Medium Level Of Education Research Articles

Electoral reforms and the representativeness of turnout

AbstractVoters tend to be richer, more conservative, and more educated than non-voters. While many electoral reforms promise to increase political participation, these policy instruments may have multidimensional and differential effects that can increase or decrease the representativeness of turnout. We develop an approach that allows us to estimate these effects and assess the impact of postal voting on representational inequality in Swiss referendums using individual-level ($N = 79,\; 000$) and aggregate-level data from 1981 to 2009. We find that postal voting mobilizes equally across a wide range of political and sociodemographic groups but more strongly activates high earners, those with medium education levels, and less politically interested individuals. Yet, those who vote are not less politically knowledgeable and the effects on the composition of turnout remain limited. Our results inform research on the consequences of electoral reforms meant to increase political participation in large electorates.

Prevalence and predictors of overweight and obesity among women in the Gaza strip-Palestine: a cross-sectional study

BackgroundThe prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip.MethodsA cross-sectional study was conducted to recruit a total of 357 mothers aged 18–50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity.ResultsThe combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)).ConclusionsThis study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.

Dependence between travel distance, individual socioeconomic and health-related characteristics, and the choice of the travel mode: a cross-sectional study for Kaunas, Lithuania

The aim of this study was to analyse the associations between individual socioeconomic and health-related characteristics, travel distance, and the choice of different travel modes in urban population. A cross-sectional study included 932 adults of Kaunas city, Lithuania. The choice of the travel mode and individual characteristics were self-reported by the participants, and their travel routes were calculated using the geographic information system. Multivariate logistic regression was used to assess the most significant factors determining the choice of a car, cycling, walking, or public transport. In total, 529 participants reported using a car, of whom 65.8% had medium or high education levels. These participants were more likely to be younger, male, married, and employed. Among bicycle users, statistically significant differences between the employment status, body mass index, and travel distance were observed. Walkers were significantly more likely to be older, those with lower incomes, unemployed, and travelling the shortest distances. The analysis of the travel distance on the choice of the travel mode revealed that men travelled longer distances with a car compared to women. The employment status was significantly associated with travel distance by car or public transport. Employed individuals travelled longer distances by public transport or by car, compared to unemployed individuals. Among bicycle users, we found that people with higher levels of education and overweight individuals cycled the longest distances. Our study emphasizes the importance of considering different individual characteristics when analysing the choice of transport modes. It provides evidence that is relevant for all urban populations on the choice of the transport mode, particularly considering active versus passive transport.

Global Intake of Major Beverages in Adults by Country Wealth and Sociodemographic Characteristics: Analysis of the Global Dietary Database 2015

Abstract Objectives Assessing the impact of beverage intake on health has been limited by lack of reliable and standardized individual-level data on a global scale. We provide updated estimates of global intakes of sugar-sweetened beverages (SSBs), fruit juices, and milk, as well as novel estimates of coffee and tea, jointly by country, age, sex, education, and urban-rural residence for adults in 2015. Methods Beverge intake data in the Global Dietary Database were derived from 1144 national and subnational surveys from 1980 through 2015, covering 97.5% of the world's population. Mean intakes and 95% uncertainty intervals were estimated using a Bayesian hierarchical prediction model, and stratified by country (n = 185), urban-rural residence, sex, age group (all ages, 20 age groups), and education level (low, middle, high). The model combined primary data on individual-level intakes with time-varying country-level and survey-level covariates. Results Grouped by World Bank wealth categories, intake of SSBs was highest in low-income countries (LIC) and high-income countries (HIC) (0.7 servings (8-oz)/d each), and lowest in upper-middle income countries UMIC (0.4 s/d). Intakes were generally higher in men, urban residence, and with higher education, except in HIC were intakes did not differ by education. Fruit juice was highest in HIC (0.2 s/d) and lowest in lower-middle income countries (LMIC) (&amp;lt;0.04 s/d); and within countries, generally higher with urban residence and higher education. Coffee intake was highest in HIC (1.2 s/d) and lowest in LIC (0.7 s/d); and generally higher in men and with medium or high education level, without urban-rural differences. Tea intake was highest in HIC (0.8 s/d) and lowest in LMIC (0.5 s/d); and generally higher in women, urban residence, and with high education. Average milk intake ranged from 0.5 s/d in HIC to 0.2 s/d in LIC, LMIC and UMIC; and was generally higher at high education level, without differences by sex or urban-rural residence. Country-specific intakes and temporal trends since 1990 will be presented. Conclusions These novel global results highlight key findings and heterogeneity in intakes of different beverages, informing potential effects on health and corresponding policy priorities. Funding Sources Bill &amp; Melinda Gates Foundation.

Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to care. However, it is unclear whether those affected discuss their financial problems with general practitioners. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate:50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Conversations about financial problems with general practitioners were reported by 22.6% (n = 135) of respondents. Individuals with a high educational level were less likely to report such conversations than those with medium educational level (aOR 0.11; 95%CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background(aOR 2.09; 95%CI 1.32-3.32), the chronically ill(aOR 1.90; 95%CI 1.16-3.13) and individuals who reported high financial distress(aOR 2.15; 95%CI 1.22-3.78) and cutting on necessities to pay for medications(aOR 1.86; 95%CI 1.12-3.09) were more likely to discuss financial problems than their counterparts. Few over-indebted individuals discussed financial problems with their general practitioner. Patients' health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

Education and incident type 2 diabetes: quantifying the impact of differential exposure and susceptibility to being overweight or obese.

Educational inequality in type 2 diabetes incidence is evident in many high-income countries. Previous studies have shown that differential exposure to being overweight/obese across educational groups may partly explain this inequality. Whether differential susceptibility to being overweight/obese across educational groups contributes to this inequality has been investigated less frequently, even though it is a plausible mechanism. The two mechanisms may even be highly intertwined. In this longitudinal cohort study, we investigated the simultaneous contribution of differential exposure and differential susceptibility to being overweight/obese to educational inequality in type 2 diabetes incidence. The study population comprised 53,159 Danish men and women aged 50-64years at baseline who were followed for a mean of 14.7years. We estimated rate differences of type 2 diabetes by education level per 100,000 person-years. Using counterfactual mediation analysis, these rate differences were decomposed into proportions attributable to differential exposure, differential susceptibility and all other pathways, respectively. We compared this approach with conventional approaches to mediation and interaction analysis. Compared with a high level of education, a low education level was associated with 454 (95% CI 398, 510) additional cases of type 2 diabetes, and a medium education level with 316 (CI 268, 363) additional cases. Differential exposure to being overweight/obese accounted for 37% (CI 31%, 45%) of the additional cases among those with a low education level and 29% (CI 24%, 36%) of the additional cases among those with a medium education level. Differential susceptibility accounted for 9% (CI 4%, 14%) and 6% (CI 3%, 10%) of the additional cases among those with a low and medium education level, respectively. Compared with the counterfactual approach, the conventional approaches suggested stronger effects of both mechanisms. Differential exposure and susceptibility to being overweight/obese are both important mechanisms in the association between education and type 2 diabetes incidence.

Knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers at public health centers of East Gojjam\xa0zone, Amhara region, Ethiopia: a facility based cross- sectional study

BackgroundThe study was conducted in public health centers of East Gojjam Zone, Amhara region, Ethiopia. The purpose of this study was to assess knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers in the study setting.MethodsA facility-based cross-sectional study design was conducted from March 1–30, 2018. The study was conducted among three hundred and nine sampled obstetric caregivers. Structured questionnaire was used to collect the data. The data were entered into Epi-data version 4.2 Software for cleaning and exported to SPSS version 23.0 for data analysis. Multivariate logistic regression was carried out for variables with a p-value < 0.25 in bivariate logistic regression to determine significant relationships between the dependent and independent variables. Statistical significance was determined at 95% confidence interval (CI) and p-value below 0.05.ResultThe overall use of labour pain relief methods reported was 34.4%, (30.4% non-pharmacological and 8.4 pharmacological, respectively). More than half of the study participants (54.2%) had adequate knowledge about labour pain relief methods. In multivariate analysis, being a midwifery profession [AOR =2.814, 95% CI = (1.574–5.031)], having positive attitude [AOR = 4.370, 95% CI = (2.523–7.567)], and professionals with a medium level of education [AOR = 3.450, 95% CI = (1.993–5.971)] were factors significantly associated with knowledge of obstetric caregivers about labour pain relief methods. In multivariate analysis, knowledge of obstetric caregivers [AOR = 3.821, 95% CI = (2.091–6.980)], positive attitude of obstetric caregivers [AOR = 2.455, 95% CI = ((1.358–4.436))] and experience of obstetric caregivers [AOR = 2.56, 95% CI = (1.350–4.845) were factors significantly associated with the use of labour pain relief methods.ConclusionIn this study, the overall use of labour pain relief methods by obstetric caregivers was low. Systemic opioid (Pethdine) was reportedly one of the most known pharmacological pain relief methods in this study. Providers’ knowledge, attitude and work experience had shown statistical significance with the use of labour pain relief methods. Task-oriented in- service training is required to fortify obstetric caregivers’ knowledge and attitude towards the use of labour pain relief methods.

Integration and Productivity of Labor Factor in Europe. Perspective from Nationality and the Attainment Level

Productivity in Europe remains stagnant over a long period of time for several reasons: structural barriers hampering proper development and the diffusion of innovations; and also due to high structural unemployment. This puts a significant brake on growth and competitiveness. A high-potential alternative for improving productivity lies in increasing labour participation and the attraction/retention of talent as a result of European integration. Therefore, this study examines how economic growth is affected by labour productivity and the local and foreign workers' employment rates, as well as their level of achievement. Using the Durbin Spatial Model (DSM), we analyse OECD data from 13 European countries covering the period 2000-2017. Our results confirm, first of all, that there has been a positive convergence among European countries and that it is of considerable benefit for the growth of countries with different levels of development. In terms of labour productivity, it positively influences economic growth, especially for highly skilled local workers. Moreover, it is confirmed that increased participation has a statistically significant impact on each country's growth rate in the studied sample. In terms of educational levels, an increase in the number of workers with a high and medium level of education entails a growth that is also transferred to neighbouring countries. Also, these types of strategies serve to create conditions that allow for attracting and retaining talent in the long term, which also generates positive effects on growth itself, but also for neighbouring countries in the same area of integration.

Mortality inequalities in Rome: the role of individual education and neighbourhood real estate market

to investigate the association between real estate prices, education, and mortality. cohort study. residents in Rome at the 2011 Italian Census, not living in institutions, and living in the address reported in the Census survey. People aged 18-99 years were followed from 2011 to 2016 using anonymous record linkage procedures with administrative databases. The Census includes several individual information, such as gender, age, education, residential neighbourhood. Data and cause of death were collected from mortality register. Real estate prices (euros/m2) were available for each neighbourhood. adjusted Cox regression models (hazard ratios - HRs and 95%CIs) were used to estimate the association among individual education, real estate price in the neighbourhood, and mortality. the subjects selected were 2,051,376 (54% women, 22.5% with high education level). During the follow-up, 127,352 subjects died. Taking into account gender, age, marital status, and real estate prices, education level was strongly associated with all-cause mortality; compared to highly educated the higher mortality, risk was 35% (95%CI 32%-37%) for low education level and 16% (95%CI 14%-19%) for medium education level. Taking into account the same factors and education level, each increase of 1,000 euros in price/m2 was inversely associated with mortality (HR 0.96, 95%CI 0.96-0.97). there is an independent association between the two indicators and mortality in Rome. A simple indicator such as real estate prices can be used to tackle inequalities.

The Over-Searching Accidents Causative Factors in Ghana: The Role of Policyholders Education Levels

Available statistics indicates that about 90% of all claims or accident in Ghana is caused by human behavior. Therefore, policyholders’ errors are categorized depending on the severity and extend of casualties caused as a result of misinterpretation of road traffic control devices based on their education levels. Hence, in order to ascertain all the possible causes within the human element to reduce the increasing trend of yearly claims, this study report on the influence of education levels on accident/claims frequency and severity drawing upon a purposive sample of 203 policyholders who have experienced at least one accident in a year using structural equation modeling (SEM). The findings from our regression weights gave enough evidence to reject most of our hypotheses with few ones being supported. This study provides enough evidence that education generally to perspective policyholders influence accidents/claims occurrence. However, in terms of education levels of policyholders, we did not have enough evidence in support of any of these levels either causing or reducing claims/accident frequency. Besides accident/claim frequency, we extended our regression analysis on claim severity and also included some well know auto insurance rating factors to ascertain their impacts on accident frequency. Consequently, it was revealed that most of the severe claims or accidents that results into deaths and serious injuries on yearly basis are caused by policyholders or drivers with medium level of education in Ghana with its frequency driving mostly by rating factors such as the vehicle’s age, cubic capacity, mileage, etc.

Economic crisis and obesity in the Canary Islands: an exploratory study through the relationship between body mass index and educational level

BackgroundThe Canary Islands is one of the Spanish Regions with the highest obesity prevalence, and one of the Autonomous Communities that was hit hard by the economic crisis that arrived to Spain in 2008. This research studies the education-related inequalities in adult obesity in the Canary Islands and their evolution in recent years, considering the possible impact of the economic recession.MethodsA repeated cross-sectional analysis is carried out with data obtained from the Canary Islands Health Surveys of 2004, 2009 and 2015. Obesity is measured through the body mass index (BMI). The analysis is performed using linear regression models for the general population and by gender, adjusting by age, educational attainment and island of residence. Likewise, the models also include dummy variables for each year and the corresponding interactions between the years and the education variable.ResultsThe results show a decrease in the obesity prevalence in 2015 compared to 2009 (from 19.54 to 18.64%). An increase in the BMI of the population and that of women (+ 0.33 and + 0.59 units, respectively) in 2009, as well as a decline in the BMI of women with medium education (− 0.21 units) are also observed. Besides, there is an inverse correlation between education and BMI, and statistically significant differences among some islands.ConclusionsObesity figures in the Canary Islands have decreased and women have been more greatly affected by the changes in BMI during the economic crisis. Due to the fact that educational attainment is a protective factor in general (and for women with medium education levels in times of crisis, in particular), regional authorities should implement actions that promote access to education and healthy lifestyles, paying attention to territorial disparities.

Attractiveness as a motive for tanning: Results of representative nationwide survey in Germany.

In previous research, enhancing attractiveness is reported to be an important aspect of tanning motivation. Our aim was to analyze attractiveness as a reason for tanning in a large representative sample in relation to sociodemographic characteristics, perceived risks of ultraviolet radiation (UVR), and exposure to natural and artificial UVR. We analyzed data from 3000 participants (14-45years) in the German representative National Cancer Aid Monitoring (wave 3). Attractiveness was measured using the General Attractiveness Subscale of the Physical Appearance Reasons for Tanning Scale. Associations were analyzed using chi-square tests and logistic regression analyses. Attractiveness played a larger role for participants aged 18-35, those with an immigrant background, medium educational level, and not in a relationship. Significant associations were also identified with a low risk perception of UVR. For sunbathing, the highest OR (9.96, P<.001) was found for high scores on General Attractiveness Subscale, whereas risk perception of UVR was not related to sunbathing in multivariate analyses. For sunbed use, risk perception also only played a minor role as a preventing factor, while higher associations could be identified for age (OR18-25 years =8.21, P<.001) and attractiveness (OR=3.55, P<.001). Our study showed that people who tan to enhance their attractiveness are more likely to perceive fewer risks of UVR and to show higher UVR exposure behavior and are therefore at greater risk of developing skin cancer. Measures for prevention of UVR-related skin damage should therefore focus more on reducing the positive perception of a tanned appearance instead of only emphasizing the risks of UVR.

Seasonal influenza vaccine uptake and vaccine refusal among pregnant women in France: results from a national survey

ABSTRACT Pregnant women and infants are at high risk for severe influenza and many countries, including France, recommend annual influenza immunization during pregnancy. We aimed to estimate influenza vaccination and refusal rates and assess associated factors among pregnant women during the 2015–16 season in France. We used data from a national representative sample of women who gave birth in March 2016 and were interviewed before hospital discharge (N = 11,752). In the multivariable analysis, robust Poisson regression models were used to study associations with maternal characteristics and prenatal care characteristics. Influenza vaccine coverage among pregnant women was 7.4% (95% confidence interval [CI]: 6.9–7.9). Only 24.9% (95% CI: 24.2–25.7) of women said that they received a care provider proposal for vaccination and 70.4% (95% CI: 68.7–72.0) of these declined it. Vaccine uptake was associated with low parity (prevalence ratio [PR] = 2.1; 95% CI: 1.4–3.2 for parity 0 vs ≥ 3), high educational level (PR = 2.5; 95% CI: 2.0–3.2), healthcare occupation during pregnancy (PR = 1.8; 95% CI: 1.5–2.1) and preexisting conditions at risk for influenza (PR = 1.7; 95% CI: 1.3–2.2). Women were more frequently vaccinated when their main care provider was a general practitioner. Multiparae women and those with medium or low educational level were significantly more likely than others to decline influenza vaccine after a provider proposal. Influenza vaccine coverage is very low in France, mainly because of infrequent care provider proposals and also frequent women’s refusals. Effective interventions should be designed to promote vaccination among medical professionals and reduce vaccine hesitancy among pregnant women.

‘The psychosocial burden of alopecia areata and androgenetica’: a cross‐sectional multicentre study among dermatological out‐patients in 13 European countries

Hair diseases play an important burden on patients' lives, causing significant emotional and psychosocial distress. However, the impairment due to different hair conditions, such as alopecia areata (AA) and androgenetic alopecia (AGA), has rarely been compared. The aim of this study was to assess the psychological burden of subgroups of patients with different hair diseases and to compare them to a healthy population. In this study, we analysed a subgroup of patients with hair diseases from patients of a large multicentre study including 3635 dermatological patients and 1359 controls from 13 European countries. In the subgroup of patients with hair diseases, we analysed the socio-demographic characteristics, the stress level, and the impact of hair diseases on quality of life (QoL), anxiety, and depression and we compared them among patients with AA, AGA and healthy controls. The study population included 115 patients (77% women, 23% men) with hair diseases, 37 of whom with AA and 20 with AGA. Patients with hair diseases had a lower education level than healthy controls (medium educational level: 43% vs. 28%). Overall, 41% of the patients reported stressful life events during the last 6months compared with 31% of the controls. Patients with the same age, sex, depression level and comorbidities had a worse QoL when suffering from AA than from AGA (Mean Dermatology Life Quality Index score: 5.8 vs. 2.5). Patients with hair diseases are more anxious, depressed and have a lower QoL than controls.

Education and T2DM: the role of differential exposure and susceptibility to overweight and obesity

Abstract Background There is a clear educational gradient in type 2 diabetes and differential exposure and susceptibility to overweight and obesity across educational groups may explain part of this gradient. Previous studies have mainly addressed differential exposure to overweight/obesity, even though the pathways are highly intertwined. We take advantage of novel methodological developments to assess the simultaneous contribution of both pathways. We further compare these analyses to more traditional approaches. Methods A prospective cohort of 53,159 Danish men and women, aged 50-64 years at enrollment in 1993-1997, were followed for a mean of 14.7 years. We used national register data to ascertain education and incident type 2 diabetes. Overweight/obesity was determined by BMI. Using a marginal structural approach and a three-way effect decomposition, we estimated rate differences of type 2 diabetes by education and decomposed these into direct, indirect and mediated interactive proportions. We compared this approach to traditional and separate approaches to mediation and interaction analysis. Results Compared with high education, medium education was associated with 316 (95% CI: 268-363) extra cases of type 2 diabetes per 100,000 person-years, and low education with 454 (95% CI: 398-510) extra cases. Differential exposure to overweight/obesity accounted for 29% (95% CI: 24-36) and 37% (95% CI: 31-45) of the cases in the medium and low educational levels, respectively, while differential susceptibility accounted for 6% (95% CI: 3-10) and 9% (95%CI 4-14). Traditional approaches suggested stronger effects of both pathways. Conclusions Differential exposure and susceptibility to overweight/obesity are both important pathways in the education-type 2 diabetes association, and the results emphasize the importance of addressing them simultaneously. Key messages Lower educated groups are more exposed and susceptible to the adverse effects of overweight/obesity with regard to type 2 diabetes, suggesting a large preventive potential. Future studies could benefit from estimating both differential exposure and differential susceptibility to better understand social inequality in type 2 diabetes and other health outcomes.

Sociodemographic factors associated with health literacy in a large sample of mothers of newborn children: cross-sectional findings from the KUNO-Kids birth cohort study.

Health literacy is an important public health goal and of particular relevance when people are starting a family. Health literacy is thought to be crucial for the management of the manifold demands relating to child health which are imposed on parents. The aim of this study was to investigate health literacy in a large sample of mothers of newborn children in Germany. Sociodemographic factors and health literacy (as assessed by the HLS-EU health care scale) were analyzed using data from 2403 mothers of newborns who take part in an ongoing birth cohort study (KUNO-Kids health study). Almost 40% of mothers had a limited health literacy level. Being primiparous was significantly associated with lower health literacy, while having a high level of education compared with a medium level of education was significantly associated with higher health literacy.Conclusion: The finding of a substantial amount of mothers experiencing problems in dealing with and navigating through the healthcare system is important for the design of pediatric health services.What is Known:• New parents are confronted with many recommendations about child health.• Health literacy of parents is considered crucial for child health outcomes.What is New:• Many mothers of newborns have a limited health literacy level.• First-time mothers and mothers with lower education are particularly at risk for low health literacy.

Predictors of E-Cigarette Use Susceptibility-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.

Precarious working conditions and health of metropolitan bus drivers and conductors in Minas Gerais, Brazil.

To investigate the relationship between precarious working conditions and the health of bus drivers and conductors. Data were gathered by means of a survey and interviews conducted in 2012 with 1607 employees of the public transport system of the metropolitan region of Belo Horizonte, Brazil. Nine proxy variables were used to create a precariousness score, ranging from 0 to 9, on a comparative scale: score 0 "less precarious" and 9 "more precarious." Negative self-evaluations of health, medical diagnoses of depression and sleep disorders, common mental disorders, musculoskeletal pain and medical leave were assessed. Poisson regression was used to assess associations between precariousness and health adjusted for age, sex, education, vibration, and noise. The sample was composed of 853 drivers and 754 conductors. Most were men (87%), with age below 40 years (67.4%) and medium educational level (64.5%). The maximum precariousness score observed was 7. Most individuals were in the groups of scores 3 (26.7%) and 4 (26.1%). The prevalences of the health situations were: common mental disorders, 26.3%; medical diagnosis of depression, 9.7%; medical diagnosis of sleep disorder, 14.6%; musculoskeletal pain, 43.0%; medical leave (absenteeism), 34.8%; and negative self-evaluation of health, 20.2%. The prevalences of health conditions, with the exception of negative self-evaluations of health, were significantly higher among workers with higher levels of precarious working conditions. Worse health, particularly common mental disorders, was associated with self-assessed work precariousness.

Formação política via autoeducação no movimento hiphop: experiências de rappers ativistas no Brasil

Este artigo apresenta resultados de pesquisa sobre a formação política de rappers ativistas no Brasil. Rappers são compositores e cantores do gênero musical rap, um dos quatro elementos do hip-hop, movimento artístico-cultural surgido no gueto novaiorquino na década de 1970. Não raramente esses artistas extrapolam as fronteiras da música e se dedicam a atividades assistenciais, culturais e políticas direcionadas às populações de seus bairros e da periferia urbana de modo geral. Considerando que esses sujeitos, em geral, vivem em precárias condições socioeconômicas, têm conturbadas histórias de vida e contam com níveis de escolaridade baixos e medianos, cabe investigar o modo pelo qual se formam politicamente. Sustenta-se, aqui, a existência de uma dinâmica autoeducativa no âmbito do movimento hip-hop. Processo que contribuiria decisivamente para a educação política de rappers, uma vez que estes localizam a) na audição da música rap, b) na composição do seu próprio rap e c) nas vivências no interior do movimento hip-hop momentos-chave da constituição de sua visão de mundo. Produções musicais e atividades político-culturais promoveriam, assim, momentos significativos de reflexão sobre a condição social de negros e pobres no Brasil. Mediante pesquisa etnográfica, foram reunidos materiais oriundos de entrevistas individuais, diálogos informais, letras musicais e observação de atividades e situações que tiveram a participação de rappers ativistas da cidade de Marília-SP. Letras musicais e entrevistas registradas em sites, revistas e documentários também compuseram um conjunto de informações sobre o ativismo e a formação política de rappers de outras cidades e regiões brasileiras.

Determinants of Adherence to the Mediterranean Diet: Findings from a Cross-Sectional Study in Women from Southern Italy.

The Mediterranean diet (MD)—the dietary pattern usually consumed by Mediterranean populations—can help promote a favorable health status and better quality of life. Uncovering the main factors associated with the adherence to MD may be useful in understanding and counteracting the global shift toward a Western diet, which has been documented also in the Mediterranean region. Here, we evaluated the adherence to MD and its major social and behavioral determinants in women from Catania, Southern Italy. This cross-sectional study included 841 women, aged 25–64 years, with no history of severe diseases. Adherence to MD was assessed by the Food Frequency Questionnaire and Mediterranean Diet Score (MDS). Associations between variables were tested by multivariable logistic regression analysis and expressed as an odds ratio (OR) with a 95% confidence interval (CI). Among social factors, medium and high educational levels were associated with an ideal intake of alcohol (OR = 4.059; 95%CI = 1.311–12.570; p = 0.015; OR = 4.258 95%CI = 1.068–16.976; p = 0.040; respectively), living in a couple with ideal intake of cereals (OR = 2.801 95%CI = 1.188–6.602; p = 0.018), and having children with an ideal intake of fruits (OR = 3.149; 95%CI = 1.245–7.762; p = 0.015). With respect to behaviors, current smoking was negatively associated with an ideal intake of meat (OR = 0.449; 95%CI = 0.0220–0.917; p = 0.028), while more engagement in physical activity was associated with an ideal intake of vegetables (OR = 6.148; 95%CI = 1.506–25.104; p = 0.011) and legumes (OR = 5.832; 95%CI = 1.414–24.063; p = 0.015). In line with these findings, moderately or highly physically active women were more likely to show medium or high adherence to MD than those who performed less physical activity (OR = 6.024; 95%CI = 1.192–30.440; p = 0.040; OR = 9.965 95%CI = 1.683–58.993; p = 0.011; respectively). Our results confirm an urgent need for public health strategies, which should take into account determinants of diet quality. Particularly, our study indicates that more engagement in physical activity is a major positive determinant of the adherence to MD.