Low Socioeconomic Backgrounds Research Articles

Pregestational body mass index and weight gain during pregnancy associated with epidemiological variables and socio-demographic

Objective To correlate the pregestational Body Mass Index and weight gain during pregnancy with various epidemiological variables. Methodology A cross-sectional study was carried out in a third level hospital in Cali, Colombia. Socioeconomic and anthropometric data, obstetric history and general medical history was collected from 300 pregnant women aged between 18 and 37. BMI was calculated at the beginning and end of pregnancy. Statistical analysis of multiple linear regression was performed. Results An increased BMI at the beginning and end of gestation positively correlated with age (Coefficient = 0.156; p=0.013, Coefficient = 0.153; p=0.011), diagnosis of gestational diabetes (Coefficient = 2.264, p=0.018, Coefficient = 0.153; p=0.011) and concern about weight gain during pregnancy (Coefficient=1.226; p=0.038, Coefficient=1.568; p=0.004). A low BMI correlated negatively with Intrauterine Growth Restriction (Coefficient=-3.208; p=0.005). Furthermore, a higher final BMI positively correlated with a diagnosis of hypertensive disorder (Coefficient=2.733; p≤0.001) and negatively with socioeconomic status (Coefficient=2.239; p=0.045). Conclusion Excessive weight gain before and during pregnancy is a predictive factor in the appearance of gestational diabetes and hypertensive disorders, differentially affecting women from low socioeconomic backgrounds. While pregnancy is a critical period in a woman’s life which may motivate positive lifestyle changes, excessive weight gain is still not perceived as a health problem.

Tuberculosis of Penile ShaftA Rare Clinical Presentation

Tuberculosis (TB) is an opportunistic infection caused by Mycobacterium TB, and it has plagued mankind since ages, posing a major health concern in developing countries. Pulmonary TB is the most common form, but extrapulmonary TB is also not uncommon, with an incidence of 8-14%. Cutaneous manifestations of TB, known as lupus vulgaris, are extremely rare, constituting less than 1% of cases worldwide. Diagnosing a cutaneous lesion of TB poses a challenge for clinicians, as it requires both absolute and relative criteria. In the present case report, the author presents the case of a 15-year-old male from a low socio-economic background who presented with painless oedema over the penis for one and a half months. The patient had a history of dry cough and tested positive for Coronavirus Disease-2019 (COVID-19). Systemic examination was normal, and vital signs were stable. Local examination revealed oedema, redness, and phimosis over the penile shaft, along with non tender ulcerative lesions and deep cracks in the groin crease. A skin biopsy revealed lymphocytic infiltration with Langhanstype giant cells and epithelioid cell granulomas, suggesting TB of the skin overlying the penis. Laboratory investigations revealed a positive Mantoux test and an elevated Erythrocyte Sedimentation Rate (ESR) of 42. The patient was initiated on antitubercular therapy, comprising isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE). After one month of treatment, the oedema subsided, and the penile ulcers and groin skin cracks healed. Penile skin involvement in TB is rare, and the clinical appearance of such involvement may vary.

Original Article Risk Factors for Enteric Fever in Children Aged 1 to 14 Years: A Cross-Sectional Study at Gandaki Province of Nepal

Introduction: Enteric fever is one of the major public health problems in Nepal. This study aimed to evaluate the risk factors associated with enteric fever in children Methods: This is prospective cross-sectional study conducted from April 15 to November 2023, with sample size of 139 children aged 1-14 years, diagnosed as enteric fever. Data were collected through pretested and validated proforma containing structured questionnaires. Data were analysed through SPSS version 23. Results: About seventy (69.8%) percent of the children had a history of consuming untreated water, and 52.5% lacked access to proper sanitation facilities. Additionally, 59% of the children were from low socioeconomic backgrounds, and 38.8% had close contact with infected individuals. The children from rural areas were more likely to be exposed to untreated water sources (73.9%) and had a higher prevalence of low socioeconomic status (62.5%) compared to their urban counterparts. Logistic regression analysis revealed that children exposed to untreated water were 2.1 times more likely to develop enteric fever than those not exposed, with this result being statistically significant (OR = 2.10, 95% CI = 1.30-3.40, p=0.002). Conclusion: Untreated water, inadequate sanitation, and low socioeconomic status as key risk factors for enteric fever in children. Rural children faced higher risks. Children exposed to untreated water were 2.1 times more likely to develop enteric fever than those not exposed, with this result being statistically significant. The findings underscore the need for improvement on water quality, sanitation, and socioeconomic conditions. Local health authorities should prioritize these areas to reduce enteric fever incidence, with further research recommended on intervention effectiveness.

Effectiveness of oral health interventions for schoolchildren from disadvantaged backgrounds: a systematic review protocol.

Disadvantaged schoolchildren from rural and low socioeconomic backgrounds face persistent oral health inequalities, specifically dental caries, and periodontal diseases. This protocol aims to review the effectiveness of promotive and preventive oral health interventions for improving the oral health of primary schoolchildren in these areas. We will search the PubMed, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Web of Science, Dentistry and Oral Sciences databases for studies published from 2000-2023. The review includes randomised/nonrandomised controlled trials and community trials evaluating the effectiveness of promotive and preventive oral health interventions on at least one of these outcomes: changes in dental caries status, periodontal disease status, oral hygiene status/practices, sugar consumption, or smoking behaviours. Two reviewers will independently assess the searched articles, extract the data, and assess the risk of bias in the studies using the Cochrane Risk of Bias 2 (ROB 2) for randomised controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomised controlled trials. Both narrative and quantitative analyses will be conducted. However, only narrative synthesis will be performed if the data are substantially heterogeneous. The synthesised evidence from this review can inform policymakers on evidence-based interventions to improve the oral health outcomes of schoolchildren from rural and low socioeconomic backgrounds. Systematic Review Registration PROSPERO (Registration number: CRD42022344898).

Sociodemographic profile and pattern of congenital heart disease in referred children at tertiary cardiac centre – An observational study

Abstract Background: Sparse data are available regarding congenital heart disease (CHD) from southern India. This study was designed to document the sociodemographic factors, clinical profile and pattern of CHD at a referral centre. Methods: A cross-sectional observational study was done by direct interview method and review of medical records of 414 participants using internally validated, pre-defined proforma. Results: More than half of the cases (54.6%) referred were within 1 year of age. Wasting was present in 45%. Most of the cases belonged to middle and lower socio-economic status group (79%) and were referred by paediatricians (70%); 48% had travelled more than 500 km to avail cardiac services. Predominant symptoms of referral were respiratory distress (61.8%), feeding difficulties (50%), cyanosis (43.7%) and palpitation (24.9%). Major abnormalities detected were ventricular septal defect (31.2%) and tetralogy of Fallot (21.7%). Conclusions: This study highlights the need of prioritising and planning for the implementation of affordable and accessible cardiac infrastructure to people from rural areas with low socio-economic background.

Profile of patients presenting at the echocardiography laboratory of a tertiary institution in the central region of South Africa

Introduction: Worldwide cardiovascular disease is associated with substantial economic challenges and profound morbidity and mortality. Considering the dearth of information for the central region of South Africa, this study aimed to assess the profile of patients who were referred to an echocardiography laboratory at a tertiary institution. Methods: A hospital-based, observational, descriptive study was conducted. Demographic, anthropometric, socio-economic, clinical and echocardiographic data were collected. Patients were categorised by hospitalisation status and reason for referral. Standard transthoracic echocardiograms were performed. Data were analysed using standard statistical software. Results: The study population had a mean age of 51.8±17.38 years, was predominantly black (64%) with a slight female preponderance (55%). The majority of patients were from a low-socioeconomic background (H0-H2; 91%). Most patients were from the Mangaung district (37%) and the referral pattern showed that regions with more hospitals tend to refer more patients for echocardiography. Alarmingly, two-thirds of the study population were hypertensive (64%) and 57% had a body mass index exceeding 25 kg/m2. Cardiology referred most patients for echocardiography (49%) and inpatient and outpatient referrals were almost equal (48% vs 52%). Abnormal echocardiographic findings were reported in 74% of patients with myocardial dysfunction being the most significant pathology (73%). Sixty-three percent of referrals were for routine echocardiographic assessment. Conclusion: This is the first study describing the profile of patients referred for echocardiography in the central region of South Africa. Travel distances and obtainability of health services appeared to have impacted referral patterns. Specific patterns of disease related to the individual referring specialist health care services. Hospitalisation status did not influence referrals.

Spatial Epidemiology of Signet-ring Cell Colorectal Cancer in India.

Signet-ring cell colorectal carcinoma (SRCC) is an extremely aggressive yet uncommon histologic subtype of colorectal cancer (CRC) with an unknown etiology. There is a stark difference in the prevalence of signet cancers between Western countries and the Indian subcontinent; however, India itself is a vast and diverse country with variable cancer incidence. To study the spatial epidemiology of SRCC in India for identifying regions with high prevalence. This retrospective study included all patients diagnosed with colorectal adenocarcinoma at Tata Memorial Hospital, the largest colorectal cancer referral unit in India, between January 2020 and December 2022. Geocoding based on the location of the residence was done to map the incidences. Comparisons were performed between the proportion of signet cell and non-signet colorectal cancers. A total of 4100 patients with colon or rectal adenocarcinomas were included, of which signet cell histology was found in 624 (15%) patients. SRCC accounted for the highest proportions of CRCs in the Central (19%) and Northern (19%) regions, and the lowest in the North-Eastern (10%) and Western (12%) regions of India (P < 0.001), with non-overlapping confidence intervals. Compared with patients with non-signet CRCs, those with SRCC more commonly had colon cancers (22% vs. 17%; P = 0.003) and belonged to a lower socioeconomic background (67% vs. 59%; P < 0.001). This study found that SRCCs accounted for a significant proportion of CRC cases in India, but there was no substantial disparity in distribution across regions.

Influential Factors Affecting Intestinal Anastomotic Leakage and Their Predictive Significance

Background: The occurrence of anastomotic leakage following intestinal surgery stands as a significant contributor to postoperative complications and fatalities. This prospective study was conducted with the aim of assessing different factors associated with the risk of anastomotic leakage. Methods: This study was carried out within the Department of Surgery over the course of one year. It encompassed patients who underwent intestinal anastomosis, whether in emergency situations or as part of routine surgical procedures. The study encompassed a total of 150 patients. Results: Anastomotic leakage was identified in 18.02% of cases, with a higher incidence among males and individuals from a lower socioeconomic background. However, age, gender, and socioeconomic status were not found to be significant risk factors for anastomotic leakage. The incidence of leaks was elevated in patients with chronic illnesses such as malignancy, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and those on chronic corticosteroid therapy. Additionally, malnourished patients and those with sepsis, as indicated by their blood investigation reports, had a notably higher leak rate. After conducting logistic regression analysis, several independent predictors for anastomotic leaks were identified, including peritonitis (\(p&lt; 0.05;\) odds ratio \(2.156\)), bowel obstructions (\(p&lt; 0.05\); odds ratio \(2.864\)), receiving more than 2 units of blood transfusion (\(p&lt; 0.05\); odds ratio \(2.334\)), serum albumin levels \(&lt; 3.0\) gm/dL (\(p&lt; 0.001\); odds ratio \(8.873\)), corticosteroid therapy (\(p&lt; 0.001\); odds ratio \(4.877\)), serum creatinine levels \(&gt;1.2\) mg/dL (\(p&lt; 0.001\); odds ratio 11.785), surgery duration exceeding 4 hours (\(p&lt; 0.01\); odds ratio 3.0251), and ASA Grading (III &amp; IV) (\(p&lt; 0.01\); odds ratio 3.707). Conclusion: This study has successfully identified key risk factors that influence the occurrence of anastomotic leakage. The findings from this research are expected to be valuable in efforts to mitigate the incidence of anastomotic leakage following surgery.

Prevalence of Infertility among Young Women with Polycystic Ovarian Syndrome (PCOS)

Background: Polycystic ovarian syndrome (PCOS) is the most common cause of infertility among young women trying to conceive. Most of the times due to lack of awareness, women remain undiagnosed and unable to seek treatment at young age when the success rates of conceiving are higher. Objective: To determine the true prevalence of infertile young women diagnosed with PCOS. Study Design: Prospective study. Settings: Department of Gynecology and obstetrics, Ghulam Muhammad Mahar Medical College, Sukkur Pakistan. Duration: July 2022 to June, 2023. Methods: All young women (18 years – 35 years) diagnosed as PCOS, and failure to conceive for more than 1 year were included for this study. Data were collected regarding baseline and clinical characteristics. Outcome variable was presence or absence of infertility among young women with PCOS. Results: Final analysis was performed on 124 young women diagnosed with polycystic ovarian syndrome. The mean age and standard deviation was 27.84 ± 4.21 years and BMI was 25.14 ± 6.33 kg/m2. More than 80% of women were housewives (n = 101) and had lower socioeconomic background, 60.48% (n = 75). The prevalence of infertility was 62.90% (n = 78) and 37.09% (n = 46) did not have infertility. Infertility was more common among young women with higher mean age (26.34 ± 2.67 years), higher BMI (26.34 ± 2.67 kg/m2), and women addicted to chewable tobacco, p value &lt;0.05. Conclusion: Higher infertility rate is observed among young women diagnosed with polycystic ovarian syndrome. Fertility rate can be increased among such women by providing awareness regarding the disease and treatment plan.

Assessing the Association of Socio Demographic Factors with Dental Anxiety: A Cross Sectional Study at A Tertiary Care Hospital in Islamabad

Background: Dental anxiety among patients is a significant impediment leading to delayed or incomplete dental treatment. Understanding the determinants of dental anxiety is crucial, given the potential variations in causative factors across different regions due to cultural diversity and past dental experiences. In light of limited available data and cultural heterogeneity, this study aimed to explore the correlation between age, gender, educational level, socio-economic status, and residence with dental anxiety among patients seeking care at a teaching dental hospital. Methods: A cross-sectional study involving 375 patients attending a private teaching hospital was conducted, with dental anxiety assessed using the Modified Dental Anxiety Scale. Exclusion criteria involved patients with known anxiety disorders or a history of intellectual disabilities. Results: The findings demonstrated a statistically significant gender-based difference in dental anxiety (p-value: 0.00), with a majority of females exhibiting anxiety levels ranging from moderate to extreme. Additionally, a significant association was observed between socio-economic status and dental anxiety (p-value: 0.03), revealing lower levels of dental anxiety among individuals from lower socio-economic backgrounds compared to those from middle and upper socio-economic strata. However, no significant differences were identified in dental anxiety concerning age, educational level, and residence (urban/rural). Conclusion: The study concludes that targeted anxiety reduction protocols should be prioritized for female patients and those belonging to the upper socio-economic status.

Data-Driven Analysis of MRI Scans: Exploring Brain Structure Variations in Colombian Adolescent Offenders

With the advancements in neuroimaging techniques, understanding the relationship between brain morphology and behavioral tendencies such as criminal behavior has garnered interest. This research addresses the investigation of disparities in neuroanatomical structures between adolescent offenders and non-offenders and considers the implications of such distinctions regarding offender behavior within adolescent populations. Employing data-driven methodologies, MRI scans of adolescents from Barranquilla, Colombia, were analyzed to explore morphological variations. Utilizing a 1.5 Tesla Siemens resonator (Siemens Healthineers, Erlangen, Germany), T1-weighted MPRAGE anatomical images were acquired and analyzed using a systematic five-step methodology including data acquisition, MRI pre-processing, feature selection, model selection, and model validation and evaluation. Participants, both offenders and non-offenders, were aged 14–18 and selected based on education, criminal history, and physical conditions. The research identified significant disparities in the volumes of 42 brain structures between adolescent offenders (AOs) and non-offenders (NOs), highlighting particular brain regions potentially associated with offending behavior. Additionally, a considerable proportion of AOs emanated from lower socioeconomic backgrounds and showcased marked substance use. The findings suggest that neuroanatomical disparities potentially correlate with criminal behavior among adolescents at a neurobiological level. Noticeable socio-environmental factors, such as lower socioeconomic status and substance abuse, were substantially prevalent among AOs. Particularly, neurobiological deviations in structures like ctx-lh-rostralmiddlefrontal and ctx-lh-caudalanteriorcingulate perhaps represent a link between neurological factors and external stimuli.

Personal agency among students from low socio-economic backgrounds: An examination of student profiles, perceived teaching support, and achievement

Personal academic agency—the thoughts, actions, and emotions that impact individual functioning at school—is central for academic success. On average, students from low socio-economic status (low-SES) backgrounds report lower levels of personal academic agency than their more advantaged peers, but there are also many who achieve academic success. Identifying different personal academic agency profiles among students from low-SES backgrounds may assist in targeting efforts to boost these factors within that population—and to identify students who are faring well, as well as those who might require additional support. This study examined five factors of personal academic agency (perceived competence, school belonging, perseverance, academic buoyancy, and conduct problems) among 20,125 secondary school students from low-SES backgrounds at 421 Australian schools. We identified profiles of students that vary in patterns of personal academic agency, and examined teaching support predictors and achievement differences associated with profile membership. Latent profile analysis revealed five student profiles: Vulnerable (9% of sample), Resigned (27%), Precarious (28%), Average (32%), and Flourishing (14%) profiles. Students’ perceptions of teaching support predicted membership in more adaptive profiles (i.e., Average and Flourishing profiles)—with the most consistent teaching support predictors being emotional support, classroom management, and instructional relevance. In addition, the Flourishing profile displayed the highest achievement.

General and math vocabulary contributions to early numeracy skills in a large population-representative sample

There are well-documented associations between numeracy development in preschool age children and general and math vocabulary, literacy, and executive functions. However, the studies have largely included small samples of children with parents with either predominantly low or higher socioeconomic background (SES); further, few studies have included measures of all these domains in the same analyses. In this current study, we examined how general vocabulary, math vocabulary, rhyme detection and three measures of executive functions are associated with numeracy development in a population representative sample of 2,931 Danish children 3–5 years (51% male, 89% white). Multi-level regressions controlling for child age and, sex, and in some analyses also parental education and income confirmed that general vocabulary (β = 0.16), math language (β = 0.17), rhyme detection (β = 0.14), attention shifting (β = 0.09), inhibitory control (β = 0.05), and working memory (β = 0.09) each are associated with numeracy after controlling for covariates when estimated in the same model. Analyses of extreme performance (low-high) suggests a much closer and symmetrical connection between math language and numeracy compared to that between general vocabulary and numeracy. Interestingly, family SES is weakly but significantly related to all measures, most strongly for the vocabulary measures, but does not influence the pattern of results from regression analyses. In conclusion, both general vocabulary and mathematics-specific vocabulary contribute substantially to early numeracy skills. Rhyme detection and executive functions are also associated with numeracy skills, but with a lower magnitude.

South African student retention during 2020: Evidence from system‐wide higher education institutional data

AbstractUsing longitudinal, institutional data, we document the impact of COVID‐19 on undergraduate student retention at public universities in South Africa in 2020. We find that student dropout increased in 2020 for students in years 3–5, with little evidence of a change for those entering their second year of study. These aggregate findings mask significant differences across institutions. Students enrolled in most historically advantaged, traditional institutions, and some comprehensive institutions, were not significantly affected, whereas dropout increased significantly at the University of Fort Hare, Walter Sisulu University and the University of Venda, three historically disadvantaged institutions located in rural areas. No difference in retention is found, however, for students enrolled at the University of Zululand (UZ) or the University of Limpopo (UL), equally resource‐disadvantaged institutions where a majority (over 90%) of students are funded via the National Student Financial Aid Scheme (NSFAS). Furthermore, at institutions where dropout increased, NSFAS‐funded students were typically less impacted than their unfunded peers. Our overall findings accord with growing evidence that COVID‐19‐related changes in the sector differentially impacted students from lower socioeconomic backgrounds. However, they also illustrate that the NSFAS bursary appears to have provided a social safety net during this time. Finally, the example of UZ and the UL provide suggestive evidence that institutional relational aspects not observed in our data are important too. Together, results foreground the complex interplay of factors impacting a student's decision to drop out of or remain in university, highlighting that institutional responses and/or relational context during a crisis like COVID‐19 can positively impact student retention.

The PPSQ: assessing parental, child, and partner's playfulness in the preschool and early school years.

Developmental research has traditionally focused on parenting behaviors such as nurturance and care, due to a focus on mothers' behaviors. Other parenting dimensions such as parental playfulness (i.e., use of creativity, imagination, and humor during parent-child interactions) have comparatively received little attention. Although some measures tap into parents' and children's playfulness, these measures are limited. Indeed, they do not assess multiple domains of playfulness (i.e., both parents' and the child's playfulness) or focus on one specific setting such as children's play with peers. Additionally, existing measures do not consider parents' reactions to their partners' playfulness. To address this gap, we created the Playful Parenting Style Questionnaire (PPSQ), which assesses three domains of playfulness: (a) parental domain, (b) child domain, and (c) partner domain. The current study is part of a validation effort of the PPSQ using a quantitative design. We aimed to explore the structure of the PPSQ by conducting an exploratory factor analysis (EFA) for each domain of playfulness; and assess the construct validity of the PPSQ factors by examining the association between factors and existing measures of playful parenting, child playfulness, and co-parenting. The sample includes 347 parents (294 mothers and 53 fathers) of preschool/school-age children (M = 5.10 years; 182 girls, 127 boys). Parents were mostly White (76%) and from a low socioeconomic risk background. Parents completed a series of online questionnaires including the PPSQ, 3 existing measures of parent playfulness (Parental Playfulness Questionnaire; Adult Playfulness Scale; Challenging Parenting Behavior Scale), 2 existing measures of child playfulness (Child Behavior Inventory; Children's Playfulness Scale), a coparenting instrument (Co-parenting Relationship Scale), and sociodemographic information. The EFA revealed 4 factors for parental playfulness, 1 factor for child playfulness, and 3 factors for partner's playfulness. The construct validity analyses identified multiple associations indicating convergence with existing measures for the parent and partners domain but not the child factor. This study allowed for a better understanding of the playful dynamics that occur within a family.

Music Education in Charter Schools: A Scoping Review

The purpose of this PRISMA Scoping review was to synthesize research regarding charter school music education. Findings regarding charter school music offerings were varied. At state and national levels, charter schools were less likely to offer music courses than traditional public schools; however, in large urban districts, charter schools offered music courses at comparable or greater rates. Charter school music teachers tended to be less experienced and more likely to be certified through alternative licensure programs. Disparities in music education between charter schools and traditional public schools were also intertwined with factors such as race, socioeconomic status, school size, and location, as charter schools tended to be smaller, serve higher proportions of students of color and/or from low socioeconomic backgrounds, and be in urban areas. Recommendations for music educators include considering state and local policies, administrative structures, and curricular or pedagogical foci when exploring music programs in charter schools.

Geographic Reach of Surgery Residency Applicants During In-Person and Virtual Interviews.

Background Virtual interviews for surgery residency may improve interview opportunities for applicants from underrepresented in medicine (UIM) and lower socioeconomic backgrounds. Objective To compare the geographic reach of surgical residency applicants during in-person versus virtual interviews. Methods This study compared applicants for the 2019 (in-person) and 2020 (virtual interviews) application cycle for surgery residency. Geographic reach (GR) was defined as the distance between applicants' current location and the program. Federal Financial Institutions Examination Council's website supplied socioeconomic data using applicants' geographic locations. Applicant demographics, United States Medical Licensing Examination (USMLE) scores, and geographic distance to program were collected. Multivariable analyses examined GR with interaction terms between interview type, UIM status, and socioeconomic status, while controlling for USMLE scores. Results A total of 667 (2019) and 698 (2020) National Resident Matching Program applications were reviewed. Overall, there was no difference in GR for applicants during in-person and virtual interviews in multivariable testing. UIM status had no association with GR for in-person interviews, but virtual interviews were associated with an increased GR for UIM applicants compared to non-UIM applicants (235.17; 95% CI 28.87-441.47; P=.02). For in-person interviews, applicants living in communities with poverty levels ≥7% had less GR vs those in communities with levels <7% (-332.45; 95% CI -492.10, -172.79; P<.001), an effect not observed during virtual interviews. Conclusions There was no difference in overall GR, or the proportion of UIM applicants or those from higher poverty level communities, but virtual survey interviews during the COVID-19 pandemic were associated with increased GR for UIM and from lower socioeconomic backgrounds applicants.

Implementation of a smartphone application for precision brain health assessment in a rural low socioeconomic setting: The Bogalusa Heart Study

AbstractBackgroundSmartphone apps for digital health with decentralized data collection enable more frequent and precise brain‐health monitoring via the abundance of embedded sensors. Such methods may improve the sensitivity of traditional metrics and representation among diverse populations impacted by health disparities, especially in ADRD studies. Here, we describe a framework for implementing a smartphone‐based digital platform for precision brain health assessment in a longitudinal cohort of Black and White men and women.MethodsParticipants are being recruited as part of a multi‐site study from the Bogalusa Heart Study (BHS), a community‐based cohort in rural Louisiana that began in 1973. The digital platform consists of a smartphone application that is used remotely every three months for two weeks. It includes tasks that assess cognition, speech, gait and balance, and questionnaires that ensure instructions are appropriately followed and to monitor usage experiences. The BHS study personnel handle the initial screening, enrollment, and application setup. To overcome internet connection and time/availability issues, remote phone calls from BHS staff and text messages from a local area code using RingCentral software were implemented. Messages included short reminders, a link to step‐by‐step instructions to complete the application setup, and examples of smartphone tasks. (Figure 1.) Participants could schedule a call to receive phone instructions to complete the process.ResultsA total of 94 participants [age 56 ± 4.5, women n = 60 (69%), Black n = 16 (19%)] have been enrolled in the study thus far. Of those, 77 (82%) registered and set up the application (69 at the study site and 8 remotely via text/phone), and 62 (81%) completed at least one set of tasks. There was no significant difference in completion rates between race [White n = 52 (84%) and Black n = 10 (77%); p = 0.54] and sex groups [women n = 45 (82%) and men n = 17 (85%); p = 0.75].ConclusionResults showed that individuals from a rural community‐based cohort are willing to use digital technologies for brain health assessments. These findings highlight the importance of utilizing low‐cost, scalable platforms and adapting research protocols to meet the requirements of specific populations, particularly those from low socioeconomic and underrepresented backgrounds.

Nutritional Status of Adolescents in Public and Private Secondary Schools in Asaba, Delta State, Nigeria

This study aimed to compare the nutritional status of adolescents in private and public secondary schools in Asaba, Delta State. A cross-sectional analytical design was conducted among 282 adolescents from private day, private boarding and public secondary schools, selected by multistage sampling technique. Anthropometrics measures and socio-demographic characteristics data were collected using pretested questionnaire. Using WHO-reference-2007, height, BMI and weight-for-age were measured for stunting, wasting and underweight respectively and BMI-for-age for overweight and obesity. The collected data were entered in to Microsoft Excel and exported to SPSS for further statistical analysis. Chi-square test at 95% confidence interval (CI) was used to quantify independent variables of nutritional indices. The mean age of the students in public, private day, and private boarding schools were 14.28±2.79, 13.54±2.24, and 14.04±2.53 years, respectively. The prevalence of stunting, thinness, underweight, normal weight and overweight among public school participants was 31, 35, 29, 71, 0% respectively; that of private day school participants was 34, 45, 29, 63, 9%, respectively whereas that of private boarding school participants was 39, 47, 23, 61, 16%, respectively. These differences in the underweight and obesity were statistically significant (p&lt;0.05). Statistical analyses revealed significant associations (p&lt;0.05) between socioeconomic levels and underweight, highlighting the vulnerability of adolescents from lower socio-economic backgrounds. The influence of poverty on stunting was particularly pronounced within private boarding schools. The result also showed that there was no significant association between thinness, stunting, underweight and eating patterns among adolescents in all school types, however, significant association were observed for overweight. Thus, nutrition interventions to improve nutritional status of the adolescents through providing comprehensive nutritional assessment and counseling services at community, school, and health facility levels, and creating household’s income-generating activities are recommended before they reach conception to break the intergenerational cycle effect of malnutrition.

Epidemiology of ophthalmic trauma in the United States from 2009–2018: A Nationwide Emergency Department Sample Analysis

PurposeTo determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US). DesignRetrospective study. MethodsThe Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018. Linear regression was used to estimate trends in annual incidence and mean inflation-adjusted ED charges. Logistic regression was used to assess variables associated with inpatient admission. ResultsThere were over 7.3 million ED visits for ophthalmic trauma in the US over the 10 years, with an annual incidence of 233 per 100,000 population. Patients were predominantly male (65 %), 21–44 years old (39 %), and from low-income households (56 %). Only 1 % of patients were hospitalized. Older age, male sex, metropolitan teaching hospitals, and trauma centers were associated with significantly higher odds of inpatient admission. The mean inflation-adjusted ED charge per visit more than doubled over the decade ($1,333 to $3,187) with total charges exceeding $14 billion. Superficial injuries (44 %) and eyelid/orbit wounds (20 %) accounted for the majority of visits. Orbital floor fractures (4 %) and open globe injuries (2 %) accounted for a minority of visits but were responsible for most admissions (49 % and 29 %, respectively) and the highest mean ED charge ($7,157 and $6,808, respectively). ConclusionsOphthalmic trauma represents an increasingly significant burden to EDs in the US. Preventive efforts should target young males from low socioeconomic backgrounds. Strategies to improve outpatient access and redirect non-urgent injuries may help alleviate costs.