OBJECTIVES: This study examined the association between childhood adversity and late-life cognitive outcomes among older Puerto Rican adults. METHODS: Data were from the Puerto Rican Elder: Health Conditions study, a population-based cohort of 3,713 older Puerto Rican adults (mean age 72.5 years; 60% female). Adverse childhood experiences were categorized into four factors: economic hardship, parental illiteracy, childhood illness, and neighborhood disadvantage. Cognition was assessed with the Mini-Mental Cabán (MMC). For our analyses, cognitive impairment was defined as scoring 1.5 standard deviations below the expected score, adjusted for age, sex, education, and reading ability. Ordinal logistic regression (baseline) and generalized linear mixed models (all 3 waves) analyzed MMC scores; generalized estimating equations assessed incident cognitive impairment (Waves 2 and 3). RESULTS: All four adversity factors were associated with poorer MMC scores at baseline. Parental illiteracy (β = -0.35, p < .001) and neighborhood disadvantage (β = -0.27, p < .001) showed stronger associations than economic hardship (β = -0.10, p = .003) and childhood illness (β = -0.21, p < .001). No factors were significantly related to changes in cognitive scores over time. Depressive symptoms and self-rated health partially mediated cross-sectional relationships, with depressive symptoms showing a stronger effect. All adversity factors except economic hardship were linked to baseline cognitive impairment (OR = 1.42 parent illiteracy, OR = 1.24 childhood illness, OR = 1.82 neighborhood disadvantage, p < .05). Only neighborhood disadvantage was associated with incident cognitive impairment (OR = 1.19, p = .003). DISCUSSION: This study highlights the lasting effect of childhood adversity on late-life cognitive health among older Puerto Ricans, suggesting that addressing early adversity may promote cognitive health later in life.
- MeSH
- charakteristiky okolí bydliště MeSH
- chudoba statistika a číselné údaje psychologie MeSH
- gramotnost statistika a číselné údaje MeSH
- kognitivní dysfunkce * epidemiologie etnologie etiologie MeSH
- lidé MeSH
- nepříznivé zkušenosti z dětství * statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Portoriko MeSH
Introduction: The aim of this study was to investigate health science students' perceptions of poverty and health inequality to gain insight into the perspectives of future healthcare workers. Design: A descriptive cross-sectional study. Methods: Data was collected via an online survey that was developed based on a thorough literature review. Participants were students (n = 106) from undergraduate nursing and applied kinesiology programmes. Statistical analyses were conducted with IBM SPSS Statistics 29.0. using bivariate statistical analysis. The significance level was set at p < 0.05. Results: 28.3% of students cited lack of opportunity as the main cause of poverty. There were significant differences in perception between nursing and kinesiology students (p < 0.05), particularly in relation to personal responsibility for poverty. On average, students scored 58/85, indicating a moderate yet significant awareness of social determinants of health. Conclusion: The findings illustrate how different disciplines influence perceptions of poverty and emphasise the inclusion of empathy in health education. While views on the roots of poverty vary, a common nuanced understanding points to a move towards empathic, socially conscious healthcare education. The study highlights the importance of an education system that emphasises social determinants of health and empowers students to engage with the complexities of poverty and health inequality.
- MeSH
- analýza dat MeSH
- chudoba MeSH
- dospělí MeSH
- lidé MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- sociální determinanty zdraví MeSH
- studenti ošetřovatelství psychologie statistika a číselné údaje MeSH
- studenti zdravotnických povolání * psychologie statistika a číselné údaje MeSH
- zdravotní nespravedlnost * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
BACKGROUND: Biological aging reflects a decline in the functions and integrity of the human body that is closely related to chronological aging. A variety of biomarkers have been found to predict biological age. Biological age higher than chronological age (biological age acceleration) indicates an accelerated state of biological aging and a higher risk of premature morbidity and mortality. This study investigated how socioeconomic disadvantages influence biological aging. METHODS: The data from the National Health and Nutrition Examination Survey (NHANES) IV, including 10 nationally representative cross-sectional surveys between 1999-2018, were utilized. The analytic sample consisted of N = 48,348 individuals (20-84 years). We used a total of 11 biomarkers for estimating the biological age. Our main outcome was biological age acceleration, indexed by PhenoAge acceleration (PAA) and Klemera-Doubal biological age acceleration (KDM-A). Poverty was measured as a ratio of family income to the poverty thresholds defined by the U.S. Census Bureau, adjusted annually for inflation and family size (5 categories). The PAA and KDM-A were regressed on poverty levels, age, their interaction, education, sex, race, and a data collection wave. Sample weights were used to make the estimates representative of the U.S. adult population. RESULTS: The results showed that higher poverty was associated with accelerated biological aging (PAA: unstandardized coefficient B = 1.38 p <.001, KDM: B = 0.96, p = .026 when comparing the highest and the lowest poverty level categories), above and beyond other covariates. The association between PAA and KDM-A and age was U-shaped. Importantly, there was an interaction between poverty levels and age (p <.001), as the effect of poverty was most pronounced in middle-aged categories while it was modest in younger and elderly groups. CONCLUSION: In a nationally representative US adult population, we found that higher poverty was positively associated with the acceleration of biological age, particularly among middle-aged persons.
- MeSH
- biologické markery MeSH
- chudoba * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- senioři MeSH
- stárnutí * MeSH
- výživa - přehledy MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
While economic inequality continues to rise within countries, efforts to address it have been largely ineffective, particularly those involving behavioral approaches. It is often implied but not tested that choice patterns among low-income individuals may be a factor impeding behavioral interventions aimed at improving upward economic mobility. To test this, we assessed rates of ten cognitive biases across nearly 5000 participants from 27 countries. Our analyses were primarily focused on 1458 individuals that were either low-income adults or individuals who grew up in disadvantaged households but had above-average financial well-being as adults, known as positive deviants. Using discrete and complex models, we find evidence of no differences within or between groups or countries. We therefore conclude that choices impeded by cognitive biases alone cannot explain why some individuals do not experience upward economic mobility. Policies must combine both behavioral and structural interventions to improve financial well-being across populations.
BACKGROUND: Early marriage occurs in some regions of the world. Given that early marriage can have many negative consequences for girls by affecting their physical, mental, and social health, the purpose of this study was to investigate the reasons for early marriage from the perspective of women who had experienced it in Zahedan, Iran. METHODS: This qualitative research was conducted based on the qualitative content analysis method in 2020-2021. The target population included women aged 18-35 living in Zahedan who were married under the age of 18 years. Purposeful sampling was used to select the participants. In order to collect data, in-depth interviews were performed to decipher the reasons for early marriage from these women's perspectives. A total of 36 interviews were conducted from October to December 2020 until reaching theoretical saturation. Conventional content analysis was used to analyze the data and extract the relevant concepts and categories. RESULTS: The analysis of the interviews in this study revealed three main categories:(1) "early marriage as a transcendental coercion" ( early marriage as a cultural heritage and early marriage as a control tool, girls' weaknesses and inability to resist, dominant attitudes toward gender and gender restrictions), (2) "early marriage as a solution or a kind of problem solving" (escape from undesirable family environment, escape from financial poverty, and strategic escape from an unpleasant situation), and (3) "early marriage as a voluntary act" (real agency and imaginary agency). To substantiate these findings, we presented excerpts from the interviews conducted with the participants. CONCLUSION: The results of this study suggest a multidimensional picture of early marriage. It seems that improving cultural conditions and empowering families and girls in various areas, including marriage, can reduce the rate of early marriage and/or at least mitigate its undesirable consequences.
- MeSH
- chudoba * MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- řešení problému * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Írán MeSH
- MeSH
- chudoba ekonomika statistika a číselné údaje MeSH
- ekonomika lékařská * dějiny etika MeSH
- komodifikace MeSH
- lidé MeSH
- obchodování s lidskými orgány ekonomika etika statistika a číselné údaje MeSH
- predátorské časopisy jako téma MeSH
- sociální problémy ekonomika etika MeSH
- těhotenství etika MeSH
- vědecká komunikace ekonomika MeSH
- Check Tag
- lidé MeSH
- těhotenství etika MeSH
INTRODUCTION: Chronic kidney disease (CKD) is a major threat to public health, especially in low-income and lower middle-income countries, where resources for treating patients with advanced CKD are scarce. Although early CKD identification and intervention hold promise for reducing the burden of CKD and risk factors, it remains unclear if an uniform strategy can be applicable across all income groups. The aim of this scoping review is to synthesise available evidence on early CKD identification programmes in all world regions and income groups. The study will also identify efforts that have been made to use interventions and implementation of early identification programmes for CKD across countries and income groups. METHODS AND ANALYSIS: This review will be guided by the methodological framework for conducting scoping studies developed by Arksey and O'Malley. Empirical (Medline, Embase, Cochrane Library, CINAHL, ISI Web of Science and PsycINFO) and grey literature references will be searched to identify studies on CKD screening, early identification and interventions across all populations. Two reviewers will independently screen references in consecutive stages of title/abstract screening and then full-text screening. We will use a general descriptive overview, tabular summaries and content analysis on extracted data. ETHICS AND DISSEMINATION: The findings from our planned scoping review will enable us to identify items in early identification programmes that can be used in developing screening toolkits for CKD. We will disseminate our findings using traditional approaches that include open-access peer-reviewed publication, scientific presentations and a white paper (call to action) report. Ethical approval will not be required for this scoping review as the data will be extracted from already published studies.
Diabetes prevalence is increasing worldwide, especially in low- and middle-income countries (LMIC), posing the need for improved detection and management strategies. Chronic disease models and lifestyle medicine provide structures for action. Community health workers (CHWs) can significantly contribute to chronic disease care if they are trained and integrated into low-resource health systems. Although most current CHWs worldwide are performing maternal/child health and infectious disease-related tasks, other programs involving CHWs for noncommunicable disease prevention and management are increasing. In this article, we discuss the advantages, challenges, and questions regarding possible roles assigned to CHWs in the prevention and management of diabetes. These roles include performing simple screening tests, implementing lifestyle/behavioral interventions, and connecting patients with alternatives to biomedicine. Specifically, CHWs can aid diabetes epidemiological surveillance by conducting risk score-based screening or capillary glucose testing, and they can facilitate diabetes self-management by delivering interventions described in the transcultural diabetes nutrition algorithm. Furthermore, while this role has not formally been assigned, CHWs can leverage their intimate knowledge of local practices to provide decision-making support to patients in environments with pluralistic health systems. Ethnocultural differences in CHW functions and transcultural adaptations of their roles in diabetes care should also be considered. In summary, CHWs can improve diabetes care by screening high-risk individuals and implementing lifestyle interventions, especially in LMIC.
- MeSH
- chudoba MeSH
- diabetes mellitus * prevence a kontrola MeSH
- dítě MeSH
- lidé MeSH
- poskytování zdravotní péče MeSH
- rozvojové země * MeSH
- zdravotní pomocníci v komunitě MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Brazílie MeSH
Ending all violence against children by 2030 is a core part of Sustainable Development Goals 5 and 16. A number of promising violence reduction strategies have been identified in research studies. However, we lack an understanding of the implementation and impact of these programs in respect to their delivery at a large scale or within existing service systems, particularly in low- and middle-income countries (LMICs). We advocate for greater collaboration between researchers, policymakers, donors, governments, non-governmental organizations, and program managers and staff to study how violence prevention programs operate on a large scale. We describe a new initiative aiming to foster such collaborations in the field of family strengthening programs.
- MeSH
- chudoba MeSH
- dítě MeSH
- lidé MeSH
- násilí * prevence a kontrola MeSH
- organizace MeSH
- příjem MeSH
- rozvojové země * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
