Lower Socioeconomic Class Research Articles

High-Resolution Computed Tomography of the Temporal Bone in Chronic Otitis Media: An Observational Study at a Tertiary Care Center in Jharkhand, India.

Chronic otitis media refers to middle ear inflammation. A radiological exam is a crucial step in this diagnostic process, in addition to a clinical evaluation and an evaluation by an audiologist. For the development of innovative surgical treatment plans for middle ear otitis media with the aim of minimally invasive surgery, accurate information regarding the extent of lesions is required. This is made possible by a temporal bone imaging test. The study was conducted at the Rajendra Institute of Medical Sciences (RIMS), a tertiary care facility in Ranchi, Jharkhand, India. The research was conducted between June 1, 2021, and October 31, 2022. In this prospective observational study, 50 patients who visited the otorhinolaryngology clinic at RIMS Ranchi were the participants. The median age was 26 years, there was a male-to-female ratio of 1.63 to 1, and the vast majority (84%) were from lower socioeconomic classes. High-resolution computed tomography has been shown to be highlysensitive and specific in identifying conditions including scutum erosion, malleus erosion, pneumatization type, mastoiditis, mastoid abscess, and morphological abnormalities such as low-lying dura. The semicircular canal, fallopian canal, dural plate, and sigmoid sinus may all be clearly defined by non-contrast computed tomography of the temporal bone in erosion in cases of otitis media.

Study of options and procedures in reconstruction of post mastectomy breast defects in a regional cancer centre

Background: Post mastectomy autologous breast reconstruction is challenging and involves restoring the patients lost structure and prepping the patient for adjuvant therapy and also psychosocial benefits that comes with early breast reconstruction. We analysed latissimus dorsi flap, transverse rectus abdomenis flap, deep inferior epigastric perforator flap and thoracoabdominal flap. Aim was to reconstruct post mastectomy defect using various methods, to enable the patient to receive early adjuvant therapy. Objectives were to study the various procedures used for post mastectomy defect autologous breast reconstruction. To evaluate the reliability of various flaps used. To evaluate the complications of flaps and their management. To assess the advantages and disadvantages of each flap. Methods: 42 post mastectomy defect patients reconstructed with 4 flaps over 24 months, included in the study and results analysed. Results: In 42 cases, latissimus dorsi flap was done in 11 cases, transverse rectus abdominis flap was done in 6 cases, deep inferior epigastric perforator flap was done in 3 cases and thoracoabdominal flap was done in 22 cases. Total flap loss in 1 case and partial flap loss in 6 cases was seen. Conclusions: Immediate autologous breast reconstruction is helpful in making the patient ready for upcoming adjuvant therapy along with psychosocial benefits. We have analysed 4 different types of flaps and compared their advantages and disadvantages. We found that thoracoabdominal flap is a good option of immediate coverage in low socioeconomic class patients and ones with terminal disease.

Maternal Violence Against Children: A Brief Literature Review

Domestic Violence against Children and Adolescents (DVCA) is considered a social and public health problem, which occurs in the private space of the family. Mothers are among those who most violate their children because they are the main ones responsible for their care. This review analyzed the articles published in the last 12 years that dealt with maternal violence. It was found that most of the studies were qualitative, written in Portuguese, carried out in Brazil, and in the area of psychology. The high production by Brazilian authors shows that this phenomenon has become visible in the country. Physical violence and neglect were the most highlighted and the mothers participating in the studies were mostly from lower socioeconomic classes. There is a gap regarding the inclusion of mothers with other socioeconomic characteristics and from other countries. The content of the articles provided a wealth of information about the life histories and personalities of these women, but only a minority explored the relational vicissitudes of the mother-child dyads, which could result in more comprehensive and effective intervention proposals in the context of DVCA.

The hidden menace of smokeless tobacco in Pakistan: understanding the risks and possible solutions; a letter to the editor

The hidden menace of smokeless tobacco in Pakistan: understanding the risks and possible solutions; a letter to the editor

Evaluation of Clinical Profile and Complications Associated with Snake Bite among Such Patients at a Tertiary Care Hospital

Background: Snakebite occurs in Pakistan ofently mostly an occupational infection like farmers, plantation workers, fishers, and even among wildlife park rangers and military personnel. Monsoons are essential to farming, and most farmers are from lower-income backgrounds. Snake bite morbidity and fatality rates are species- and time-specific. The sufferers are often from lower socioeconomic classes, despite the absence of evidence to support their usage in the treatment of snake bite poisoning. Snake bites may be fatal if not treated quickly, thus having accurate data on the frequency and severity of these incidents is crucial for both diagnosis and policymaking. So, the study focuses on the evaluation of clinical profile and complications associated with snake bite among such patients at a tertiary care hospital. Objective: The objective of this study is to identify potential contributors to snake bite occurrences and also to determine the mortality and morbidity rates associated with snakebites and how they vary by snake species, venom type, bite location, and anti-venom use. Study Design: Observational Retrospective Study. Settings: This study is conducted in the department of Forensic Medicine and Toxicology, Sheikh Zayed Medical College, Rahim Yar Khan Pakistan. Duration: One year from Jan 2022 to Dec 2022. Methods: Both sexes from any age group and only suspected of snake bite were included. The poison illness other than snake bite were excluded from the study. Tertiary care facilities located in Pakistan included 150 snake bite cases were studied retrospectively between (study period). Using hospital records, researchers were able to learn specifics about snakebite-related mortality and morbidity, such as the species of snake if known, the method of envenomation, the victim's age, sex, residence, occupation, bite site, bite location, clinical manifestations of snakebite, initial treatment, and antivenom use. The admission and death registry were used to compile the historical record of data. Results: There were 96 male and 57 female enrolled in the study. The afternoon had the highest rate of bites (47% during the day), followed by the morning (28%), for a total of 78.5% during the day and 26.5% during the night. Seventy-five percent of the victims were alert when they were taken to the hospital, and most stayed there for between three and ten days as part of their surveillance, improvement, and recovery. The ages have been divided into different groups and we found that majority were from between 30 to 40 years. Pain, swelling, bleeding, tingling, numbness, and a blackened discoloration of the skin were all seen locally in 92 percent of the cases. Conclusion: Surveillance of envenomation’s is crucial for defining standards, arranging therapeutic supplies, and teaching medical personnel on Snakebite treatment since under-reporting of Snake bite occurrences has led to variances in observed rates of it. In addition, it has been noted that snake bites continue to be a significant occupational (farming) danger for people of working age, particularly men, in rural areas.

Investigating the Relationship between Compulsive Smartphone Use and Impulsive Buying: Role of Self-Control

In contemporary research, there is a growing concern about the addictive nature of smartphone usage, particularly among young consumers, and its impact on consumers' social activities and overall welfare. In this context, a significant concern is the impact of compulsive Smartphone use on impulsive buying. The current study examines the relationship between compulsive smart phone use and impulsive buying. Moreover, the present study aims to investigate the mediating role of self-control in this relationship. For this purpose, we executed an empirical study comprising 200 participants. The data were collected via the convenience sampling method. We used SPSS for the analysis of potential links. The findings indicated that compulsive Smart phone use positively correlates to impulsive buying, and there is a significant negative association between self-control and impulsive buying. Mediation analysis through SPSS is executed to analyze the mediating role of self-control using Andrew F. Hayes model 4, and results indicate that self-control fully mediates the relationship between compulsive smartphone use and impulsive buying. Moreover, exploring the study's demographic variables, we found that impulsive buying is more prevalent among the upper and lower socioeconomic classes.

Grammatical Analysis of African American Vernacular English in The Eminem Show Album: A Linguistics Perspective

Albeit the research on African American Vernacular English (AAVE) as nonstandard form of English spoken by African Americans in lower socioeconomic classes has been documented by many scholars, little is known about it from the perspective of Wolfram's theory. To fill this lacuna, the present study aims to elucidate the grammatical elements of Eminem's lyrics song in the album "The Eminem Show." This single case study showcased 32 lyrics song from Eminem's album with that seven grammatical features such as copula/auxiliary absence, the invariant be, the remote been, the subject verb agreement, the negation, the question formation, and the nominals. The findings found that negation is the most common grammatical features whereas the invariant be is the least common. The findings indicated that songs serve as a platform for asserting identity and criticizing diverse social, cultural, political, and economic issues. The performers are free to improvise in accordance with the tendencies and interests of the critic. Thus, the song can serve both to identify the current social crisis and as a catalyst for the crisis itself.

Prognostic Factors of Function in Nonoperatively Treated Radial Head Fractures - A Prospective Cohort Study.

To identify patient-related factors and fracture characteristics influencing the functional outcomes of non-operatively treated radial head fractures and to determine function at one year. Prospective cohort study. Academic level 1 trauma center. Consecutive isolated radial head fractures fitting the inclusion criteria between May 2013 and July 2016. Nonoperative treatment of isolated radial head fractures. Logistic regressions between potential prognostic factors and function assessed with the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) score and Range of Motion (ROM) at 1.5-3-6-12 months. 114 patients were included (78% Mason I [OTA/AO 2R1B1], 20% Mason II [OTA/AO 2R1B3] and 2% Mason III [OTA/AO 2R1C3]). Mean MEPS and DASH score at the last follow-up were excellent [96.4 ± 7.6 and 3.7 ± 8.6] with respectively 79.8% and 92.7% of satisfactory results. Depressive symptoms at injury baseline (Quick Inventory of Depressive Symptomatology > 5) are a constant predictor of unsatisfactory function (MEPS <90 or DASH >17]). Older age and female sex were all linked to worse function at the first follow-ups (p <0.05), whereas lower socioeconomic class and receiving financial compensations were associated to unsatisfactory function at 1-year (p <0.05). While most non-operatively treated radial head fractures heal with excellent function, some patients still exhibit unsatisfactory results at 1-year. Symptoms of depression at injury baseline are a constant and significant predictor of unsatisfactory function. Early detection of depressive symptoms would allow interventions that may optimize function.

Menstrual Hygiene Issues And Reproductive Tract Infections In Flood Affected Victims.

Menstruation, a physiological phenomenon, is still considered a stigmatized subject in 3rd world countries like Pakistan, leading to incorrect and incomplete knowledge, resulting in unhealthy practices (1). In lower socioeconomic classes, menstrual hygiene management(MHM) can be unhygienic and inconvenient for women (2). According to research in Karachi, at menarche, only 28.4 per cent of the general population had an idea of menses and proper placement of absorbent (1). Another study found a statistically significant association between reproductive morbidity and unhygienic menstrual practices (3). Unhygienic practices lead women to Reproductive tract infections, and many women have Pelvic inflammatory disease (PID). According to research, 76.7 per cent of women who came to health clinics had Reproductive tract infections (RTIs), and 14.7 per cent had PID (4). Reproductive tact infections is also a significant reason for secondary infertility (5). In rural areas, women do not have access to and knowledge about sanitary products (6). Recently, floods have inundated one-third of Pakistan. As a result, 33 million people were displaced, and 660,000 people live in relief camps (7), of which 8 million women are of reproductive age. Along with all other issues, women are facing problems regarding menstrual hygiene. Some women in Baluchistan were reported to be using tree leaves instead of pads (7). According to a study by AKU, women in Dadu (an area affected by flood from 2019-2021) were not using sanitary products, instead repeatedly changing out of and washing their stained clothes(7) During the evacuation from flood-affected areas, menstrual products have been unavailable for extended use of soiled products or bloodstained clothing (8). These unhygienic practices will cause Reproductive tract infections in these women, which may complicate PID or even secondary infertility. Paying attention to this problem is the need of the hour. Destigmatizing menstruation, educating women and ensuring the availability of low-cost menstrual hygiene products should be prioritized. These interventions will lead to decreased number of urogenital infections. Along with providing MHM products, women should be educated about proper disposal &amp; waste management. Incineration could be used for this. Plastic pads will cause more water pollution in the flood-affected areas, and cloth towels need to be washed with clean water, which is unavailable in those areas. So natural sanitary products from bamboo fibre, banana fibre or sea sponges can be used (4). Women should be educated about stitching pads from cheap absorbent clothes available locally. ---Continue

Assessment of cyanide intake through consumption of cassava‐based diets in the Democratic Republic of Congo

AbstractBackgroundKonzo is attributed to inadequate cassava processing and consumption of cassava meals with little protein, which is characterized by a neurological disorder that causes paralysis of the lower limbs. However, the exposure to cyanide in the Mwana health zone is still unknown while the prevalence of konzo is assumed to be high compared with other areas in the Democratic Republic of Congo (DRC).ResultsThe results showed that women are the most affected (56.7%), followed by young people under the age of 10 (27%), and people from low socioeconomic class at 93.4%. The prevalence of konzo in Burhinyi is 0.06%. Cyanide intake by the population of Burhinyi ranged from 26 to 271 mg/kg bw/day at the 95th percentile through consumption of cassava‐based ugali. Margin of exposure was around 0.271 and 0.393 g/person/day.ConclusionPoor people, women, and children are more at risk for konzo disease due to a diet dominated by under processed food made from cassava. However, since 2011, the study area's konzo prevalence has remained constant.

Risk Factors and Foeto-Maternal Outcome in Preterm Labour

Background: Preterm labor is one of the biggest health issues in the globe and is associated with high perinatal mortality and morbidity. A healthy pregnancy can turn into one that is at high risk for both the mother and the fetus in one of these clinical scenarios. Objective: The aim of the present study is to determine the risk factor and maternal and perinatal outcome of patients presenting with preterm labor and to evaluate the preventable causes of preterm labour. Methods: A Case control study conducted in the Department of Gynaecology and Obstetrics Dhaka Medical College Hospital, during February 2010 to July 2010. Results: A total of 50 cases having preterm labour in between 28 - 36 weeks of gestation and 50 controls having 37-40 weeks pregnancy with lobour pain were screened and enrolled in the study. Several significant risk factors were associated with preterm labour and the following risk factors were identified. Low socio-economic class, rupture of membrane (OR = -2.45), previous history of abortion (OR = 2.25), Preterm delivery (OR -9.33), and Anaemia (OR = 8.31). Conclusions: As preterm labour is grave consequences for both the mother and the newborn of preterm labor should be aim and developing awareness of pregnant mother who are high risk for preterm labor.

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

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

Assessment of Depression and Anxiety Among Adult Patients With Solid Tumours Admitted in National Institute of Cancer Research &amp; Hospital

Background: Cancer is one of the most common causes of mortality &amp; morbidity globally, accounting for an estimated 10 million deaths in 2020. The diagnosis of cancer is a stressful event causing significant psychological distresses, most commonly depression and anxiety, directly interfering with disease outcome and quality of life. The aim of the study is to assess the level of depression and anxiety among adult patients with solid tumours as well as the association of various socio-demographic and clinical factors with them. Methods: This cross-sectional type of descriptive study was conducted at the National Institute of Cancer Research &amp; Hospital (NICRH), Dhaka for a period of 12 months. A total of 405 histologically confirmed adult solid tumour patients were enrolled in the study using purposive sampling after fulfilling inclusion and exclusion criteria. Data were collected from the patients by face-to-face interviews using a semi-structured questionnaire and Bangla version of the DASS-21 scale. Results: In this study, the mean age of the respondents was 47.4 ± 16.5 years, the respondents were predominantly male with the male-tofemale ratio being 3:2 roughly. Gastrointestinal cancers (27.4%) were most prevalent, followed by lung (19.5%), gynaecological (11.4%), breast cancers and sarcomas (both 9.4%). The majority of the patients were undergoing chemotherapy (71.9%) and harbouring stage IV disease (64.4%) with duration of illness for less than twelve months (62% of respondents). The prevalence of depressive and anxious symptomatology among all patients was 38.02% and 42.96%, respectively. More than half (53.3%) of the adult patients with solid tumours were suffering from either of depression and/or anxiety. 19.7% had mild, 13.6% had moderate, 3.7% had severe and 1% had extremely severe levels of depression, while the percentages were 17.3%, 11.6%, 9.4% and 4.7% respectively, for severity of anxiety. In inpatient setting, depressive disorders were significantly higher in females than males (p&lt;0.01) and among the lung cancer patients; in contrast, gastrointestinal cancer and the presence of co-morbidities predisposed more to anxiety (p&lt;0.05). Although mode of treatment and severity of disease showed no significant relationship with the prevalence of depression or anxiety, ECOG performance status was found to have a significant impact on both of the disorders. On analysis of the socio-demographic variables, illiterate and low-income people were seen to suffer more with a severe and extremely severe level of depression, on the other hand, homemakers and lower socio-economic class had higher levels of anxiety. Conclusion: The study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting; therefore, counselling, screening, and timely evaluation of mental health should be a part of the standard protocol of oncology care. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 215-216

A study of stressors, family environment, coping patterns, and family burden in persons with dissociative disorder.

Dissociative disorder is a stress-related disorder usually present in adolescents and younger age groups. It is also accompanied by significant impairment in activity of daily living and family relations. Family environment and use of dysfunctional coping strategies play important roles in the initiation and maintenance of symptoms and this puts a considerable burden on the family. This study aims to study the presence of stressors, the role of family environment, the role of family burden, and the use of coping mechanisms in persons with dissociative disorder. This was a descriptive cross-sectional study in which 100 persons with a dissociative disorder were included after fulfilling inclusion and exclusion criteria from the outpatient department (OPD) of psychiatry. In this study, the major part of the sample were women (87%), most were educated up to 12th standard or less than 12 years of formal education. According to stressors, 44% had family stress/problems. 77% (mostly women) had dissociative stupor. The dissociative disorder caused a considerable degree of burden on the other family members. There was a significant difference in financial burden among caregivers of persons who were married, belonging to rural areas, joint families, and from lower socio-economic classes. There was a significant difference in disruption of routine family activities, and burden in persons having a longer duration of illness. There was a significant difference found in conflict, achievement orientation, and dimensions of family environment between males and females. A significant difference in the venting of emotions, behavioral disengagement, and restraint as a coping strategy between males and females was found. Present study showed dissociative disorder patients cause a considerable degree of burden on family members in terms of leisure, physical, mental, financial, and routine family interrelationship domains. In personal growth and relationship dimensions, the use of dysfunctional coping strategies in the family environment has a causal effect on the symptoms of dissociative disorder patients.

Knowledge, attitudes and practices regarding quackery in dentistry at Ayub Dental Hospital, Abbottabad

Objectives: To assess knowledge, attitudes and practices of people regarding dental quackery. Method: The descriptive, knowledge-attitude-practice study was conducted June 2 to August 1, 2022, at the Dentistry Department of Ayub Medical Complex, Abbottabad, Pakistan, and comprised adult subjects of ether gender belonging to lower or middle socioeconomic class and visiting the dental outpatient clinic. Data was collected using a predesigned questionnaire. To explore the subjects’ knowledge, attitude and practice regarding dental quackery. Data was analysed using SPSS 21. Results: Of the 261 subjects. 135(51.7%) were males and 126(48.3%) were females. The overall mean age was 29.15+/-10.15 years. Of the total, 243(93.1%) participants had satisfactory socioeconomic status and 18(6.9%) had unsatisfactory status. There were 97(37.2%) subjects having good knowledge, 217(83.1%) with good attitude, and 53(67.1) showing good practices towards dental quackery. Low socioeconomic status, low awareness, and easy accessibility were the main reasons for people visiting dental quacks. Increasing the number of public hospitals was suggested as the main solution by 119(45.6%) subjects. Conclusion: The level of knowledge, attitude and practice regarding dental quackery was good. Low socioeconomic status and lack of awareness were the two important reasons for quackery. Key Words: Dentistry, Frauds, Healthcare, Malpractice, Quackery.

Transitar los intersticios: entendiendo procesos identitarios transnacionales desde el caso de una mujer inmigrante brasileña en Santiago

This paper discusses the subjective identity processes produced in the transnational migration experience through the concept of interstitial identities. To illustrate the uses of this concept, a case built from life stories, in-depth interviews, and photo stories is analyzed. Thus, Maria is identified, a skilled Brazilian immigrant in Santiago de Chile, who chooses to descend from the upper to low socioeconomic class in the destination country to construct herself as the subject of her history. In addition, it reflects on the processuality of their identities and on the identity negotiations that she establishes in the interstice between different cultural configurations she relates transnationally, in which gender and class are relevant categories. Finally, it is concluded that thinking about the migratory experience from interstitial identities does not allow to build identity typologies but to explore the articulations between subject and culture in migration.

CLINICO-EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH RHINOSPORIDIOSIS AT TERTIARY CARE CENTRE: AN OBSERVATIONAL STUDY

Introduction: Rhinosporidiosis is a rare chronic granulomatous infection of the mucous membranes caused by Rhinosporidium seeberi. It is mostly prevalent in India and Sri Lanka. In India, the disease is endemic to Chhattisgarh, South India (mostly Kerala &amp; Tamil Nadu), West Bengal and Odisha. To observe the clinical presentati Aim: on and epidemiological factors in Rhinosporidiosis. We conducted a descriptive, cross-sectional Materials and Methods: study in 42 clinically diagnosed Rhinosporidiosis cases, who were surgically treated in the department over a period of 1 year, from October 2021 to October 2022 and diagnosis was confirmed by post excision histopathological examination. Results: This study involved 42 clinically diagnosed cases of Rhinosporidiosis. Majority (76.2%) of patients were males and 23.8% were females. The male to female ratio was found to be 3.2:1. Most common age group was 11-20 years. All 42 patients had history of pond bathing and 60% cases were from Rural area. 54.8% of cases belonged to lower middle and 40.5% cases belonged to lower socio-economic class. 97.6% cases had mass in Nose and nasopharynx, most common presenting complaint was Nasal obstruction (92.85%). Most common Site of attachment of mass was Inferior meatus (45.23%) and Nasopharynx (38%). O+ was most common blood group seen in 19 cases (45.23%) followed by A+ in 12 (28.57%), B+ in 8 (19%). The results of the study showed that the disease was associated with male g Conclusion: ender, young and middle age, low socio-economic status, rural population and pond bathing and O+ blood group. Most common site involved was Nose and Nasopharynx and most common attachment of mass was seen in inferior meatus

SOCIO-DEMOGRAPHIC CORRELATES IN PATIENTS COMING TO AN ADDICTION TREATMENT FACILITY AT A TERTIARY CARE HOSPITAL.

Substance use is a multifactorial challenge involving the individual, the substance and the community. Substance users are generally the active workforce of the nation who contribute to the progress,but owing to the substance use, the nation misses out on them. By our study we compiled the sociodemographic data of people coming to an addiction treatment facility in a tertiary care hospital. A cross sectional study was done from April 2021 to December 2022 and 921 patients were assessed. Majority of the patients (71.45%) were from the age group of 21-50 years, and 94.94% of the study sample were males.79.59% were working as a semiskilled / skilled worker. 52.33% were educated up to high school.90.01% of patients were from the upper lower socioeconomic class as per Kuppuswamy's Socioeconomic Scale. A majority of the sample (45.1%) were seen using tobacco and 40.1% of the study sample was using alcohol. Our Results were consistent with many other studies, and were in contrast with some as they had different location where the study was done. It was seen that substance use is more common in working age group with more population belonging to the upper lower socioeconomic class as per kuppuswamy's socioeconomic scale. To tackle this challenge of substance use, awareness about hazards of substance use and better accessibility to addiction treatment facilities is of paramount importance.

Assessing brand switching level and behaviour of growing-up milk products in Java: A structural equation modeling and multigroup analysis

The biggest consumers of dairy products for children aged 1–3 years, which are referred to as growing-up milk (GUM), come from the middle and lower socioeconomic classes. More than 90% of Indonesians belong to this segment. In 2020, the proportion of the population living in rural and urban areas will be almost equal, namely 43.3% and 56.7%, respectively. Understanding brand switching behavior is essential to enabling GUM manufacturers to stay in business and thrive by retaining loyal customers. The aims of this study are (i) to assess the level of brand switching; (ii) to examine the determinant factors of brand switching behavior; and (iii) to compare the brand switching behavior of GUM consumers in rural and urban areas of middle and lower socioeconomic classes in Java. The research was conducted in 4 sub-districts in 2 provinces (East Java and D.I. Yogyakarta) using a guided interview method with a questionnaire. Research respondents were 419 consumers of GUM, and they were selected using the purposive sampling method. Data analysis used partial least squares - structural equation modeling (PLS-SEM) and multigroup analysis (MGA). The study found that the level of brand switching among GUM consumers in Java is 57%, which is considered high. The most important factor that influences the brand switching behavior of GUM consumers in Java's middle and lower socioeconomic classes is bad prior experiences, followed by variety seeking, bad product attributes, and customer dissatisfaction. A defective product is the most reflective indicator of a bad prior experience. There is no difference in brand switching behavior between rural and urban consumers in Java from the middle to lower socioeconomic classes. Therefore, GUM manufacturers are allowed to adopt the same marketing strategy to increase efficiency.

A-40 | Dissecting Disparities of Post-Percutaneous Intervention Outcomes in Acute Myocardial Infarction Patients With COVID-19: Insights from National Inpatient Sample, 2020

It is well-established that COVID-19 increases the risk of cardiovascular conditions, including acute myocardial infarction (AMI) and its associated complications. Through this study, we sought to establish the association of sociodemographic attributes with in-hospital all-cause mortality among COVID-19 patients with AMI who underwent PCI. We extracted data from the National Inpatient Sample 2020 using the ICD-10-CM codes for admissions related to COVID-19 patients with AMI who underwent PCI. We performed multivariate regression analysis, adjusted for demographics and hospital-level confounders to assess the trends of the age, race, sex, and median household income-related disparities in post-PCI in-hospital all-cause mortality among COVID-19 patients with AMI. A total of 3735 COVID-19 patients admitted with AMI and who underwent PCI were included in this study. The prevalence of COVID-19 patients with AMI who underwent PCI was highest among elderly [ages >/= 65 (47.7%)], male (70.4%), white (60.6%), and lowest income quartile (35.6%) patients. Among 3735 COVID-19 patients with AMI, 20.2% had all-cause in-hospital mortality, and 3.2% had a stroke after the PCI. A statistically significant association was present between post-PCI in-hospital all-cause mortality and among elderly patients (adjusted odds ratio (aOR) 4.67, 95% confidence interval (CI) 1.64-13.31, p=0.005) and the lowermost income quartile patients (aOR 1.90, 95% CI 1.01-3.57, p=0.031). However, we did not find any statistically significant association between post-PCI in-hospital all-cause mortality and sex, race, ages 18-64, or medium lowest/medium highest/highest income quartiles. This population-based analysis revealed that elderly and lower socioeconomic class COVID-19 patients with AMI had higher odds of post-PCI in-hospital all-cause mortality. Associated comorbidities with advancing age and late access to health care among low socioeconomic classes could be the reasons for the observed disparities among these groups. Further studies are needed to understand the impact of social determinants on long-term association in a better way.