Poor Economic Conditions Research Articles

Knowledge of cancer symptoms and risk factors: A cross-sectional study from a developing country.

The delayed presentation of cancer patients to healthcare facilities for diagnosis is a pressing issue, as late-stage cancer cases are often more challenging to treat effectively. In low-resource settings, such as those with limited access to healthcare facilities, the impact of inadequate awareness of cancer signs and symptoms can be particularly severe. Therefore, this study aimed to evaluate public knowledge of cancer signs and symptoms and risk factors in the context of Jordan. This cross-sectional study was conducted among participants from all settings. Data was obtained from an Arabic version of the cancer awareness measure (CAM), which was answered online. It described demographic data and knowledge of cancer prevalence, age-related risk, signs, symptoms, and risk factors in recall and recognition-type questions. Participants (n = 1998) completed the questionnaire with a Median age of 35 and an interquartile range of 24. About half (n = 1070) thought that cancer is unrelated to age. Most participants identified breast cancer as the most common cancer among women (81%). Awareness of cancer signs/symptoms significantly differed in the level of knowledge in favor of females. The symptom "unexplained weight loss" was most commonly recognized (66.3%) and "persistent difficulty swallowing" the least (42.6%). As for risk factors, "smoking" was the most identified (76.9%) and "eating less than 5 portions of fruits and vegetables a day" was the least (19%), and "doing <30 minutes of moderate physical activity 5 times a week" as a close second least (19.95%). Females identified "smoking," "passive smoking," "HPV infection," and "having a close relative with cancer" as risk factors significantly more than males. Those with good economic status were more aware that smoking is a cancer risk factor by 1.51 times compared to those with poor economic status. To enhance early diagnosis and presentation in Jordan, there is a need for increased public awareness of the signs, symptoms, and risk factors of cancer. One effective strategy to achieve this goal is to conduct targeted public campaigns that cater to different population groups, such as the youth, to improve their understanding and ensure that the message resonates.

The status of intimate partner violence against pregnant women in contemporary China: a scoping review

Purpose: This review explored the status of publications on intimate partner violence (IPV) against pregnant women in contemporary China.Methods: The PubMed, Cochrane Library, Embase, CINAHL, and PsycInfo databases were searched using the terms “IPV,” “pregnant woman,” “Chinese,” and synonyms in English, along with related keywords for Chinese publications. All literature pertaining to IPV during pregnancy, conducted in China, and published between 1987 and September 2023 was included.Results: A total of 37 articles from 30 studies were selected. The prevalence of IPV during pregnancy ranged from 2.5% to 31.3%, with psychological violence being the most common form. Frequently identified risk factors included unintended pregnancy, poor family economic conditions, male partners engaging in health risk behaviors, poor employment status of women or their partners, low education levels among women, physical or mental health issues, strained couple relationships, and in-law conflicts. IPV during pregnancy primarily led to mental health problems for the victims and could result in adverse obstetric outcomes, as well as negative effects on the temperament and development of the offspring. Victims in China demonstrated a low willingness to seek help from professionals. Furthermore, relevant research in mainland China is scarce, with a limited number of studies and non-standardized research methodologies.Conclusion: Future research should investigate IPV in pregnancy from various perspectives, identify factors unique to IPV during pregnancy, and focus on high-risk groups. Considering the conditions in China, there is a pressing need to increase public awareness of IPV and to investigate interventions aimed at addressing this issue.

Subsistence and Survival: Strategies Women in the Republic of Barbados Engaged in Transactional Sex Work Employ to Stay Safe

ABSTRACT Women engaged in sex work (WESW) are at increased risk for exposure to work setting violence. This phenomenological study examines the experience of work setting violence and strategies utilized to maintain safety for WESW in Republic of Barbados in the Caribbean. In-depth, semi-structured interviews were conducted with 30 cis-gender WESW in Barbados. This study found participants experienced work-related violence that includes physical assault, rape, robbery, kidnapping, and attempted murder. Participants were actively engaged in strategies for maintaining safety that were central to their business practices. Moreover, local HIV prevention intervention efforts including condom assertiveness training, free condom distribution, and rapid, accessible STI testing further enabled participants to assert and enforce safe business practices. Unfortunately, poor economic conditions at the time of the study, which reduced the market of available customers who were willing to pay full price while increasing the number of WESW, diminished the participants’ power to insist on safe business practices. This has implications for interventions to prevent and counteract gender-based violence, as well as gender-based social and economic development efforts.

Where have all the flowers gone? The Impact of COVID-19 on UK Households’ Economic Well-Being

The United Kingdom introduced a national lockdown in March 2020, as a means to curb the rising pace of COVID-19 infections in the country. Since then, the various restrictions imposed on citizens have produced enormous social and economic consequences. However, full awareness of the mid-term and long-term impacts of such restrictive measures is still lacking. In this paper, by making use of longitudinal data from the Understanding Society COVID-19 study, consisting of nine survey waves administered to a representative sample of UK citizens from April 2020 to September 2021, we analyze the potential determinants of lack of employment and poor economic conditions, considering individuals’ length of stay in an economic hardship context and the differential effects related to their socio-demographic characteristics.

The Attitude of Healthcare Providers and the General Population on the Concept of Do-Not-Resuscitate (DNR) Order in End-Stage Patients

Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.

Evaluation of absenteeism and presenteeism status of factory employees

BACKGROUND: While absenteeism refers to not attending work, presenteeism is defined as not being present at work. These two conditions, which negatively affect employee health, can be indicators of work efficiency, work peace, work safety and work engagement. OBJECTIVE: Several factors were evaluated in this study concerning absenteeism and presenteeism among factory workers. METHODS: This cross-sectional study was conducted among workers in a factory operating in a heavy industry in southern Turkey in 2021. A survey consisting of 57 questions was applied to 152 factory workers by face-to-face interview method. The participants’ behaviour over the last month was evaluated regarding absenteeism and presenteeism. RESULTS: It was reported that 24 (15.8%) of all employees were absent from work in the last month (absenteeism), excluding holidays and sick leave, and that 20 (13.2%) employees engaged in presenteeism, working when they should not have been at the workplace. There was a high absenteeism rate among employees who had an acute illness and were dissatisfied with their jobs. Several factors have been associated with presenteeism, including poor economic conditions, family health problems, previous unemployment, working overtime, job dissatisfaction, poor relationships with colleagues and difficulty finding a replacement, acute illness, sleep problems and fatigue. CONCLUSIONS: To increase the productivity and commitment of employees, it may be useful to identify the reasons for absenteeism and present behaviours, to facilitate effective interpersonal communication skills by examining the organisational climate of employees, and to regulate workload based on a comprehensive assessment of the health status of employees.

Decision-making model of elderly service companies under government subsidies

This study considers two government subsidy policies, namely, supply-side (subsidising elderly service companies) and demand-side (subsidising elderly customers) subsidies. A Nash game model consisting of elderly customers and two elderly service providers with different levels of infrastructure is developed to present the effects of government subsidies on the price, quality and quantity of demand for elderly services under different subsidy policies. The results show that the economic situation of the region and the strategic objectives of the local government are important factors influencing the effectiveness of the government’s subsidy strategy. For areas with good regional economic conditions, subsidies should be biased in favour of elderly care institutions with poorer infrastructure; for areas with poorer economic conditions, subsidies should be biased in favour of institutions with better infrastructure. Moreover, if the government plans to reduce prices more effectively, then it should adopt a demand-side subsidy policy for areas with a small or large elderly population and a supply-side subsidy policy for areas with a medium elderly population.

Hunger Games

Undernutrition among children has always been a major concern in the Philippines. According to the Philippine 2018- 2019 Expanded National Nutrition Survey (ENNS) reported in 2022, the prevalence of underweight among children less than five years old was 18.8% among males and 19.3% among females. It was higher in the rural areas and highest among the poorest wealth quintiles.1 In terms of magnitude and severity, the prevalence was considered as a medium public health problem.&#x0D; In line with this, we note an article published in this issue of our journal that looked at the factors affecting survivalof children with severe acute malnutrition (SAM). 2 They report that children with SAM have a mortality risk 11.6 times higher than well-nourished children. They also found that the educational attainment of parents, malignancy, and hypovolemic shock were significant predictors of mortality.&#x0D; Other studies have likewise mentioned the negative effects of undernutrition among children.3 They also mentioned increased risk for mortality and morbidity, substantial cognitive deficits in school-age children, grade repetition, and a reduced likelihood of employment in formal sectors in adulthood that may result in lower earning potential. Among school children in the Philippines, less diverse diet, food insecurity, residing in urban areas, being older and male, being part of a larger household, and having parents engaged in fishing or farming can be additional determinants. 4,5 Malnutrition among children, including overweight, is also a significant contributor to other diseases that affects them.6&#x0D; In their article, Pabustan-Calleja et al. reported that among the various demographic factors, only the paternal and maternal educational attainment were significantly associated with mortality. Low paternal educational attainment was significantly associated with mortality 21 times compared to high paternal educational attainment while low maternal educational attainment was significantly associated with mortality 51 times as compared to those with high maternal educational attainment.2 These highlight the potential of improving survival outcomes in SAM by improving education.&#x0D; The relationship between education (or lack thereof ) and undernutrition is a reciprocal one. Lack of education can lead to undernutrition directly due to poor food choices among those who may not know better. Indirectly, lack of education can lead to lower socio-economic status (SES) contributing to food insecurity and eventually undernutrition. 7 That our educational system leaves much to be desired is indicated by the latest reports. The Philippines has just recently been ranked 77th out of 81 countries in the student assessment conducted by the Organization for Economic Cooperation and Development (OECD) for 15-year-old learners. 8 The relationship between SES and academic performance, however, appear to be a more complex one. For example, in the Programme for International Student Assessment (PISA), students from the Philippines performed significantly lower as compared to students from Turkey and Vietnam belonging to similar socio-economic background.9&#x0D; Conversely, undernutrition can lead to inferior cognitive performance, lower academic achievements, lower employment status and in the longer term, also lead to lower SES.10,11 Poor economic status has certainly plagued our country as well for the longest time. According to the latest data, the Philippines is ranked 99 th globally in 2023 in terms of GDP per capita (PPP) and 59 th in terms of the Gini coefficient (a measure of economic inequality with higher being better).12&#x0D; Addressing undernutrition among children is an urgent public health crisis. Although mortality due to SAM is obviously important, other consequences such as cognitive impairment and subsequent poor SES need to be recognized as these lead to the unending undernutrition. Improving education in our country in all its aspects, and not just on proper nutrition, can just turn out to be the way to sustain a win in the “hunger games”.

High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis

BackgroundGlobally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children.ObjectiveTo estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia.MethodsA cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12–35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant.ResultsThe overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15–24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5].ConclusionIn the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents’ needs.

Exploring the triggers of premature and early menopause in India: a comprehensive analysis based on National Family Health Survey, 2019–2021

Due to ovarian insufficiency, some women attain menopause at an early age due to lifestyle factors and hormonal imbalances. Menopause occurring before the age of 40 is premature and between 40 and 44 years age is early, since the natural age of menopause lies between 45 and 50. The study estimated the prevalence of both premature and early menopause, and examined the potential associated factors that could trigger its occurrence in India. The National Family Health Survey, conducted during 2019–2021, was used to fulfil the study objective. The study sample was divided into two parts, with age group 15–39 and 40–44 for estimating premature and early menopause, respectively. Cox-proportional hazard model was used for the multivariate analysis. The estimated prevalence of premature menopause is 2.2% and early menopause is 16.2%. Lower educational level, poor economic condition, smoking, fried food consumption, early age at menarche are some of the significant explanatory factors. In India, both the proportion and the absolute number of post-menopausal women are growing, therefore it is critical to revamp public reproductive healthcare facilities to include menopausal health segment in women's health as well. Future detailed micro-studies would help in better understanding of the premature or early menopausal cases.

Parental Recognition of Double Reduction Policy，Family Economic Status And Educational Anxiety: Exploring the Mediating Influence of Educational Technology Substitutive Resource

China's double reduction policy, aiming to curb excessive extracurricular tutoring, sparks debate and concerns among parents about its impact on the next generation's academics and competitiveness. Some forward-thinking parents seek alternatives like one-on-one tutoring or paid online learning, yet financial constraints intensify anxiety, especially for economically disadvantaged families. A study involving 200 parents examines their views on policy implementation, family economic status, and the role of alternative resources in educational anxiety. Findings highlight that the stronger the implementation of the double reduction policy in a region, the higher the parental education anxiety becomes. Parents with poorer economic conditions are more hesitant than those with better economic status when it comes to choosing to use paid alternative educational resources. The government and society should explore measures to ensure equitable access to education and alleviate anxiety. Additionally, establishing a dynamic tracking and feedback system for the double reduction policy is essential, actively seeking input from parents to better serve their needs and align educational policies with national education goals.

Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation.

Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.

Reconsidering Treaty 8 Negotiations: The Canadian Government’s Purposeful Exploitation of a Disadvantaged Population

Treaty 8 was signed on June 21, 1899, between the Government of Canada and Indigenous Peoples living in the northern Alberta, northeastern British Columbia, southwestern Northwest Territories, and northwestern Saskatchewan region. Calls for the treaty began in the 1870s, but negotiations only began one day before the treaty was signed, raising questions about the fairness and professionalism of the negotiation process.1 Issues involving the mistreatment of Indigenous Peoples, both historically and contemporarily, have been on the front pages of media increasingly since the discovery of unmarked graves at a Kamloops formerresidential school in 2021. Each case of the Canadian government’s mistreatment of Indigenous Peoples, or enabling of it, is different and needs to be examined individually with consideration of the different sources relevant to each event or case. This research sought to uncover if injustice or mistreatment of Indigenous groups occurred during the Treaty 8 negotiations, and if so, how. The research reveals that the government took advantage of the poor economic conditions affecting Indigenous Peoples in Northern Alberta and created Treaty 8 to unfairly benefit itself on the premise that Indigenous Peoples are less worthy of respect from the government. Negotiations were unfair and Indigenous Peoples were mocked and exploited, calling into question the ethics of Treaty 8 and the need to not only reconcile, but to completely re-examine Treaty 8 and other historical treaties and laws concerning Indigenous groups.

The relation between economic stressors and higher education students' mental health during the initial outbreak of the COVID-19 pandemic.

The COVID-19 pandemic has had a large impact on the financial situation of higher education students, disproportionately affecting students with a low socioeconomic status (SES). This raises the question of whether economic stressors related to COVID-19 have aggravated existing socioeconomic inequalities in mental health. This study examined the relationship between economic stressors and students' depressive symptoms, and the role of students' SES and countries' socioeconomic conditions. Data from the COVID-19 International Student Well-being Study was used for multilevel analyses, with depressive symptoms as dependent variable. Three indicators measured SES: educational level of the parents, ability to borrow money from their social network, and struggling with financial resources prior to COVID-19. Students with a low SES had more depressive symptoms, and those not able to borrow money and with parents without higher education were more exposed to a deterioration in their financial situation. Both economic stressors (reduction in working hours and a deterioration of their financial situation) were positively related to depressive symptoms. In addition, the positive relationship between a decrease in working hours and depressive symptoms was stronger in countries with a higher unemployment rate. We observed socioeconomic inequalities in students' mental health, which, in part, can be ascribed to a larger exposure to the economic stressors related to COVID-19 among students' with a low SES. The macroeconomic context also played a role, as the impact of a reduction in working hours on depressive symptoms was stronger in countries with poor economic conditions.

Evaluating Spectrum of Epithelial Cell Abnormalities in Cervical Cytology Smears with a Focus on Atypical Squamous Cells of Undetermined Significance (ASCUS): A Study in Eastern India

Background: Cervical cancer being one of the major causes of death in women living in developing countries likeIndia, this study evaluates the spectrum of epithelial cell abnormality while primarily focusing on the prevalenceof ASCUS and their correlation with predisposing factors.Materials and Methods: Descriptive type of study was conducted over 456 patients. Patients underwent perspeculum examination followed by cervical smear examination. Cervical lesions were categorized according toRevised Bethesda system, 2014.HPV detection &amp; sequencing was done as required.Results and conclusion: ASCUS was most prevalent in the sexually active age group (7.01%). The incidence ofintraepithelial lesions among multiparous women was high (50.8%). Early coital age, smoking, poor economicconditions, multiple sexual partners, contraceptive usage and HPV infection were associated with higher chancesof squamous cell abnormality.Cervicitis, cervical erosion, and hypertrophic cervix need careful investigation for the presence of ASCUS due toits high prevalence in sexually active females in Eastern India. Henceforth, addressing these factors and spreadingawareness about early diagnosis, necessary treatment, HPV vaccination along with the maintenance of propersexual and menstrual hygiene becomes a cornerstone in the reduction of the overall burden of atypical cervicalcytology and finally, cervical cancer.

Evaluación del estado de salud bucal, necesidades autopercibidas, necesidades insatisfechas y barreras para la utilización de servicios dentales entre la población de edad avanzada institucionalizada en Chennai, India: Un estudio transversal

Aim: The aim of the study was to assess the oral health status and identify oral health perceived and unmet needs, and barriers in utilization of dental services among institutionalized elderly population in Chennai. Materials and Methods: Across sectional study was conducted among institutionalized an elderly population aged 65-74 years. Oral health status was assessed using the WHO Oral Health Assessment Form (2013). Self-perceived oral health needs and barriers in the utilization of dental services were assessed using a pre-tested questionnaire. Descriptive statistics and Pearson Chi Square Test was done to analyse the data. Results: There was a high frequency of periodontitis among the study participants. The unmet oral health needs were high. The self-perceived oral health condition was good among the study participants. The major barrier for utilization of dental services was the lack of information on oral health. Conclusions: In India, which is a developing country, a low level of dental care results from low-level financing of the Indian health care system. This, however, does not mean that even in the current poor economic conditions, it is impossible to improve the dental awareness of the residents of care homes. The improvement is also possible through the inclusion of dental check-ups into the schedule of general dental examinations of the residents performed once in 6 months. Keywords: Oral health; Needs assessment; Barriers to access of health services; Aged; Health of institutionalized elderly; Dental care for aged

Socio-Economic Factors and Subjective Well-Being Among Women of Reproductive Age: A Secondary Analysis of Punjab

Subjective Well-Being (SWB) of women in Punjab, Pakistan is remained an unattended topic of research since the independence. SWB is a multidimensional phenomenon and based upon numerous socioeconomic factors. These factors differ grounded on geographical split-ups, culture and societal traditions. In countries like Pakistan, evaluation of SWB of women involves many complexities. In this study, the first ever data collected on this subject via Multiple Indicator Cluster Survey (MICS) -2014 is utilized for statistical modeling of SWB of women for age bracket 15-24 years. The Multiple Regression Modeling technique is used in which SWB of women is taken as response variable along with relevant socioeconomic factors such as age, marital status, economic status, employment, and access to mass media etc. as predictors. The finalized model suggests a positive relationship of SWB of women with age, use of internet, watching T.V. and negative with a number of household members and employment status. While, women belonging to poor economic status are more satisfied than that of moderate and rich class. In region wise comparison, women living in southern Punjab have better SWB as compare to northern and central region of the Punjab.

Depression, anxiety, stress and other mental health conditions of personnel undergoing hospital isolation during the COVID-19 pandemic and influencing factors.

To understand the depression, anxiety, stress and other mental health conditions of personnel undergoing hospital isolation during the COVID-19 pandemic and the influencing factors. This was retrospective study. A total of 120 personnel undergoing Baoding No.1 Hospital isolation who completed the questionnaires were included from June 10, 2021 to February 07, 2022. The Patient Health Questionnaire-9(PHQ-9), the Generalized Anxiety Scale (GAD7) and psychological stress measurement table (PSTR) were used for psychological problem screening for personnel undergoing hospital isolation. The incidence of depression was the lowest, while that of stress was the highest. The difference in the incidence of depression, anxiety and stress among personnel undergoing hospital isolation with different gender, age, income statuses, marital statuses and attitude towards isolation was statistically significant (p< 0.05), while the difference in the incidence of these problems among personnel with different degree of education was not statistically significant(p> 0.05). Multivariate Logistic regression analysis showed that age, gender, marital status, economic status and attitude towards isolation are factors associated with stress. Economic status and attitude towards isolation are factors associated with depression. A high economic level is a protective factor against depression, while a negative attitude is a risk factor for depression. During the COVID-19 pandemic, anxiety, depression and stress increased to different extents in personnel undergoing hospital isolation, especially in females with poor economic conditions and poor attitudes towards isolation. Therefore, necessary psychological counseling and social support should be provided to these people.

Home, unsweet home – effect of homeownership on financial investments of Indian households

PurposeThe study analyzes the relationship between homeownership and financial investment of households in the context of emerging markets like India. It also examines how homeownership affects the portfolio decisions of Indian households.Design/methodology/approachUsing the nationally representative All-India Debt and Investment Survey of 2019 and employing an instrumental variable approach, the authors analyze the relationship between homeownership and the share of financial assets held by Indian households. The study also employs several sensitivity checks, including alternate estimation techniques and alternative definitions of the housing variables, and accounts for additional factors to ensure that the authors are able to capture the effect of homeownership on the outcome variable.FindingsThe analysis suggests homeownership crowds out financial investment in India due to high repair and maintenance costs. The negative effect is mainly observed in urban households. Further, the findings imply that homeownership leads households to reallocate their asset portfolio. Homeowners have a lower share in liquid short term deposits, indicating the high liquidity risk of their portfolios. On the other hand, homeownership increases the share of long term retirement funds along with no effect on risky asset share. The authors observe that the crowding out effect is more striking for younger households and poorer households with low income, and the effect is lower for indebted households.Practical implicationsThe findings underscore the need for financial awareness programs so that housing does not crowd out liquid investments of households. Additionally, the results highlight that policies should first focus on young and poor households as the negative effect is more prominent for these groups. Finally, there is scope for policies to support repair and maintenance costs incurred by vulnerable households to reduce the negative effect of housing on liquid financial investments.Originality/valueThis paper is among the few studies that provide insights into how homeownership relates to financial investment and portfolio decisions in the context of an emerging economy. Furthermore, the heterogeneous effects based on poor economic status and age underscore the need for complementary policies.

Prevalence of Subjective Unmet Mental Healthcare Needs, Barriers, and Socioeconomic Inequality among Adult Individuals with Physical, Visual, Hearing, and Speech Disabilities in West of Iran

People with disabilities are susceptible to mental disorders, so it is very important to check and monitor their access to mental health services. There has been no study in this regard in Iran. This study aimed to measure the prevalence and socioeconomic inequality of subjective unmet needs for mental healthcare services (SUNMH) among individuals with disabilities and the various reasons behind them in the west of Iran. This descriptive-analytical and cross-sectional study was conducted on 613 people with disabilities over 18 years of age in Sanandaj city in 2023. Simple random sampling was used, and a questionnaire was applied to collect the data. The multivariate logistic regression was used to determine significant predictors of SUNMH. The concentration index (C) and concentration curve (CC) were calculated to measure inequality in the prevalence of SUNMH. Data were analyzed using STATA software version 16.0 (Stata Corp, College Station, TX, USA. About 47% of people had experienced SUNMH. Lack of financial ability with 45%, insufficient payment of basic health insurance for mental health services with 27%, and noncoverage of mental health services by basic health insurance with 25% were the three main reasons for SUNMH. According to the logistic regression model, unemployment (OR: 2.70, 95% CI: 1.31–5.53), not having supplementary insurance (OR: 2.03, 95% CI: 1.11–4.74), having another member with a disability in the household (OR: 3.33, 95% CI: 1.34–8.29), and poor economic status increased the odds of experiencing unmet need for mental health services by about 3, 2, 3, and 21 times, respectively (OR: 21.11, 95% CI: 13.72–48.11). The concentration index was −0.496, indicating a greater concentration of SUNMH in people with low socioeconomic status. Access to health services is not suitable among people with disabilities and a significant percentage of them suffer from SUNMH. Policy recommendations are proposed to address the primary obstacle of financial barriers to SUNMH and increase access to the necessary services, which include increasing the allocation of financial resources to specialized mental health services for individuals with disabilities and expanding disability-specific health insurance coverage with government financial support.