Lower Middle Socioeconomic Status Research Articles

Socioeconomic Status Transition Throughout Life and Risk of Dementia

Socioeconomic status (SES) is associated with dementia. However, the role of SES transitions in dementia is less explored; such evidence would be useful to understand whether social mobility is associated with healthy longevity at older ages. To investigate the association of lifetime SES transition with risk of dementia. This prospective cohort study, conducted from August 2010 to December 2016, used data from the Japan Gerontological Evaluation Study for participants aged 65 years or older from 31 different areas in Japan. Individuals with missing SES values, loss of follow-up, or new dementia onset 1 year or less from baseline were excluded. Data analysis was performed from April 2022 to April 2023. Transitions in SES across the life course. The main outcome was risk of dementia incidence and corresponding loss or gain of dementia-free periods in a lifespan. The incidence of dementia was identified with a national registry of long-term nursing care services. A total of 9186 participants (4703 men [51.2%]) were included. The mean (SD) age at baseline was 74.2 (6.0) years. Six SES transitions were identified: upward, stable-high, upper-middle, lower-middle, downward, and stable-low. During the follow-up period, 800 cases of dementia were identified. Many dementia risk factors, including lifestyle behaviors, comorbidities, and social factors, were associated with SES transition patterns. Compared with lower-middle SES, the lowest risk of dementia was observed for upward transition (hazard ratio [HR], 0.66; 95% CI, 0.57-0.74) followed by stable-high (HR, 0.77; 95% CI, 0.69-0.86), downward (HR, 1.15; 95% CI, 1.09-1.23), and stable-low (HR 1.45; 95% CI, 1.31-1.61) transition (P < .001 for linearity); there was no association of upper-middle transition with risk of dementia (HR, 0.91; 95% CI, 0.79-1.03). The greatest increases in dementia-free years in the lifespan were also associated with upward SES transition (eg, 1.8 years [95% CI, 1.4-2.2 years] at age 65 years), while the downward transition was associated with the largest loss in lifetime dementia-free years at 75 years or older (eg, -1.4 years [95% CI, -2.4 to -0.4 years] at age 85 years). This cohort study of Japanese older adults identified that upward and downward SES transitions were associated with risk of dementia and the length of dementia-free periods over the lifespan. The results may be useful to understand the association between social mobility and healthy longevity.

Locus Of Control in Cancer And Cardiac Patients: Comparison Across Gender And Socio-economic Status

The objective of the study was to explore the locus of control in cancer and cardiac patients in comparison to gender and SES (socio- economic status). A total of 360 respondents constituted the sample of the present study. Modification of Rotter’s Internal-External Control of Personality Scale (Ara’s Bengali Adaptation 2006) was used for the collection of data. The sample was equally divided into three categories (cancer, cardiac, normal) on the basis of type of individuals (N=120 for each category). Again they were equally divided into male and female on the basis of gender (N=60 for each group).Each category was again equally subdivided into lower middle and upper middle on the basis of SES (N=30 for each group). Results analyzed through ANOVA revealed that the main effects for type of individuals, gender and SES were statistically significant. That is, Both cancer and cardiac patients were more externally controlled as compared to normal individuals, Females were more externally controlled as compared to males and lower middle SES individuals were more externally controlled as compared to upper middle SES individuals. Again the two way interactions between type of individuals &amp; gender, and gender &amp; SES were statistically significant. The Chittagong Univ. J. B. Sci.,Vol. 7(1 &amp;2):131-149, 2012.

Exploring the Determinants of Diabetes’ Self-Care Practices among the Diabetics Living in Urban Field Practice Area of Medical College in Hyderabad

Background: Diabetes is a chronic disease, and among the adults, type II diabetes is more common. In 2021, approximately 537 million adults between 20 to79 suffered from diabetes. Diabetics who follow self-care practices can manage their blood glucose levels better, which in turn prevents the secondary complications. Methods: This was a community-based and cross-sectional study performed in the urban field practice (UHC) area of a tertiary care medical college conducted on 110 type II diabetics. The ‘summary of diabetes self-care activities’ questionnaire was used for data collection. Results: Mean age was 53 +/- 7.6, 70% of whom were females and 45.4% were lower-middle Socio-Economic Status. 33% of the participants had uncontrolled diabetes. The majority of study subjects (68.2%) suffered from hypertension as a co-morbidity, followed by heart disease (10.9%), thyroid disease (10%), and hypercholestrolism (1.8%). 62.7% of the subjects showed treatment adherence for &gt; 4 days/week. Diabetics who had the disease for more than 5 years and followed a proper diet and adhered to treatment (&gt; 4 d/week), showed a better control of glucose levels. Conclusion: The findings of this study can be used to strengthen NPCDCS program to bridge the knowledge gap regarding self-care among patients and caregivers.

Impact of Human Papillomavirus (HPV) Infection on the Treatment Outcome of Concomitant Chemoradiotherapy (CRT) in Cervical Cancer

Background: Human Papilloma Virus (HPV) infection and its persistence are responsible for the development of cervical cancer (CaCx). Chemoradiotherapy (CRT) is the only treatment option, especially in advanced stages. However, it is not influenced by the status of HPV infection. CRT controls cancer growth along with mild to severe adverse effects. Objective: The aim of this study was to assess the HPV-associated risk factors and correlate them with chemoradiation therapy (CRT) response in cervical cancer. Methods: The study was undertaken in 103 histologically positive CaCx patients. Anthrodemographic and obstetric characterizations were conducted by face-to-face interviews, and HPV testing was done by conventional PCR. All the patients received a 40-50Gy total effective dose using tele‑ and brachytherapy. The treatment response, survivorship and statistical analysis were made using GraphPad Prism 9 and SPSS (ver.25.0). Results: Out of 103 patients, 84% were HPV infected, and 16% CaCx were HPV-negative. Advanced age, lower-middle socioeconomic status (SES), illiteracy, and patients from rural backgrounds were significantly higher in CaCx patients with HPV infection. Multiparity, irregular menstrual cycle, poor menstrual hygiene, and use of contraception were significantly associated with HPV positivity. Patients with HPV infection showed a better clinical response (P =0.031), alive vital status (P =0.007), and 59 months of median survival (P &lt;0.001) with a poor hazard ratio (HR 0.29 at 95% CI). Conclusion: HPV-infected CaCx patients showed better response to definitive chemoradiation therapy compared to HPV-negative with a poor hazard ratio. Therefore, HPV testing can potentially stratify CaCx patients for more effective therapeutic regimens, treatment assessments and follow-ups.

Common mental disorders among adolescents in an urban area of Delhi.

Common mental disorders (CMDs) among adolescents may hamper their psycho-social development. This study evaluated the prevalence and determinants of CMD like depression and anxiety among late adolescents of an age of 15--19 years residing in an urban resettlement colony of southeast Delhi. A community-based cross-sectional study was carried out among 556 randomly selected adolescents. CMD was assessed using Mini International Neuropsychiatry Interview - Kid version 6 (MINI-Kid) based on DSM-IV TR and compliant with ICD-10 definitions of CMD. The associated risk factors were studied using a self-developed semi-structured interview schedule and analyzed using multi-variable logistic regression. A total of 491 adolescents were interviewed (a response rate of 88.3%), of whom 247 (50.3%) were female and 210 (42.8%) belonged to a lower-middle socio-economic status. The lifetime prevalence of CMD was 34% [95% confidence interval (CI): 29.8-38.2]. Of the total, 22.4% (95% CI: 18.7-6.1) of the participants reported depression and 6.7% (95% CI: 4.5-8.9) reported generalized anxiety disorder during their lifetime. Female sex [adjusted odds ratio (aOR) 2.1, 95% CI: 1.4-2.2], experiencing a stressful event in the past 6 months (aOR 4.7, 95% CI: 3.1-7.3), and smoking tobacco (aOR 2.0, 95% CI: 1.2-7.4) significantly increased the odds of having CMD in multi-variate analysis. There is a high prevalence of CMD among adolescents residing in urban resettlement colonies of Delhi, which is composed mostly of people belonging to lower socio-economic strata. Hence, tailored intervention at stress management with promotion of healthy lifestyle is needed for this age group.

Breast composition during and after puberty: the Chilean Growth and Obesity Cohort Study

BackgroundBreast density (BD) is a strong risk factor for breast cancer. Little is known about how BD develops during puberty. Understanding BD trajectories during puberty and its determinants could be crucial for promoting preventive actions against breast cancer (BC) at early ages. The objective of this research is to characterize % fibroglandular volume (%FGV), absolute fibroglandular volume (AFGV), and breast volume (BV) at different breast Tanner stages until 4-year post menarche in a Latino cohort and to assess determinants of high %FGV and AFGV during puberty and in a fully mature breast.MethodsThis is a longitudinal follow-up of 509 girls from low-middle socioeconomic status of the Southeast area of Santiago, recruited at a mean age of 3.5 years. The inclusion criteria were singleton birth born, birthweight between 2500 and 4500 g with no medical or mental disorder. A trained dietitian measured weight and height since 3.5 years old and sexual maturation from 8 years old (breast Tanner stages and age at menarche onset). Using standardized methods, BD was measured using dual-energy X-ray absorptiometry (DXA) in various developmental periods (breast Tanner stage B1 until 4 years after menarche onset).ResultsIn the 509 girls, we collected 1,442 breast DXA scans; the mean age at Tanner B4 was 11.3 years. %FGV increased across breast Tanner stages and peaked 250 days after menarche. AFGV and BV peaked 2 years after menarche onset. Girls in the highest quartiles of %FGV, AFGV, and BV at Tanner B4 and B5 before menarche onset had the highest values thereafter until 4 years after menarche onset. The most important determinants of %FGV and AFGV variability were BMI z-score (R2 = 44%) and time since menarche (R2 = 42%), respectively.ConclusionWe characterize the breast development during puberty, a critical window of susceptibility. Although the onset of menarche is a key milestone for breast development, we observed that girls in the highest quartiles of %FGV and AFGV tracked in that group afterwards. Following these participants in adulthood would be of interest to understand the changes in breast composition during this period and its potential link with BC risk.

A CASE STUDY OF AUTO-RICKSHAW DRIVERS IN HNAHTHIAL TOWN OF MIZORAM

In this paper, we examine the auto-rickshaw drivers in Hnahthial town of Mizoram, India by focusing their socio-economic status, issues and challenges that are being faced and the level of their job satisfaction. The study utilizes a mixed-methods approach, combining quantitative data analysis with qualitative interviews and observations from auto-rickshaw drivers, transportation authorities, and other key stakeholders. The study found that majority of the auto-rickshaw drivers are from the family of lower middle socio-economic status reflecting the fact that the driving of auto-rickshaw as the main source of livelihood is still not a gainful job. The study also found that low rate of fare with an index value of 0.8 was the most serious problem among the various problems confronted by auto-rickshaw drivers, followed by lack of auto-rickshaw stand and increasing private vehicles while lack of bad quality of road was ranked as the least significant problem with an index value of 0.51. As regard to job satisfaction, the study found that overall job satisfaction of auto-rickshaw drivers is very low. There is a higher level of dissatisfaction in terms of job security and income compared to working hours. The findings of this research shed light on the socio-economic conditions of auto-rickshaw drivers, their working conditions, income levels, and the challenges they encounter on a daily basis. The paper also explores potential solutions and strategies to address these issues and improve the livelihoods of auto-rickshaw drivers in urban Mizoram.

Treatment Disparities Partially Mediate Socioeconomic- and Race/Ethnicity-Based Survival Disparities in Stage I-II Hepatocellular Carcinoma.

Low socioeconomic status (SES) patients with early-stage hepatocellular carcinoma (HCC) receive procedural treatments less often and have shorter survival. Little is known about the extent to which these survival disparities result from treatment-related disparities versus other causal pathways. We aimed to estimate the proportion of SES-based survival disparities that are mediated by treatment- and facility-related factors among patients with stage I-II HCC. We analyzed patients aged 18-75 years diagnosed with stage I-II HCC in 2008-2016 using the National Cancer Database. Inverse odds weighting mediation analysis was used to calculate the proportion mediated by three mediators: procedure type, facility volume, and facility procedural interventions offered. Intersectional analyses were performed to determine whether treatment disparities played a larger role in survival disparities among Black and Hispanic patients. Among 46,003 patients, 15.0% had low SES, 71.6% had middle SES, and 13.4% had high SES. Five-year overall survival was 46.9%, 39.9%, and 35.7% among high, middle, and low SES patients, respectively. Procedure type mediated 45.9% (95% confidence interval [CI] 31.1-60.7%) and 36.7% (95% CI 25.7-47.7%) of overall survival disparities for low and middle SES patients, respectively, which was more than was mediated by the two facility-level mediators. Procedure type mediated a larger proportion of survival disparities among low-middle SES Black (46.6-48.2%) and Hispanic patients (92.9-93.7%) than in White patients (29.5-29.7%). SES-based disparities in use of procedural interventions mediate a large proportion of survival disparities, particularly among Black and Hispanic patients. Initiatives aimed at attenuating these treatment disparities should be pursued.

Perspectives of and Experience toward the Abuse of Antidiarrheal Drug (Loperamide) among Community Pharmacists: A Cross-Sectional Study.

A cross-sectional study was conducted in Jordan, using a self-administered online questionnaire. The questionnaire consisted of three main parts: demographics, the experience of pharmacists with abusers' behavior, as well as their perspectives toward loperamide abuse. A total of 250 community pharmacists completed the survey, 54% (135) of which were female. Almost one-third (33.2%; 83) of the participants reported exposure to suspected cases of loperamide abuse during the last six months. Pharmacists declared that most of the suspected loperamide abusers were male (60.2%), of middle-low socioeconomic status (69.9%), and between 20 and 30 years of age (57.8%). The largest quantity (packs) of loperamide requested by a single patient was around 33.2 ± 14.9 at once. As reported by pharmacists, the suspected reasons behind loperamide abuse included 50% seeking euphoria, 17% relieving anxiety, and 33% controlling addiction (weaning off other opioids). The multivariate logistic regression analysis demonstrated a significant correlation between the male sex (OR = 1.2, 95% CI 0.12-1.59), pharmacy location in the center of Jordan (OR = 21.2, 95% CI 2.45-183.59), late-night working shift (Shift C, OR = 1.29, 95% CI 0.12-2.08), and abuse to loperamide during the last six months. This study sheds light on loperamide abuse potentials, which could be influenced by different sociodemographic characteristics. Accordingly, close monitoring and thorough tackling of the abuse practices are mandated through an increase in educational and awareness campaigns about proper medication use.

COVID-19 Vaccine Hesitancy among the General Population: A Cross-Sectional Study.

A cross-sectional study was carried out to determine the primary variables causing COVID-19 vaccination hesitancy among residents of Pune. The general population was sampled through simple random sampling. The minimum sample size was determined to be 1246. The questionnaire inquired about the individuals' sociodemographic information, vaccination status, and reasons for vaccine hesitancy. In total, there were 5381 subjects, 1669 of whom were unvaccinated and 3712 of whom were partially vaccinated. Fear of adverse effects (51.71%), fear of losing a few days of work (43.02%), and inability to secure a vaccine slot online (33.01%) were the most frequently cited reasons. An older population (>60 years, p = 0.004), males (p = 0.032), those who were literate (p = 0.011), those of lower middle socioeconomic status (p = 0.001), and smokers were significantly associated with fear and mistrust of the COVID-19 vaccine, while mistrust of the vaccine was greatest among individuals from the upper and lower middle classes (p = 0.001). Vaccine hesitancy due to concerns about the side effects and long-term complications was prevalent among the elderly, males, those from the lower middle class, and smokers. This study emphasizes the importance of communicating effectively about the vaccine's efficacy, its distribution, and vaccination sites.

Investigating Mortality Disparities Among Insured Patients With Colon Cancer Treated in an Integrated Health care System and Other Private Settings.

Lower socioeconomic status (SES) affects health care delivery and is associated with worse outcomes. Integrated healthcare systems (IHS) may help reduce barriers to health care and affect outcomes. Our aim was to compare outcomes of colon cancer cases diagnosed at the largest IHS in California, Kaiser Permanente Southern California (KPSC), to other insured patients (OI) to determine how SES influences mortality. This retrospective cohort study included insured adults in southern California diagnosed with colon cancer between 2009 and 2014, using data from the California Cancer Registry, and followed through 2017. Main outcome was all-cause mortality. Person-year mortality rates were calculated for two groups, KPSC and OI. Multivariable hazard ratios were calculated for association between SES quintiles and mortality. Total of 15923 patients were diagnosed with colon cancer, 4195 patients (26.3%) within KPSC and 11728 patients (73.7%) in OI. The overall mortality rate per 1000 person-years (PY) was lower in KPSC [103.8/1000 PY (95% CI:98.5-109.3)] compared to OI [139.3/1000 PY (95% CI:135.2-143.4)]. Compared to the highest SES group, the lowest SES group did not experience higher mortality risk in the KPSC population, after adjusting for race/ethnicity and other factors (HR, 95% CI = 1.13, .93-1.38). However, in OI patients, lowest and lower-middle SES groups had higher mortality risk compared to the highest SES group (HR, 95% CI = 1.26, 1.13-1.40 and 1.28, 1.16-1.41, respectively). Lower SES was associated with higher mortality risk within the OI group; however, within KPSC no such association was observed. Care coordination in IHS settings mitigate SES-related mortality differences.

To Assess the Maternal and Perinatal Outcome with Isolated Oligohydramnios in Third Trimester of Pregnancy

Introduction: Oligohydramnios is described as a condition with decreased amniotic fluid volume relative to gestational age. Oligohydramnios is most commonly defined as an amniotic fluid index (AFI) ? 5 cm or the largest vertical pocket measuring ? 2 cm. Isolated oligohydramnios (IO) refers to the presence of oligohydramnios without fetal structural and chromosomal abnormalities, without fetal growth restriction, without intrauterine infection and in the absence of known maternal disease. Aim: To study was to analyse the maternal and fetal outcome in isolated oligohydramnios in third trimester of pregnancy. Method: This is prospective hospital based observational study which was carried out in department of obstetrics and gynaecology, S.P. Medical College, Bikaner for a period from June 2021 to May 2022. This study included 100 pregnant women, who fulfill inclusion and exclusion criteria, out of which 50 pregnant women with 28 completed weeks of gestation who had singleton pregnancy with cephalic presentation and Amniotic Fluid Index (AFI) &lt; 5 cm enrolled as study cases while 50 pregnant women with AFI &gt; 5 cm were in control group. Results: Majority of the patients were in 21-30 years of age in both groups. Majority of patients in both groups were illiterate, unbooked, belonged to rural area and were from lower middle socioeconomic status; hence both groups were comparable in this regards. In our study in group A out of 50 patients, 33 (66%) had LSCS and 17 (34%) patients delivered by vaginal route and group B out of 50 patients, 43 (86%) patients delivered by vaginal route and only 7 (14%) patients had for LSCS. NICU admission in group A was 14 (28%) and in group B 3(6%) respectively. Conclusion: C-Section rates were more common in group A compared to group B. NICU admission rate were more in group A (40%) compare to group B (14%). In Isolated oligohydramnios more babies had APGAR&lt;7 at 1&amp; 5min.

THE PATTERN OF CUT THROAT INJURIES, EARLY MANAGEMENT AND OUTCOME-A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL

Objective: To analyze pattern, sex and age ratio, common causes, the most common site and extent of the injury in the patients with cut throat injury at our hospital. To compare the same with previous similar studies conducted at other centers in different parts of the world. Also to note the early management and outcome in our study. Department Setting: of ENT and Head and Neck Surgery, Gauhati Medical college and Hospital, Guwahati, from January 2022 to January 2023. Methods: A total of 60 cases of cut throat injury were included in our study. Proforma was prepared to collect data. Results: 60 cases of cut throat injury patients were included in the study. Out of 60 cases 51 were males and 9 were females. Simple primary wound closure was done in 58 cases and 2 required secondary wound repair. In 20 patients, tracheostomy with primary repair was done. 32 patients needed psychiatric consultation. In our study, Conclusion: majority were males between 20 years to 40 years from lower middle socioeconomic status. Early and improved management will reduce the mortality and morbidity

Socio-Economic Status of Bamboo Artisans of Karnataka, India

Aim: To study the demographic profile and socio economic status of the bamboo artisans of Northern Karnataka districts.&#x0D; Study Design: Exploratory design was used.&#x0D; Place and Duration of Study: Study was conducted in Northern Karnataka districts of Dharwad, Belgavi and Uttar Kannada in the year 2019-2020.&#x0D; Methodology: Random sampling method was applied to select a sample size of 120 bamboo artisans’ family (Forty respondents from each district). The respondents were interviewed personally to elicit the primary information by using self structured interview schedule and Aggarwal et al. [1] was used to study the socio economic status of the bamboo artisans.&#x0D; Results: The study resulted that bamboo artisan’s belonged lower middle socio economic status. Higher per cent of the respondents belonged to middle age group followed by young age group. Women participation was more compare to men counterpart in the bamboo artisans occupation.&#x0D; Conclusion: Majority of the respondents belonged to middle age group, and majority of them were female followed by male. More than fifty per cent of the respondents had primary school level of education. Majority of the respondents were married followed by widow. Nearly fifty per cent of the respondents belonged to small family. Higher per cent of the respondents had less than 13 years of experience in the bamboo enterprise products making. More than half of the respondents spent 5-6 hours a day in bamboo enterprise. Majority of the respondents involved daily in bamboo enterprise work. Nearly fifty per cent of the respondents had habit of storing the bamboo raw materials inside the home. Majority of the selected bamboo artisans belonged to the lower middle socio economic status and were having less than 13 years of experience.

Processed foods, socio-economic status, and peri-urban obesity in India

The ‘State of Food Security and Nutrition in the World 2020′ report states that switching to healthy diets will both prevent backsliding into hunger and help countries meet their sustainability goals. In 2019–2020, 17 percent of India’s adult population was undernourished. At the same time, however, 23 percent of all adults were obese. The increasing prevalence of obesity implies that improving diets and reducing risks for obesity and non-communicable diseases (NCDs) is a major food security challenge for India in the coming years. Overconsumption of calories from processed foods is known to increase the risk of obesity. To gain insights into the dietary transition and its relationship with obesity, we use cross-sectional data from a primary socio-economic survey conducted in the rural-urban interface of Bangalore, a mega-city in India that is characterized by high economic development. We show that for women in lower-middle socio-economic status (SES) groups, higher share of calories from semi-processed foods (SPF) is associated with a higher prevalence of obesity, while excess consumption of calories from ultra-processed foods (UPF) is associated with a higher obesity prevalence among women in higher SES groups. Older women and women who consume above the recommended daily allowance (RDA) of calories are more vulnerable to excess calories from SPF consumption than younger women and women who consume less than the RDA of calories. Furthermore, a lower prevalence of obesity is observed among women who consume excess calories from SPF but engage in labor-intensive occupational activity. These results speak to the need for interventions that incentivize weight loss and increased physical activity. The result that SPF consumption is associated with an increased prevalence of obesity especially among lower-middle SES group calls for interventions that increase access to and affordability of healthy diets. Policy instruments such as diversifying the public distribution system (PDS) are important to improve accessibility and affordability of healthy diets. In addition, increasing sugar and processed food taxes and incentivizing companies to invest in culturally sensitive food labeling should be considered to shift consumer demand towards healthier diet choices.

A prospective study evaluating perioperative quality metrics of cancer surgery: Experience from a tertiary care cancer centre in India.

Well-defined quality metrics were studied at this high-volume tertiary care academic oncology centre to evaluate surgical quality and outcomes. A prospective cohort of 691 patients undergoing major surgeries for all cancers was observed between 1 September 2018 and 30 August 2019 and predefined quality indicators in three categories: namely, optimal hospital resource utilisation, quality of surgery and perioperative outcomes were recorded during their admission period. Surgical procedures were divided into group I versus group II involving simple/moderate complexity versus high complexity procedures for analysis done using appropriate tests in STATA v14.0. There were 373 versus 318 patients in group I versus group II with a mean of 48 years of age and 459 (66.43%) being females. Mean BMI was 24.58 kg/m2 , haemoglobin 12.12 g/dL and mean serum albumin of 4.25 g (SD ± 0.6). A total of 667(96.53%) patients had an Eastern Co-Operative Oncology Group performance score of 1 with 271 (39.22%) having comorbidities and 195 (28.22%) having tobacco/alcohol addictions. A total of 393 (56.87%) patients underwent prehabilitation. 83% of patients belonged to lower-middle socioeconomic status and 32% of patients had some prior surgical intervention. Neoadjuvant therapy was administered in 44.5% versus 37.42%, mean preoperative hospital stay was 3.65 versus 6.16 days whereas postoperative was 2.6 versus 6.09 days with total stay being 6.27 versus 12.21 days, mean surgical duration was 132 versus 268 min with mean blood loss of 100 versus 245 mL (group I vs. group II, respectively). Intraoperative events, namely, unexpected bleeding and hypotension occurred in 144 (20.84%) patients while packed red blood cells and/or fresh frozen plasma transfusion was required in 56 (8.1%) patients. 40% of patients needed intensive care unit care postoperatively with 45 (6.51%) patients having some event (hypotension, sepsis, acute kidney injury, etc.). A total of 29 (<4%) patients had ≥grade 3 surgical complications while ≥grade 2 medical complications occurred in 6.43% versus 12.58% of patients (group I vs. group II). A total of 90 (13.02%) patients were readmitted, 15 (2.17%) re-explored and 5 (0.72%) patients died. Optimal surgical outcomes in this study compared to international standards underpin the need for well-defined multidisciplinary perioperative pathways to be followed for each organ system and this framework can be adopted by other cancer centres in LMIC to achieve good surgical outcomes.

Self-Care Activities by Patients with Chronic Cardiovascular Morbidities: Explanatory Sequential Facility-Based Mixed Method Study in West Bengal, India

Background: Chronic cardiovascular morbidities are major public health concern. The objective was to assess awareness and practice of selfcare activities among patients with chronic cardiovascular morbidity in Burdwan Medical College (BMC) and to explore constraints in selfcare practice. Materials &amp; Methods: A facility-based, explanatory sequential, mixed-method study was conducted in Cardiology super-specialty outpatient department of BMC, West Bengal. A calculated sample of 185 patients with chronic cardiovascular morbidity were selected randomly; interviewed with predesigned, pretested schedule (adapted from H-SCALE) for quantitative component. For qualitative component, eight study participants, selected purposively, were interviewed with In-depth-interview guide. Multivariable logistic regression was done to find out predictors of selfcare practice. Thematic inductive analysis was done to explore constraints. Results: 73% study participants were aware about overall selfcare practices; 43.8% performed satisfactory overall selfcare practice. Below secondary level educational status [AOR:0.412, 95% CI (0.178-0.956)] and lower &amp; lower-middle socioeconomic status [AOR:0.063, 95% CI (0.017-0.230)] were found to create negative influence on favourable self-care practice. Thematic analysis revealed false belief, lack of motivation, lack of proper knowledge, emotional disturbances and Covid-19 pandemic impact as major constraints in selfcare practice. Conclusion: Selfcare awareness &amp; practice both are low. Interventions are needed to ensure healthy lifestyle of patients.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi

This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05). The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

The Relationship Between Executive Functions and Externalizing and Internalizing Behaviors in Mexican Preschoolers

ABSTRACT Executive functions allow the regulation of behavior and emotions. This study aimed to analyze the association of executive functions with externalizing and internalizing behaviors in 30 Mexican preschoolers with typical development (age M = 53.63 months; SD = 7.83 months; 40% girls) from homes of middle-low socioeconomic status. Behavioral and cognitive measures were used to assess executive functions and analyzed them using robust statistical methods. We found that executive functions are related to externalizing and internalizing behaviors at the behavioral level. Only Forward Digit Span predicts attentional problems. Individual differences in children's cognitive development in a Mexican context were adressed, and they have clinical and educational implications.

Pengaruh kecemasan terhadap persepsi risiko bahaya covid 19 pada pekerja pasar tradisional

The news about the Covid 19 virus has made people with lower middle socioeconomic status who work in traditional market worried about this virus. How they thinking about covid 19 reflected in their daily behavior at traditional market. They anxiety that reflected by their behavior become predictor how they thinking about the covid 19 virus. The purpose of this study was to determine the effect of anxiety on the perception of the risk of the danger of covid 19 virus. This study is a quantitative research using survey method. There are 166 participant who surveyed by accidental sampling with some criterias; male and female traditional markets worker and aged 18-61 years. The data collected by instruments; Covid 19 Pperceived Risk Scales (CPRS) and State Trait Anxiety Inventory-Trait (STAI-T) and analized using simple regression. The results showed that there was a significant positive effect on anxiety on the perception of the dangers of covid 19 in traditional market workers (r = 0.205, R2 = 0.042, P = 0.008) Keywords : subjective assessment, anxiety as a trait, lower middle socioeconomic