BRS), the standard deviation of the inter-beat interval (SDNN) and the root mean square of successive differences between normal heartbeats (RMSSD). The associations between chronic stressors (work, home, psychiatric, financial, negative life events, lack of job control and perceived discrimination) in a variety of domains and BRS, SDNN and RMSSD were assessed using linear regression, adjusted for age, ethnicity, waist-to-hip ratio and pack-years smoked. Mediation analysis was used to assess the contribution of chronic stress to the association between education and sympathovagal balance.ResultsModest but significant associations were observed between financial stress and BRS and SDNN in women, but not in RMSSD nor for any outcome measure in men. Women with the highest category of financial stress had 0.55% lower BRS (ms/mmHg; β = -0.055; CI = -0.098, -0.011) and 0.61% lower SDNN (ms; β = -0.061; CI = -0.099, -0.024) than those in the lowest category. Financial stress in women contributed 7.1% to the association between education and BRS, and 13.8% to the association between education and SDNN.ConclusionNo evidence was found for the hypothesized pathway in which sympathovagal balance is altered by chronic stress, except for a small contribution of financial stress in women.

Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey

BackgroundOptimal breastfeeding practices including early initiation of breastfeeding and exclusive breastfeeding (EBF) are associated with positive health outcomes. Socioeconomic inequalities in key breastfeeding indicators may play a role in the prevalence of breastfeeding practices. The objective of this study was to examine the socioeconomic inequalities in early initiation of breastfeeding and EBF practices in Bangladesh based on the 2018 Bangladesh Demographic and Health Survey (BDHS).MethodsThis was a secondary data analysis of the nationally representative 2018 BDHS. Data on 4950 women of reproductive age who had ever given birth and 924 children aged 0–5 months were extracted, for early initiation of breastfeeding and EBF. Early initiation of breastfeeding was determined from children who were put to the breast within the first hour of birth. Exclusive breastfeeding was estimated from children aged 0–5 months who were exclusively breastfed.ResultsThe weighted prevalence of early initiation of breastfeeding and EBF were 60.8% (95% CI; 59.0, 62.6%) and 66.8% (95% CI; 63.1, 70.3%), respectively. The estimated prevalence of early initiation among the poorest, poorer, middle, richer and richest households were 67.8, 66.3, 58.4, 56.3 and 54.4%, respectively. Similarly, early initiation prevalence of 64.4, 65.0, 61.1 and 52.3% were estimated among women with no formal education, primary, secondary and higher education, respectively. The estimated prevalence of EBF among the poorest, poorer, middle, richer and richest households were 63.0, 65.2, 67.7, 66.7 and 69.9%, respectively. Similarly, the estimated EBF prevalence were 62.5, 66.0, 66.3 and 68.9% among women with no formal education, primary, secondary and higher education, respectively. Early initiation of breastfeeding was higher among lower household wealth (Conc. Index = − 0.049; SE = 0.006) and lower educational attainment groups (Conc. Index = − 0.035; SE = 0.006).ConclusionsImproving optimal breastfeeding practices in Bangladesh should be given utmost priority. A need to address the socioeconomic inequalities in breastfeeding practices was also identified.

Effect of oral health literacy on self-reported tooth loss: A multiple mediation analysis.

This study aims to investigate the mediating pathways of oral health literacy (OHL) and oral health-related behaviours on the relationship between education and self-reported tooth loss among Australian adults. Data used for studying the effects of mediating pathways are from the National Dental Telephone Interview Survey 2013, a random sample survey of Australian adults aged 18+ years. To study the mediating effects, we use counterfactual-based analysis. To decompose the effect of multiple mediator's alternate, to natural effect, methods such as interventional effects have been proposed. In this paper, we use these approaches to decompose the effect between education, OHL and oral health-related behaviours on self-reported tooth loss. Sensitivity analysis was performed for unmeasured confounding with multiple mediators. Data were available for 2936 Australian adults. The prevalence of persons with ≥12 self-reported tooth loss was approximately 15%. The average total causal effect from the low education group was nearly 150%, and the interventional indirect effect through OHL and the dependence of oral health-related behaviours on OHL to more than 12 missing teeth were 20% and 120%, respectively, higher than in the high education group. Sensitivity analysis indicated if the difference in the prevalence of unmeasured confounder is as big as 6% the direct effect and the indirect effect remains as observed. An additional two-fifths reduction on having more than 12 missing teeth for Australian adults with lower education level could be achieved if the proportion of lower OHL was decreased and optimal dental behaviours were increased.

Educational level as a cause of type 2 diabetes mellitus: Caution from triangulation of observational and genetic evidence.

We obtained observational evidence from the English Longitudinal Study of Ageing (ELSA). Self-reporting educational attainment was categorised as high (post-secondary and higher), middle (secondary), and low (below secondary or no academic qualifications) in 6,786 community-dwelling individuals aged ≥ 50years without diabetes at ELSA wave 2, who were followed until wave 8 for the first diabetes diagnosis. Additionally, we performed two-sample Mendelian randomisation (MR) using an inverse-variance weighted (IVW), MR-Egger, weighted median (WM), and weighted mode-based estimate (WMBE) method. Steiger filtering was further applied to exclude single-nucleotide polymorphisms (SNPs) that were correlated with an outcome (T2DM) stronger than exposure (education attainment). We observed 598 new diabetes cases after 10.4years of follow-up. The adjusted hazard ratios (95% CI) of T2DM were 1.20 (0.97-1.49) and 1.58 (1.28-1.96) in the middle- and low-education groups, respectively, compared to the high-education group. Low education was also associated with increased glycated haemoglobin levels. Psychosocial resources, occupation, and health behaviours fully explained these inverse associations. In the MR analysis of 210 SNPs (R2 = 0.0161), the odds ratio of having T2DM per standard deviation-decreasing years (4.2years) of schooling was 1.33 (1.01-1.75; IVW), 1.23 (0.37-4.17; MR-Egger), 1.56 (1.09-2.27; WM), and 2.94 (0.98-9.09; WMBE). However, applying Steiger filtering attenuated most MR results towards the null. Our inconsistent findings between cohort and genetic evidence did not support the causality between education and T2DM.

Air pollution exposure and different dimensions of depression: findings from the French CONSTANCES cohort

BACKGROUND AND AIM: The evidence for the association between air pollution exposure and depression is growing. We aim to explore this association across different dimensions of depressive symptoms. METHODS: Data from the enrollment phase of the French CONSTANCES cohort were analyzed cross-sectionally. Annual concentrations of PM2.5, black carbon (BC), and Nitrogen dioxide (NO2) from the ELAPSE land-use regression models were assigned at the residential addresses of participants. The z-score of depressive symptoms measured by the Centre of Epidemiologic Studies Depression (CES-D) questionnaire, and its four dimensions (depressive affect, interpersonal relations, low positive affect, somatic complaints) were used as outcomes in multiple linear regression models (reported as β and 95% confidence interval (CI) for an interquartile range (IQR) increase in exposure), for each pollutant separately. Stratified analyses were performed by sex, income, family status, education and community-level deprivation index. RESULTS:Of the 116,170 included participants (mean age: 46.4±13.6 years), 53.2% were women. The median exposure to PM2.5, BC and NO2 was 14.4 µg/m3 (IQR=4.4), 1.4 10-5/m (IQR=0.8), and 19.8 µg/m3 (IQR=15.3), respectively. The prevalence of depressive symptoms in women was higher than in men (27.7% vs. 17.0%). Exposure to BC and NO2 were significantly associated with higher total CES-D and all dimensions scores. PM2.5 was associated with depressive affect only (β= 0.03; 95% CI=0.01: 0.04). For all models and pollutants, the largest estimate was observed for the depressive affect. We found stronger associations for men, lower-income participants, low education groups, and those living alone. CONCLUSIONS:Air pollution exposure was associated with all dimensions of depressive symptoms and not only somatic complaints. Considering the burden related to depression, its prevalence, and the increasing trend of urbanization which is associated with higher exposure to pollutants, our findings are of utmost importance. KEYWORDS: Depressive symptoms, Particulate matters, Black carbon, Nitrogen dioxide, CONSTANCES Cohort

Verbal Fluency Tasks: Influence of Age, Gender, and Education and Normative Data for the Spanish Native Adult Population.

Phonological and semantic verbal fluency (VF) tasks are frequently used to assess language and executive functions in both clinical and research settings. F, A, and S are the most commonly used letters in phonological tasks across languages and cultures. Unfortunately, the lack of norms for the native Spanish population for these letters, and for certain semantic categories such as "proper names," may lead to misinterpretation of scores due to demographic differences. The aim of the present study was to provide normative data for F, A, and S and for "proper names," "animals," and "fruits and vegetables" for the native Spanish population. 257 healthy subjects took part in the study (ages: 17-100years, 3-20years of education). Correlation, multiple regression, and t-tests were used to select the most appropriate variables for stratification. Education was the best predictor of performance in all tasks, followed by age. Given that t-test results showed no differences related to gender, with the only exception of the semantic category "animals," this variable was not considered for stratification. Consequently, the data were stratified in two education levels (<13, ≥13years of education) and in two age levels (<60, ≥60) within the low-educational level group. Mean, standard deviation, and percentile scores for each group are provided. The present norms provide a reference for clinicians assessing VF. This data may also facilitate comparisons with other normative studies in cross-cultural and cross-linguistic research.

Associations of education and income with hazardous drinking among postpartum women in Japan: results from the TMM BirThree Cohort Study

BackgroundAlthough the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan.MethodsWe analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups.ResultsThe prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59–2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04–1.94) and 1.12 (0.81–1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively.ConclusionsPostpartum women with lower education and lower income had higher risks of hazardous drinking in Japan.

Effects of Job Market Demand on Higher Education in Pakistan

The research report also includes officials' recommendations, such as universities taking the lead in engaging with industry to reconcile education and training in a mutually beneficial manner in order to avoid the grim prospect of unemployment. This would also serve as a two-way information channel, with students learning about possible employers and their needs and companies learning about their future employees' attributes. It's also possible that the value of social and political connections in acquiring work will be reduced. Across all age groups, the father's educational level is favorably and significantly related to the children's educational success.Except in the case of students, where the low educational group showed the predicted sign, the mother's educational level was less essential.Employees and self-employed people are surprised by the indicators in the medium educational category. The research report also offers policymakers options to avoid the grim future of unemployment, such as colleges taking the lead in collaborating with industry to reconcile education and training in a mutually beneficial manner. This would also serve as a two-way information channel, with students learning about potential employers and their requirements and employers learning about the characteristics of their future employees. It's also possible that the value of social and political connections in acquiring work will decline.