Low Socioeconomic Status Research Articles

Abstract 4017: The prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program

Abstract Cancer survivors in racial/ethnic minority, low socioeconomic status, and aging populations are more likely to have other chronic conditions, including 30% of cancer survivors who have diabetes or cardiovascular disease, many of which were pre-existing before cancer diagnosis. We examined the prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program (AoURP) cohort (2016-2024) and disease code identification from the National Library of Medicine and compared demographic, social determinants, and health-related social needs across specific cancer diagnosis sites. Comorbidities were self-reported data from the personal health history survey and found in electronic health records. We assessed the socioeconomic status (SES) barrier as a composite score (0-5) that combined education (≤ high school), income (≤ 35K), uninsured, housing (rent/other), and employment status (unemployed). We identified 12,415 breast cancer, 4,047 colorectal cancer (CRC), 3,126 lung cancer, and 7,951 prostate cancer cases among 574,000+ AoURP participants, as of Nov 2024. 54% of breast, 65% of colorectal, 76% of lung, and 57% of prostate cancer patients reported having at least 1 comorbid condition. About 20% had at least 2 comorbidities. Obesity and diabetes were the two most common conditions for breast and colorectal cancer, chronic pulmonary disease (CPD) and diabetes were the most common for lung cancer, and diabetes and moderate/severe kidney disease for prostate cancer. Among the other top 5 common comorbid conditions were rheumatoid arthritis, liver disease, and congestive heart failure. About a quarter of lung cancer patients with diabetes had 3 or more SES barriers, compared to 23% of colorectal, 20% of breast, and 12% of prostate cancer patients. Also, about 28% of lung cancer patients with liver disease had 3 or more SES barriers. A smaller proportion of CRC patients (19%) with obesity had 3 or more SES barriers, compared to 18% of lung, 13% of breast cancer, and 8% of prostate cancer patients. The highest proportion (>40%) of Black patients reported having diabetes for all cancer types, except prostate cancer (where Hispanic patients reported the highest rate). A higher proportion of Black patients with breast and colorectal cancer had obesity while similar proportions were reported between Hispanic and Black lung and prostate cancer patients. Understanding comorbidity prevalence in this national sample of cancer survivors provides insight into care coordination, disease management, and team-based care strategies needed to improve cancer survivorship care quality and address inequities in cancer survivorship outcomes. Further assessment of All of Us Research Program data, including patterns of care through EHR data and lab and self-reported survey data, may provide opportunities to comprehensively assess and intervene in survivorship care improvements. Citation Format: Sue E. Kim, Crystal Rubalcava, Jennifer Tsui. The prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4017.

Socio-Demographic Risk Factors Associated with Diabetic Foot Ulcer in India: A Case Control Study

ABSTRACT Background: Diabetic foot ulcers (DFU) are a devastating complication of diabetes mellitus, having a significant impact on the quality of life of patients and indeed putting an enormous burden on health care systems, especially in low- and middle-income countries like India. Understanding socio-demographic risk factors is, therefore, essential in designing successful prevention strategies adapted to the Indian population. Methods: The duration was one year, and the study was conducted in India on 150 cases. Cases consisted of patients with diabetic foot ulcers, while controls were diabetic patients without foot ulcers, consisting of 75 cases and 75 controls, respectively. Information on socio-demographic variables, history, and lifestyle factors was collected through structured interviews and medical records. Logistic regression analysis was used to identify risk factors independently associated with DFU. Results: Low socioeconomic status was significantly associated with an increased risk of DFU (OR = 3.45, 95% CI: 2.1–5.7), as were poor glycemic control (HbA1c >8%) (OR = 2.96, 95% CI: 1.9–4.8), living in a rural area (OR = 2.72, 95% CI: 1.8–4.1), and lack of formal education (OR = 2.30, 95% CI: 1.5–3.5). Risk factors were smoking, diabetes of more than 10 years’ duration, and history of bad foot care practice. Conclusion: Socioeconomic disparities and lack of awareness about diabetic foot care contribute significantly to the DFU burden in India. Targeted interventions, education, better glycemic control, and accessible health services are ultimately needed to manage this potentially preventable complication.

Abstract 4961: Bridging gaps in cervical cancer screening: Prevalence and key predictors among women aged 25-59 years in Eswatini

Abstract Background: Cervical cancer is the most prevalent cancer and the leading cause of cancer-related deaths among women in Eswatini, which reported the world’s highest cervical cancer incidence (95.9 per 100,000) and mortality (64.3 per 100,000) rates in 2022. Despite this significant burden, cervical cancer screening coverage was limited to 19% as per WHO’s 2019 report. This study assessed progress in cervical cancer screening prevalence and identified predictors of screening uptake among women aged 25-59 in Eswatini. Method: Data were obtained from the 2021 Eswatini Population-based HIV Impact Assessment Survey, a cross-sectional household survey designed to assess the coverage and impact of HIV services among individuals aged 15 years and older. In this study, women aged 25-59, the national target group for cervical cancer screening, were included. Survey weights were applied to adjust for the study design. Bivariate analyses identified factors associated with screening uptake, with significant variables (p < 0.05) entered into multivariate logistic regression models. Screening predictors were identified using stepwise backward elimination, with results reported as adjusted odds ratios (OR) and 95% confidence intervals (CI). Result: Among 3,193 women aged 25-59, the lifetime cervical cancer screening prevalence was 48.2%. HIV-positive women had significantly higher odds of screening compared to HIV-negative women (59% vs. 39%; OR=2.22, 95%CI:1.90-2.59). Women aged 36-45 were more likely to undergo screening than those aged 25-35 (OR=1.35, 95%CI: 1.12-1.62). Higher economic status (fourth vs. lowest wealth quintile) was associated with increased screening uptake (OR=1.41, 95% CI: 1.06-1.88). Conversely, lower odds of screening were observed among women with no formal education (OR=0.58, 95%CI: 0.41-0.84), no healthcare visits in the past 12 months (OR=0.67, 95% CI: 0.55-0.83), and no use of family planning services (OR=0.81, 95% CI: 0.68-0.96). Women with no sexual partners were also less likely to be screened compared to those with two or more partners (OR=0.08, 95% CI: 0.01-0.62). Although rural women had lower odds of screening than urban women, the difference was not statistically significant (OR=0.86, 95% CI: 0.70-1.05). Conclusion: While cervical cancer screening in Eswatini has shown significant progress, disparities persist among women with lower socioeconomic status, limited education, and fewer healthcare visits. Citation Format: Abenezer M. Tafese, Bikiltu D. Dirbaba, Meseker T. Fentie, Charnita Zeigler-Johnson. Bridging gaps in cervical cancer screening: Prevalence and key predictors among women aged 25-59 years in Eswatini [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4961.

Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database

Background: Upper Gastrointestinal Bleed (UGIB) is a common and potentially life-threatening condition with an annual incidence of 80–150 per 100,000 individuals and a mortality rate of 2–10%. Esophagogastroduodenoscopy (EGD) is the gold standard for both diagnosis and treatment, but post-discharge outcomes, including readmissions, remain underexplored. Methods: This study utilized the 2021 National Readmission Database (NRD) to analyze 30-day readmission rates following EGD for UGIB. Adult patients (≥18 years) admitted for UGIB and undergoing EGD were included; those who died during the index hospitalization were excluded. Demographic, clinical, and socioeconomic factors associated with readmission were examined using multivariate logistic regression. Results: Among 34,257 patients admitted for UGIB and undergoing EGD, 11,088 (32.4%) were readmitted within 30 days, with 5423 (49%) due to recurrent UGIB. Readmitted patients had a higher mean age (68.46 vs. 67.63 years) and greater prevalence of cirrhosis (16.71% vs. 13.84%). Hospital resource utilization was significantly higher among readmissions, with increased total hospital charges (USD 82,544.82 vs. USD 61,521.17) and longer hospital stays (5.38 vs. 4.97 days). Mortality was lower among readmitted patients (1.46% vs. 3.53%). Multivariate analysis identified cirrhosis (OR 7.20, 95% CI: 6.45–8.02), untreated H. pylori infection (OR 3.43, 95% CI: 2.15–4.30), atrial fibrillation (OR 1.52, 95% CI: 1.36–1.69), and chronic antithrombotic therapy (OR 1.63, 95% CI: 1.41–1.89) as significant predictors of recurrent UGIB readmission. Lower socioeconomic status was also associated with increased readmission risk (OR 1.15, 95% CI: 1.05–1.25). Conclusions: Readmission following EGD for UGIB is common and driven primarily by recurrent bleeding. Cirrhosis, untreated H. pylori infection, atrial fibrillation, and chronic anticoagulation therapy are key risk factors. These findings highlight the need for targeted interventions, including improved post-discharge management and optimization of anticoagulation strategies, to reduce readmission rates and improve patient outcomes.

Knowledge, attitudes, and practices on urinary schistosomiasis among schoolchildren in Ethiopia: cross-sectional study

BackgroundUrinary schistosomiasis is a disease caused by Schistosoma haematobium and is one of the public health problems in Ethiopia. When developing specific schistosomiasis control intervention program, the existing knowledge, attitudes and practices (KAPs) must be taken into account. This study aimed to assess the KAPs of primary schoolchildren towards urinary schistosomiasis in Ethiopia.MethodsA total of 1171 study participants aged 5 to 15 years were selected randomly.ResultsOf the 1171 interviewed schoolchildren, 654, or 55.8%, said they had heard of urinary schistosomiasis. Using river or dam water for household consumption had association with urinary schistosomiasis infection history (P = 0.001). Logistic regression analysis showed that males had higher risk of getting urinary schistosomiasis infection compared to females (OR = 3.01, P < 0.001). Children in low socio-economic status had higher risk of having urinary schistosomiasis compared to high socio-economic status (OR = 2.81, P < 0.001). Compared to urban dweller, children in rural area had higher risk of having urinary schistosomiasis (OR = 4.34, P < 0.001). Respondents who used river water (OR = 2.48, P = 0.005) and lake or dam water (OR = 3.33, P = < 0.001) were at higher risk of urinary schistosomiasis infection. Furthermore, respondents swimming or playing in river water had higher risk of urinary schistosomiasis infection history (OR = 1.62, P = 0.005).ConclusionsThere was knowledge gap in schoolchildren about urinary schistosomiasis causes, transmission, symptoms and prevention. Therefore, appropriate health education and behavioral change intervention is needed to create better knowledge and practices in children to prevent and control urinary schistosomiasis. Health organizations and policy makers should contribute to improve knowledge at the school as well as community level.

Enhancing Interprofessional Community Engagement and Humanistic Interactions in Health Professional Education in Salvador, Brazil: The Programa Candeal Experience.

Twenty years of existing medical literature speak to a global interest in interprofessional experiences and the role of community engagement in the formation of 21st century health professionals, with recent literature highlighting shortcomings in the ability to form satisfactory therapeutic alliances with patients of lower socioeconomic status. A paucity of literature regarding effective interventions to rectify these gaps in care remains. This manuscript reports the findings of a retrospective analysis of participant satisfaction with Programa Candeal, a previously un-evaluated interprofessional health education program at the Bahiana School of Medicine and Public Health in Salvador, Brazil, seeking to improve the capacity of health professional students to work successfully on interdisciplinary health care teams through hands-on experience interacting with disenfranchised populations outside of the traditional roles of provider and patient. Results of a mixed quantitative-qualitative survey reveal that Programa Candeal is successful in encouraging health professional students to practice community engagement, cultivates a literacy with the concept of multi professional teamwork, and promotes humanistic interactions with community members at some of the widest socioeconomic divides in Brazil. This manuscript also highlights the relative ease of implementing a semi-automated online evaluation protocol without undue administrative burden in a low-resource environment.

Lifecourse socioeconomic status and high-risk pregnancy in Chinese women: Evidence from Grandmothers, Mothers, and Their Children's Health study.

Lifecourse socioeconomic status and high-risk pregnancy in Chinese women: Evidence from Grandmothers, Mothers, and Their Children's Health study.

Uptake of the recently introduced vaccines among children aged 12–23 months in Ethiopia: a multilevel analysis of the 2019 Ethiopia Mini Demographic and Health Survey

ObjectiveThough vaccination coverage in Ethiopia has shown steady progress over the years, there are districts with below targeted vaccination coverage. This study assessed the magnitude and determinants of recently introduced...

Clinical profile and cytogenetics of siblings with Jacobsen syndrome

Abstract The clinical care of patients has greatly benefited from the advancement of genetic testing. Over time, a gradual move toward a “genotype-first” strategy and growing use of genome-wide testing techniques such as chromosomal microarray analysis and next-generation sequencing have been noted to facilitate arriving at the diagnosis. However, the cost of these genetic tests is too high which people from low socioeconomic status cannot afford. Our case report was about one such affected family, in which both siblings were diagnosed with Jacobsen syndrome. We describe about a 2-year-old male child who has dysmorphic facial features, cardiac and renal defects, and developmental delay without thrombocytopenia. Segmental duplication (22.2 Mb) on the long arm of chromosome 14 and deletion of 5.9 Mb on 11q24 were revealed by chromosomal microarray analysis.

The influence of childhood socioeconomic status on indulgent consumption

IntroductionConsumers routinely confront goal conflicts, navigating the tension between persevering in goal pursuit and succumbing to the temptation of indulgent purchases. While prior literatures have endeavored to explore diverse factors influencing indulgent consumption, they have largely overlooked the longitudinal lens of consumer development to uncover deeper, underlying causes. Childhood socioeconomic background has been established as a critical factor influencing various behaviors both in early life and adulthood. This study aims to explore the impact of childhood socioeconomic status on indulgent consumption in adulthood, and to examine the mediating role of pleasure pursuit in this relationship, as well as the moderating effect of individuals' sense of worthiness.MethodsAcross four behavioral experiments, spanning three domains of indulgence-related decisions and relying on different methods of childhood socioeconomic status measurement, this study sheds light on how consumers of different childhood socioeconomic status to choose when facing a conflict decision (self-control vs. indulgence). A total of 627 participants from China (66.19% female, Mage = 30.46) were recruited through the Credamo platform for this study, and SPSS analytical software was utilized to conduct comprehensive analyses on the relevant data, encompassing primary effect analysis, mediation analysis, and moderated mediation analysis.ResultsThe study corroborates that individuals with high childhood socioeconomic status are more likely to choose indulgence compared to those with low childhood socioeconomic status (β = 0.24, p &amp;lt; 0.05). This effect is found to be independent of people's current level of socioeconomic status (p &amp;gt; 0.05), which is mediated by differences in pleasure pursuit [β = 0.1026, 95% CI= (0.0312, 0.1688)]. In other words, individuals who grew up wealthy are generally more likely to pursue pleasure (novel experiences and potential rewards) from decision-making, thus increasing their choice of indulgences. Furthermore, the strength of this effect is moderated by individuals' sense of worthiness (β = 0.15, p &amp;lt; 0.05). Lastly, sense of control has been disqualified as a plausible psychological mechanism underlying this phenomenon [95% CI= (−0.035, 0.021)].DiscussionThis study demonstrates that childhood socioeconomic status has a significant positive impact on indulgent consumption in adulthood. The underlying psychological mechanisms and boundary conditions of this influence were also examined. The findings offer a novel theoretical perspective on the antecedents of indulgent consumption and provide valuable insights for businesses in developing targeted marketing strategies and enhancing consumer wellbeing.

Socio-demographic Status, Rearing System and Prevalence of Diseases in Black Bengal Goats Maintained in Nadia District of West Bengal

Background: One of the most successful approaches for helping India’s impoverished citizens alleviate poverty and enhance their sources of income is goat rearing. The present study was carried out with an objective to assess the current scenario of socio-demographic status of farmers, managemental practices and prevailing diseases of goats in Nadia district of West Bengal. The predominant availability of black bengal goat resources prompted the selection of these regions. Methods: A descriptive cross-sectional study was undertaken over a period of six months. Survey data were collected from a total of 100 goat farmers in different villages in the Nadia district of West Bengal, India. For each household survey, a structured questionnaire was formulated. Result: Survey data indicated that 72.0% of women farmers are associated with goat husbandry. The data found that 52.0% of goat farmers were in the middle age having attended primary schooling (86.0%). More than half of the farmers (51.0%) reared goats under intensive system of rearing. The majority of farmers (63.0%) did not follow vaccination programme while 52.0% farmers dewormed their goats. Our research revealed that the most prevalent disease-causing mortality of goats was PPR (61.0%). The results of this study indicate that farmers did not pay much attention to management systems and healthcare services because of the low socio-economic conditions. The present study recommends frequent training of farmers in a modern scientific way creating awareness with regular conduct of vaccination campaigns.

Perspectives of type 2 diabetes mellitus management in Algeria: a comprehensive expert review

BackgroundThe health and economic impacts of type 2 diabetes mellitus (T2DM) remain substantial, notably in developing countries.ObjectivesTo provide an in-depth assessment of the T2DM situation in Algeria to understand its multifaceted burden and identify priority areas of intervention.MethodsA systematic literature search was conducted on all published articles about T2DM in Algeria over the past 30 years, including original research, reviews, and case series. The extracted data were thoroughly analyzed and synthesized by a committee of diabetes experts.ResultsAlgerian epidemiological data point towards a constant rise of T2DM prevalence, roughly from 8.9% in 2003 to 14.4% in 2016-2017. The mean onset is around 41 years with women experiencing a greater burden at younger age. Low socioeconomic status, limited education, and lack of health insurance exacerbate T2DM risk and health inequities. Lifestyle and metabolic risk factors are prevalent. Despite advancements in glycemic control, prescribing practices lack standardization, with suboptimal use of antidiabetic drugs and absence of novel drugs in the market. Health and economic burdens are dominated by complications, highlighting inadequate primary and tertiary prevention strategies.ConclusionNotwithstanding the increasing burden of T2DM in Algeria, the healthcare strategies and therapeutic outcomes remain suboptimal. This underscores the necessity for a comprehensive strategy including enhanced prevention, access to novel treatments, standardized practices, along with a patient-centered approach.

Childhood Maltreatment and Midlife Mortality: A Prospective Investigation.

Previous studies have reported mixed findings regarding the relationship between childhood maltreatment and midlife mortality. To fill gaps in the literature, we examine the impact of childhood maltreatment on midlife mortality and test potential explanations for the relationship. Using a prospective cohort design, individuals with documented histories of childhood maltreatment (ages 0-11 years) during 1967-1971 and a demographically matched control group were followed into midlife. The National Death Index and Social Security Death Index were searched for all individuals (N = 1575) to determine date and cause of death. Individuals who survived were interviewed in 1989-1995 (M age = 29). By 2023, 18% (N = 283) had died. Contrary to expectations, there were no significant differences in midlife mortality between maltreated and control groups overall. Incidence rates for maltreated females were higher than for control females. Physically abused males were at decreased risk of midlife mortality. Among individuals interviewed in young adulthood, being female reduced risk, whereas lower SES and suicide attempt increased risk for midlife mortality. Childhood maltreatment, alcohol, drugs, anxiety, depression, smoking, and violent arrests did not. SES and problematic behaviors appear to play an important role in understanding midlife mortality and suggest targets for intervention.

Increased school absence among children with juvenile idiopathic arthritis - a national matched comparison study.

This study compares rates of school absence (SA) of all children with juvenile idiopathic arthritis (JIA) attending public Danish schools to peers both before and after JIA diagnosis. Further, we aimed to investigate the role of socioeconomic status (SES) on the possible association. We performed a register-based matched cohort study. We included all children attending public Danish schools between 2010 and 2019 diagnosed with JIA and compared them to school mates. Rates of differentiated and total SA both before and after JIA diagnosis were compared. In the primary study we included children diagnosed with JIA after starting school, whereas the secondary study only included children diagnosed before starting school. We included 716 children with JIA and 3632 matched controls in the primary study and 382 children with JIA and 1910 matched controls in the secondary. Our primary study showed higher rates of sickness SA and total SA from three years before diagnosis and the following five years among children with JIA. After diagnosis, JIA children also had significantly more legal (planned) SA. Children diagnosed with JIA before starting school (secondary study) had significantly more SA (both sickness SA and legal school SA) up to 8th grade. In both studies children of low SES both with and without JIA had highest rates of SA, although no difference in the association between JIA and SA across SES groups were found. Children with JIA had more sickness and legal absence from school.

Risk Factors for Preterm Birth: A Comprehensive Review of Current Evidence

Preterm birth, defined as the termination of pregnancy before the completion of 37 weeks of gestation, remains one of the most critical challenges in contemporary perinatal care. High neonatal mortality rates, along with frequent neurological, respiratory, and developmental complications, underscore the importance of identifying risk factors associated with preterm labor. The aim of this review was to comprehensively synthesize current scientific evidence on the multifactorial etiology of preterm birth, encompassing biological, immunological, genetic, environmental, and socio-economic determinants. A systematic literature search was conducted in PubMed during January and February 2025, covering peer-reviewed publications from 2020 to 2024. Included in the analysis were meta-analyses, cohort studies, case-control studies, systematic reviews, and population-based analyses. The findings indicate a significant association between preterm birth and obstetric abnormalities, maternal comorbidities, inflammatory and genetic factors, as well as low socioeconomic status and limited access to prenatal care. In high-income countries, assisted reproductive technologies (ART), particularly fresh embryo transfer, continue to pose a considerable risk. The conclusions emphasize the need for an interdisciplinary approach to prevention, standardization of diagnostic criteria, and further development of biomarker-based tools and personalized strategies for perinatal care.

A Tri-Directional Examination of Parental Personality, Parenting, and Context on Adolescent Behaviors: A Replication and Extension in a New Cultural Context.

A Tri-Directional Examination of Parental Personality, Parenting, and Context on Adolescent Behaviors: A Replication and Extension in a New Cultural Context.

Lag Time Between Onset of First Symptom and Treatment of Retinoblastoma: Outcomes at Three Years from Recruitment

ABSTRACT Purpose To evaluate the effect of lag time between diagnosis of retinoblastoma (RB) and treatment in patients from 10 countries. Methods Prospective study of 692 treatment-naïve RB patients from 10 countries followed up for 3 years from recruitment. Results The mean lag time from the onset of the first symptom to visit to the RB treatment center was 150 days. The mean follow-up duration was 26 months (median, 32 months; range, <1–51 months). A higher socioeconomic status of the country was associated with a lower risk of enucleation: Lower-middle-income countries vs. low-income countries (p<.001), Upper-middle-income vs. low-income countries (p = .009), and high-income countries vs. low-income countries (p = .014). A greater AJCC stage was associated with a greater risk of enucleation: T2 vs. T1 (p<.001) and T3 vs. T1 (p<.001). Increased lag time (p<.001) and AJCC T4 stage (T4 vs. T2; p<.001) were associated with increased risk of death. By Kaplan–Meier analysis, the cumulative incidence of enucleation at 3 months, 1 year, and 3 years was 49%, 55%, and 61%, respectively; and survival at 1, 2, and 3 years was 92%, 88%, and 87%, respectively. Three-year Kaplan–Meier survival estimates were 95% with a lag time of <3 months vs. 83% with a lag time of 3–12 months vs. 62% with a lag time of >12 months. Conclusion A lower socioeconomic status and greater AJCC stage were associated with an increased risk of enucleation. Increased lag time from the onset of the first symptom to visit the RB treatment center and AJCC T4 stage were associated with an increased risk of death from RB.

Meal skipping among adolescents in the Philippines: prevalence, associated factors, and associations with dietary, mental health, and health risk behavioural outcomes

BackgroundMeal skipping is poorly understood among adolescents in Southeast Asia. The study aimed to investigate the type of and any meal skipping prevalence, its associated factors (sociodemographic and protective) and associations between meal skipping types and dietary, mental, and various health risk behaviour outcomes among school adolescents in the Philippines.MethodThe 2019 Philippines Global School-based Student Health Survey (GSHS), a nationally representative survey of teenagers aged 11 to 18 (mean age 13.8 years, Standard Deviation-SD = 1.5) that used a multistage sampling technique, provided the study’s data. In order to determine the variables associated with meal skipping (breakfast, lunch, dinner, any meal) and associations of meal skipping with six dietary indicators, four mental health indicators, and ten health risk behaviours, the study used bivariate and multivariable multinomial and binary logistic regression analysis.ResultsThe past-month prevalence of most skipping breakfast was 37.1%, most skipping lunch 20.1%, most skipping dinner 10.8%, and any meal skipping 68.1%. Most of the students (89.1%) reported having been exposed to healthy eating classes in school, and 51.7% said that they cannot buy soft drinks in school. Female sex, older adolescents, lower socioeconomic status, not being religious, no school truancy, low or no peer and/or parental support were associated with meal (breakfast, lunch, and/or dinner) skipping. Exposure to skipping breakfast, lunch, dinner, or any meal increased the odds of low vegetable, soft drink, and fast-food intake, overweight, obesity, suicidal ideation, plan, attempt, psychological distress, sedentary behaviour, alcohol use, drug use, physical injury, poor hand, and oral hygiene, and not always wearing a seatbelt.ConclusionAlmost seven in 10 adolescents skipped any meal in the past month. Sociodemographic and protective factors were associated with meal skipping. Exposure to meal skipping was associated with 15 out of 17 dietary, mental health, and other health risk behaviour outcomes. In order to lower various adverse health outcomes in adolescents, the results thus showed how important it is to improve in a regular meal pattern, particularly meal frequency and meal skipping. Interventions incorporating parental and peer engagement could be strengthened alongside school health education to effectively address meal skipping behaviours.

Unplanned rehospitalizations after abdominal wall surgery: Update according to a review of the literature.

Unplanned rehospitalizations after abdominal wall surgery: Update according to a review of the literature.

Examining Differences in the Preparation and Performance of U.S. MCAT Examinees from Lower-SES Backgrounds: Awareness, Access, and Action Insights to Narrow Learning Opportunity and Performance Gaps and Promote Learning for All Aspiring Physicians

Phenomenon: On the Medical College Admission Test (MCAT), required for entry into all medical schools in the U.S. and many in Canada, average scores are typically lower for individuals from lower socioeconomic status (SES) backgrounds compared to their more advantaged peers, although individuals from every background score in the lower, middle, and upper ranges of the score scale. This achievement gap is potentially due in part to disparities in resource utilization and effective study strategies. Viewing this challenge through a socioecological systems lens can help identify potential systems-level opportunities to support students from these backgrounds to succeed in medicine. Approach: This investigation was the first large-scale review of MCAT preparation strategies, resource utilization, and challenges for examinees from lower-SES backgrounds, focusing on those who obtained higher versus lower MCAT scores. It aimed to examine differences in students’ use of evidence-supported learning/studying strategies and challenges experienced in preparing for the MCAT exam. Survey data from the Association of American Medical Colleges Post-MCAT Questionnaire on MCAT preparation strategies and resources used and challenges experienced by 2021–2023 examinees were analyzed, focusing on the 3,240 survey respondents from lower-SES backgrounds. T-tests and chi-square analyses compared continuous variables and proportions between lower- and higher-scoring examinees from lower-SES backgrounds, using Cohen’s h to estimate effect size. Findings: Higher-scoring examinees reported greater use of many evidence-supported effective test preparation and learning strategies, including discussing preparation strategies with advisors/peers, establishing baseline capabilities, practicing applying knowledge to practice questions, and evaluating readiness by taking a practice test. Utilization rates of high-value, free/low-cost MCAT resources were significantly higher among top scorers. Conversely, lower-scoring examinees were more likely to report challenges in obtaining reliable internet access, determining how to begin studying, and accessing concrete information about the MCAT exam. Insights: This study highlights critical differences in preparation approaches and challenges among examinees from lower-SES backgrounds. Identifying these gaps may provide insights regarding interventions to improve access to resources and potential improvement to MCAT performance. We provide systems-level ideas for how to better support students from lower-SES backgrounds. For example, learning specialists and advisors could use the findings from this study to screen and educate examinees about evidence-based MCAT preparation strategies and resources. This study identifies opportunities to inform interventions to help students from lower-SES backgrounds advance toward a career in medicine.