Poor Social Status Research Articles

Women's empowerment, household dietary diversity, and child anthropometry among vulnerable populations in Odisha, India.

Women's empowerment has been promoted by researchers and development practitioners as one of the most promising strategies to address widespread hunger and malnutrition. However, the relationship between women's empowerment and dietary diversity and child nutrition has rarely been studied among vulnerable populations or individuals at greater risk of poor physical and social health status. Moreover, the effects of different domains of women's empowerment on nutritional outcomes, including dietary diversity and child anthropometry, have rarely been examined, especially with panel data. Using two rounds of panel data from 1900 households and fixed effects regression models, we analyze the effect of women's empowerment on household dietary diversity score (HDDS) and child anthropometry among the particularly vulnerable tribal groups in Odisha, India. We also estimate the effects of various decision-making domains of women's empowerment on HDDS and child anthropometry to understand which empowerment domains matter for nutrition. Results show that women's empowerment is positively associated with HDDS (coef. 0.41 food groups; p < 0.1) and reduces the prevalence of underweight (coef. 39%; p < 0.05) and wasting (coef. 56%; p < 0.1) in children but has no effect on the prevalence of child stunting. Women's empowerment in agricultural input use; output sales; income; food purchases; and credit, group membership, and employment contribute to improved dietary diversity and child nutrition. We conclude that women's empowerment contributes to improved dietary diversity and child nutrition and is a promising strategy to improve farm household diets and child nutrition among vulnerable populations. Strengthening women's empowerment through the promotion of women's access to land and other agricultural inputs, market participation, access to information, capital, and credit is important.

Analysis of factors predisposing to increased number of complications and mortality in patients with Fournier’s gangrene

Introduction and objective: Fournier’s gangrene is an infectious disease affecting the soft tissues of the groin area. The primary cause is bacterial infection of the tissues, which can quickly lead to necrosis and even systemic infection. Analysing the risk factors allows for estimating the potential course and complications of the disease. Materials and methods: An analysis was conducted on a group of 53 patients with Fournier’s gangrene hospitalised between 2010 and 2022 in the Military Institute of Medicine – National Research Institute, to assess the most common risk factors with a view to determining if their occurrence affects the length of hospitalisation, the severity of the disease, inflammatory parameters, kidney function, and mortality. Results: Diabetes, infection with resistant bacteria, and previous urological procedures did not significantly affect any of the examined parameters. Cardiovascular diseases, poor social status, and other cancers significantly increased the severity of the disease determined by the Fournier’s Gangrene Severity Index (FGSI). Cardiovascular diseases significantly worsened kidney function parameters. Cardiovascular and gastrointestinal diseases were the only ones significantly increasing mortality in the studied group. Hospitalisation during the COVID-19 pandemic only led to a significant increase in inflammatory parameters. No correlation was found between the number of risk factors and the length of hospitalisation, while a positive correlation was shown between the risk factors and the FGSI score. Conclusions: Patients diagnosed with Fournier’s gangrene and having cardiovascular or gastrointestinal diseases should undergo closer clinical observation to reduce mortality and the risk of complications. Patients with a higher number of risk factors present a more severe course of infection, as assessed by the FGSI.

DEMOGRAPHIC DISTRIBUTION, ETIOLOGICAL BACTERIAL SPECTRUM AND ANTIBACTERIAL TREATMENT OF PATIENTS WITH ODONTOGENIC ABSCESSES AND PHLEGMONS OF THE HEAD AND NECK

Background: Odontogenic abscesses are the most common pathology in maxillofacial surgery. Their frequency is significantly higher in people with poor social status. Materials and methods: The study retrospectively included 81 patients with odontogenic abscesses and phlegmons of the head and neck, hospitalized and operated on as an emergency case. Incision wound secretion for microbiological examination and preparation of an antibiogram were taken from each of them as a standard routine procedure. Results and discussion: The most affected are young patients (till 44 years), followed by patients in middle age (45-59 years). The reason for this is that with age, teeth gradually fall out of the dentition of mature individuals, and with this, the possibility of the occurrence of odontogenic infections decreases. The lower jaw is more affected. A mixed resident microflora comprising more than one bacterial species is isolated in 62% of all patients. Gram-positive bacteria isolated in the samples of the studied patients were coagulase-negative staphylococci (Staphylococcus coagulase negative, CNS), Staphylococcus aureus, Streptococcus anginosus and Streptococcus viridans. Gram-negative bacteria were Escherichia coli, Enterobacter cloacae and Stenotrophomonas maltophilia. Obligate anaerobes were found in only one sample. The isolated fungi were Candida albicans and Candidanonalbicans. Conclusion: In the studied group of patients with odontogenic abscesses, Gram-positive bacteria In the studied group of patients with odontogenic abscesses, Gram-positive bacteria were 2.5 times more than Gram-negative. Single antibacterial therapy is preferable for patients with small-area odontogenic abscesses, while triple antibacterial therapy is recommended for large-area odontogenic abscesses and their phlegmonous forms.

The effect of psychosocial state in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer’s disease: A cross‐sectional study

AbstractBackgroundSocial support and mental health are important issues in the context of elderly care. Social support is beneficial to both mental health and cognition. The purpose of this study was to investigate the effect of social support and mental health in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI) and Alzheimer´s disease (AD).MethodIn this cross‐sectional, observational study, participants were 219 people between 45 and 93 (mean age = 61.82; SD = 10.13), and divided into three cognitive groups (SCD, MCI, AD). Neuropsychological assessment and psychological questionnaires were used for data collection and analysis.ResultThe SCD group and MCI group scored higher than patients with AD on the Adult Mental Health Scale (AMHS) and the Social Support Rating Scale (SSRS). The results of this study suggest that the degree of cognitive impairment of middle‐aged and old people is affected by age and education level, and is related to the level of social support and mental health status (P&lt;0.05).ConclusionThe level of social support, mental health and cognitive decline are closely related in patients with cognitive impairments. Therefore, it is very important to give early intervention to middle‐aged and old people with poor mental health status and social support status, so as to delay the progression of cognitive impairment.

Factors Responsible for Worse Outcomes in Stemi Patients with Early vs Delayed Treatment Presenting in a Tertiary Care Center

Objectives: The aim of the study is to compare the outcomes among STEMI cases with early treatment vs delayed treatment. To identify the contributing factors behind treatment delays and worse outcomes following STEMI symptoms.&#x0D; Methodology: It was a prospective comparative study on 186 patients with consecutive (non-probability) sampling. Two groups of cases were made as per their time to get admitted to the hospital (i.e. within 2 hours of symptom onset = Group-A; after 2 hours of symptom onset = Group-B). Patients were asked for factors causing a delay in treatment after the onset of symptoms and were monitored for STEMI outcomes.&#x0D; Results: The mean age of all patients was 46.62 ± 9.76 years and there were 140(75.27%) male and 46(24.73%) female, and male to female ratio 3:1.Factors significant for delayed treatment versus non- delayed treatment were poor social economic status (65.6% versus 20.4%), history of chronic stable angina (33.3% versus 11.8%), delayed response in the emergency room (20.4% versus 8.6%), delayed ECG acquisition (26.9% versus 8.6%), delayed ECG interpretation (25.8% versus 4.3%), pain at night 12:00 to 6:00 am (21.5% versus 9.7%) and belief that the chest pain is non-cardiac (26.9% versus 3.2%). Acute heart failure was significantly greater in group B (9.7%) in comparison with group-A (2.2%), Re- infarction was 18.3% in group B in comparison with 7.5% group-A. Similarly sustained ventricular tachycardia and ventricular fibrillation and in hospital mortality were higher in group B (12.9%, 14 % and 12.9% respectively).&#x0D; Conclusion: Our study highlights that while most post-AMI patients receive the recommended minimum statin therapy, the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.

Socioeconomic disparities in diabetes-concordant comorbidity: national health interview survey, 1997–2018

ObjectiveAlthough social disparities in morbidity and mortality are well-documented, little is known how socioeconomic status (SES) shapes diabetes-concordant comorbidity (DCC). This study examines socioeconomic inequalities in DCC among adults with diabetes in the United States. Study designThe study incorporated a cross-sectional nationally representative household health survey. MethodsThis study used data from the National Health Interview Survey, 1997–2018. The analysis included 56,192 adults aged 30 or above with diabetes. Multinomial logistic regression was used to obtain relative risk ratios in gender-stratified models after adjusting for sociodemographic covariates. ResultsThe multivariable-adjusted analyses suggest that across all SES indicators and in both men and women, individuals with lower SES had greater odds of DCC than individuals with higher SES. The associations of SES indicators with DCC were larger in magnitude among women than in men. For example, compared to individuals with a college or higher degree, men with less than a high school degree were 2.06 times (95% confidence interval = 1.76–2.41) and women with less than a high school degree were 3.19 times (95% confidence interval = 2.67–3.82) more likely to have 3 or more DCCs. Similar associations were observed for other indicators of SES. ConclusionStudy findings suggest strong social status and gender-based patterns in DCC. Identifying population groups with poor social status may be useful for informing interventions aiming to improve healthcare services of diabetes-related complications.

Predictors of perceived poor social support status of pregnant women attending antiretroviral therapy clinics in south west Ethiopia, 2021

BackgroundTo improve pregnancy outcomes, a pregnant mother living with HIV/AIDS requires a high level of social and emotional support. However, women from low-income countries were subjected to low social support status despite adequate counseling and health messages to increase their social support. Therefore, this study aimed to investigate the predictors of the perceived poor social support status among pregnant women attending ART clinics in Southwest Ethiopia. MethodsA hospital-based cross-sectional study with consecutive sampling was conducted to enroll 265 pregnant women on antiretroviral therapy (ART) from December 1 to 30, 2021. The data were collected using an interviewer-administered questionnaire. Epidata was used for data entry and analyzed after it was exported to a statistical package for the social sciences. Binary logistic regression was used and the level of significance was declared at P-value <0.05 using Adjusted odds ratio at 95% CI after candidate variables were identified in binary logistic regression at a P-value of <0.25. ResultsFinding from the study figured out that low level of poor social support is found to be 47.2%. Study revealed that income level[AOR = 5.1 95% CI [1.9,13.6]], disclosure status[AOR: 1.9 95% CI [1.1,3.3]], unwanted pregnancy [AOR = 2.3 CI; [ 1.4,3.9]], and low adherence level[AOR: 2.1 95% CI [1.1,3.1]] were strong predictors. ConclusionThis study identified high levels of poor social support. Increasing access to information education and communications focusing on stigma, disclosure & refresher training that boosts the counseling skills of health care providers to enhance adherence level is strongly recommended.

Categorization of the health status and its transition of community-dwelling older adults during the coronavirus disease (COVID-19) epidemic

The purpose of this study was to categorize and clarify transitions in the health status of older adults living in the community during the coronavirus disease (coronavirus disease 2019: COVID-19) pandemic. The participants were older adults (≥65 years of age) who lived in Takasaki City, Gunma Prefecture. The survey items included basic information and subjective health perception (questionnaire for medical checkup of old-old). Latent class analyses were conducted for the first (baseline) and second surveys (6 months). The scores for each item were compared to identify the characteristics of each class at baseline and at 6 months. In addition, transitions in class affiliation from baseline to 6 months were summarized. A total of 434 of 1,953 participants (mean age: 79.1 years, 98 males and 336 females) completed the survey (22.2%). In both time periods, the responses were categorized into four classes: 1) good, 2) poor physical, oral and cognitive function, 3) poor social status and lifestyle, and 4) poor in all except social status and lifestyle. During 6 months of follow-up, a transition from the generally good class to the poor physical, oral and cognitive functions class was observed in many cases. The health status of the older adults living in the community was classified into four classes, and changes in health status occurred even within a short period of time during the COVID-19 pandemic.

Associated Factors for Tooth Loss in the Postpartum Women in Vojvodina

Background: Pregnancy increases the risk of developing oral diseases and can lead to tooth loss. The aim of our study is to determine the influence of demographic factors, social status, attitudes, habits, and behaviors related to diet and oral hygiene, that may result in tooth loss in postpartum women. Methods: This cross-sectional survey was conducted in General Hospitals and Clinics for gynecology and obstetrics in the territory of the Autonomous Province of Vojvodina. Data on attitudes, habits and behaviors related to diet and oral hygiene that may result in tooth loss were obtained by surveying postpartum women on the day of discharge. Univariate and multivariate logistic analysis was used to study the relationship between associated factors and the tooth loss using CR and a 95% confidence interval. Values p &lt;0.05. was considered statistically significant. Results: Our study included 4310 mothers with an average age of 27.31 years. Based on multivariate regression analysis, higher tooth loss was observed in: mothers over the age of 35 (CI=1.029-1.660; p=0.028), with low or no education (CI=1.388 -2.258; p&lt;0.001), living alone (CI=1.126-3.728; p=0.019), who are of poor social status (CI=1.300-2,005; p&lt;0.001), brush teeth for less than 2 minutes (CI=1.006-1.575; p=0.044),visit a dentist for dental treatment (CI=1.367-2.131; p&lt;0.001), and consume cigarettes (CI=1.015-1.685; p=0.038). Conclusions: Our research has shown that sociodemographic factors, habits, attitudes and behaviors of postpartum women regarding oral hygiene and nutrition are directly related to tooth loss and can serve as a platform for adoption of special oral health promotion programs.

Oral health inequalities and disability: Closing the gap.

The social determinants of health impact disproportionately on disabled people creating a cumulative risk of unequal oral health outcomes, compounded by impairment. Problems in early life, education and employment, poor social status and support, social exclusion, poverty and stress characterize the life course of many disabled people. Ableism and exclusion combine to ensure that disabled voices are rarely heard, ignorance and indifference lead to prejudice in policy-making and enforcement and negative media attitudes fuelled by political austerity lead to stigmatization. Yet, the health disparities experienced by disabled people are still perceived as being uniquely caused by a medical condition or impaired body function, excluding disabled people from the inequalities discourse. In parallel, the influence of medical conditions within other marginalized groups are minimized (e.g. mental health), leading to the underestimation of the impact of disability on oral health generally. The common ground between all groups subject to oral health inequalities can be conceptualized using the WHO International Classification of Functioning. Outcomes for all might be improved by emphasizing this common ground; by considering disability as a primary variable, such as gender or age; by identifying disabled people within existing inequalities research; and by explicitly including disabled people in future research.

Factors Contributing to the Prevalence of Adolescent Pregnancy in Pajulu Sub County, Arua District

Introduction and problem: Adolescent pregnancy is a public health concern in both developed and developing countries. Globally, it affects more than 16 million girls and young women .It is estimated that about 11% of births worldwide are to adolescents aged 15-19 years, more than 90% of which occur in low and middle income countries (WHO, 2014). Adolescent pregnancy is a concern in Uganda despite the endless efforts put in place by Ministry of Health and the other health stakeholders to reduce and stop it. This study focused on assessing factors contributing to adolescent pregnancy in Pajulu Sub-county, Arua district. Objectives: To assess the health service related, individual, and social cultural factors contributing to the prevalence of adolescent pregnancy in Pajulu Sub-county, Arua district. Methodology: The study employed a descriptive cross-sectional research design involving both qualitative and quantitative approaches. It was conducted in Pajulu Sub-county, Arua district, West Nile region among adolescent girls, adolescent mothers and pregnant adolescents aged between 12 to 19 years, and some key informants in the community. Results: The prevalence of teenage pregnancy in Pajulu Sub County was found to be 22.7%. Negative attitude of the health workers, lack of adolescent specific S/RH services, contraceptive nonuse, peer pressure, alcohol, cultural norms, family neglect, adolescent’s education level, and adolescent’s poor social status were found to be significantly associated with adolescent pregnancy. Conclusions and recommendations: The relatively high prevalence of adolescent pregnancy and the factors contributing to it pose a task for all stakeholders in the communities and nationwide to work towards addressing the problem. Therefore parents, community members, schools, and health workers are recommended to adopt a culture of discussing sexual and reproductive health issues, advocating for abstinence and where necessary, contraception be made open and accepted without stigma.

Self-care practice and associated factors among hypertensive follow-up patients at East Gojam zone public hospitals, North West Ethiopia, 2021.

Uncontrolled hypertension leads to cardiovascular complications and organ damage. Self-care practice is crucial for the prevention and management of hypertension by improving quality of life, preventing complications and decreasing health care expenditure. The study aimed to assess self-care practice and its associated factors among hypertensive follow up patients at East Gojjam Zone public hospitals; in Northwest Ethiopia. Quantitative cross-sectional study design and qualitative phenomenological approach were applied. The quantitative result was supported by in-depth interview. Out of 480 patients included in the study, 49% have good self-care practices. Out of the total participants 44.6% have poor in antihypertensive medication adherence, 92.5% have low in diet management, 82.8% were poorly practiced physical activity and 62.5% poor practice to weight management. Participants who cannot read and write (AOR = 3.1, 95% CI: 1.6-5.9), and have no comorbidity (AOR = 0.4, 95% CI: 0.2-0.6), uncontrolled blood pressure status (AOR = 2.1, 95% CI: 1.2-3.6), poor social support status (AOR = 2.5, 95% CI: 1.5-4.3) and unfavorable attitude (AOR = 3.1, 95% CI: 1.9-5.2) are the factors for poor self-care practice. During interview; family meal preparation habits, inadequate information about self-care practice during follow-up time, inconvenient working environment, pressure during social events to share food, negligence, and poor self-efficacy were highly described as challenges for practicing and sustaining self- care. The level of hypertension self-care practices was found to be low. Therefore, hypertension self-care practices should be strengthened throughout their follow-up time, and creating awareness in the community is highly encouraged.

Factors Associated with Non-Adherence to Glaucoma Treatment in a Korean Nationwide Survey.

Glaucoma is a main cause of blindness despite the effectiveness of treatments, and adherence to treatment is a critical aspect of glaucoma management. We aimed to identify the factors associated with non-adherence to treatment among Korean glaucoma patients. Data were collected from 4,833 glaucoma patients during the Korea Community Health Survey (KCHS) in 2008 and 2011 regarding current treatment for glaucoma, demographics, comorbidities, perceived health status, and health-related behaviors were subjected to analysis. A multivariable regression model was applied to identify factors related to non-treatment for glaucoma. Approximately, half of the 4,883 patients failed to adhere to treatment. Compared to the treatment group, the non-treatment group had lower social status, fewer comorbid conditions, were more optimistic about their health statuses, and more likely to adopt unhealthy behaviors. Stepwise regression analysis showed that poor social status (low level of education and unmarried), self-perception of a satisfactory health status, and unhealthy behaviors (smoking and no flu-vaccination) were significantly associated with non-adherent to treatment. More attention should be paid to glaucoma patients with low social status or that are overconfident about their health. Future prospective studies that more comprehensively assess treatment compliance, are needed to confirm our findings.

Livelihood Struggle for Sustainability and Dignity in Context of Caste (Case of Musahar Youth in Rural Uttar Pradesh in India)

Musahar youth have been struggling for basic needs and face indignity at multiple facets in the society due to caste. In contemporary times, historicity of caste, stigmatized identity, indignity, poor social values and low participation status make it difficult to avail any kind of social, educational and employment support. Sustainability is a form of survivability, and lack of dignity diminishes wage work, forcing them to migrate. This paper is based on PhD research data and applied qualitative research methods following in-depth interview, oral history, seasonal calendar and so on. Historical marginality of caste persists and frames aspiration, dignity and sustainability.

Economic Violence against Women in Punjab: Dimensions, Determinants and its Implications on Women Social Status in Society

Purpose: Women are almost half the population of the world while their poor social status and limited participation in society is a serious issue of their deprivation specifically in developing countries like Pakistan. This study was attempted to investigate economic violence against women and its influential factors on women's social status in society.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Design/Methodology/Approach: &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; The study used multiple regression analysis for empirical estimation of cross-sectional data of 840 married men from three low socio-economic districts Dera Ghazi Khan, Rajanpur and Muzaffargarh from Punjab province of Pakistan.&#x0D; Findings: Empirical estimates of the study indicated among men above secondary school education, agricultural occupational status, emotional health status, childhood violence experience and witness are significant factors that impact women's economic violence.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Implications/Originality/Value: &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; There is a need for adequate legislation and policy measures for free and easy access to schooling, particularly in rural areas. In reducing gender disparity and violence’s regarding women social media, electronic media and print media can play a significant role by providing productive and positive messages in discussions and programs.

Social Vulnerability Predicts Frailty: Towards a Distinction between Fragility and Frailty?

All definitions of frailty converge in two aspects: the notion of loss or decline and the ability to predict negative health outcomes. Numerous factors were reported to be associated with frailty among which biological, psychological, economic and social factors. Whether the latter contribute at the same level is a relevant question, as social vulnerability does not refer to an ongoing process of decline leading a person to become frail but rather to a relativity stable state making the person fragile. Thus, social vulnerability should increase the risk of frailty. This study aims at assessing whether social vulnerability increases the risk of incident frailty. 1531 participants aged 65 or older from the PAQUID cohort study were included. Cox regression models tested the association between social vulnerability index (SVI, based on 28 social items) and frailty index (FI, based on 25 health-related items) over the 27 years of follow-up. Adjusted for age and sex, higher SVI was associated with increased risk of incident frailty (HR=3.85, 95% CI=1.87-7.94, p<.001). After additional control for IADL disability and comorbidities, higher SVI was associated with increased risk of frailty (HR=3.40, 95% CI=1.63-7.07, p<.05). The association remained significant after controlling for MMSE (HR=2.34, 95% CI=1.08-5.07, p<.05). Poor social status is a risk factor of frailty. From a conceptual point of view, our results claim for a distinction between the concepts of frailty and fragility, the first one being the consequence of an ongoing decline, the other one related to a relatively stable condition of fragility, mainly explained by unfavorable social conditions.

Does the social status of the elderly impact morbidities among them? – A cross sectional Study in a district of Gujarat

Background: The aging population is both medical &amp; sociological problem for the country and they suffer with high rates of morbidity and mortality. So Social factors lay a significant impact on the health practices and this study will help us to understand and evaluate their health problems of elderly. Aims and Objective: 1. To assess the social status of elderly population. 2. To associate the findings with morbidities of elderly Methods: A cross sectional study was carried out in urban and rural area of Surendranagar district among 611 elderly, using a predesigned and pre tested questionnaire by directly questioning the subjects with oral and written consent. For selection of the area, in both areas, the sampling units were enumerated and samples were collected by using simple random sampling, data was entered and analyzed using MS excel 2007. Result: Nearly 60 % of the subjects were currently unemployed and the predominant family system was 3 generation family. Majority of the families in the urban areas were from social class 4, whereas in the rural areas were from social class 5. Having poor social score had a statistically significant association with presence of morbidity in elderly both areas. Conclusions: Majority of elderly in both urban and rural areas had a poor social status. Role of the family and social structure on the health of the elderly can be clearly established. However, support structure must be developed in our social system in a way that the destitute and dependent elderly are taken care of by either government system or social organizations like NGOs and old age home.

From Learning on Mannequins to Practicing on Patients: Nursing Students' First-Time Experience of Clinical Placement in Jordan.

IntroductionAlthough clinical nursing placement is an indispensable component of student nurses' education, data on students' first clinical experiences is scarce in developing countries.ObjectivesThe study aim is to uncover nursing students' first-time clinical placement experience and identify related influencing factors in Jordan.Methods: Focus group discussions (n=4) were used.ResultsThe results showed that the transition from learning with mannequins to practicing on real patients in the clinical placement involved both effective learnings through hands-on practice to dealing with clinical challenges. Students perception of nursing ranged from positive comments such as “humanistic” and “nursing almost medicine” to negative images such as “nursing is all about bedside care” and “nursing has poor social status.”ConclusionStudents' experience in their first clinical placement is multifaceted, and incorporation of student's perspective in the first clinical placement is a crucial component of educational planning.

The Impact of Intersectionality of Multiple Identities on the Digital Health Divide, Quality of Life and Loneliness amongst Older Adults in the UK

Abstract The study measures the digital divide between digital/internet users and non-digital/internet users and the intersectional impact of multiple identities, i.e. gender, race and social status, on older adults in the UK. The analysis interviewed 9,246 adults aged fifty-five plus years in 2012 and 8,484 in 2014 in the English Longitudinal Study on Ageing. The digital health divide was evaluated both by CASP-19 (quality of life, QoL) and UCLA-Loneliness Scale with the intersectional effect of respondents’ multiple identities and digital/internet use. The results suggested a reduction in the digital divide amongst elders in the UK. Generalised estimating equations found that, amongst regular internet users having good social status, white females attained good QoL and little loneliness (CASP-19: β = 2.921, p &amp;lt;0.001; Loneliness: β=–0.631, p &amp;lt;0.001); and white and BME (black and minority ethnic) males both scored low on the loneliness scale (white: β=–0.809, p &amp;lt; 0.001 BME: β= –0.549, p &amp;lt;0.05). BME females with poor social status despite regular internet use got lower QoL and greater loneliness scores (CASP-19: β=–3.107, p &amp;lt;0.05; Loneliness: β=0.935, p &amp;lt;0.001), showing inequalities in their health outcomes. The intersectional perspective of cumulative disadvantages can help social workers better understand how the multiplicative effect of multiple identities socially excludes the vulnerable adults. Implications for research and practice are discussed.

A scoping review of the contributions of farmers\u2019 organizations to smallholder agriculture

Farmers’ organizations (FOs), such as associations, cooperatives, self-help and women’s groups, are common in developing countries and provide services that are widely viewed as contributing to income and productivity for small-scale producers. Here, we conducted a scoping review of the literature on FO services and their impacts on small-scale producers in sub-Saharan Africa and India. Most reviewed studies (57%) reported positive FO impacts on farmer income, but much fewer reported positive impacts on crop yield (19%) and production quality (20%). Environmental benefits, such as resilience-building and improved water quality and quantity were documented in 24% of the studies. Our analysis indicates that having access to markets through information, infrastructure, and logistical support at the centre of FO design could help integrate FOs into policy. Natural resource management should also be more widely incorporated in the services provided by FOs to mitigate risks associated with environmental degradation and climate change. Finally, farmers who are already marginalized because of poor education, land access, social status and market accessibility may require additional support systems to improve their capacities, skills and resources before they are able to benefit from FO membership.