Middle-income Families Research Articles

Trends and key disparities of obesity among US adolescents: The NHANES from 2007 to 2020.

This study aimed to estimate the trends in the body mass index (BMI) and prevalence of obesity among United States (U.S.) adolescents (10-19 years) and to examine the associations between sociodemographic factors and both BMI and obesity prevalence. The 2007-2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative repeated cross-sectional survey data (n = 9,826) were used. Outcomes included: 1) Mean BMI and 2) obesity (yes/no; defined as BMI ≥95% percentile). Sociodemographic variables included age, sex, race/ethnicity, and poverty income ratio (PIR; low-income <1.3, middle-income ≥1.3 and <3.5, high-income ≥3.5). By accounting for the complex survey design, weighted generalized linear/Poisson models were used to conduct the analyses. Girls constituted 49% of the sample. From 2007-2008 to 2017-2020, there was an increase in BMI and obesity prevalence, particularly among Black and Hispanic adolescents, and those from low- and middle-income families. Additionally, there was an increase in obesity prevalence among both boys and girls. However, there were no significant changes in BMI and obesity prevalence in the other race and ethnic adolescents. Girls had a 12% (Adjusted Prevalence Ratio [APR] = 0.88; 95% CI, 0.81-0.96) lower likelihood of being obese than boys. Compared to White adolescents, Black and Hispanic adolescents had 22% (APR = 1.22; 95% CI, 1.06-1.40) and 19% (APR = 1.19; 95% CI, 1.05-1.36) greater risk of being obese. Compared to high-income families, adolescents from low- and middle-income families had 62% (APR = 1.62; 95% CI, 1.39-1.90) and 47% (APR = 1.47; 95% CI, 1.24-1.76) greater risk of being obese, respectively. The results indicated persistent disparities in obesity prevalence among different race/ethnic and sociodemographic groups. Future obesity intervention should address key disparities by targeting specific race/ethnic adolescents from low-income families and promoting health equality.

Multilevel survival analysis of the age at first birth among women in Ethiopia.

The age at first birth refers to the age at which a woman has her first child. It can significantly influence the demographic behavior of women and the general community. Moreover, teenage childbearing is a serious public health and social problem. The main objective of this study was to identify factors associated with age at first birth among women in Ethiopia. Secondary data on women were obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). These population-based cross-sectional data were downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 8,885 women aged 15-49 years from 305 enumeration areas. A multilevel survival analysis was employed to identify the factors associated with teenage childbearing among women in Ethiopia. The majority (67.7%) of randomly sampled women were subjected to teenage childbearing. Women being rural dwellers [hazard ratio (HR) = 1.27, 95% CI: 1.05, 1.54]; women from middle-income families (HR = 1.43, 95% CI: 1.18, 1.74); and women from higher-income families (HR = 1.40, 95% CI: 1.15, 1.70) were associated with a higher risk of teenage childbearing. Conversely, contraception method users (HR = 0.87, 95% CI: 0.77, 0.99), Muslims (HR = 0.75, 95% CI: 0.64, 0.89), Orthodoxes (HR = 0.68, 95% CI: 0.57, 0.80), women with secondary education (HR = 0.53, 95% CI: 0.43, 0.65), women with higher education (HR = 0.28 (95% CI: 0.22, 0.37), and the higher age of household head (HR = 0.99, 95% CI: 0.98, 0.99) were associated with a lower risk of teenage childbearing among women in Ethiopia. Since the median age of women to have their first child was 18 years old, this study strongly suggests that stakeholders at the federal and regional levels must work closely toward enforcing the legal age of marriage and implementing national adolescents' and youths' targeted sexual and reproductive health programs.

COVID-19 Pandemic and Transformation of Activity Space: Implications for Urban Area Planning in the Yogyakarta Metropolitan Area

Abstract Travel patterns and spatial behavior of people in the Yogyakarta Metropolitan Area during the COVID-19 pandemic have experienced adjustments due to restrictions on out-of-home activities. Spatial behavior has information on the coordinates of the location of the activity visited, and the area that represents this behavior is called activity space. Exploration of activity space may play an essential part in urban area planning. This study utilizes travel activity diary data before and during the pandemic for change analysis with a quantitative approach. Data before the pandemic used the Probability Proportional to Size method and random selection of respondents. While re-measurement during the pandemic, respondents were collected using convenience sampling on 109 individuals willing to re-engage in the survey while still considering population size. The generalization of findings applies to workers and part of middle-income families. A literature review strengthens the empirical findings and explores their implications. The findings indicate that the coverage area for activities has shrunk due to the pandemic, with most activity places falling within a short distance of one’s residence and from one another. The consistency of these findings in the future has implications for providing more flexible, multifunctional, and decentralized spaces equipped with safe and comfortable paths for active transportation modes and integrated with reliable communication technology services.

The Health Effects of Modern Gaming Devices and Phones n the Child's Mind and Intellectual Level

This study included 200 children between the ages of 2-12 years, who use mobile phones for multiple purposes. This study was conducted by distributing questionnaires to parents, and their answers were approved for their children. This study showed that the age group &gt;=5 years had the highest percentage, reaching 60% of children. The study sample was mostly females (girls) at 54%, while the remaining section was males (boys) at 46%. This study showed that children in an urban environment use mobile phones more than children who live in a rural environment, where their percentage reached (66%). The study showed that the educational level of the parents of these children was good, as most of them held a university degree (38.0%, 36. %) for both the mother and the father, respectively. The study showed a significant relationship P = 0.0001 between parents’ occupation and Children used mobile phones and gaming devices, and the percentage was higher if both parents worked (42% and 78%) for the mother and father, respectively. The study showed that most children belong to a middle-income family environment. The study showed that the percentage of children who use modern phones and gaming devices reached (96%), while those who do not use mobile phones (4%). Most of the families had more than two phones at home (58%), and (78%) of the children used the phone throughout the day, and (48%) of them felt happy as a result of using the mobile phone, and (52%) of the study sample used the mobile phone for a period of time. (two years or more). The study showed that 56% of children suffer from lack of concentration and a low level of intelligence. According to the results of the study, 54% of them suffer from problems in their fingers as a result of frequent use of toys, and 70% of children suffer from dry eyes and a constant feeling of sleepiness as a result of radiation emitted from toys and devices. 93% of them suffer from anxiety and depression. The study also showed that (72%) of the children were addicted to the phone and the phone caused them headaches. It is clear from this study that children’s use of the phone causes them many problems, including psychological and physical ones. Therefore, parents must keep their children away from mobile phones as much as possible, and if they have to, allow them to use them. There must be a specific time for using phones, and the harmful effects of phones must be explained to them, whether in the short or long term.

A Narrative Inquiry into the Meaning of Smoking among Farmworkers in Southern Philippines

Cigarette smoking is recognized as a global health threat. By the same token, it remains highly prevalent in low and middle-income families like farmworkers, despite efforts by the government and private health agencies to prevent smoking. Thus, this study explored the meaning of smoking among farmworkers and how the meanings reproduced their tenets while living in a farming community. To the best of the authors’ knowledge, this is the first study that qualitatively investigated the smoking phenomenon among farmworkers in a rural area in Southern Philippines— a topic that has not been treated in much detail in the literature. The research framework used in this work is the socio-cultural tradition (SCT) of communication theory, which theorizes communication as the (re)production of the social order. Using narrative inquiry, the study delved into the seven narratives of farmworker participants about the meaning of smoking. Individual open interviews were conducted among the participants to elicit stories relative to their experience with smoking. The data were analyzed through re-storying and narrative thematic analysis, yielding five themes constituting their meaning of smoking that reproduced a new social order. Results showed that smoking is (1) a parent and peer influence, (2) a means to manage negative feelings and emotions, (3) a thought-provoker and organizer, (4) a culture among friends, and (5) an integral part of life. All these meanings consequently formed and reinforced a new social order, seemingly an indestructible barrier to smoking cessation. Anchored on SCT, it can be surmised that farmworkers’ tenets, while living in their community, were reproduced by these meanings of smoking that governed their lives.

Assesment of Pain Management in Chronic Pancreatitis after Lateral Pancreatico Jejunostomy

Background: The main symptom of chronic pancreatitis is pain, which is treated via lateral pancreaticojejunostomy (LPJ) to relieve symptoms. Patients with dilated pancreatic ducts and excruciating pain are treated with it. Slowing the disease's course and providing optimal pain relief can be accomplished through surgical decompression of the duct and ductal drainage. Objective: The aim of this study is to assessment of pain management in chronic pancreatitis after lateral pancreatico jejunostomy. Methods: The cross-sectional observational study was conducted in the department of Surgery, Avicenna hospital limited, Sirajganj, Bangladesh, from October 2022 to September 2023. A total of 90 patients who underwent lateral pancreatico jejunostomy for patients with chronic pancreatitis were included in the study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, with a range from 20 to 70 years, maximum 36 (40.0%) of the patients were within the age group of 31 - 40 years and minimum 5 (5.6%) of the patients were in the age 61 - 70 years and most of the patients 56 (62.20%) were male and 34 (37.80%) patients were female. Most of the patients 46 (51.1%) came from middle-income families. The majority of respondents had history of smoking 53 (58.90%) and 37 (41.10%) were nonsmoker. The majority of respondents had no history of alcohol intake 66 (73.30%) and 24 (26.70%) were alcoholic. Among total population 58 (64.40%) had diabetes mellitus and 32 (35.6%) did not had diabetes mellitus. Majority of the respondents had upper abdominal pain (100%) followed in decreasing order by nausea/vomiting 68 (75.6%), history of weight loss 61 (67.80%), fatigue 47 (52.2%), fever 37(41.10%), steatorrhoea 35(38.90%), diarrhoea 29(32.20%) and shortness of breath 21(23.30%). Majority of the ..

Socio-Demographic Determinants of Insurance Literacy among University Students in Indonesia

Introduction/Main Objectives: This research aims to investigate the level of insurance literacy among economics and business students and identify the socio-demographic factors impacting the level of insurance literacy. Background Problems: Low insurance literacy has long been identified as the cause behind the weak insurance penetration growth in Indonesia. College students area potential market for the development and deepening of the insurance sector. Novelty: However, hardly any studies have been published that assess the insurance literacy of university students in Indonesia. This study also presents a unique view of students’ insurance knowledge across different universities in Indonesia, providing an understanding of the factors contributing to their literacy level. Research Methods: We conduct the commonly applied ordinary least squares test on the survey data collected using stratified random sampling. Findings/Results: The test results conclude that students from universities in Java, who have mothers who graduated from college, come from middle-income families, and live in Java have significantly higher insurance literacy levels compared to the rest of the students. However, gender and residency do not seem to significantly impact insurance literacy. Conclusion: Our study shows that socio-demographic factors influence university students’ level of insurance literacy. These findings provide valuable information for policymakers and insurance firms to target this potential market with their insurance products.

The effects of heavy screen viewing on the health of secondary school-aged children in Duhok city

Background and objectives: Although there has been a remarkable increase in screen time among children over recent years, the literature includes contradictory reports on its effects of the individuals' health. In this regard, the present study was an attempt to figure out the effects of heavy screen time on the health of secondary school-aged children in Duhok city, Kurdistan-Iraq. Methods: A cross-sectional study was conducted on 850 secondary school students aged 14- 18 years, from September 2022 to September 2023 in Duhok secondary schools. Data about screen viewing were gathered through a questionnaire. then data were analyzed via SPSS (version 25.0). Chi-square were used and 0.05 was set a level of significant. Results: The students aged 14-18 years, with the largest group being 18 years of age (38.4%). Most of the students (59.4%) were females. Grade 12 students were the largest group (57.3%). Most of them (76.2%) were from middle-income families and (65.4%) had healthy body mass index. Significant associations were found between the students' screen time and their age (P-value&lt;0.001), gender (p-value&lt;0.001), parents' education (P-value&lt;0.001), parents' occupation (P-value&lt;0.05), and socioeconomic status (p-value=0.014). Moreover, significant associations were found between their screen time duration and their medical problems (P-value&lt;0.001), previous surgical operation (p-value=0.008), mood during the day (P-value&lt;0.001), relationship with parents (p-value=0.003), sleep difficulties (p-value=0.002), and eating during screen viewing (p-value&lt;0.001). Conclusions: Most adolescence in Duhok city have excessive screen time (more than two hours) in which affects their health and quality of life adversely. Health practitioners and families should consider these factors while designing and implementing adolescent health promoting programs.

Relations between adolescent perceptions of household chaos and externalizing and internalizing behaviors in low- and middle-income families.

A large body of literature has established that chaos in the home environment, characterized by high levels of disorganization, lack of household routine, crowding, noise, and unpredictability, undermines social-emotional and behavioral development in early childhood. It is less clear whether household chaos is linked to elevated risk for behavior problems in adolescence. The aims of this study were 3fold: (1) characterize the variability of adolescent and caregiver reports of household chaos over time; (2) examine associations among caregiver and adolescent reports of chaos over a 9-month period; (3) consider how between- and within- individual variability in household chaos predicts adolescent externalizing and internalizing problems. This study drew data from the Family Income Dynamics study, a 9-month longitudinal study. Participants included 104 adolescents between 14 and 16 years old (55% female; M age = 14.85) and their caregiver (92% female) from low- and middle-income families. Results showed that adolescent-reports of household chaos were more variable over time compared to caregivers' reports. Adolescent-reports of household chaos had positive within- and between-level associations with externalizing problems and between-level associations with internalizing, while caregiver-reports of chaos had no links to behavior. This work highlights the importance of adolescents' own perceptions of household chaos when considering its links to adolescent development.

Chinese mothers' profiles of color-conscious socialization and social dominance orientation: Relations to children's racial attitudes.

This study concerns Chinese mothers' color-conscious socialization and social dominance orientation and how these relate to children's racial attitudes. Data were collected from a sample of 155 Chinese children (71 girls) aged 7-11 years and their mothers, from urban regions across China (Shanghai, Jinan, and cities in Jiangsu Province), including observations of mothers' color-conscious practices, self-reported social dominance orientation, and children's attitudes toward light-skinned Chinese, tan-skinned Chinese, and White groups. All children were born in urban areas and from middle-income families. Variable- and person-centered analyses suggested three areas of color-conscious practices, racial appearance, cultural background, and grouping, and revealed heterogeneity in associations between color consciousness and social dominance orientation. Mothers' acknowledgment of shared culture was associated with children's positive attitudes toward their racial ingroup with darker skin tone. This study emphasizes the importance of a nuanced and contextualized understanding of color-conscious socialization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Targeted transfers, a left-wing policy? The impact of left-wing governments and corporatism on transfers to low-income families (1982–2019)

In the last decades, several countries introduced new income-tested child benefits and targeted in-work tax credits to boost the income of low-income families. Inspired by the power resource theory, I postulate that left-wing governments tend to increase benefits to low-income families because their ideology favours redistribution and to consolidate the vote of low-income families, but that both right- and left-wing governments increase benefits for middle-income families. The impact of left-wing governments should be stronger in countries with a weak bargaining system as social partners are unable to reduce inequalities between families. To demonstrate this argument, I use statistical analyses based on OECD data to measure the effect of government ideology and corporatism on the level of benefits received by low- and middle-income families in OECD countries from 1982 to 2019. The results indicate that left-wing parties have a significant impact on benefits received by low-income families, but not on benefits received by middle-income families. Also, even though corporatism is associated with different types of child benefits, it does not influence the relationship between left-wing governments and benefits received by low-income families.

Predicting students’ performance at higher education institutions using a machine learning approach

PurposeMany studies have examined pre-diploma students' backgrounds and academic performance with results showing that some did not achieve the expected level of competence. This study aims to examine the relationship between students’ demographic characteristics and their academic achievement at the pre-diploma level using machine learning.Design/methodology/approachSecondary data analysis was used in this study, which involved collecting information about 1,052 pre-diploma students enrolled at Universiti Teknologi MARA (UiTM) Pahang Branch between 2017 and 2021. The research procedure was divided into two parts: data collecting and pre-processing, and building the machine learning algorithm, pre-training and testing.FindingsGender, family income, region and achievement in the national secondary school examination (Sijil Pelajaran Malaysia [SPM]) predict academic performance. Female students were 1.2 times more likely to succeed academically. Central region students performed better with a value of 1.26. M40-income students were more likely to excel with an odds ratio of 2.809. Students who excelled in SPM English and Mathematics had a better likelihood of succeeding in higher education.Research limitations/implicationsThis research was limited to pre-diploma students from UiTM Pahang Branch. For better generalizability of the results, future research should include pre-diploma students from other UiTM branches that offer this programme.Practical implicationsThis study is expected to offer insights for policymakers, particularly, the Ministry of Higher Education, in developing a comprehensive policy to improve the tertiary education system by focusing on the fourth Sustainable Development Goal.Social implicationsThese pre-diploma students were found to originate mainly from low- or middle-income families; hence, the programme may help them acquire better jobs and improve their standard of living. Most students enrolling on the pre-diploma performed below excellent at the secondary school level and were therefore given the opportunity to continue studying at a higher level.Originality/valueThis predictive model contributes to guidelines on the minimum requirements for pre-diploma students to gain admission into higher education institutions by ensuring the efficient distribution of resources and equal access to higher education among all communities.

Extent of Students Involvement in Extracurricular Activities and Academic Performance Among Grade 8 Students

This research study explored the extent of extracurricular activities on student’s academic performance. The study aimed to address the students’ involvement in extracurricular activities and academic performance. It was conducted among the Grade 8 High School Students of Zambales National High School. This study utilized a descriptive quantitative research design, a survey questionnaire was used as the main research instrument for obtaining data and analyzing quantitative data gathered from the respondents. Based from the findings, it concludes that the majority of respondents were female students aged 13-14 with a middle-income family income. Sports was the most involved, and students did not participate in debates. The level of involvement in extracurricular activities was slightly involved. The students rated satisfactory academic performance. There was no significant difference in involvement based on profile variables or academic performance. The study recommends that secondary schools should consider extracurricular activities as a way to promote student growth and provide experiences outside the classroom. School counselors should work with students to identify activities that align with their interests and skill levels.

A cross-sectional study on the dietary patterns of multiethnic Malaysian preschoolers and their sociodemographic determinants.

Early childhood is a critical developmental stage where established dietary patterns can impact lifelong health outcomes. This study investigates dietary patterns and their relationships with sociodemographic factors among Malaysian preschoolers. A total of 643 preschoolers of Malay, Indian, Chinese and other ethnicities participating in South East Asian Nutrition Surveys (SEANUTS II) were included. Dietary intake was assessed using a single triple-pass 24-h dietary recall method. Dietary patterns were derived using principal component analysis and their association with sociodemographic factors was determined using complex sampling logistic regressions. Five dietary patterns were identified: "healthy eating," "wholegrains and starchy vegetables," "high salt and sugar," "Western food," and "sugary drinks and legumes". Having older siblings was inversely associated with a "healthy eating" pattern (adjusted OR: 0.54, 95% CI: 0.33-0.87). Malay ethnicity was associated with higher odds of adhering to the "high salt and sugar" pattern (adjusted OR: 4.12, 95% CI: 2.20-7.75). Meanwhile, children living in urban areas (adjusted OR: 1.76, 95% CI: 1.03-3.01), those from middle-income families (adjusted OR: 3.20, 95% CI: 1.38-7.40) and whose fathers were overweight (adjusted OR: 2.79, 95% CI: 1.58-4.94) showed a higher association with "Western food" pattern. Conversely, children whose mothers had overweight were less likely to adhere to the "Western food" pattern (adjusted OR: 0.50, 95% CI: 0.30-0.83). Older age was significantly associated with a greater likelihood of the "sugary drinks and legumes" pattern (adjusted OR: 3.99, 95% CI: 1.75-9.06). There was no significant association between "wholegrains and starchy vegetables" pattern with sociodemographic characteristics (all p > 0.05). These findings suggest that ethnicity, age, residence area, having older siblings, parental weight status and household income level are associated with dietary patterns among multiethnic preschoolers in Malaysia. Thus, these sociodemographic characteristics should be considered when designing targeted dietary strategies and interventions for preschoolers.

Continuity vs. Discontinuity: A Case of Home Language and Literacy Socialization in Indonesia

The present study explores the language and literacy socialization (LLS) of Indonesian children from low- to middle-income families. The Indonesian government has never truly involved home and family as the base for literacy socialization in its programs, affecting the nation-state's low rank in literacy proficiency. This paper aims to describe the LLS of low- to middle-income Indonesian families and examine how the language used by caregivers and parents stimulates the issue of continuity or discontinuity between home and school literacy practices. The study used an ethnographic approach in which the researchers observed the LLS events of 6 families in Surabaya, Indonesia. Conversations between caregivers/parents and children during literacy events were recorded. The findings suggest that every family has different patterns of literacy practices depending on their beliefs and culture at home and that parents' or caregivers' language and style of communication may facilitate or hinder children's access to literacy. Two socialization patterns were identified, including reference to past experience and collaborative negotiation of meaning. It is argued that not only the background of education but also caregivers' literacy culture and educational beliefs play a role in their strategy of language and literacy socialization at home.

The distributional effects of introducing a lottery system in school assignment rule: Evidence from an experiment in Beijing, China

This paper examines the distributional effects of a multi-school districting reform, involving lottery property allocation, on families’ school choice behavior in Beijing, China. Employing a competitive school district housing market model, we investigate the reform's implications on housing prices and school enrollment patterns. Using a unique dataset that combines second-hand housing transaction records and school enrollment data, we document this notable consequence: a substantial 4.57% decrease in housing prices in Haidian District post-reform, resulting in enhanced access to high-quality schools for middle-income families. However, the impact on school choice behavior exhibits structural disparities. While the reform creates opportunities for middle-income families, lower-income families may encounter challenges in accessing public primary schools, where housing prices with improved educational quality have risen by 1.21%. Conversely, affluent families opt for private schools to secure high-quality educational resources, evident in a 4.25% increase in corresponding rent. Additionally, Chinese families prefer proximity to schools to minimize commuting expenses, as reflected in a 0.56% rise in rents near public primary schools. These findings emphasize the importance of addressing both “excessive school choice competition” and the diverse educational preferences of families when implementing school assignment rule reforms in developing countries. Our research expands the literature on primary education and extends concepts for education reform in other developing countries.

The Role of HPV Genotype among Colposcopy Diagnosed Cervical Precancerous Lesions

Background: Cancer is the leading cause of death and a major contributor to reduced life expectancy in every country on Earth [1]. Cervical cancer (CC) is a serious global health concern that is more common in developing countries, especially those on the Indian subcontinent. More and more women are suffering from CC. Cervical cancer is mostly caused by the Human Papillomavirus (HPV), a sexually transmitted virus that is one of the most common illnesses of the reproductive system. Objective: The aim of this study is to evaluate the role of HPV genotype among colposcopy diagnosed cervical precancerous lesions. Methods: The cross-sectional observational study was conducted in the Department of Gynecological Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2021 to June 2022. A total of 132 subjects were included in the study. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.7±6.3 years, with a range from 31 to 60 years, the majority 53 (40.2%) of patients completed SSC and 118 (89.4%) were housewives and 125(94.7%) were Muslims. In this study most of the patients 101 (76.5%) came from middle-income families. About 45 (34.1%) patients were married between the ages of 15-17 years, 45 (34.1%) were between 16-18 years during their first delivery and 56 (42.4%) had 3-4 children. Most of the patients 92(69.7%) had history of received OCP. About 10(7.0%) patients were found HPV 16 positive followed by 1(0.7%) HPV 18, 3(2.1%) other HR-HPV, 3(2.1%) HPV 16 &amp; other HR-HPV and 1(0.7%) HPV 16-HPV 18 &amp; other HR-HPV. Most of the 95 (72.0%) patients had CIN I, 30 (22.7%) had CIN II and 7 (5.3%) had CIN III identification by colposcopy reports. In this study 59 (44.7%) patients had CIN I followed by 13 (9.8%) had CIN II, 9 (6.8%) had CIN III, 5 (3.8%) had CIS and 46 (34.8%) ..

Diagnostic Performance between Colposcopy Findings and Histopathology Reports

Background: Cervical cancer is the most frequent cancer in women worldwide. With appropriate screening, the condition can be prevented and treated. Colposcopy is a useful tool in the diagnosis and management of precancerous cervical lesions following primary screening. The gold standard for identifying precancerous lesions is histopathology. Objective: The aim of this study is to evaluate the diagnostic performance between colposcopy findings and histopathology reports Methods: The cross-sectional observational study was conducted in the Department of Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to June 2023. A total of 62 subjects were included in the study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.8±11.9 years, with a range from 20 to &gt;51 years maximum 44 (71.0%) of the patients were within the age group of 20 - 40 years. The majority 37 (59.7%) of patients completed SSC and most of the patients 56 (90.3%) were housewives. Most of the patients 59 (95.2%) were Muslims and about 32 (51.6%) came from middle-income families. About 25 (40.3%) patients were married between the ages of 15-17 years. About 25 (40.3%) were between 16-18 years during their first delivery and about 26 (41.9%) had 3-4 children and 21 (33.9%) had more than 4 children. Most of the patients 43(69.4%) had history of received OCP. Regarding colposcopic diagnosis, 12.9% (n=8) were normal, 69.4% (n=43) were CIN I, 9.7% (n=6) were CIN II and 8.1% (n=5) were CIN III and 30.6% (n=19) chronic cervicitis, 46.8% (n=29) CIN I, 6.5% (n=4) CIN II, 6.5% (n=4) CIN III, 4.8% (n=3) carcinoma in situ and 4.8% (n=3) were invasive squamous cell carcinoma by the histopathological diagnosis. Conclusion: Colposcopy had a rather high diagnostic accuracy for histopathologically verified precancerous cervical lesions. Even if the results of the screening tests are normal, patients who report with postcoital and postmenopausal bleeding should have colposcopies and biopsies. Colposcopy also has a high sensitivity, therefore it is simple to use the "see and treat" approach to lower dropout rates.

Risk preference and relative poverty: An analysis based on the data of China Family Panel Studies

It is posited that solving the problem of relative poverty (RP) first requires the identification of its cause. We use data from China Family Panel Studies to examine the impact of risk preference on RP of urban and rural families in China and the underlying mechanism. This paper contributes to the existing body of evidence on the determinants of RP. The results show that a high degree of risk preference is conducive to alleviating families' RP. The effect is still significant after dealing with potential endogeneity through instrumental variables. Furthermore, the effect is more obvious among health insurance participation families, endowment insurance participation families, families with low life satisfaction, non-poor families, especially middle-income families, urban families, male-headed families and families in the West in China. Further analysis suggests that risk preference affects RP by promoting entrepreneurship and credit in urban and rural families. Families with a higher risk preference are more likely to engage in entrepreneurship and utilize credit, which in turn helps alleviate their RP. Overall, this paper provides new empirical evidence for understanding the mechanism of risk preference influencing RP.

Differences in Healthcare Utilization in Children with Developmental Disabilities Following Value-Based Care Coordination Policies.

To address healthcare spending growth, coordinate care, and improve primary care utilization, a majority of states in the United States have adopted value-based care coordination programs. The objective of this study was to identify changes in national healthcare utilization for children with developmental disabilities (DDs), a high-cost and high-need population, following the broad adoption of value-based care coordination policies. This retrospective study included 9,109 children with DDs and used data from 2002-2018 Medical Expenditure Panel Survey. We applied an interrupted time series design approach to compare pre- and post-Affordable Care Act (ACA) care coordination policies concerning healthcare utilization outcomes, including outpatient visits, home provider days, emergency department (ED) visits, inpatient discharge, and inpatient nights of stay. We found statistically significant increases in low-cost care post-ACA, including outpatient visits (5% higher, p <.001) and home provider days (11% higher, p <.001). The study findings also showed a statistically significant increase in inpatient nights of stay post-ACA (4% higher, p =.001). There were no changes in the number of ED and inpatient visits. Overall, broad implementation of care coordination programs was associated with increased utilization of low-cost care without increases in the number of high-cost ED and inpatient visits for children with DDs. Our study also found changes in population composition among children with DDs post-ACA, including increases in Hispanic (16.9% post-ACA vs. 13.4% pre-ACA, p =.006) and non-Hispanic multiracial children (9.1% post-ACA vs. 5.5% pre-ACA, p =.001), a decrease in non-Hispanic Whites (60.2% post-ACA vs. 68.6% pre-ACA, p =.001), more public-only insurance (44.3% post-ACA vs. 35.7% pre-ACA, p =.001), fewer children with DDs from middle-income families (27.4% post-ACA vs. 32.8% pre-ACA, p <.001), and more children with DDs from poor families (28.2% post-ACA vs. 25.1% pre-ACA, p =.043). These findings highlight the importance of continued support for broad care coordination programs for U.S. children with DDs and potentially others with complex chronic conditions. Policymakers and healthcare leaders might consider improving care transitions from inpatient to community or home settings by overcoming barriers such as payment models and the lack of home care nurses who can manage complex chronic conditions. Healthcare leaders also need to understand and consider the changing population composition when implementing care coordination-related policies. This study provides data regarding trends in hospital and home care utilization and evidence of the effectiveness of care coordination policies before the COVID-19 interruption. These findings apply to current healthcare management because COVID-19 has incentivized home care, which may have a strong potential to minimize high-cost care for people with complex chronic conditions. More research is warranted to continue monitoring care coordination changes over a longer period.