Low Socioeconomic Level Research Articles

Extrapulmonary Tuberculosis at the Sylvanus Olympio University Hospital Center

Objective: describe the epidemiological, clinical, paraclinical and therapeutic aspect of extrapulmonary tuberculosis at Centre Hospitalier Universitaire Sylvanus Olympio in Lomé. Methodology: This was a retrospective and descriptive study over a period of 4 years, from November 2019 to October 2023, of extrapulmonary tuberculosis cases diagnosed at CHU SO in Lomé, and put on treatment. Results: We identified 132 cases of extrapulmonary tuberculosis during this period. The average of age of patients was 43.39 years old, with the extreme of 4 and 85 years. Low socioeconomic level was found on 65.2 % of patients. An history of tuberculosis contamination was found on 4.6 % of patients. On the 132 patients of our study, 31 performed BCG vaccination. An HIV infection was found on 21.2 %. In our study, loss of weight was found on 94 patients and 60 patients had vesperal fever. In our study the main localization was osteoarticular with 53.0 %. The diagnosis was presumptive in 78.8 % of cases. A confirmation diagnosis was most often histological (12.1 %). All our patients received a standard antituberculosis treatment, RHEZ during the initial phase. We noticed 3.0 % of death with a significative association with HIV infection. Conclusion: Extrapulmonary tuberculosis concerns all groups of age. Immunodepression favors its development. Its diagnosis is most often presumptive.

Pengaruh Problem Solving Therapy terhadap Kecemasan Global pada Pasien Skizofrenia

Background: Schizophrenia is a serious mental disorder that is often encountered and hospitalized. Schizophrenia is a long-term and serious brain disease that results in psychotic behavior, concrete thinking, and difficulties in processing information, interpersonal relationships, and solving problems. One of the symptoms that arise from various types of disorders and symptoms of schizophrenia is anxiety which affects daily functional limitations, including the inability to solve problems. Therefore, non-pharmacological therapy with CBT is given to train the patient's problem-solving skills. Objectives: This study aims to determine the effect of problem-solving therapy on global anxiety in schizophrenia patients. Methods: This research uses a quantitative approach, with a pre-experimental research design type One group Pretest-posttest. The research sample consisted of 22 people, obtained through purposive sampling. The instrument used to measure the sample's anxiety was the Hamilton Anxiety Rating Scale (HARS). Hypothesis testing analysis uses a paired sample t-test. Results: The research sample was dominated by men (63.6%), aged 26-35 years (50%), had a history of high school/K education (50%), and a low socioeconomic level (81.8%). Hypothesis testing showed a p-value of 0.000 (p<0.05). Conclusion: Problem-solving therapy affects the global anxiety of schizophrenia patients at RSJD Dr. RM. Soedjarwadi Klaten. Bibliography: 74 (2009-2023) Keywords: Problem-Solving Therapy, Anxiety, Schizophrenia

Influence of Health System Affiliation and Pain Manifestation on Advanced Oral Cavity Squamous Cell Carcinoma Risk: A Retrospective Cohort Study in a Latin American Population

Background/Objectives: Oral cavity cancer, a subtype of head and neck cancer, is one of the most common malignancies globally. This study assessed the influence of health system affiliation and pain manifestation on the risk of advanced oral cavity squamous cell carcinoma (OCSCC) in a Latin American population. Methods: In this retrospective cohort study, we analyzed medical records from 2015 to 2016, including data from the past 19 years, of 233 patients with OCSCC treated at a public hospital in Medellín, Colombia. Sociodemographic and clinical variables were evaluated, and multivariate regression models incorporated variables significant in bivariate analysis. Results: Among 233 patients, 196 (84.1%) had advanced OCSCC. The sample had a mean age of 63 ± 13 years, 53.6% were male, and 64% came from urban areas with predominantly low socioeconomic levels. Men showed a threefold increased risk of advanced OCSCC (95% CI: 1.3–6.8), while patients referred to pain clinics exhibited a 19.5 times higher risk (95% CI: 2.3–159.5). Patients in the subsidized health system or without health insurance had 2.6 (95% CI: 1.07–6.3) and 2.7 times (95% CI: 1.17–6.4) higher risks, respectively. Conclusions: This study found that male patients, referrals to pain clinics, and subsidized or no health system affiliation significantly increased the risk of advanced OCSCC.

Socioeconomic inequalities in high-risk fertility behaviour among Nigerian women: A non-experimental population-based study.

High-risk fertility behaviour (HRFB) has adverse health, social and economic effects on women. An understanding of socioeconomic inequalities is needed to design effective interventions targeted to lower maternal morbidity and mortality due to HRFB. The objective was to quantify socioeconomic inequalities in HRFB among Nigerian women. This was a cross-section study that used population-based data. A sample of 21,792 Nigerian women aged 15-49 years from the 2018 Nigeria Demographic Health Survey was analyzed. Percentage was employed in univariate analysis. In addition, concentration index was used to assess the extent of inequalities in HRFB. This was further decomposed to ascertain the explanatory components' relative contributions to the socioeconomic inequalities in HRFB. The weighted prevalence of HRFB (63.5%; 95% CI: 62.6-64.4%), included <18 years at childbirth (4.9%; 95% CI:4.5-5.3%), >34 years at childbirth (18.3%; 95% CI: 17.6-19.0%), >3 children birth order (49.6%; 95% CI: 48.7-50.5%) and <24 months at preceding birth interval (17.0% 95% CI: 16.3-17.6%) were estimated. Education (Contri: 50.3997%, Ec: 0.2771), wealth (Contri: 27.2811%, Ec: 0.2665), socioeconomic disadvantaged (Contri: 14.9163%, Ec: -0.0996), religion (Contri: 13.8636%, Ec: -0.0496), region (Contri: 11.1724%, Ec: 0.0711), partner education (Contri: 7.1351%, Ec: 0.2138), media use (Contri: 4.5064%, Ec: 0.1449) and family motility (Contri: 3.7890%, Ec: -0.0281) were positive contributors to HRFBs among Nigerian women. However, age (Contri: -14.6237, Ec: 0.0089) and history of contraceptive use (Contri: -8.7723, Ec: -0.2094) were negative contributors to HRFBs among women of reproductive age in Nigeria. Women who have low socioeconomic level reported higher prevalence of HRFB. Targeted interventions are required to lower HRFB among Nigerian women from poor households and with no formal education. Women should get counselling and assistance from healthcare and educational institutions to help them adopt healthy sexual and reproductive practices.

Determinants of obstetric vesicovaginal fistula surgery at the National Reference Center for Obstetric Fistula (CNRFO)

Vesicovaginal fistula is a major public health problem in sub-Saharan Africa in general and in Niger in particular. The objective was to study the determinants of obstetric surgery of the vesicovaginal fistula. This was a cross-sectional, analytical, retro-prospective study conducted from January 2022 to February 2024. All women with obstetric vesicovaginal fistulas who had been treated were included. The search for factors associated with surgical treatment was performed by bivariate analysis using the Pearson Chi2 test at the 5% significance level. A total of 64 patients were identified, the frequency was estimated at 22.14%. The mean age was 30.09 years. Uneducated patients accounted for 71.95%; 78.12% had a low socio-economic level and for 81.3%, the age at first marriage was between 15 and 25 years old. The causal duration of labour was ≥ 72 hours in 57.8%. The surgical treatment (fistulorrhaphy) was a success for 92.18%. The causative child was stillborn in 84.4% of cases. Withdrawal was observed in 46.66%. In the bivariate analysis, the result of surgical treatment was statistically associated with the number of interventions (p = 0.007). The fistula sufferer is a young woman, uneducated, of low socio-economic status who has lost the fruit of her pregnancy and who is socially withdrawn in our study. The reconstructive surgery performed was mostly successful. The best way to eliminate obstetric fistula is to prevent it through interventions that protect women's health. Socio-professional reintegration is necessary in order to reduce the psychosocial repercussions of this pathology. Keywords: determinants, surgery, fistulas, vesico-vaginal, obstetrics, Niger.

Modeling the Population Equity of Alzheimer Disease Treatments in the US

The arrival of new medications for Alzheimer disease (AD) has prompted efforts to measure their value using conventional cost-effectiveness analyses; however, these analyses focus on how much health improvement new medications generate per dollar spent. As AD disproportionately affects older adults, women, racial and ethnic minority individuals, and individuals with lower socioeconomic and educational levels, it is critical to also examine the health equity outcomes of treatment. To estimate the health equity impact of a hypothetical disease-modifying treatment for early AD in the US and to examine targeted policies to mitigate health care disparities. This economic evaluation, which used a distributional cost-effectiveness analysis, was conducted from June 16, 2022, to January 11, 2024. The study included subgroups defined by race and ethnicity and by social vulnerability quintiles in the US. A hypothetical disease-modifying treatment compared with best supportive care. The main outcomes were population-level quality-adjusted life-years (QALYs), lifetime costs, and net health benefits. The social welfare impact and change in health inequality were estimated using the Atkinson index. The distributional cost-effectiveness analysis simulated 316 037 100 individuals from the US population, including 25 subgroups defined by 5 categories of race and ethnicity and population quintiles of social vulnerability, with the fifth quintile representing the most socially vulnerable group. At an opportunity cost benchmark of $150 000 per QALY, treatment was associated with improved population health, adding 28 197 QALYs per year to the US population. Accounting for health inequality preferences (using an aversion level of 11, based on an Atkinson inequality aversion parameter that can range from 0 to infinity, with higher values assigning greater weight to health gains that accrue to the population with the lowest lifetime quality-adjusted life expectancy), treatment was associated with a 0.009% reduction in existing population health inequalities annually. Scenario analyses examining earlier and expanded treatment access suggested a population health improvement of up to 221 358 QALYs. The findings of this economic evaluation suggest that treatment for AD could improve population health and health equity. Policies to enable earlier diagnosis and treatment initiation, as well as expanded access to treatment, may further improve treatment and health equity impacts.

Health-promoting school. Mediation effects on health behaviors and the socio-economic level of pupils

Abstract Pupils health indicators and behaviors are marked by social and territorial inequalities which develop early (DREES, 2015, 2019). In order to combat these inequalities and improve the health behaviors and well-being of pupils, the “health-promoting school” approach is recognized as convincing. It is endorsed by the World Health Organization (Langford, 2015; WHO, 2021). The health policy currently implemented in French schools is convergent (MEN, 2018, 2021). In order to disseminate this policy, since 2019, the Alliance project has been implemented in 101 French schools (9 - 12 years old) and 97 municipalities in the AURA region. Each school and community are trained and supported to promote the development of professional practices and a health promotion project to improve the health behaviors of pupils. The question arises as to the extent to which the development of health-promoting teaching projects and practices participating in the strengthening of health protective factors - life skills and health literacy - of pupils would have a mediating effect from the point of view of socio-economic level and health behaviors of pupils? Each year, data are collected from pupils by questionnaire, mesuring their well-being, health habits, psychosocial competencies and their families’ socio-economic level. 11500 questionnaires collected during 3 years have been analyzed. Descriptive and bivariate analysis indicate sevreral improvements between years in their health habits like for example daily physical activities (6% for T0 and 16% for T2) or daily consumption of sweets (17% for T0 and 13% for T2). They confirm negative influence of risk factors as low socio-economic level on health habits. But mediation analysis show that psychosocial competencies, especially emotionnal and social competencies, mediate significatively this influence (mediation effect range from 5% to 21%). Key messages • The health indicators and behaviors of young people are marked very early on by social and territorial health inequalities. • Health-promoting school approach and particularly – life skills and health literacy – would have a mediation effect on health behaviors and the socio-economic level of students.

Implementation of sodium-glucose co-transporter 2 inhibitors in patients with heart failure through a new digital strategy (EMAIL-HF): a randomised clinical trial study design

Abstract Introduction Delayed implementation of new medical discoveries remains a global healthcare challenge and is mainly due to the complexity of cross-institutional patient care. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors is the latest medical discovery in heart failure (HF) and have recently been added to clinical guidelines as they have proven to reduce the risk of adverse cardiovascular outcomes in patients with HF across the ejection fraction spectrum. Whether a new digital strategy can optimise and accelerate the implementation of SGLT2 inhibitors in patients living with HF is of great importance for public health. Purpose To evaluate whether a new and streamlined digital strategy can optimise and accelerate the implementation of SGLT2 inhibitors in patients with HF. Design and methods: The trial is a multicentre, parallel group, register-based randomised clinical study, evaluating the effect and potential of a new digital strategy to implement new guideline therapies to patients living with a chronic disease, specifically SGLT2 inhibitors to patients with HF (figure 1). The setup employs data from nationwide health registers and official digital letters to inform patients about the new therapy option and invite them to have their eligibility evaluated by a HF specialist and start therapy. A total of ~10,000 patients with HF across the ejection fraction spectrum (with and without diabetes), who have not yet been started on SGLT2 inhibitors, are identified through Danish nationwide health registers, and randomised 1:1 to receive the digital letter (figure 2). The primary outcome is the proportion of patients redeeming a prescription of a SGLT2 inhibitor within six months. Secondary outcome is a composite HF endpoint consisting of all-cause death or HF hospitalisation. Other outcome measures are renal failure, stroke and myocardial infarction, safety outcomes, adherence to therapy and proportion of vulnerable patient groups initiating therapy including immigrants, elderly, frail patients, patients with lower socioeconomic level and lower educational level. A total of 4689 patients have been randomised (February 2024) and data will be presented in 2025. Conclusions The trial will determine the efficacy and safety of a new and streamlined digital strategy to implement SGLT2 inhibitors to patients with chronic HF. The setup has the potential to be used in a broad spectrum of patients living with chronic diseases and is expected to be highly cost-effective.Figure 1.Study hypothesisFigure 2.Study design

Socioeconomic Status and Local Biodiversity as Predictors of Attitudes towards Nature among High School Students in a Latin American Metropolis.

Urbanization and biodiversity loss disconnect humans from nature and may limit pro-environmental actions. Although, a growing body of knowledge exists on people's attitudes towards nature, the majority focuses on the influence of socio-environmental factors. Significant variations in socioeconomic and educational levels in urban areas affect access to biodiversity. In this study, we aim to identify the socio-environmental variables that are associated with people's attitudes towards nature (student's knowledge about urban birds and their participation in conservation actions). We collected data on local biodiversity, socioeconomical status, and high school students' attitudes towards nature (15 schools, n = 175 students) in a large Latin American capital city. Structural equation modeling (SEM) was utilized to identify relationships among all variables. Socioeconomic characterization was assessed using levels of socio-materiality and school performance scores. Definitions of ecological complexity were based on bird species richness and vegetation density. Knowledge of urban birds was evaluated using two indicators: urban bird identification (recognition of names) and identification of the biogeographic origin of urban birds (native or exotic). Participation in conservation actions by students was assessed based on implementation scale and implementation frequency. According to our results, respondents' knowledge of birds was poor: 42% of students identified only two species (the domestic pigeon and the monk parakeet, both exotic). Only 26% of total students participated in conservation actions. SEM analysis revealed that socioeconomic status was positively associated with the ecological complexity of surrounding areas. In turn, ecological complexity showed a positive relationship with students' knowledge on urban birds. Finally, students' knowledge of urban birds showed a positive influence on conservation actions. Our findings suggest that, the improvement of students' knowledge about local biodiversity and ensuring equitable access to biodiversity could be an effective way to foster students' involvement in conservation actions, especially in neighborhoods of lower socioeconomic levels.

The Art of Not Stopping: Grit Among the Breadwinner Senior Citizens in Pilar, Bataan

Approximately fifty percent of elderly individuals in the Philippines are currently employed. A significant number of them are exposed to health hazards and have a low socioeconomic level despite having worked for a considerable number of years. The current study aims to provide a detailed account and analysis of the core essence of the experience of breadwinner senior citizens as they strive to maintain their grit for numerous years. The findings revealed four themes, or 4K of grit, namely: keep on, keep at, keep up, and keep growing. Each theme generated subthemes that further elaborated on the experiences of breadwinner senior citizens. Keep on is divided into five subthemes: familial’s sake, financial autonomy, fortitude in the past, and founding leisure. Keep at is divided into two themes, namely the personification of aging and perceived hardships. Meanwhile, the keep-up had four subthemes: guarding the mind, being God-centered, getting support, and having greater focus in the body. Lastly, the keep growing is composed of two themes the steadfastness in work and senescence’s’ joy. While the participants have shown resilience in the face of several challenges, it is strongly recommended that local government agencies improve and closely supervise the current program and activities aimed at addressing the financial difficulties as well as the physical and mental difficulties of the breadwinner senior citizens. More so, the said research will add additional fund of knowledge in the field of gerontology and psychology in the Philippines.

EFFECTS OF SOCIOECONOMIC AND CLINICAL FACTORS ON TREATMENT ADHERENCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES PATIENT: FOCUS ON INHALATION THERAPY

Objective: Chronic obstructive pulmonary disease (COPD) refers to a persistent blockage of airflow that requires bronchodilator medication for the rest of one’s life. The goal of the treatment can only be met when the patient is adhering to the prescribed medicine. This study identifies and analyzes how clinical and socioeconomic factors affect COPD patients’ drug adherence to given therapy. The impact of our findings will reduce socioeconomic inequality in COPD management which will improve adherence to drugs and overall physical well-being. Methods: The hospital-based cross-sectional studies were conducted at the Department of TB and CD for 6 months in a tertiary care hospital. A total of 55 patients diagnosed with COPD participated in the study after signing the informed constant. The individual patients were interviewed using MMAS-8 and Kuppuswamy scale questionnaires. The data were analyzed by Chi-square test to determine the correlation between medication adherence and socioeconomic status in patients with COPD. Results: Among 55 COPD patients included in the study, their mean age was 62.2(+10.76) years. Out of the total participants: Significant associations between the medication adherence scale (MMRS-8) scores and the Kuppuswamy scale were found as p&lt;0.0001, indicating that medication adherence was influenced by the patient’s socioeconomic status. In addition, the BORG scale which is used to measure exercise tolerance in COPD that found to have a significant correlation with an MMAS-8 score of p=0.03. Conclusion: Our study found that a person with low socioeconomic levels will have poor adherence to inhaler therapy, leading to poor health outcomes like exacerbation and low physical activity due to shortness of breath.

A Clinicodemographic Analysis of Egyptian Females Condyloma Accuminata Patients

Abstract Background Human papillomavirus (HPV) is the most common viral infection of the reproductive tract in women and men. Although most HPV infections resolve spontaneously, persistent infections can lead to precancerous lesions and cancer of the cervix, vagina, vulva, anus and penis. HPV related cancers accounted for an estimated 4.5% of all cancers worldwide in 2012. Objective To describe the patients’ demographic features, clinical presentations, sexual aspects, and possible risk factors of codyloma accuminata among female patients treated at Dermatology, venereology and Andrology outpatient clinics of Ain Shams University hospitals and Al-Houd Al-Mrsoud hospital, Cairo, Egypt. Patients and Methods This prospective cross sectional clinical study was conducted on 500 female patients aged above 18 years old with condyloma accuminata. Results Most of the studied patients (71.2%)gave a history of no condom use, (13.7%) of patients gave history of occasional condom use while the rest 7.5% weren’t sexually active. Most of the patients (61.3%) gave a history of cryotherapy, (8.6%) patients gave a history of chemical cautery, (4.5%) patients gave a history of electro surgery and (2.1%) patients gave a history of immunotherapy. Among the studied patients those had chemical cautery as a treatment modality had the highest recurrence rate. Conclusion The main risk factors for condyloma accuminata are young age, unprotected sexual intercourse, multiple sex partners and lower socioeconomic and educational levels. Smoking or alcohol together with immunosuppressive medications and chronic diseases as well as other STDs are possible risk factors. History of medical intervention as laser hair removal of genital area, colonoscopy and vaginal ultrasound could play a role in condyloma accuminata transmission in non-sexual active women. Condyloma accuminata occurred in more than one genital sites in relation to laser hair removal of genital areas compared to mostly one site in sexual transmission.

Investigating the relationship between spermogram parameters and sexual desire in infertile men: a cross-sectional study from a tertiary centre in Iran

BackgroundMale factor infertility can affect spermatogenesis, sexual desire, and thus the quality of life of couples. The present study was conducted to investigate the relationship between spermogram parameters, and the...

Health Impacts of Pre-eclampsia: A Comprehensive Analysis of Maternal and Neonatal Outcomes.

Background and Objectives: Hypertensive disorders, particularly pre-eclampsia, pose significant risks during pregnancy, affecting both maternal and neonatal health. The study aims to analyze short- and long-term health implications for mothers and their children, comparing those with pre-eclampsia to those without, to improve understanding of risk factors, diagnostic markers, and outcomes. Materials and Methods: This retrospective observational study involved 235 patients, 98 with pre-eclampsia and 137 without, monitored from 2015 to 2018 at the Obstetrics and Gynecology Department of the "Pius Brînzeu" Emergency County Clinical Hospital in Timișoara, Romania. Results: Women with pre-eclampsia were older, had higher BMIs, and more frequently had a family history of pre-eclampsia, hypertension, and diabetes. They also had lower educational and socioeconomic levels and fewer prenatal visits. Biochemical markers such as higher proteinuria, elevated sFlt-1, and lower PlGF were significant in diagnosing pre-eclampsia. Short-term maternal complications like eclampsia, HELLP syndrome, and acute kidney injury were more prevalent in the pre-eclampsia group. Neonatal outcomes included higher rates of preterm birth, low birth weight, and NICU admissions. Long-term mothers with a history of pre-eclampsia had higher incidences of chronic hypertension, cardiovascular disease, kidney problems, diabetes, and mental health disorders. Their children faced increased risks of neuropsychological delays, chronic respiratory issues, behavioral disorders, learning difficulties, and frequent infections. Conclusions: The study highlights the significant short- and long-term health impacts of pre-eclampsia on both mothers and their children. Early monitoring, intervention, and comprehensive management are crucial in mitigating these risks. These findings underscore the need for personalized care strategies to improve health outcomes for affected individuals.

Niveles de estrés, ansiedad y depresión en población con hipertensión arterial

Long-term illnesses, including high blood pressure (HTN), are associated with a variable prevalence of mental health disorders, due to the restrictions they generate in daily life, uncertainty about the future, social isolation and the feeling of blame. The objective of the article is to know the prevalence of depression, stress and anxiety among adults with a diagnosis of primary HTN; as well as the factors associated with these mood disorders. A systematic review of publications from specialized databases such as APA PsycNet, Pubmed and Cochrane Library was carried out. Mesh terms and Boolean operators were used. Observational publications from 2019 to 2024 with adult patients (age ≥ 18 years) with primary HTN were included. Traceability data was extracted from the articles: author(s), year, country, DOI. The quality of the articles was evaluated using the STROBE checklist for observational research. 11 articles were included. Depression was evaluated in 9, anxiety in 5 and stress in two. Depression had a prevalence from 5.2% - 64.1%. Anxiety, 25% - 100%, while psychological stress was 60% - 71.5%. The factors related to these disorders were female sex, marital status, comorbidities, not having a job, low socioeconomic and educational level. The relationship between HTN and these disorders appears to be bidirectional. With a bidirectional relationship, the adult population with primary HTN experiences a variable prevalence of depression, anxiety and stress. It is necessary to further study this relationship.

The Impact of Climate Change on Public Health

Climate change is becoming increasingly recognized as a major hazard to public health, with rising temperatures, irregular weather patterns, and environmental degradation all contributing to poor health outcomes worldwide. This study investigates the complex relationship between climate change and public health, focusing on major health concerns such as heat-related sickness, respiratory and cardiovascular disorders, and the expansion of vector-borne diseases. Vulnerable groups, such as those in lower socioeconomic levels and marginalized areas, incur greater risks. The paper also examines mitigation and adaptation methods that are critical for reducing the public health consequences of climate change. Addressing these difficulties would necessitate interdisciplinary collaboration and policy reform in order to protect health and resilience against future climate-related dangers. Keywords: Climate change, public health, environmental health, air pollution, heat-related illness.

Digitally intensive mothering and unequal emotional work of Chinese mothers

ABSTRACT Due to the unequal gender division of labour in parenting practices, intensive mothering has been further reinforced in the digital age, amplifying mothers’ otherwise implicit emotional work. Using data from 70 self-narration cases of Chinese mothers during lockdown learning, this study found that mothers experienced four kinds of negative emotions – anxiety, anger, frustration and guilt during online learning, and adopted two possible coping strategies – active self-reflection and passive intervention by others. This study foregrounded the unequal emotional work of Chinese mothers, especially the vulnerability in emotion management among mothers at lower socioeconomic levels. This study revealed how the ideological discourses constructed by intensive mothering influence Chinese mothers’ emotions in digital educational involvement and the digital inequality it may trigger.

Goiter, iodine bioavailability and intrauterine growth restriction in Indigenous and Afro-descendant pregnant women from six non-metropolitan areas of Colombia (2019-2020).

Iodine is an essential mineral for fetal growth and brain development. The aim of this research was to evaluate goiter, iodine deficiency and intrauterine growth restriction in pregnant women of minority ethnic groups in Colombia. A cross-sectional study was performed in six non-metropolitan areas of Colombia. A total of 318 Indigenous and Afro-descendant pregnant women were invited to participate: 248 (83.2%) Indigenous and 50 (16.8%) Afro-descendants were studied. The mean age was 24 years (range 13-44 years). Of the women, 130 (43.5%) were from the department of Cauca, 72 (24.1%) were from C&oacute;rdoba, 28 (9.4%) were from Guajira, 26 (8.8%) were from Sierra Nevada de Santa Marta, 22 (7.4%) were from Amazonas, 16 (5.4%) were from Meta and 4 (1.3%) were from the department of Cesar. A total of 244 (81.8%) were illiterate and 291 (97.7%) were of very low socioeconomic level. Goiter was observed in 69 (23.3%) pregnant women (38 (41.7%) from the department of Cauca, 10 (35.7%) from Guajira, 5 (31.2%) from Meta, 6 (27.2%) from Amazonas and 10 (13.8%) from C&oacute;rdoba). Iodine deficiency (<100 &micro;g/L) was observed in 42 (14.9%) pregnant women (16 (11.6%) mild (50-99 &micro;g/L), 19 (13.8%) moderate (20-49 &micro;g/L) and 7 (5.1%) severe (<20 &micro;g/L)). Being literate was a protective factor for iodine deficiency (odds ratio (OR)=0.19, 95% confidence interval (CI) 0.04-0.84, p=0.016). Being illiterate and iodine deficient was only a risk factor for goiter (OR=6.72, 95%CI 3.9-9.5, p=0.038) in the department of Cauca. A high prevalence of goiter, iodine deficiency and intrauterine growth restriction was observed in minority ethnic groups of Colombia. The highest prevalence and risk was observed in the department of Cauca.

Relationship between persistence with topical antiglaucomatous prescription and patient socioeconomic status at a tertiary university hospital in Jerez de la Frontera (Spain).

To study the relationship between socioeconomic status and persistence with topical antiglaucomatous medication. A retrospective epidemiological observational cohort study was conducted with a sample of 1563 patients. The main dependent variable was persistence (medication possession ratio), the independent variable was socioeconomic status (deprivation index). Additional independent variables were used for multivariate analysis: individual health card index, sex, age, pharmacological group, number of eye drops, preservatives, diagnosis and concurrent medications. Bivariate statistical analysis was obtained using non-parametric tests. Logistic regression was used for multivariate analysis. The level of statistical significance was set at p < 0.05. We obtained data showing greater persistence in the groups with a higher socioeconomic level (deprivation index 1 and 2), with medication possession ratio values of 79.97 and 75.30, respectively) as opposed to the groups at lower socioeconomic levels (deprivation index 4 and 5, with medication possession ratio values of 73.75 and 69.85, respectively. Logistic regression corroborated this difference, reaching a significant value (no persistence in deprivation index group 5 versus 1) with OR = 1.62; 95%CI: 1.13-2.31. Additionally, lower persistence was detected in males, under 60 years of age, undergoing treatment with alpha-agonists, and in patients with ocular hypertension. Low socioeconomic status of the patient was significantly associated with decreased persistence with topical antiglaucomatous therapy.

Okul Yönetici Rolleri ile Öğrenci İyi Olma İlişkisinin Çeşitli Değişkenlere Göre Yöntem Analizinin İncelenmesi

The aim of this research is to examine the relationship between school administrator roles and student well-being according to various variables. The research was carried out with a mixed approach in which quantitative and qualitative patterns were used together. In this research, explanatory pattern, one of the mixed method patterns, was used. The study group of the research consists of Teachers working in Secondary Schools of Istanbul province and students aged 12 in the 2021-2022 academic year. The schools participating in the research were determined by stratified sampling method. In the study, the proportional stratified sampling method was used by selecting samples from each layer in equal proportion. In order to make stratification, the data of the ‘Mahallem Istanbul’ (2017) project conducted by the Faculty of Economics of Istanbul University were used. Accordingly, the application was made in a total of 6 schools located in the lower and upper socioeconomic level neighborhoods of Ataşehir, Beyoğlu and Beykoz Districts, where the socioeconomic difference is highest in Istanbul. A total of 589 people, including 38 teachers and 551 students, participated in the research. The ‘School Administrator Roles Scale’ was applied to the teachers in the schools determined in the research, and the ‘International Child Well-Being Scale’ was applied to the students of the same school. The study data were analyzed by t-test, ANOVA and regression analysis for independent groups using SPSS 21. According to the results of the study, the scores obtained by school administrators vary according to the socioeconomic level of the region where the school is located. The average school administrators in the upper socioeconomic level neighborhood are higher than the average school administrators in the lower socioeconomic level neighborhood. When the average scores of school administrators‘ roles are examined, it is seen that the highest score is ’providing information‘, then ’Decisional‘ and ’interpersonal role' scores, respectively. When student well-being scores are examined, there is a meaningful relationship between the school where the student is studying and the scores of your home and family, the things you have, the environment you live Decently, your life and the future. When the relationship between the ’School Administrator Roles scale’ and the ’International Child Well-Being scale' was examined, Dec.; There are statistically significant and negative relationships between the ’School Administrator Roles scale‘ ’interpersonal‘ sub-dimension and the ’International Child Well-being scale‘ ’self-feelings' dimension. Dec.1. There is a statistically significant and negative relationship between the 'School Administrator Roles scale' and the 'self-feelings' sub-dimension. Dec. 1. As the interpersonal role scores of school administrators increase, the scores of the students' feelings about themselves decelerate. Keywords: School Administrator Roles, Child Well-Being