Mean Socioeconomic Status Research Articles

Does Socioeconomic Status Moderate the Association Between Screen Time, Mobile Phone Use, Social Networks, Messaging Applications, and Mental Health Among Adolescents?

The aim of this study was to examine the relationship between different screen time (ST)-related behaviors and mental health conditions such as depression, anxiety, and stress. In addition, this study aimed to determine the moderating role of socioeconomic status (SES). This was a cross-sectional study and included data from 620 adolescents, aged 12-17 years, from the Valle de Ricote, Region of Murcia, Spain. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Overall ST, mobile phone use, social network use, and messaging application use were measured using validated questionnaires. SES was assessed using the Family Affluence Scale-III. The results indicated that overall ST was significantly associated with symptoms of depression at the mean SES (unstandardized beta coefficient [B] = 0.005, p = 0.023) and 1 standard deviation (SD) below the mean (B = 0.007, p = 0.011), and with stress only 1 SD below the mean (B = 0.006, p = 0.011). No significant associations were found for anxiety and stress across all socioeconomic levels. Mobile phone use exhibited a strong positive association with symptoms of depression (B = 0.891, p < 0.001), anxiety (B = 0.530, p = 0.014), and stress (B = 0.790, p < 0.001) at 1 SD below the mean SES. Similar patterns were observed for mean SES, albeit with slightly weaker associations. Conversely, social network use was positively associated with all three DASS-21 scales, particularly at 1 SD below the mean SES, with the strongest associations found for symptoms of depression (B = 0.327, p < 0.001), anxiety (B = 0.325, p < 0.001), and stress (B = 0.318, p < 0.001). Furthermore, messaging application use did not show significant associations with symptoms of depression, anxiety, or stress across any SES levels. In conclusion, social inequalities may influence the associations between various ST-related behavior and symptoms of depression, anxiety, and stress among adolescents. These findings may have implications for the design of effective interventions to improve symptoms of depression, anxiety, and stress in this population.

Drinking and mental health in middle adulthood: exploring the impact of wellbeing, mental health literacy, and drinking motives on risk of alcohol dependence

Objectives Risky drinking is a concern among UK-based middle-aged adults. We aimed to explore the relationship between risky drinking, drinking motives, wellbeing, and mental health literacy (MHL). Method Cross-sectional analysis of online survey data completed by 193 UK-based adults aged 40–65 who drank alcohol, incorporating the Alcohol Use Disorders Identification Test (AUDIT); Drinking Motives Questionnaire-Revised (DMQ-R); Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); Mental Health Literacy Scale (MHLS) and demographic questions. Results Coping, enhancement and conformity motives and gender significantly predicted higher AUDIT scores (measuring risky drinking). Enhancement motives were found to mediate the relationship between the self-help component of MHL and AUDIT scores, while coping motives mediated the association between wellbeing and AUDIT scores. Conclusion Findings support research emphasising the influence of drinking motives on risky drinking and highlights how low wellbeing may interact with coping motives to explain risky drinking among middle-aged adults, particularly men. Interventions supporting individuals to understand the relationship between drinking motives and risky drinking, develop adaptive coping strategies, and address the causes of low wellbeing, may be beneficial. However, as the sample was 84% ethnically White, 64% women, 85% educated to at least undergraduate level, and reported a relatively high mean socioeconomic status (6.98 out of 10), the results may not generalise beyond these groups. Future research should use stratified sampling to increase generalisability, as well as exploring whether alcohol-specific, component-specific, or disorder-specific MHL is associated with risky drinking and wellbeing.

Links between Ethnicity, Socioeconomic Status, and Measured Cognition in Diverse Samples of UK Adults

Abstract In the UK, immigrant groups frequently have lower mean socioeconomic status (SES) than do White British, which is a source of concern for the British government. Group-level SES tends to show positive relationships with cognitive ability scores. Thus, the authors estimate the mean cognitive and SES scores of various ethnic groups and test empirically if they correlate. They compute SES and cognitive ability scores using high-quality representative samples of adults. They then computed correlations between the two measures. General SES and group-cognitive ability correlated strongly at r = .59 to r = .79 (N = 18 groups). Finally, the authors computed cognitive scores predicted by the nation or region-of-origin of the ethnic groups and calculated correlations between these expected scores and the measured scores. The predicted and measured scores correlated strongly at r = .93 (N = 16 groups). The authors conclude that ethnic differences in SES are partly linked to differences in cognitive ability.

Abstract 18229: The Effectiveness of a Student-Delivered Weight Loss Program in a High-Risk Urban Practice

Introduction: Obesity is a global epidemic contributing to CVD, the leading cause of death worldwide. Diet, exercise, and lifestyle are crucial to CVD prevention and treatment. The Healthy Eating Index (HEI) is a 13-component dietary analysis tool based on the Dietary Guidelines for Americans, with higher scores associated with lower CVD risk. Calculating the HEI involves a 24-hour food recall and complex scoring. The Diet Risk Score (DRS), a 9-question, efficient alternative screening tool, has been validated against the HEI. JeffWLP, a unique low-cost, long-term student-delivered nutrition education program, evaluates improvement in DRS. Hypothesis: JeffWLP participants in JeffWLP would demonstrate significant weight loss, increased physical activity, and improved DRS in urban at-risk patients. Methods: In this randomized controlled trial, 30 obese adults from an underserved urban population were randomized to intervention (n=18) or control/usual care (n=12) groups. Mean age was 46 +/- 13 years. 80% were African American, and 90% were female; mean baseline BMI was 38 +/- 5. Mean socioeconomic status, self-assessed using the MacArthur Scale, was 6 (maximum 10). JeffWLP includes 12 core weekly group and individual nutrition education counseling sessions, meal replacements, and an exercise component, followed by unlimited bimonthly maintenance counseling. Vitals were obtained pre, mid, and post-core intervention. Results: JeffWLP participants achieved mean weight loss of 6.1 +/- 7.8 lbs (p=0.01), or 2.7 +/- 3.3% body weight (p &lt; 0.01) in 12 weeks. Mean DRS improved by 7 +/- 6 points (p &lt;0.001). Number of weekend steps walked increased by 3500 +/- 3150 (p = 0.016). Pilot JeffWLP patients (n=7), sustained weight loss of 4.8 +/- 8.1 lbs, 285 days after enrollment (p = 0.17). Conclusions: Our study demonstrates the cost-effectiveness of JeffWLP for improving weight loss, exercise, and dietary risk in 12 weeks. We anticipate additional sustained improvements in this ongoing study with double the sample size; this additional data will be available at the AHA meeting. JeffWLP empowers medical students to improve health outcomes in disadvantaged, at-risk underserved populations affordably, addressing critical health disparities.

Understanding the Influence of Teacher-Student Relationship on Mathematics Achievement: Evidence From Korean Students

Learning does not occur through one-way lecturing. Rather, it occurs through reciprocal interactions. This means that a student’s response to a teacher’s guidance is critical in their learning. Moreover, it has been known that student learning can be influenced by school mean SES (socioeconomic status) insofar as it impacts the shared learning environment. In the present study, we examine (1) the relationship between math teacher support and student motivation on student mathematics achievement; and (2) whether student motivation interacts with teacher support in learning mathematics and how those interactions affect student mathematics achievement across various school mean SES (low, medium, high). The Programme for International Student Assessment 2012 survey data for 5,033 South Korean students was used in this research. In this study, the results show that (1) the effects of math teacher support and student motivation differ by school mean SES; and (2) there is no interaction between student motivation and math teacher support. Therefore, the findings of this study indicate that school SES impacts the shared learning environment and has a strong influence on student response to math teacher support and the relationship between student motivation and math achievement. Based on these results, implications for teacher education to improve teacher support are suggested.

Lung Cancer Screening Penetration in an Urban Underserved County

To compare residential geography, sex, socioeconomic status (SES), and race/ethnicity of patients screened at Montefiore's Lung Cancer Screening Program with those of patients diagnosed with lung cancer, assessing whether screening efforts are appropriately focused. This retrospective cohort study involved patients within a multisite urban medical center undergoing lung cancer screening or diagnosed with lung cancer from January 1, 2015 to December 31, 2019. Inclusion criteria were residence within the Bronx, NY and age between 55 and 80years. Institutional review board approval was obtained. Data were analyzed using the Wilcoxon two-sample t test and χ2. The cohorts comprised 1568 (50.3%) women and 1551 (49.7%) men (mean age 65.6 ± 6.16). The Southeast Bronx had the most diagnosed lung cancers (29.96%) and screenings (31.22%). Sex did not significantly differ (p = 0.053). Cancer and screening cohorts were from impoverished neighborhoods with mean SES of -3.11 ± 2.78 and -3.44 ± 2.80 (p < 0.01). The lower tier SES neighborhoods demonstrated more patients in the screening cohort than cancer cohort (p = 0.01). Both cohorts included a majority of Hispanic patients, although race/ethnicity differed significantly (p = 0.01). Lower SES neighborhoods showed no significant difference in race/ethnicity between cancer and screening cohorts (p = 0.262). Though statistically significant differences were found between cohorts, likely due to sample size, few clinically meaningful differences were found, implying our lung cancer screening program was effective in reaching the desired population. Demographics-based programs should be considered in global efforts to screen vulnerable populations.

Family function patterns, and associated socioeconomic variables – a survey study of members of rural Egyptian families attending family medicine centers affiliated to Suez Canal University

Background: Socioeconomic status (SES) is a key factor that impact the family functioning. Results from previous studies demonstrated that low SES status was associated with less satisfaction in several areas of family functioning. Objectives: To describe the family function status patterns and associated socioeconomic status variables in a rural sample of Egyptian families. Subjects and methods: This study was carried out as a cross-sectional survey in a three rural Family Medicine Centres, Ismailia Governorate, Egypt in November 2022. An estimated total sample size of 164 participants was included. Each participant was interviewed to complete an Arabic version of Apgar questionnaire for the family function status assessment and the scale of socioeconomic status for health research in Egypt in sequence. Results: Eighty-two families representing 48.2% were in middle SES grade, 79 families representing 46.5% were in low SES grade, 9 families representing 5.3% were in very low SES grade, and 0 (0%) were in high SES grade. The family function status categories showed 43.5% of families were in highly functional category,49.4% were in moderately dysfunctional category, and 7.1% were in severely dysfunctional category. Mean score SES for the highly functional families was significantly different from the moderately dysfunctional families; 44.35 ± 11.28 (SD) vs 38.68 ± 11.09 (SD), respectively. Total SES score, education, and culture domain of SES scale showed a statistically significant positive moderate correlation with family function status total score (r 0.215, P&lt; 0.005, r 0.225, P &lt; 0.003). Conclusions: More than fifty percent of rural Egyptian families in this study lie in low, and very low SES status. Socioeconomic status score of highly functional families was significantly higher than the score of moderately dysfunctional families. SES score, and education, and culture domain showed a significant positive moderate correlation with the family function status score.

A hospital-based study on the distribution of ovarian tumors in the tribal and nontribal population of Ranchi, Jharkhand

Objectives: This study aimed to determine the types and management of ovarian tumors in tribal and nontribal population of Jharkhand. Methods: This prospective study was conducted in the Department of Pathology for duration of 24 months from December 2019 till November 2021. The study included the data (age and clinical symptoms) of patients of ovarian tumors who attended the Gynecology Outpatient Department and were managed with surgery or neoadjuvant therapy. The diagnosis was confirmed through radiology investigations, tumor markers, and histopathology. Histopathological reports of samples sent to the Department of Pathology were included. Results: A total of 150 patients with ovarian tumors were included, among which 63 (42%) were tribal. As compared to nontribals, tribals had comparable mean age (39.05 ± 12.18 vs. 36.55 ± 11.77, P = 0.469), comparable parity, and socioeconomic status. The most common complaints were pain in lower abdomen (80%), lump in lower abdomen (34%), and abdominal distension (18%). Epithelial tumors constituted the majority of tumors, and histopathological types included mucinous adenocarcinoma (26%), dermoid cyst (16%), serous cystadenoma (10%), and simple ovarian cyst (10%). Distribution of histopathological type of tumor was comparable between nontribal and tribal (P = 0.478). Seventy-four percent of the patients were managed operatively, which included unilateral ovarian mass/cyst removal, ovarian mass removal, total abdominal hysterectomy, and opposite side salpingo-oophorectomy, whereas 26% of the patients were managed conservatively with chemotherapy. There was no mortality, and the overall outcomes were comparable between nontribals and tribals (P > 0.05). Conclusion: The demographic characteristics, clinical presentations, histopathological type, management, and outcomes were similar among tribal and nontribal patients with ovarian tumors.

Social Determinants of Health and Racial/Ethnic Disparities in COVID-19 Mortality at the County Level in the Commonwealth of Virginia.

Mortality due to coronavirus disease-2019 (COVID-19) among Black and Hispanic populations is disproportionately high compared to white populations. This study aimed to explore the association between COVID-19 mortality and social determinants of health (SDOH) among Black and Hispanic populations in Virginia. County-level publicly available COVID-19 mortality data from Virginia, covariates, and SDOH indicators were used. An independent t-test and hierarchical multiple regression analysis were performed to assess the association between SDOH and COVID-19 death rates, with a focus on racial/ethnic disparities. Counties in the lowest quartile had a mean death rate of 44.72 (SD = 13.8), while those in the highest quartile had a mean death rate of 239.02 (SD = 123.9) per 100, 000 people ( P < .001). Counties with the highest death rates had significantly lower mean socioeconomic status. The regression analysis revealed that 32% of the variance in the COVID-19 mortality rate was associated with SDOH after controlling for the covariates ( P < .01). Identifying as Hispanic ethnicity accounted for 8.5% of the variance, while median household income, being uninsured, and education accounted for 32.7%, 12.9%, and 7.1%, respectively. The findings provide evidence that disparities in SDOH experienced by Hispanic populations play a significant role in increased COVID-19 mortality, thus highlighting the social needs of low-income, low-education, and Hispanic populations to advance equity in health outcomes.

Impact of neighbourhood-level socioeconomic status, traditional coronary risk factors, and ancestry on age at myocardial infarction onset: A population-based register study

BackgroundThere is consensus that low socioeconomic status (SES) is associated with an increased risk of acute myocardial infarction (AMI), but the extent to which traditional coronary risk factors and other characteristics of low SES mediate this effect remains uncertain. This study examined AMI patients residing in neighbouring city districts with the same local hospital despite having among the most considerable differences in mean SES in Norway. Our purpose was to assess low SES as a coronary risk factor and examine whether traditional coronary risk factors or ancestry mediate this effect.MethodsSix hundred six patients (215 and 391 with a low and high neighbourhood-level SES, respectively) admitted to Diakonhjemmet Hospital with non-ST-elevation myocardial infarction (NSTEMI) between 2014 and 2017, entered analysis. Data from the Norwegian Myocardial Infarction Register were used to identify patient characteristics, and the STATA/SE 15.1 software was used to perform the statistical analyses.ResultsPatients from socioeconomically disadvantaged city-districts had a 4.9 years earlier onset of AMI (68.99 vs. 73.89 years; p < 0.001) and a higher prevalence of previous AMI, known diabetes, and current smokers (36% vs. 27%, 25% vs. 12%, and 33% vs. 17%, respectively; all p ≤ 0.05). When only comparing patients with a first time AMI, an even greater difference in the age at AMI onset was found (6.1 yrs; p < 0.001). The difference in age at AMI onset remained statistically significant when adjusting for traditional coronary risk factors (3.28 yrs; 95% confidence interval (CI) 1.11−5.44; p = 0.003), but not when adjusting for presumed non-Northwest-European ancestry (1.81 yrs; 95% CI −0.55 to 4.17; p = 0.132).ConclusionThis study supports earlier research showing an increased risk of AMI in socioeconomically disadvantaged individuals. In our population, presumed non-Northwest-European ancestry could entirely explain the increased risk, whereas traditional coronary risk factors could only partly explain the increased risk.

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

Teacher Instructional Practices and Student Mathematics Achievement

Using the nationally representative sample from the United States in the 2012 Programme for International Student Assessment (&lt;em&gt;N&lt;/em&gt; = 7,429 students from 240 schools), I examined the relationship between teacher instructional practices and student mathematics achievement. To account for the multilevel structure of the data with students nested within schools, I used a two-level hierarchical linear model in the data analysis. Teacher instructional practices showed statistically significant effects on student mathematics achievement, even after controlling for socioeconomic status (SES) and sex at the student level and school mean SES and whether the school is public or private at the school level. Furthermore, I found that the relationship between teacher instructional practices and student mathematics achievement varied statistically significantly across schools.

Successful HPV Vaccination in Adolescents with Sickle Cell Disease Following a Quality Improvement Bundle Intervention

IntroductionHuman papilloma virus (HPV) infection can cause cervical, anal, penile, vaginal, and oropharyngeal cancer. The CDC recommends HPV vaccination as a 2 or 3-dose series at <15 or ≥15 years, respectively. Completion of the vaccine series decreases rates of cervical cancer in young women by 29%(Guo, F. et al. American Journal of Preventive Medicine 2018). For this reason, focus is currently on vaccinating younger patients to optimize benefit. Historically, adolescents have had low rates of completion of the HPV vaccine series. African Americans, in particular, have significantly lower rates than whites in receiving the full series (De, P. and H. Budhwani. Public Health 2017). Vaccine hesitancy in sickle cell disease (SCD) patients exists and is exemplified by a lower uptake in teenagers with SCD compared to non-SCD counterparts (Beverung, L. et al. American Journal of Hematology 2018). However, completion of 23-pneumococcal vaccine polyvalent (PPSV-23), which is routinely administered as a series during well-child visits, has notably been high. SCD programs serve as medical homes where primary care may also be provided. With this in mind, we introduced a quality improvement (QI) intervention to improve the uptake of HPV vaccination in the adolescent SCD clinic. A bundle intervention was developed including 1) provider education about HPV vaccination importance, 2) nurse review of each adolescent's vaccine records prior to clinic visit, 3) provider notification by the nurse regarding the need for HPV during the visit, 4) discussion of the vaccine benefits with the family, 5) provision of the vaccine in the SCD clinic after parent consent, and 6) offering of MOC points as incentive to providers for project participation. We sought to evaluate the impact of the QI bundle on completion of the HPV vaccine series. We hypothesized that implementation of the QI bundle would increase the rate of completion of the HPV vaccine series among adolescents with SCD. Secondary objectives included association between completion of the HPV vaccine series and frequency of outpatient visits to the SCD clinic, quality of life (QoL), SCD-specific knowledge, completion of the PPSV-23 series, and markers of socio-economic status (SES).MethodsRetrospective data was collected using the Sickle Cell Clinical Research and Intervention Program (SCCRIP) study database (Hankins JS, et al. Pediatr Blood Cancer 2018). Patients aged 12-18 years between October 1, 2018 and December 31, 2019 with any SCD genotype and who were enrolled on the SCCRIP study were included in analysis. The following variables were extracted: age, sex, race, ethnicity, age, economic hardship index (EHI), parental education level, household income, genotype, SCD-specific knowledge, and distance to healthcare facility. The prevalence of completed HPV series, defined as 2 doses ages <15 years and 3 doses ages ≥15 years, in the 12 months prior to implementation of the bundle vaccination program (before October 1, 2018) and after implementation of program (October 2, 2018 to December 31, 2019) was calculated using Fisher's exact. Demographic characteristics and QoL were compared between patients who completed the vaccine series and those who did not.ResultsIn total, 373 patients met inclusion criteria. Their median age was 15.2 (range 12-19), 50% were female, 225 (60.3%) had HbSS/Sβ 0-thalassemia, and 114 (29.7%) had HbC/Sβ +-thalassemia. The mean SES index was 70% (±27%) and the mean QoL score 73 (±14.6). HPV vaccine completion rates increased from 31% to 56.2% after the bundle implementation (Figure 1, p<0.01). Completion of the series was associated with higher SES index, completion of the PPSV-23 series, and higher frequency of outpatient visits. There was no significant association between completion of the vaccine series and QoL, distance from healthcare facility, and disease-specific knowledge (Table 1).DiscussionPrevention of communicable diseases such as HPV is imperative in the general population. However, baseline vaccination rates in adolescents with SCD is low. A QI intervention that includes provider education and incentives, active verification of HPV vaccination status, and promotes coordinated communication between the nurse, providers, and patients effectively increased completion of the HPV vaccine series among adolescents with SCD. Continued strategies are needed to further increase the rates of vaccine completion. [Display omitted] DisclosuresHankins: Vindico Medical Education: Consultancy; Global Blood Therapeutics: Consultancy; UpToDate: Consultancy; Bluebird Bio: Consultancy.

Access to CAR-T Cell Therapy in Underrepresented Populations: A Multicenter Cohort Study of Pediatric and Young Adult ALL Patients

Introduction: Social determinants of health such as race, ethnicity, and socioeconomic status (SES) are associated with inferior outcomes in patients with B-cell acute lymphoblastic leukemia (B-ALL). Latinx patients have worse event-free survival and are at increased risk of relapse when compared to non-Latinx peers; given that low SES is also an independent predictor of relapse, some of this disparity is likely the result of structural racism. Chimeric antigen receptor T-cell therapy (CAR-T) is a promising approach to improve survival for patients with relapsed/refractory (r/r) B-ALL. However, given the limited number of cellular therapy centers, these therapies may not be equally accessible to patients of low SES or patients from historically disadvantaged populations. The sociodemographic characteristics of pediatric and young adult patients referred for CAR-T have not been well-described. We aimed to evaluate how sociodemographic characteristics of patients referred for CAR-T from outside institutions (referred CAR-T) differed from r/r patients referred for CAR-T at their home institution (local CAR-T), r/r patients not referred for CAR-T at their home institution (other relapse), and patients without r/r disease (without relapse). We hypothesized that there would be a higher proportion of non-Latinx White patients and patients with higher SES among referred CAR-T patients.Methods: We conducted a multicenter, retrospective cohort study of children and young adults with B-ALL treated at five large pediatric hospitals between 2012-2018. Patients diagnosed with B-ALL between age 0 and 29 were included. Clinical and demographic data (including race/ethnicity, insurance, and primary language) were collected from the electronic health record and analyzed using descriptive statistics. For patients residing within the United States, ArcGIS NSES Index software was used to assign SES score by census tract (0-100, with 50 as the national average).Results: Our cohort included 1374 patients with B-ALL, of which 372 (27%) had r/r disease (Table 1). Among 372 r/r patients, 142 were referred CAR-T patients and 230 were treated for r/r leukemia at their home institution (35% local CAR-T and 65% other relapse). Median distance traveled to CAR-T therapy was 824 miles among referred patients and 20.5 miles among local CAR-T patients. The majority of patients (76% of the overall cohort and 79% of those receiving CAR-T) were either White or Latinx.A higher proportion of local CAR-T patients were Latinx compared to referred CAR-T patients (56% vs. 29%; p<0.01). Conversely, fewer local CAR-T patients were non-Latinx White compared to referred CAR-T patients (28% vs. 47%; p<0.01). A higher proportion of local CAR-T patients had public insurance compared to referred CAR-T patients (65% vs. 31%; p<0.001). A higher proportion of local CAR-T patients identified Spanish as their primary language compared to referred CAR-T patients (24% vs. 6%; p<0.001). Mean SES scores were similar across all groups.Conclusions: In a large multicenter cohort of B-ALL pediatric and young adult patients, the demographics of referred CAR-T patients were notably different than local CAR-T patients. Latinx patients are at increased risk of relapse, making access to CAR-T all the more essential; however, we found less than one-third of patients referred from outside institutions for CAR-T cell therapy were Latinx, while a majority of patients receiving CAR-T cell therapy locally were Latinx. This association suggests that barriers to access such as distance and need for travel may differentially impact Latinx patients due to structural racism. Spanish-speaking patients and patients with public insurance were also underrepresented in referrals from outside institutions. However, these observational differences may be in part due to regional variations in the demographics of the population. Preliminary analysis by site is underway and indicates that center level demographic variation may be driving some of the observed differences. Very few Black and Asian patients received CAR-T within our cohort making any assessments of patterns of care difficult. Future work will involve additional analysis to identify non-clinical factors that may influence referral and enrollment rates on CAR-T clinical trials as well as qualitative work to understand these factors from the patient and provider perspectives. [Display omitted] DisclosuresWalters: AllCells, Inc: Consultancy; BioLabs, Inc: Consultancy; Vertex pharmaceuticals: Consultancy; Ensoma, Inc.: Consultancy. Ramsey: Vertex Pharmaceuticals: Consultancy; Cystetics Medicines: Consultancy.

An Exploration of Factors Linked to Academic Performance in PISA 2018 Through Data Mining Techniques.

International large-scale assessments, such as PISA, provide structured and static data. However, due to its extensive databases, several researchers place it as a reference in Big Data in Education. With the goal of exploring which factors at country, school and student level have a higher relevance in predicting student performance, this paper proposes an Educational Data Mining approach to detect and analyze factors linked to academic performance. To this end, we conducted a secondary data analysis and built decision trees (C4.5 algorithm) to obtain a predictive model of school performance. Specifically, we selected as predictor variables a set of socioeconomic, process and outcome variables from PISA 2018 and other sources (World Bank, 2020). Since the unit of analysis were schools from all the countries included in PISA 2018 (n = 21,903), student and teacher predictor variables were imputed to the school database. Based on the available student performance scores in Reading, Math, and Science, we applied k-means clustering to obtain a categorized (three categories) target variable of global school performance. Results show the existence of two main branches in the decision tree, split according to the schools’ mean socioeconomic status (SES). While performance in high-SES schools is influenced by educational factors such as metacognitive strategies or achievement motivation, performance in low-SES schools is affected in greater measure by country-level socioeconomic indicators such as GDP, and individual educational indicators are relegated to a secondary level. Since these evidences are in line and delve into previous research, this work concludes by analyzing its potential contribution to support the decision making processes regarding educational policies.

Are there socio-economic inequalities in utilization of predictive biomarker tests and biological and precision therapies for cancer? A systematic review and meta-analysis

BackgroundNovel biological and precision therapies and their associated predictive biomarker tests offer opportunities for increased tumor response, reduced adverse effects, and improved survival. This systematic review determined if there are socio-economic inequalities in utilization of predictive biomarker tests and/or biological and precision cancer therapies.MethodsMEDLINE, Embase, Scopus, CINAHL, Web of Science, PubMed, and PsycINFO were searched for peer-reviewed studies, published in English between January 1998 and December 2019. Observational studies reporting utilization data for predictive biomarker tests and/or cancer biological and precision therapies by a measure of socio-economic status (SES) were eligible. Data was extracted from eligible studies. A modified ISPOR checklist for retrospective database studies was used to assess study quality. Meta-analyses were undertaken using a random-effects model, with sub-group analyses by cancer site and drug class. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed for each study. Pooled utilization ORs for low versus high socio-economic groups were calculated for test and therapy receipt.ResultsAmong 10,722 citations screened, 62 papers (58 studies; 8 test utilization studies, 37 therapy utilization studies, 3 studies on testing and therapy, 10 studies without denominator populations or which only reported mean socio-economic status) met the inclusion criteria. Studies reported on 7 cancers, 5 predictive biomarkers tests, and 11 biological and precision therapies. Thirty-eight studies (including 1,036,125 patients) were eligible for inclusion in meta-analyses. Low socio-economic status was associated with modestly lower predictive biomarker test utilization (OR 0.86, 95% CI 0.71–1.05; 10 studies) and significantly lower biological and precision therapy utilization (OR 0.83, 95% CI 0.75–0.91; 30 studies). Associations with therapy utilization were stronger in lung cancer (OR 0.71, 95% CI 0.51–1.00; 6 studies), than breast cancer (OR 0.93, 95% CI 0.78–1.10; 8 studies). The mean study quality score was 6.9/10.ConclusionsThese novel results indicate that there are socio-economic inequalities in predictive biomarker tests and biological and precision therapy utilization. This requires further investigation to prevent differences in outcomes due to inequalities in treatment with biological and precision therapies.

Effects of student composition in school on young adults’ educational pathways.

Which factors help young adults choose educational pathways leading to higher educational attainment? Academic self-concept (ASC), achievement, and socioeconomic background have all been found to be important predictors of postsecondary educational choices and success. Although research has shown that student composition in secondary school may affect some of these predictors, only a few studies (mostly from the United States) have investigated the effects of student composition on postsecondary educational outcomes. The results showed that students with similar individual achievement had lower postsecondary educational attainment if they graduated from secondary schools with higher mean achievement. It has been proposed that social comparison processes explain this negative context effect (big-fish-little-pond effect [BFLPE]). In contrast, students with the same individual socioeconomic status (SES) had higher postsecondary educational attainment if they graduated from secondary schools with a higher mean SES. In the present study, we investigated the effects of achievement-related and socioeconomic student composition on subsequent educational outcomes using data from a longitudinal study in Germany. Contrary to previous studies, our results showed that student composition had little relevance for later educational pathways. There was a small, long-lasting, indirect BFLPE of achievement-related composition in secondary school on postsecondary educational outcomes through students’ ASC. Furthermore, individual SES was strongly related to postsecondary educational outcomes, whereas being in an academic-track school with a higher or lower mean SES was not relevant for postsecondary educational pathways. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Central SBP and executive function in children and adolescents with primary and secondary hypertension.

The aims of the study were to assess executive function performance in children and adolescents with primary and secondary hypertension, and to investigate for associations with central SBP and ambulatory blood pressure. Forty-six pediatric patients with secondary hypertension because of kidney diseases and 46 patients with primary hypertension underwent ambulatory blood pressure monitoring, pulse wave analysis, and assessment of executive function using Behavior Rating Inventory of Executive Function. Results for comparisons are presented as mean (SD). Analysis of covariance was performed to examine the effect of blood pressure parameters and hypertension cause. Patients with secondary hypertension had higher T scores in parent and self-reported Metacognition Indices compared with those with primary hypertension (51.2 ± 8.9 vs. 47.6 ± 7.5, P = 0.05 and 49.6 ± 9.1 vs. 42.1 ± 7.9, P = 0.001, respectively), but did not differ in Behavior Regulation Index T scores, as well as in mean arterial pressure z-score. Patients with secondary hypertension had higher central SBP z-scores (P = 0.05). Adjustment for central SBP attenuated differences in parent Metacognition Index between groups. Central SBP z-score associated with parent Metacognition (B = 0.95, 95% CI 0.02-1.87), Behavior Regulation (B = 1.14, 95% CI 0.07-2.21), and self-reported Metacognition Indices T scores (B = 1.48, 95% CI 0.39-2.56), independent of mean arterial pressure z-score, age, sex, socioeconomic status, hypertension cause, and antihypertensive treatment. Central SBP associates with executive function performance in youth with hypertension and could have complementary role to ambulatory blood pressure for identifying children at risk for adverse cognitive outcomes.

Association of Use of Oral Contraceptives With Depressive Symptoms Among Adolescents and Young Women

Oral contraceptives have been associated with an increased risk of subsequent clinical depression in adolescents. However, the association of oral contraceptive use with concurrent depressive symptoms remains unclear. To investigate the association between oral contraceptive use and depressive symptoms and to examine whether this association is affected by age and which specific symptoms are associated with oral contraceptive use. Data from the third to sixth wave of the prospective cohort study Tracking Adolescents' Individual Lives Survey (TRAILS), conducted from September 1, 2005, to December 31, 2016, among females aged 16 to 25 years who had filled out at least 1 and up to 4 assessments of oral contraceptive use, were used. Data analysis was performed from March 1, 2017, to May 31, 2019. Oral contraceptive use at 16, 19, 22, and 25 years of age. Depressive symptoms were assessed by the DSM-IV-oriented affective problems scale of the Youth (aged 16 years) and Adult Self-Report (aged 19, 22, and 25 years). Data from a total of 1010 girls (743-903 girls, depending on the wave) were analyzed (mean [SD] age at the first assessment of oral contraceptive use, 16.3 [0.7]; (mean [SD] age at the final assessment of oral contraceptive use, 25.6 [0.6] years). Oral contraceptive users particularly differed from nonusers at age 16 years, with nonusers having a higher mean (SD) socioeconomic status (0.17 [0.78] vs -0.15 [0.71]) and more often being virgins (424 of 533 [79.5%] vs 74 of 303 [24.4%]). Although all users combined (mean [SD] ages, 16.3 [0.7] to 25.6 [0.6] years) did not show higher depressive symptom scores compared with nonusers, adolescent users (mean [SD] age, 16.5 [0.7] years) reported higher depressive symptom scores compared with their nonusing counterparts (mean [SD] age, 16.1 [0.6] years) (mean [SD] score, 0.40 [0.30] vs 0.33 [0.30]), which persisted after adjustment for age, socioeconomic status and ethnicity (β coefficient for interaction with age, -0.021; 95% CI, -0.038 to -0.005; P = .0096). Adolescent contraceptive users particularly reported more crying (odds ratio, 1.89; 95% CI, 1.38-2.58; P < .001), hypersomnia (odds ratio, 1.68; 95% CI, 1.14-2.48; P = .006), and more eating problems (odds ratio, 1.54; 95% CI, 1.13-2.10; P = .009) than nonusers. Although oral contraceptive use showed no association with depressive symptoms when all age groups were combined, 16-year-old girls reported higher depressive symptom scores when using oral contraceptives. Monitoring depressive symptoms in adolescents who are using oral contraceptives is important, as the use of oral contraceptives may affect their quality of life and put them at risk for nonadherence.

What Role Does School Play in Helping Socioeconomically Disadvantaged Students Succeed against the Odds?

Based on the data of a large scale survey conducted by Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, this study examined the role of school in reducing education inequality. The results showed that schools concentrated with resilient students had higher mean socioeconomic status (SES) and SES heterogeneity, more education resources, higher teaching quality, and more positive school climate, and these factors also functioned as significant predictors of academic resilience. Provid-ing socioeconomically disadvantaged students with access to both high SES schools and enriched school resources can even the education ine-quality related to family background. In order to promote education equality, policymakers and education practitioners should take measures to reduce the degree of stratification and encourage student integration, promote equal distribution of high quality education resources among schools, enhance teachers’ ability to effectively use individualized, coop-erative and inquiry teaching methods, and build a supportive climate.