Low Socioeconomic Backgrounds Research Articles

Multilevel needs assessment of physical activity, sport, psychological needs, and nutrition in rural children and adults.

Physical activity yields significant benefits, yet fewer than 1 in 4 youth meet federal guidelines. Children in rural areas from low socioeconomic (SES) backgrounds face unique physical activity contextual challenges. In line with Stage 0 with the NIH Stage Model for Behavioral Intervention Development, the objective of the present study was to conduct a community-engaged needs assessment survey with middle school children and adults to identify perceptions, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition from a multi-level lens. A cross-sectional survey data collection was conducted with children (n = 39) and adults (n = 63) from one middle school community in the Midwestern United States. The child sample was 33% 6th grade; 51% 7th grade and was 49% female. The adult sample was primarily between 30 and 39 years old (70%) and comprised predominantly of females (85%). Multi-level survey design was guided by the psychological needs mini-theory within self-determination theory and aimed to identify individual perceptions, barriers, and facilitators in line with the unique context of the community. At the individual level, 71.8% of children and 82.2% of the overall sample (children and adults) were interested in new physical activity/sport programming for their school. Likewise, 89.7% of children and 96.8% of adults agree that PA is good for physical health. For basic psychological needs in the overall sample, relatedness was significantly greater than the autonomy and competence subscales. Children's fruit and vegetable intake were below recommended levels, yet only 43.6% of children were interested in nutritional programming. Conversely, 61.5% indicated interest at increasing leadership skills. At the policy-systems-environmental level, the respondents' feedback indicated that the condition and availability of equipment are areas in need of improvement to encourage more physical activity. Qualitative responses are presented within for physical activity-related school policy changes. Interventions addressing children's physical activity lack sustainability, scalability, and impact due to limited stakeholder involvement and often neglect early behavioral intervention stages. The present study identified perspectives, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition in a multi-level context and forms the initial campus-community partnership between scientists and community stakeholders.

Teaching Machine Learning to Middle and High School Students from a Low Socio-Economic Status Background

Knowledge about Machine Learning is becoming essential, yet it remains a restricted privilege that may not be available to students from a low socio-economic status background. Thus, in order to provide equal opportunities, we taught ML concepts and applications to 158 middle and high school students from a low socio-economic background in Brazil. Results show that these students can understand how ML works and execute the main steps of a human-centered process for developing an image classification model. No substantial differences regarding class periods, educational stage, and sex assigned at birth were observed. The course was perceived as fun and motivating, especially to girls. Despite the limitations in this context, the results show that they can be overcome. Mitigating solutions involve partnerships between social institutions and university, an adapted pedagogical approach as well as increased on-by-one assistance. These findings can be used to guide course designs for teaching ML in the context of underprivileged students from a low socio-economic status background and thus contribute to the inclusion of these students.

The efficacy of a computer science curriculum for early childhood: evidence from a randomized controlled trial in K-2 classrooms

ABSTRACT Background and context Despite the growing importance of computer science (CS) education, high-quality CS curricula for students in kindergarten to lower elementary grades are lacking. It is also unclear how students from underrepresented groups such as female students, students from low socioeconomic status, and students with disability respond to CS curriculum at this age range. Objective This study is aimed to examine the effectiveness of a novel CS curriculum (Coding as Another Language – ScratchJr) on the development of programming and computational thinking skills for students in kindergarten to second grade classrooms. Method We conducted a randomized controlled trial with 1057 students and used multilevel regression analysis to examine the impact of the CAL curriculum on students’ coding and computational thinking skills, as well as moderation analysis to investigate how students’ demographic characteristics including gender, socioeconomic status, English learners and disability interacted with the intervention effectiveness. Findings The CAL curriculum was effective in improving students’ programming skills, but no significant differences were detected for students’ computational thinking skills. Students with limited English proficiency and students from low socioeconomic backgrounds achieved similar gain in coding skills but students with disabilities and female students did not demonstrate the same improvements as their peers. Implications These findings shed light on the educational efficacy of CAL as a promising CS curriculum for young children and underscore the importance of understanding how underrepresented minority students respond to the curriculum in order to better guide the development and design of the CS programs.

Abstract 14640: Community Socioeconomic Distress is Associated With Poor Access to Heart Failure Clinical Trials in the United States

Introduction: Clinical trials have historically lacked representation from minorities and individuals from lower socioeconomic backgrounds. Little is known about the role geographic access plays in recruiting diverse populations for clinical trials. Objectives: Given disparities in clinical trial enrollment, we sought to analyze how access to heart failure trials varies across demographic groups. Methods: We queried clinicaltrials.gov for trials classified under “heart failure” that are recruiting and enrolling adult patients. Trial site addresses were obtained using Google Maps. We calculated drive times from each US census tract to the closest trial site using ArcGIS Pro v3.1. Demographic information and urban / rural statuses for census tracts were obtained from the US Census Bureau. Distressed Community Index (DCI) scores (0 = no distress, 100 = severe distress) based on metrics including education level, poverty, and unemployment were collected. Data were analyzed using Python v3.8. Results: We identified 954 heart failure trials with 644 unique sites in the US. About 54% of the rural population lives more than 30 minutes from a trial site compared to 22% of the urban population (OR 0.23; p < 0.001). Analysis of DCI scores covering 328 million people revealed that drive times increase with higher socioeconomic distress ( p < 0.001; Figure). In both urban and rural settings, median drive times for individuals in the top 10% of distressed communities (56 min urban and 79 rural) are more than three times those of individuals in the lowest 10% of distressed communities (18 min urban and 23 rural). A larger proportion of non-white minorities live less than 30 minutes from a trial site compared to the white population (77% vs. 60%; OR 2.23; p < 0.001). Conclusions: Increased socioeconomic distress is associated with worse access to heart failure trial sites for both urban and rural populations. Geographic barriers should be addressed to improve diversity in trials.

Socio-economic barriers affecting mother’s motivations in seeking medical postpatrum depression treatment in Danao City, Philippines

Postpartum depression (PPD) is a debilitating mental condition that mothers from low socio-economic backgrounds are more susceptible to acquiring. The study examined the socio-economic barriers affecting mothers’ motivation to seek medical PPD treatment using a descriptive correlational research design. A purposive sampling technique was used to recruit eighteen (18) mothers aged 20 - 39 years old who scored below 20 on the Edinburgh Postnatal Depression Scale (EPDS). The study’s findings suggested that educational attainment and health care insurance significantly correlate with mothers’ perceived barriers. Regarding their access to maternal postpartum care, age, income, educational attainment, and health care insurance directly correlate to their seeking attitude. Finally, financial and social barriers significantly impact the mothers’ access to maternal postpartum care, while geographic factors show no direct correlation. The study recommended coming up with means to alleviate economic constraints and the stigma of PPD to increase mothers’ motivations in seeking medical PPD treatment. Furthermore, the output of this study is aimed at developing an educational and livelihood program to alleviate financial and social barriers for mothers seeking PPD treatment.

Remote teaching in times of COVID-19: teachers’ adaptation and pupil level of participation

ABSTRACT This article draws on data from a broader research study focusing on Portuguese teachers’ perceptions and experiences of remote teaching during the COVID-19 pandemic. In total, 2638 teachers participated in the study. Data were collected through an online survey which included both closed- and open-ended questions. Findings suggest that, overall, teachers experienced a positive adaptation process and were able to teach according to what they had planned. However, difficulties were also found. These relate to reconciling work with family life and extra workload in the context of remote teaching. In addition, findings show that pupils from lower socioeconomic backgrounds presented a lower level of participation in learning tasks. Differences as a function of gender and age were identified. Implications of the findings are discussed.

Factors associated with the plan to pre-lacteal feeding for the first 6 months among Ethiopian mothers: a multilevel mixed effects analysis of 2019 performance monitoring for action Ethiopia

IntroductionDespite efforts to promote exclusive breastfeeding for the first six months of life, pre-lacteal feeding remains prevalent in Ethiopia. The study will use data from the 2019 Performance Monitoring for Action Ethiopia (PMA-ET), which is a nationally representative survey that collects information on maternal and child health indicators. Therefore, this study aims to identify individual and community-level factors associated with the plan to pre-lacteal feeding for the first six months among mothers in Ethiopia.MethodsThe datasets from the 2019 Performance Monitoring for Action Ethiopia Survey were analyzed in this study, which included 685 mothers from the survey. Stata version 17.0 was used for data analysis. Multi-level mixed-effect logistic regression was utilized to identify individual and community-level factors that are linked with the plan to pre-lacteal feeding. The strength and direction of the association were presented using an adjusted odds ratio with a 95% confidence interval, and statistical significance was declared at a P value less than 0.05.ResultsThe study found that factors significantly associated with the plan to pre-lacteal feeding included mothers without higher education (AOR = 2.5, 95% CI: 1.204–1.204), mothers belonging to poor households (AOR = 11.1, 95% CI: 3.482–35.175), and women in clusters with poor wealth status (AOR = 0.2, 95% CI: 0.043–0.509).ConclusionAs per the findings of the study, both individual and community-level factors were found to influence the decision to practice pre-lacteal feeding. Educational status and household wealth were significant individual-level factors associated with pre-lacteal feeding, whereas community wealth status was a significant community-level factor. To address this issue, it is recommended to focus on increasing the education level of mothers from lower socioeconomic backgrounds and providing education on the benefits of exclusive breastfeeding and the risks associated with pre-lacteal feeding. These efforts can help in reducing the prevalence of this harmful practice.

Transportation Cost Is a Significant Barrier to Quality Care for Hematologic Malignancy Patients in a Minority-Rich, Socioeconomically Disadvantaged Population

Background Transportation to and from clinics is a barrier to care for cancer patients. Depending on treatment regimen, patients' clinic visits could be frequent, and this could lead to cumulative financial toxicity. We aim to study transportation costs as a barrier to care in hematologic malignancy patients with new cancer diagnosis and in patients referred for cellular therapy at a tertiary care academic Medical Center located in Bronx, NY. A deeper understanding of the role of financial toxicity in relation to transportation will help to understand the effect this may have on health outcomes and ways to overcome this barrier to medical care that predominantly affects minorities from low socioeconomic backgrounds. Methods This is an ongoing prospective survey-based study carried out at Montefiore Medical center, Bronx NY. Adult patients with either a newly diagnosed (ND) hematologic malignancy (HM) or those undergoing cellular therapy (CT), such as autologous, allogeneic stem cell transplant or CAR-T therapy are identified at Montefiore Oncology clinics. Patients who agree to participate are given a research team generated 5-question survey to gauge their concerns surrounding transportation for oncology visits. Responses are grouped according to cohort (ND vs CT). Sociodemographic information was collected, and race and ethnicity were self-identified. For patients with long-term follow-up, we also capture no-show rates. The study is approved by the local IRB. Results There were 72 patients across groups at the time of analysis. Forty-one patients completed surveys for the ND group and 31 for the CT group. Twelve (29%) and three (7%) patients identified their race as Black and White respectively in ND group with 8 (26%) and 4 (13%) as Black and White in the CT group, respectively. In ND, 22 (54%) patients identified their ethnicity as Hispanic/Latino with 17 (55%) in CT. The median distances between Montefiore Hospital and the patient's homes according to zip code were 3.59 miles (mi) with range 0-81.42 mi for ND and 3.47 mi with range 0-50.35 mi in the CT group. Nearly 50% of patients in ND and CT groups reported concerns about access and cost of transportation to the oncology clinic. Insurance paid for transportation for only 12.5 and 17.9% of patients in ND and CT groups, respectively. Across groups, over half of patients (52.5%) used a personal vehicle to get to appointments in the ND group with 46.5% in the CT group. Many of patients in the ND (18%) and CT (17%) group reported missing their appointments due to transportation issues. Ten percent of patients in ND and 13% in CT groups reported missing appointments due to caregiver issues. Fifty-nine percent of patients in ND and 47% in CT groups reported feeling comfortable with phone/video visits. Of patients with long term follow up and >10% no-show rates, 60% in ND and 50% in CT groups use a personal vehicle. Conclusion We report preliminary results from an ongoing prospective study evaluating transportation barriers to care for hematologic malignancy patients in an underserved population in Bronx. Even in a well-connected city such as New York City, half of patients with new hematologic cancer and those referred for cell therapy are worried about access and cost of transportation to and from medical appointments. Although the distance between clinic and home is less than 5 miles for over half of patients, patients are still missing appointments due to transportation and caregiver issues. Patients who travel using personal vehicles may also have difficulty driving due to chemotherapy or being accompanied for visits due to caregiver issues. As many novel cellular therapies recently approved are only available at tertiary centers, transportation is expected to be a bigger factor affecting social determinants of health. One potential solution is to incorporate more tele-visits as nearly half our patients are amenable to them. More information including follow-up surveys and the number of missed appointments is being collected to identify specific groups of patients who will benefit from interventions.

National service is free, not cancer disease: Financial toxicity in a public universal coverage healthcare system.

32 Background: Italian National Health Service provide regional control on clinical pathways to be cost-free. ASL Napoli 1 centralized model of Palliative Care Unit ensure free multidisciplinary medical and nursing assistance, beyond aids and devices. Since healthcare costs are rising and private spending is becoming necessary, our aim is screening financial toxicity in the most densely populated area in Europe. Methods: From January to April 2023 we performed simple random sampling to select 27 home care patients. From the richest neighborhoods to poorest ones, patients answered the COST-FACIT questionnaire. We collected information about medical history, sociodemographic characteristics (employment status or retired, family composition, if benefiting from state allowances) and, above all, out-of-pocket costs. Results: Data highlight that wealthiest and middle-class patients are afraid about out of control medical expenses and their satisfaction about economic status is declining. Patients from a lower socioeconomic background are deeply concerned about not being able to work and not being of financial support to often single income families. Score analysis reveals significant variation among the different items, and the average score is 12.4. Highest scores count 28 and 29, respectively, suggesting that these patients are more able to manage the costs of treatment or access financial resources to cope with medical expenses. Three scores of 0 suggest higher financial toxicity in the realm of palliative oncology care. These patients face greater difficulty in handling treatment costs, encounter barriers in accessing financial resources, or experience high expenses. Patients have highlighted that purchase of non-reimbursable drugs is the most onerous out-of-pocket cost in home care setting. Conclusions: Our centralized Palliative Care Unit organizational model coordinates by adapting purchasing and providing holistic sanitary approach beyond patients' economic abilities. Our centralized Palliative Care Unit provides health services to endure equity across all the city. However, score analysis suggests a range financial suffering for home care patients. Low average score 12.4 suggests how much financial suffering in palliative care impacts, even in a model of centralization of health care with global coverage. So, screening for financial toxicity plays a key role in directing health policies on pharmaceutical expenditure.

Beyond the Usual Diet: A Challenging Case of Xylophagia Resulting in Intestinal Obstruction From Xylobezoar

ABSTRACT Xylobezoar is indeed a rare condition associated with xylophagia, characterized by varying degrees of intestinal obstruction due to the entrapment of undigested paper in the gastrointestinal tract. Xylophagia is a form of pica that primarily affects children from low socioeconomic backgrounds with mental conditions and nutritional deficiencies. It is rarely seen in adults. Medical and endoscopic interventions are often challenging in these patients, and surgical intervention is often required. We present an endoscopically challenging case of pancolonic obstruction due to toilet paper accumulation in a patient with pica secondary to iron deficiency anemia.

Relationality and student engagement in higher education: Towards enhanced students’ learning experiences

This study examines how student engagement and social relationships between teachers and students may enhance the learning experiences of students in a South African university. Two separate sets of semi-structured interviews were held with 27 university teachers and 51 students respectively. The findings revealed that that the relationships between the behavioural and cognitive dimensions of student engagement and social relationships between teachers and students are motivated by good relational communication; relational pedagogy; good inter-relational culture; teacher relational competences (cognitive, behavioural and inter-cultural); and teacher demonstration of care. The current study adds to the literature on relational pedagogy and student engagement by highlighting the importance of inter-relational culture and teacher relational competences to the behavioural and cognitive development of university students. Moreover, when students and particularly, first generation students, students from low socio-economic backgrounds and students from rural communities develop good relationships with their teachers, they are set to have positive learning experiences. Keywords: Student engagement, learning experiences, social relationships, inter-relational culture, teacher competences

Every tenth child: Heterogeneity in characteristics and life-course patterns among children in contact with child welfare services

Every tenth Norwegian child has been in contact with the child welfare services (CWS) before age 18. This paper describes the variation in background characteristics of CWS children with different types of services and their life-course patterns from ages 10 to 25, compared to other children. We use high-quality population-wide Norwegian register data, covering about 860000 children from birth cohorts 1987–2001, of which roughly 85000 have received a CWS initiative. CWS children typically have lower socioeconomic backgrounds than other children. In terms of individual outcomes, they are more likely to have a criminal charge, be prescribed drugs for mental health and ADHD, fail in the educational system, and experience labor market marginalization. However, the heterogeneity among CWS children receiving different initiatives is more pronounced than differences between those in contact and those not. Adolescents with multisystemic therapy (MST) have the most unfavorable life-course patterns, in line with children in childcare institutions. Still, MST youth enter CWS late and have an advantaged family background compared to other CWS children, suggesting that individual-level risk factors are particularly important for sorting into MST.

Assessing the Socioeconomic Impacts of Transitioning from Plutocracy to Meritocracy in University Admissions

This paper examines the effects of transitioning from a plutocratic to a meritocratic university admission system on students and society. We develop a theoretical model to predict the socioeconomic impacts of this transition and validate our predictions using simulations and empirical data from Georgia, where education reform shifted university admissions from a plutocratic system to a meritocratic one, providing a natural experiment that enables us to validate predictions of our theoretical model. The findings demonstrate positive outcomes for individuals from low socioeconomic backgrounds, including improved educational attainment and increased labor income.

Digital instructional leadership in schools facing different levels of challenging contexts: A survey study during the COVID-19 pandemic

This study highlights the growing significance of integrating digital technology into instructional leadership in schools. Educational administration research cannot ignore the fact that digital technology has become an integral part of human interactions and organizational processes in twenty-first-century workplaces. This paper aims to explore digital instructional leadership behaviours of principals during the COVID-19 pandemic and explain behavioural differences in leadership related to different levels of socio-economic school settings. Data were collected through an online study from 380 teachers in Bahrain. We used a series of two-sample t-tests between percentages to compare differences in digital instructional leadership behaviours. The study revealed that means of principals’ digital instructional leadership behaviours were generally higher in schools serving student populations with a high rather than low socio-economic background. Principals in schools serving student populations with low socio-economic background were higher than their peers only in one digital instructional leadership behaviours, and this was related to socio-economic gaps. The study contributes to better understanding of digital instructional leadership, an approach that is becoming highly prevalent because of the pandemic, and sheds light on how levels of principals’ behaviours vary in different circumstances. Overall, the findings attest to the presence of a digital instructional leadership divide.

Maternal factors associated with early childhood caries among 3–5-year-old children with low socio-economic status in Trishal, Bangladesh

IntroductionEarly Childhood Caries (ECC) is more prevalent in nations where a larger portion of the population resides below the poverty line. This study aimed to evaluate the connections between maternal awareness, attitudes, practices related to oral health, and the occurrence of ECC among children aged 3–5 years in Bangladesh, a low–middle income country with high level of poverty.MethodsThis cross–sectional study recruited mother–child pairs with a focus on children aged 3–5 years from low socioeconomic backgrounds in Trishal, Bangladesh. Data collected included maternal oral health knowledge, attitudes, and behaviors. Clinical examinations were conducted to check for dental plaque on the upper central incisors' labial surfaces. ECC was identified using the ICDAS II index criteria. Associations between maternal oral health knowledge, attitudes, behaviors, and children's plaque score and caries status were analyzed using multivariable logistic regression, and adjusting for confounding variables (child's age, gender, mother's age, education, and number of children).ResultsAmong 532 mother-child pairs, 491 (93.2%) mothers were unaware of the role of fluoride in preventing caries, while 516 (97%) recognized the importance of using fluoridated toothpaste during brushing. Additionally, 520 (97.7%) mothers reported not knowing how to brush their child's teeth, and 87 (16.4%) brushed their children's teeth twice daily. Visible dental plaque was observed in 420 (78.9%) children, and 321 (60.3%) had ECC. Higher plaque score increased the odds of ECC in the study population (AOR: 5.617, 95% CI: 3.511–8.987).ConclusionsMothers of preschool children with low socioeconomic status were poorly aware of caries preventive behaviors and had suboptimal oral health practices for their children. The plaque score was the only oral health factor that seems to increase the risk for ECC among children with low socio-economic status in Bangladesh. It is imperative to prioritize support and interventions aimed at improving oral hygiene practices to reduce ECC risk in this population.

Infantile tremor syndrome: a case report

Infantile tremor syndrome (ITS) is a rare but significant clinical condition characterized by a tetrad of pallor, developmental delay or regression, skin pigmentation abnormalities, and sparse brown scalp hair, often accompanied by involuntary tremors. ITS primarily affects children aged 5 months to 3 years, with a higher prevalence in males, especially in regions like the Indian subcontinent, Southeast Asia, and Africa. The exact cause of ITS remains uncertain, but a strong association with vitamin B12 deficiency has been observed in numerous studies. Malnutrition, including deficiencies of zinc, magnesium, iron, calcium, and hypoalbuminemia, is common among affected infants, who often come from lower socioeconomic backgrounds with vegetarian mothers lacking animal food in their diets. In this case report, an 8-month-old female child presented with progressive tremors, poor feeding, and developmental delay. The child had been exclusively breastfed by a vegetarian mother and lacked proper complementary feeding. Clinical examination revealed pallor, hypopigmented hair, hyperpigmented knuckles, and generalized hypotonia. Laboratory tests confirmed vitamin B12 deficiency, anemia and other nutritional deficiencies. Neuroimaging showed cerebral atrophy. Treatment involved addressing the nutritional deficiencies, primarily through vitamin B12 supplementation, iron, magnesium, calcium, and a protein-rich diet. Tremors were managed with propranolol and phenobarbitone. Within a month of treatment, the child exhibited significant improvement in tremors, developmental milestones, and overall well-being. This case emphasizes the importance of considering ITS in infants with specific clinical features and highlights the role of healthcare providers in educating parents about proper nutrition during pregnancy and infancy. Early diagnosis and management, including nutritional interventions and symptom control, can lead to substantial improvements in affected children's health and development. Further research is necessary to better understand the etiology and optimal management strategies for ITS.

Clozapine monitoring at a specialised psychiatric hospital: A retrospective chart review

Background: Clozapine is the only Food and Drug Administration (FDA) and National Institute for Care and Excellence (NICE) approved drug for treatment-resistant schizophrenia (TRS). Its potentially life-threatening haematological side effects of neutropaenia and agranulocytosis mandate rigorous monitoring of neutrophil counts, presenting unique, Third-World population challenges.Aim: To describe the Clozapine white blood cell monitoring practice and outcomes in a local psychiatric hospital.Setting: At a specialist Psychiatry unit in Durban, KwaZulu-Natal, which follows a modified algorithm of the South African Standard Treatment Guidelines for Clozapine monitoring.Methods: A retrospective chart review composed of 120 patients on Clozapine treatment from 01 July 2018–31 December 2020. Demographic and clinical information was captured in a Redcap database. Descriptive statistics using categorical variables were used.Results: The study population was from a low socioeconomic background, with low levels of education and employment. A baseline neutrophil count was recorded in 58 files (48.3%). Clozapine was stopped in 6 out of the 120 patients due to ‘neutropaenia’ (absolute neutrophil counts ranging from 1.18 to 1.6); none developed agranulocytosis. Their duration of Clozapine treatment ranged from 2 weeks–15 years.Conclusion: Haematological monitoring frequency and documentation of patients receiving Clozapine were not in compliance with the hospital’s adapted guidelines and may have resulted in the termination of treatment before true neutropaenia developed. Patients developed neutropaenia at low doses of Clozapine and after many years of treatment.Contribution: These results suggest local Clozapine monitoring guidelines should be more strictly adhered to.

Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa.

Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48-3.87], treatment adherence [0.46; 0.21-0.97], salt consumption [28.35; 7.87-102.04], physical activity [0.22; 0.13-0.37], current alcohol use [2.10; 1.22-3.61], and current cigarette smoking [4.79; 1.88-12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure.

Resilience as a Predictor of Adolescent Happiness in Orphanages in Jakarta

Happiness is characterized by the absence of negative emotions and positive emotions. Happiness is associated with fostering positive relationships, excellent health, and overall well-being. Every individual is entitled to happiness. However, certain circumstances can cause individuals to experience a range of stress, negative emotions, and decreased contentment. Adolescents are susceptible to a variety of negative emotions. Sometimes, teenagers may be reared in orphanages due to a lack of parental care, a low socioeconomic background, or other issues. Teenagers who lack a proper upbringing and secure family environment will be susceptible to psychological and behavioral issues. Positive psychology, on the other hand, posits that adolescents have the inner fortitude to endure a variety of pressures and life challenges. This concept is called resiliency. This study seeks to determine the function of resilience as a predictor of adolescent happiness in orphanages in Jakarta. The technique employed is quantitative research with a correlational design. There were a total of 403 participants in the study, including 179 men and 224 women (M = 14.88 + 1.13 years). The results demonstrated that resilience was a predictor of happiness among orphanage adolescents, accounting for 21.2% of the variance. It demonstrated that the resilience of adolescents in orphanages can enable them to withstand a variety of pressures, leading to greater satisfaction.
 Keywords: Adolescent; Happiness; Orphanage; Resilience

Evaluating knowledge about HIV and discriminatory attitudes among Pakistani women of reproductive age using 2017–18 Demographic Health Survey data

A prominent issue associated with HIV is the stigma around it owing to a lack of awareness. This study aimed to find the association between HIV and AIDS-related knowledge and discriminatory attitudes amongst Pakistani women of reproductive age using the 2017–18 Pakistani Demographic Health Survey (PDHS) data. We analyzed a sample of 3381 Pakistani women of reproductive age using ordinal logistic regression for complex survey data. Two composite variables were created using the HIV module to denote the respondents’ HIV-related knowledge and their attitude toward people living with HIV (PLHIV) and calculated using a scoring method. Additional variables included the respondents’ age, education level, socioeconomic status, residential setting, and HIV testing history. More than half (58.8%) of the respondents presented with a negative attitude toward PLHIV and 64.3% of the respondents had poor knowledge regarding the illness. In the multivariable analysis, knowledge about HIV and level of education reported significant associations with discriminatory attitudes. We concluded that the odds of individuals living in a rural setting and hailing from a low socioeconomic background presenting with a negative attitude towards PLHIV were 2.52 times (95% CI 1.07–5.89) higher as compared to those living in an urban setting from a high socioeconomic background.