Unfavorable Socioeconomic Status Research Articles

Tobacco smoking and tooth loss in adults and elderly in Brazil: a populational-based cross-sectional study.

To determine the association between smoking and tooth loss in individuals aged 18 years or more living in Brazil. Secondary analysis of the 2019 Brazilian National Health Survey data. The outcome was self-reported tooth loss, and the main independent variable was tobacco smoking. Family income, schooling, sex and age were covariates. Multiple linear regression analysis determined the association between tobacco smoking and the number of missing teeth and then the average number of missing teeth was predicted according to smoking status. The mean number of missing teeth in 88,531 individuals aged 18 or more was 7.7 (95%CI: 7.6-7.8). At least one missing tooth was identified in 72.0% (95%CI: 71.4-72.6) of the population, 21.3% (95%CI: 20.9-21.7) had a non-functional dentition, 14.2% (95%CI: 13.9-14.6) had severe tooth loss and 10.3% (95%CI: 10.0-10.6) were edentulous. The adjusted regression coefficients for number of missing teeth showed that current or former smokers, individuals with low family income and schooling, older age and females exhibited higher tooth loss. Current and former smokers had 1.40 (95%CI: 1.35-1.46) and 1.13 (95%CI: 0.54-0.98) times more lost teeth than never smokers, respectively. Both tooth loss and smoking are common in Brazilians and are associated. Unfavorable socioeconomic status and demographic factors also predict tooth loss.

Socioeconomic factors and long-term mortality risk after surgical aortic valve replacement

BackgroundThere is scarce knowledge about the association between socioeconomic status and mortality in patients undergoing surgical aortic valve replacement. This study explores the associations between income, education and marital status, and long-term mortality risk. MethodsIn this national registry-based observational cohort study we included all 14,537 patients aged >18 years who underwent isolated surgical aortic valve replacement for aortic stenosis in Sweden 1997–2020. Socioeconomic status and comorbidities were collected from three mandatory national registries. Cox regression models adjusted for patient characteristics and comorbidities were used to estimate the mortality risk. ResultsMortality risk was higher for patients in the lowest versus the highest income quintile (adjusted hazard ratio [aHR] 1.36, 95 % confidence interval [CI]: 1.11–1.65), for patients with <10 years education versus >12 years (aHR 1.20, 95 % CI:1.08–1.33), and for patients who were not married/cohabiting versus those who were (aHR 1.24, 95 % CI:1.04–1.48). Patients with the most unfavorable socioeconomic status (lowest income, shortest education, never married/cohabiting) had an adjusted median survival of 2.9 years less than patients with the most favorable socioeconomic status (14.6 years, 95 % CI: 13.2–17.4 years vs. 11.7 years, 95 % CI: 9.8–14.4). ConclusionsLow socioeconomic status in patients undergoing surgical aortic valve replacement is associated with shorter survival and an increased long-term adjusted mortality risk. These results emphasize the importance of identifying surgical aortic valve replacement patients with unfavorable socioeconomic situation and ensure sufficient post-discharge surveillance.

Abstract 15536: Impact of Social Determinants of Health on Atherosclerotic Cardiovascular Diseases Incidence

INTRODUCTION: Individuals with an unfavorable socioeconomic status have a higher risk of developing chronic diseases such as atherosclerotic cardiovascular disease (ASCVD). However, the shared contribution of socioeconomic status, psychosocial factors and living environment on ASCVD risk remains unknown. We investigated the contribution of these social determinants of health on the incidence of ASCVD. METHODS: We developed a polysocial risk score (PsRS) using latent class analysis based on socioeconomic factors (household income, level/quality of education and employment status), psychosocial factors (living alone, social support, social activities, social isolation, emotional distress, and diagnosis of psychiatric disorders), and living environment (social deprivation score, crime rate, housing quality, housing stability, proximity to green/blue spaces and proximity to nature). The study sample included 319 842 participants of the UK Biobank, free of ASCVD recruited between 2006 and 2010. As of August 2021, 23 840 of them had incident ASCVD (fatal or nonfatal myocardial infarction, ischemic stroke, or cardiac revascularization procedures). Participants were divided into three groups based on latent class analysis adjusted for age. The impact of the PsRS on incident ASCVD was assessed using Cox proportional hazards for all participants, women and men adjusted for age, sex, and ethnicity. RESULTS: Compared to participants with a low PsRS, those with an intermediate score had a slightly higher risk of ASCVD (hazard ratio [HR]=1.05 [95% CI, 1.01-1.09], p=0.024) while those with a high PsRS had a higher risk of ASCVD (HR=1.46 [95% CI, 1.40-1.52], p&lt;0.001). The effect of the PsRS on ASCVD incidence appeared to be more pronounced in women (HR=1,59 [95% CI, 1.48-1.71], p&lt;0.001 and HR=1.39 [95% IC, 1.32-1.46], p&lt;0.001, respectively, for women and men with a high PsRS compared to individuals with a low PsRS within the same sex). CONCLUSION: A PsRS based on the living environment as well as socioeconomic and psychosocial factors was associated with incident ASCVD in participants of the UK Biobank. Multifactor approaches targeting both social determinants of health and traditional risk factors could reduce the burden of ASCVD in the general population.

Religiosity as a Factor Supporting Parenting and Its Perceived Effectiveness in Hungarian School Children’s Families

The impact of a family’s socio-economic status on parenting activities has been a thoroughly researched topic. Parental involvement, which refers to parenting that supports school achievement, may be home-based and school-based, as typified by Epstein and Sanders. Earlier findings suggest that a more favorable socioeconomic status results in more active and effective parental involvement. Only a few studies show low-status parents can be more effective, whereby some factor compensates for the negative impact of low status. Our hypothesis is that parents’ self-identified religiosity can reduce the disadvantages arising from the family’s unfavorable socio-economic status. We use data from a survey conducted in 2020 among the parents of fourth-grade Hungarian primary school children, which is geographically and socially representative with a sample size of 1156. Our results show that religiosity has a significant positive influence on parenting activities and their perceived effectiveness, even after controlling for other variables. In addition, our indicator of home-based parental attention in itself is also strongly supportive of parents’ perceived effectiveness in parenting. Our findings suggest that parental religiosity and home-based parental attention are important factors that can make parenting effective despite social and cultural disadvantages.

Malignant Melanoma of the Conjunctiva: about A Case and Review of the Literature

Purpose: The aim of this study was to describe the management of a case of malignant melanoma of the conjunctiva at the National Hospital of Zinder in Niger and review of the literature. Observation: This was a young adult, 46 years old, male, from Agadez, with an unfavorable socioeconomic status, with no particular history referred for an upper left eyelid tumour. On examination, his general condition was preserved. On inspection, a mass hanging from the free edge of the left upper eyelid was noted; resulting in total mechanical ptosis preventing examination of the condition was preserved. On inspection, a mass hanging from the free edge of the left upper eyelid was noted, resulting in total mechanical ptosis preventing examination of the anterior segment. Palpation of the orbital rim did not note anything in particular, the lymph node areas were free. On the ophthalmological examination, on the right the visual acuity from afar without correction was 10/10 with a normal biomicroscopic examination, on the left the visual acuity was counting the fingers at one meter and a biomicroscopy hampered by the ptosis The assessment laboratory was normal, the orbitocerebral computed tomography showed the conjunctival origin of the tumor without notion of extension in the vicinity. Macroscopically complete excision was performed. Histopathological examination of the approximately 5 cm surgical specimen noted a malignant melanoma of the conjunctiva with impregnation of the margins (R1 resection). Adjuvant treatment with mitomycin C was instituted. The postoperative course was simple. After 6 months of postoperative follow-up, the ophthalmological examination was normal and the search for metastases was negative. Conclusion: Malignant melanoma of the conjunctiva is a rare neoplasia that can mimic a palpebral tumor. Histopathological examination remains important for treatment and monitoring.

Social networks and internet emotional relationships on mental health and quality of life in students: structural equation modelling

BackgroundSocial networks and relationships create a sense of belonging and social identity; hence, can affect mental health and the quality of life, especially in young people. The present study was conducted to determine the predicting role of social networks and internet emotional relationships on students’ mental health and quality of life.MethodsThe present cross-sectional study was conducted in 2021 on 350 students at Alborz University of Medical Sciences selected by convenience sampling. Data were collected using five questionnaires: socioeconomic status, social networks, internet emotional relationships, stress, anxiety, depression scale (DASS-21), quality of life, and a checklist of demographic details. Data were analyzed in SPSS-25, PLS-3, and Lisrel-8.8.ResultsAccording to the path analysis, the DASS-21 score had the most significant positive causal association with internet emotional relationships in the direct path (B = 0.22) and the most negative association with socioeconomic status (B = − 0.09). Quality of life had the highest negative causal association with the DASS-21 score in the direct path (B = − 0.26) and the highest positive association with socioeconomic status in the indirect path (B = 0.02). The mean duration of using social networks (B ≈ − 0.07) and internet emotional relationships (B ≈ − 0.09) had the highest negative association with quality of life.ConclusionThe use of the internet and virtual networks, internet emotional relationships, and unfavorable socioeconomic status were associated with higher DASS-21 scores and reduced quality of life in the students. Since students are the future of countries, it is necessary for policymakers to further address this group and their concerns.

Freelance in Four Countries of the Western Balkans

In this paper, the authors analyze the advantages and limitations of freelancing in four countries of Western Balkan. This work is based on the research with a total sample of 1031 respondents; 408 respondents from Serbia, 201 from Montenegro, 221 from North Macedonia, and 201 from Bosnia and Herzegovina. For the needs of the research, a special questionnaire was constructed and conducted by an electronic survey. The first goal of the research is to describe the functioning of freelancers in four countries, and the second is to describe the similarities and differences between countries of Western Balkan. In general, freelancers in all four countries have positive attitudes towards freelancing, although there are differences between them. Freelancers are especially satisfied with their income, and in Bosnia and Herzegovina with flexible working hours. No statistically significant differences were found among freelancers from four countries of Western Balkan in the structure of jobs they have worked in the last two years, nor in the assessment of the positive effects of new technologies on new forms of employment. They do not differ either in understanding that the work in the "Gig Economy" had less negative than positive effects on their private lives and in the fact that there are no differences in the assessment of the positive effects of freelance on the quality of life. They are no differences in terms of the proposed measures to improve the position of workers in the "Gig Economy". Unfortunately, there are also no differences in basic social rights (lack of health, disability, and pension insurance). The most significant differences have been noted between freelancers from Montenegro and freelancers from the other three countries. Freelancers from Montenegro see less positive contributions working in the "Gig Economy" than others, and they significantly more often believe that the "Gig Economy" can’t reduce unemployment and prevent brain drain abroad. The authors explain the negative attitudes of freelancers from Montenegro towards their work in the "Gig Economy" with the lower prevalence of freelancers, poorer job structure, and lower income with an unfavorable socioeconomic status.

Mental Health Status of the Population of a Hungarian Disadvantaged Region

Lifestyle and health culture significantly determines people’s health status. Several demographic studies have proved the correlation between disadvantaged social situation, unfavorable socio-economic status and health status. Deprivation and disadvantaged situation have become important, which should be treated as the root of difficulties on several fields since they have great impact on health behavior and -culture. Families living in lagging areas require special attention because of their social and economic backwardness and mental disadvantages. Childhood is an especially important period since skills learned before the age of 14 have a determining role in future life chances and adult health status: satisfactory psychosomatic development, loading capacity and the developing unfavorable habits influence adult health. As the part of the Creative Region program, our goal is to explore the mental health status of people living in the Hungarian Abaúj region by monitored data. 516 persons from 25 settlements and 7 primary schools of the region were included. We used the Beck Depression Inventory (filled under the age of 12) and the Spielberg State-Trait Anxiety Inventory (filled by all participants) by the help of measuring commissioners. Among children, a significant difference could be detected between genders (p=0.007). Body image seems to be a really important factor in youngsters’ life. Body weight (p=0.022) and physical exercises (p=0.02) significantly occur in the manifestation of depression symptoms in young people. The level of adult’s depression is influenced by the education level (p=0.00012), labour market status (p=0.003), alcohol consumption (p=0.007), subjective bad financial situation (p=0.022), sedentary lifestyle (p=0.001) and obesity (p=0.002). 5.5% of youngsters and 1.3% of adults are victims of domestic violence. It is important to highlight that negative future vision, unemployment and hopelessness cause anxiety and depression increasing by age, and it will manifest in endangering health behavior (inappropriate eating, sedimentary lifestyle, addictive disorders).

Who is at Risk of Loneliness? A Cross-sectional Recursive Partitioning Approach in a Population-based Cohort of Persons With Spinal Cord Injury

To develop a more thorough understanding of the risk factors for loneliness in persons with a physical impairment, using a population-based sample of persons with spinal cord injury (SCI), based on regression modeling and a recursive partitioning approach. Cross-sectional, observational cohort. Community, Switzerland. Community-dwelling persons with spinal cord injury (N=1283) 16 years or older. Not applicable. Loneliness was assessed using a modified version of the UCLA Three-Item Loneliness Scale. Those with the most disadvantaged socioeconomic characteristics in terms of education, income, subjective social position, employment status, and financial hardship demonstrated the highest risk for loneliness. Of the sociodemographic characteristics, only age had an association with loneliness, whereby persons aged 31-45 had the highest propensity for experiencing loneliness. We also saw that those with higher lesion levels and less functional independence were associated with higher levels of loneliness. In conditional inference tree analysis subjective social position, financial hardship, and functional independence had the highest discriminative power, with nationality and living arrangement having a less important role. Our findings highlight the vulnerability of persons with SCI with unfavorable socioeconomic status to loneliness. Furthermore, our findings show that persons who are more constrained because of functional limitations may face restrictions to social participation and therefore be at a higher risk of loneliness. This population-based evidence contributes to the better targeting of services aimed at alleviating loneliness for persons with a lower socioeconomic position and those with more functional limitations in everyday life.

LONG TERM MANAGEMENT OF GLYCOGEN STORAGE DISEASE TYPE 1B: A BRAZILIAN TERTIARY CENTER EXPERIENCE.

Glycogen storage disease (GSD) type 1b is a multisystemic disease in which immune and infectious complications are present, in addition to the well-known metabolic manifestations of GSD. Treatment with granulocyte-colony stimulating factor (G-CSF) is often indicated in the management of neutropenia and inflammatory bowel disease. To report on the demographics, genotype, clinical presentation, management, and complications of pediatric patients with glycogen storage disease type 1b (GSD 1b), with special attention to immune-related complications. Retrospective case series of seven patients with GSD 1b diagnosed and followed at a tertiary university hospital in Brazil, from July/2000 until July/2016. Mean age at referral was fourteen months. Diagnosis of GSD 1b was based on clinical and laboratory findings and supported by genetic studies in five cases. All patients presented suffered from neutropenia, managed with G-CSF - specifically Filgrastim. Hospitalizations for infections were frequent. Two patients developed inflammatory bowel disease. Six patients remained alive, one died at age 14 years and 9 months. The mean age at the end of the follow-up was 11.5 years. Compliance to treatment was suboptimal: poor compliance to medications, starch and dietetic management of GSD were documented, and outpatient appointments were frequently missed. Managing GSD 1b is challenging not only for the chronic and multisystemic nature of this disease, but also for the additional demands related dietary restrictions, use of multiple medications and the need for frequent follow-up visits; furthermore in Brazil, the difficulties are increased in a scenario where we frequently care for patients with unfavorable socioeconomic status and with irregular supply of medications in the public health system.

Inequalities in food consumption the Colombian households: Results from the National Survey of Nutritional Status

Introduction: adverse socioeconomic conditions may cause food intake characterized by inequality that derives in malnutrition increases. Objective. To identify inequalities in food consumption among the Colombian population according to socioeconomic status and the food security classification forhouseholds. Methods. the data were obtained from the 2005 National Survey of Nutritional Status, and the analysis used the first 24-hour recall n=39,413 Colombians. The statistical analysis took into account descriptive statistics and 95% confidence intervals. A multivariate analysis was performed through multinomial logistic regression models, with each of the food groups as a dependent variable. Finally, a latent class analysis was performed to understand the heterogeneity of the inequalities in food consumption in the households. Results. Low-socioeconomic status households showed higherconsumption of cereals, tubers and plantains, non-alcoholic beverages, and fats. I contrast, higher socioeconomic status households showed higher consumption of dairy products, fruit, vegetables, and sugars/sweets. The food security classification found that food-secure households had a higherconsumption of meat, dairy, vegetables, fruit, and sugars/sweets. Households classified as food-insecure showed a higher consumption of cereals, tubers and plantains, and non-alcoholic beverages. The consumption of tubers and plantains showed a clear social gradient, in higher socioeconomic status there was lower consumption probability of those products. Conclusion. There are inequalities in food consumption in Colombia according to socioeconomic status and the food security classification; therefore, people and families with the most unfavorable socioeconomic status have diets with less nutritional value.

Krivično delo povrede groba u praksi sudova na teritoriji AP Vojvodine

The subject of this paper is the analysis of court proceedings conducted in connection with the criminal offense of violation of a grave (Article 354 CC) which were held before the courts on the territory of Autonomous Province of Vojvodina. The analysis covers all finalized court cases of the aforementioned courts for the period from 01.01.2010. (i.e. from the introduction of the current organization of courts in the Republic of Serbia) to 01.07.2018. The research is primarily focused on the statistical presentation and analysis of data obtained from court decisions (which the author independently obtained from courts in original, raw form), as well as the identification of relevant criminal (material and procedural) and criminological characteristics. On the basis of the totality of the results, different regularities were noticed, with regard to the spatial and temporal distribution of the court proceedings, the types of court decisions, the type and amount of criminal sanctions imposed, as well as with regard to the characteristics of the perpetrators of the criminal offense in question. As a unifying conclusion, it can be stated that the crime of violation of a grave is relatively less represented in the practice of courts in the territory of AP Vojvodina, and that its spatial and temporal distribution is uneven (due to the absence of more specific regularities considering criminal expression). The penal policy regarding the crime in question can be characterized as in principle harmonized with the one at the level of the entire state regarding the same criminal offense. On the other hand, it is noticeable that the mentioned penal policy is somewhat stricter in relation to the general penal policy of the courts in the Republic of Serbia. However, this factual situation is potentially somewhat relativized by the specific features of the analyzed court proceedings (above all, the high percentage of recidivism and the frequent presence of other aggravating circumstances), as well as by the fact that all prison sentences were imposed only in the lower third of the envisaged range of the sentence (from one month to one year, although this criminal offense is punishable by up to three years in prison). Regarding the characteristics of the prosecuted perpetrators, it is noticeable that the convicts for the crime of violation of a grave were mainly nationals, and dominated by: adults over juvenile offenders; male over female; general recidivists over special recidivists; persons without education, with primary and secondary education over (non-existent) highly educated offenders; unemployed persons and persons without permanent employment over permanent employees. Considering possible strategies for prevention, it was concluded that important criminogenic factors are the low level of education of most perpetrators and their unfavorable socio-economic status, which gives grounds for assuming that timely educational work and providing conditions for improving their material opportunities could achieve significant results in the domain of both general and special prevention, especially in relation to the identified most risky categories of potential perpetrators (recidivists, illiterate persons, persons without primary education and persons in a state of severe social vulnerability).

Environmental Justice in Industrially Contaminated Sites. A Review of Scientific Evidence in the WHO European Region.

In the WHO European Region the topic of contaminated sites is considered a priority among environment and health themes. Communities living in or close to contaminated sites tend to be characterized by a high prevalence of ethnic minorities and by an unfavorable socioeconomic status so rising issues of environmental justice. A structured review was undertaken to describe the contents of original scientific studies analyzing distributive and procedural justice in industrially contaminated sites carried out in the WHO European Region in the period 2010–2017. A systematic search of the literature was performed. In total, 14 articles were identified. Wherever assessments on environmental inequalities were carried out, an overburden of socioeconomic deprivation or vulnerability, with very few exemptions, was observed. The combined effects of environmental and socioeconomic pressures on health were rarely addressed. Results show that the studies on environmental and health inequalities and mechanisms of their generation in areas affected by industrially contaminated sites in the WHO European Region are in their early stages, with exemption of UK. Future efforts should be directed to improve study strategies with national and local assessments in order to provide evidence for equity-oriented interventions to reduce environmental exposure and related health risks caused by industrial contamination.

Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus

ObjectiveTo evaluate the influence of socioeconomic and psychological factors on glycemic control in young children with type 1 diabetes mellitus. MethodsThis was a cross‐sectional study assessing prepubertal children with type 1 diabetes mellitus. The authors analyzed the socioeconomic status using the Brazil Economic Classification Criterion (Critério de Classificação Econômica Brasil [CCEB]) and psychological conditions through the Brazilian version of the Problem Areas in Diabetes, associated with glycemic control, measured by glycated hemoglobin (HbA1c). Descriptive analysis was used. The variables were assessed by bivariate and multivariate robust Poisson regression model, as well as Fisher's exact and Pearson's chi‐squared tests to obtain the ratios of gross and adjusted prevalence ratio, with confidence interval being estimated at 95%. ResultsA total of 68 children with type 1 diabetes mellitus were included in the study. A negative association between glycemic control (glycated hemoglobin levels), socioeconomic status (Brazil Economic Classification Criterion), and psychological condition (Brazilian version of the Problem Areas in Diabetes) was observed. Among the study participants, 73.5% (n=50) of the children had an unfavorable socioeconomic status; these participants were 1.4 times more likely to present altered glycated hemoglobin values. In relation to individuals with compromised psychological status, 26 (38.2%) had a score above 70, thus being classified with psychological stress; these children were 1.68 times more likely (95% confidence interval: 1.101, 1.301) to have higher glycated hemoglobin levels. ConclusionsThe socioeconomic conditions and psychological characteristics of the study participants were negatively associated with glycated hemoglobin results. These data reinforce the importance of the studied variables as predictors of glycemic control.

Evolution of fetal mortality in the setting of Argentine socioeconomic inequalities. Period 2007-2014.

Few studies have established a relationship between adverse social conditions by geographic area (GA) and fetal mortality (FM). Objective. To assess health inequalities in relation to FM by GA. Descriptive, ecological study. The principal components of 525 GAs were analyzed. A socioeconomic status indicator and indices of inequality were developed and estimated, and the FM ratio was calculated. The Kunst and Mackenbach relative index of inequality ranged from 1.8 to 1.4 in the 2007/2008 and 2013/2014 biennia, and a higher FM ratio was estimated for the highly unfavorable socioeconomic level stratum. The FM ratio is higher in this stratum. The gap between the ends of the socioeconomic spectrum narrowed towards the latest biennium. Regardless of this, in the GAs with a very unfavorable socioeconomic status, the FM ratio reduced in the latest biennium and increased in those with a very favorable socioeconomic status.

Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus

ObjectiveTo evaluate the influence of socioeconomic and psychological factors on glycemic control in young children with type 1 diabetes mellitus. MethodsThis was a cross-sectional study assessing prepubertal children with type 1 diabetes mellitus. The authors analyzed the socioeconomic status using the Brazil Economic Classification Criterion (Critério de Classificação Econômica Brasil [CCEB]) and psychological conditions through the Brazilian version of the Problem Areas in Diabetes, associated with glycemic control, measured by glycated hemoglobin (HbA1c). Descriptive analysis was used. The variables were assessed by bivariate and multivariate robust Poisson regression model, as well as Fisher's exact and Pearson's chi-squared tests to obtain the ratios of gross and adjusted prevalence ratio, with confidence interval being estimated at 95%. ResultsA total of 68 children with type 1 diabetes mellitus were included in the study. A negative association between glycemic control (glycated hemoglobin levels), socioeconomic status (Brazil Economic Classification Criterion), and psychological condition (Brazilian version of the Problem Areas in Diabetes) was observed. Among the study participants, 73.5% (n=50) of the children had an unfavorable socioeconomic status; these participants were 1.4 times more likely to present altered glycated hemoglobin values. In relation to individuals with compromised psychological status, 26 (38.2%) had a score above 70, thus being classified with psychological stress; these children were 1.68 times more likely (95% confidence interval: 1.101, 1.301) to have higher glycated hemoglobin levels. ConclusionsThe socioeconomic conditions and psychological characteristics of the study participants were negatively associated with glycated hemoglobin results. These data reinforce the importance of the studied variables as predictors of glycemic control.

Psychosocial and Medical Determinants of Health-related Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis.

Relapsing-remitting multiple sclerosis is a debilitating neurological disease accompanied with adverse consequences for quality of life. The purpose of this study was to investigate the role of relapsing-remitting multiple sclerosis on psychological, disease-related, socioeconomic, and demographic determinants of health-related quality of life of patients. In this cross-sectional descriptive study, 193 patients with relapsing-remitting multiple sclerosis were selected by compliance sampling method among the patients who attended the Iranian Multiple Sclerosis Association in Tehran from March 2014 to July 2014; and they completed the Multiple Sclerosis Quality of Life Questionnaire, the Depression Anxiety and Stress Scales, and the Socio-demographical Questionnaire. Then, a hierarchical multiple regression analysis with the stepwise method is used for data analysis by the PASW-18. According to the findings, in model 1, low socioeconomic status (SES) had a negative coefficient (beta=-0.30, p<0.01), and treatment history had a positive coefficient (beta=0.22, p<0.01). In model 2, while all variables of model 1 were controlled, depression had a negative coefficient (beta=-0.26, p<0.05), while disorder severity of multiple sclerosis had positive coefficients in lower level (beta=0.35, p<0.001), moderate level (beta=0.23, p<0.01), and severe level (beta=0.22, p<0.01). Other studied variables in model 1, and stress and anxiety in model 2 were not predicted in terms of the quality of life (p>0.05). Unfavorable SES, lack of effective treatment history, higher depression, and signs and symptoms severity of multiple sclerosis significantly predict decreased health-related quality of life in patients with relapsing-remitting multiple sclerosis. Thus, it is consequential to emphasize the value of tailored intervention for attending to these factors in the treatment and rehabilitation agendas for improvement of health-related quality of life in relapsing-remitting multiple sclerosis.

Maternal depressive symptoms and anxiety and interference in the mother/child relationship based on a prenatal cohort: an approach with structural equations modeling

This study aimed to investigate the association between maternal depressive symptoms and anxiety and interference in the mother/child relationship, using structural equations modeling. Data were used from a prospective cohort study initiated during the prenatal period with 1,140 mothers in São Luís, Maranhão State, Brazil. Data were collected during prenatal care and when the children reached two years of age. Interference in the mother/child relationship was measured with the Postpartum Bonding Questionnaire - PBQ (N = 1,140). In the initial theoretical model, socioeconomic status determined the maternal demographic, psychosocial, and social support factors, which determined the outcome, i.e., the mother/child relationship. Adjustments were performed by structural equations modeling, using Mplus 7.0. The final model showed good fit (RMSEA = 0.047; CFI = 0.984; TLI = 0.981). Depressive symptoms in pregnancy and the postpartum were associated with higher PBQ scores, indicating interference in the mother/child relationship. The greatest effect was from depressive symptoms in pregnancy. Other factors associated with higher PBQ scores were lower social support, unfavorable socioeconomic status, and living without a partner, by indirect association. Anxiety symptoms and maternal age were not associated with the mother/child relationship. The results suggest that identifying and treating depression in pregnancy and postpartum can improve mother/child bonding in childhood.

Investigating the Relationship Between Family Caregiving and Chronic Diseases Among Sandwich Generation Females

Background: In the recent years, chronic diseases have been identified as challenges of public health and healthcare and are the major causes of death in the female population. Females make up 75% of family caregivers. The sandwich generation females, who care for their aging parents while supporting their own children, encounter an increase in stress related to chronic diseases, but in some studies, the issue of care involves lower depression risk and more constructive psychological effects. Objectives: The aim of the present study was to investigate the relationship between family caregiving and chronic diseases in sandwich generation females. Patients and Methods: This study was a case-control study in Ahvaz in which 360 females including 180 sandwich generation caregivers and 180 caregivers of one generation (i.e. those only taking care of their own child) were selected using the random cluster sampling method during six months. The two groups of participants were matched in terms of age, number of children under their care and their socioeconomic status. Data analysis was conducted using the Kolmogorov-Smirnov (K-S test or KS test) and chi-square tests through the SPSS v.22 software. Results: A statistically significant difference was found between the two groups in terms of the presence of chronic diseases (P = 0.001). There was a significant correlation between chronic diseases and number of children (P = 0.03), person receiving care (P = 0.004), educational level (P = 0.001), caregiving duration (P = 0.005), and socioeconomic status (P = 0.14). Chronic diseases in caregivers with more than four children, under diploma educational level, and with unfavorable socioeconomic status were more than others. Additionally, the occurrence of chronic diseases was more in females caring for their grandchildren. There was no significant correlation between chronic diseases and the age of caregivers (P > 0.05). Conclusions: The current study revealed that a significant percentage of sandwich generation females have chronic diseases.

Comparison General Health and Life Expectancy between Students with Favorable and Unfavorable Socioeconomic Status

Introduction: The present study aims to compare general health and life expectancy between students with favorable and unfavorable socioeconomic status. Methods: The statistical population in this study consists of all the students of Lamerd city in the second semester of the academic year of 2013-2014. The sample of this study consists of 200 male and female students. A hundred of them are in the favorable socioeconomic status and the other 100 are in the unfavorable socioeconomic status which were selected by multistage random sampling. Results: The results of the analysis of MANOVA on the mean of life expectancyand general health scores indicated that there is a significant difference between the two groups regarding the investigated variables. Conclusion: In general, given the vulnerability of people who are in low socioeconomic status compared to the other segments of the society, more attention should be paid to this issue by the authorities.