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Connections between interindividual differences and people’s behavior has been widely researched in various contexts, often by using top-down group comparisons to explain interindividual differences. In contrast, in this study, we apply a bottom-up approach in which we identify meaningful clusters in people’s concerns about various areas of life (e.g., their own health, their financial situation, the environment). We apply a novel method, Dirichlet clustering, to large-scale longitudinal data from the German Socioeconomic Panel Study (SOEP) to investigate whether concerns of people living in Germany evaluated in 2010 (t0) cluster participants into robust and separable groups, and whether these groups vary regarding their party identification in 2017 (t0 + 7). Clustering results suggest a range of different groups with specific concern patterns. Some of these notably specific patterns of concerns indicate links to party identification. In particular, some patterns show an increased identification with smaller parties as the ‘Bündnis 90/Die Grünen’ (‘Greens’), the left wing party ‘Die Linke’ (‘The Left’) or the right-wing party ‘Alternative für Deutschland’ (‘Alternative for Germany’, AfD). Considering that we identify as many as 37 clusters in total, among them at least six with clearly different party identification, it can also be concluded that the complexity of political concerns may be larger than has been assumed before. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are among the leading causes of mortality and morbidity in sub-Saharan Africa, including Zambia, where cardiovascular diseases account for 8% of the mortality rates. Despite an increasing number of cardiovascular disease-related studies in Zambia, qualitative studies exploring how cardiovascular diseases and their risk factors are understood in the socioeconomic and cultural contexts are still few. This study, therefore, aimed to analyze the beliefs, perceptions, and behaviors related to cardiovascular diseases and their risk factors among the local residents of Zambia. Methods: This qualitative study was conducted from August to September 2014 among healthy residents aged 40 years and above in a rural community in Mumbwa District. We investigated the beliefs, perceptions, and behaviors related to cardiovascular diseases and their potential risk factors in the sociocultural context of Zambia by conducting in-depth interviews and focus group interviews. Audio-recorded interviews were transcribed and analyzed using thematic analysis with investigator triangulation. Results: We conducted 34 in-depth interviews and 6 focus group interviews with 27 males and 40 females. Most participants were aware of the prevalence of cardiovascular diseases around them and correctly identified hypertension, excessive salt, sugar, and cooking oil intakes, poor quality cooking oil, consumption of meat or vegetables contaminated with chemicals, obesity, stress [“thinking too much”], lack of physical exercise, and heredity as potential risk factors of cardiovascular diseases, while smoking and alcohol were mentioned by only a few participants. However, they claimed that many of these risk factors were difficult to avoid due to ingrained taste preferences for high salt and sugar, increasingly busy lives that force them to use cooking oil to reduce preparation time, cultural preference for big body size or fatness, especially for women, stigmatized body image attached to HIV, stressful life or life events related to poverty, and financial barriers to affording quality foods and healthcare services. Limited health screening opportunities and the negative impact of HIV-related stigma on health-seeking behavior also emerged as important risk factors for cardiovascular diseases. Conclusions: This study revealed that participants are relatively well aware of cardiovascular diseases and their risk factors. However, they engage in high-risk health behaviors, due to ingrained taste preferences, limited knowledge, and unavoidable socioeconomic and cultural circumstances. Results suggest that prevention interventions addressing cardiovascular diseases in rural Zambia should target gaps in knowledge and socioeconomic and cultural barriers. [ABSTRACT FROM AUTHOR]

Background: A new intervention, Tobacco Cessation on Prescription (TCP), has been developed in the Swedish primary health care (PHC) setting to address inequalities in health caused by tobacco use. It consists of counseling for at least 10 minutes, an individualized prescription of tobacco cessation treatment and follow-up on at least one occasion. TCP is currently being tested in clinical practice for the first time but there is a lack of knowledge about how it is perceived by health care providers. Aim: To explore PHC provider’s perceived barriers and facilitators of implementing TCP as an intervention targeting a context with socioeconomically disadvantaged groups in Sweden. Methods: Directed content analysis of transcripts from eight semi-structured interviews and one focus group interview with PHC providers with personal experience of TCP as informants. Data collection and analysis was guided by The Consolidated Framework for Implementation Research. Results: Perceived facilitators of implementing TCP were increased self-efficacy among the informants and involvement in the treatment among patients, which led to more intensive counseling and advice being taken more seriously by patients. Lack of resources, routines, and collaboration to work with tobacco cessation and lack of knowledge, motivation and self-efficacy among colleagues were perceived as barriers. Motivation and self-efficacy to quit was perceived as low among some patients, which was explained by low social support to quit, negative attitude and low adherence to treatment and tobacco being used as a coping strategy for life stress. Access to treatment for patients was limited by cost of treatment, long waiting times and focus on face-to-face counseling. Conclusion: TCP was perceived positively by the informants but access to treatment for patients was partly limited by how tobacco cessation services were organized. Lack of structural support, resources and differing attitudes among PHC providers need to be addressed to facilitate its implementation. [ABSTRACT FROM AUTHOR]

The aim of this study was to quantitate the relative impact of nutritional, intellectual, brain development, cardiovascular risk, socio-economic, demographic and educational variables on the results of the 2009 Quality Education Measurement System (SIMCE) tests of language and mathematics for scholastic achievement (SA) applying a multifactorial approach, in school-age children of the 2010 5th elementary school grade (5ESG) and of the 1st grade of high school (1HSG). The purposes were: i) to test the hypothesis that intellectual ability, the level of SA of the educational establishments in the 2009 SIMCE tests, sex, parental schooling levels, and head circumference-for-age Z-score are the most relevant parameters associated with 2009 SIMCE outcomes; ii) to determine the predictive ability of the 2009 SIMCE results in determining the 2013 SIMCE outcomes for the 2010 5ESG cohort (when they graduated from elementary school, 8th grade) and for determining the 2013 University Selection Test (PSU) outcomes for the 2010 1HSG group (for university admission, when they graduated from high school, 4th grade); iii) to determine the association between the 2009 SIMCE results with the 2017 PSU outcomes for the 2010 5ESG group (for university admission, when they graduated from high school, 4th grade). A representative, proportional and stratified sample of 33 schools of the Metropolitan Region of Chile was randomly chosen. In these schools, 1,353 school-age children of both sexes, of the 2010 5ESG (n = 682; mean age = 10.8 years, SD = 0.6) and of the 2010 1HSG (n = 671; mean age = 14.8 years, SD = 0.6) participated. In both grades and tests, the findings confirm the hypotheses formulated. 2009 SIMCE outcomes were positively and significantly associated with 2013 SIMCE and with 2017 PSU and, with 2013 PSU outcomes in school-age children from 2010 5ESG and 1HSG, respectively. These findings may be useful for educational and health planning in Chile and countries in a comparable stage of development. [ABSTRACT FROM AUTHOR]

Introduction: Hungary has a single payer health insurance system offering free healthcare for acute cerebrovascular disorders. Within the capital, Budapest, however there are considerable microregional socioeconomic differences. We hypothesized that socioeconomic deprivation reflects in less favorable stroke characteristics despite universal access to care. Methods: From the database of the National Health Insurance Fund, we identified 4779 patients hospitalized between 2002 and 2007 for acute cerebrovascular disease (hereafter ACV, i.e. ischemic stroke, intracerebral hemorrhage, or transient ischemia), among residents of the poorest (District 8, n = 2618) and the wealthiest (District 12, n = 2161) neighborhoods of Budapest. Follow-up was until March 2013. Results: Mean age at onset of ACV was 70±12 and 74±12 years for District 8 and 12 (p<0.01). Age-standardized incidence was higher in District 8 than in District 12 (680/100,000/year versus 518/100,000/year for ACV and 486/100,000/year versus 259/100,000/year for ischemic stroke). Age-standardized mortality of ACV overall and of ischemic stroke specifically was 157/100,000/year versus 100/100,000/year and 122/100,000/year versus 75/100,000/year for District 8 and 12. Long-term case fatality (at 1,5, and 10 years) for ACV and for ischemic stroke was higher in younger District 8 residents (41–70 years of age at the index event) compared to D12 residents of the same age. This gap between the districts increased with the length of follow-up. Of the risk diseases the prevalence of hypertension and diabetes was higher in District 8 than in District 12 (75% versus 66%, p<0.001; and 26% versus 16%, p<0.001). Discussion: Despite universal healthcare coverage, the disadvantaged district has higher ACV incidence and mortality than the wealthier neighborhood. This difference affects primarily the younger age groups. Long-term follow-up data suggest that inequity in institutional rehabilitation and home-care should be investigated and improved in disadvantaged neighborhoods. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate socioeconomic inequalities in social relationships, and to assess whether socioeconomic conditions and social relationships are independently related to mental health problems in individuals with a physical disability due to spinal cord injury (SCI). Methods: We analyzed cross-sectional data from 511 individuals with SCI aged over 16 years who participated in the community survey of the Swiss SCI Cohort Study (SwiSCI). Indicators for socioeconomic conditions included years of formal education, household income, and financial strain. Social relationships were operationalized by three structural (partner status; social contact frequency; number of supportive relationships) and four functional aspects (satisfaction with: overall social support; family relationships; contacts to friends; partner relationship). General mental health was assessed by the Mental Health Inventory (MHI-5) of SF-36 and depressive symptoms were measured by the Hospital Anxiety and Depression Scale (depression subscale, HADS-D). Established cut-offs for general mental health problems (MHI-5 ≤56) and depressive symptomatology (HADS-D ≥8) were used to dichotomize outcomes. Associations were assessed using logistic regressions. Results: Lower household income was predominantly associated with poor structural social relationships, whereas financial strain was robustly linked to poor functional social relationships. Financial strain was associated with general mental health problems and depressive symptomatology, even after controlling for social relationships. Education and household income were not linked to mental health. Poor structural and functional social relationships were related to general mental health problems and depressive symptomatology. Notably, trends remained stable after accounting for socioeconomic conditions. Conclusion: This study provides evidence for socioeconomic inequalities in social relationships as well as for independent associations of financial strain and poor social relationships with mental health problems in individuals with SCI. Further research may develop strategies to improve mental health in SCI by strengthening social relationships. Such interventions may be especially beneficial for individuals with low income and financial strain. [ABSTRACT FROM AUTHOR]

The article offers information on a study related to the tropical disease, snakebite envenoming and the related efforts for improving prevention, treatment, and rehabilitation. Topics discussed include efforts of United Nations' Secretary-General Kofi Annan in providing greater priority to this disease; goal of World Health Organization (WHO) to reduce deaths and disability by 2030; and the program by WHO that included safe and effective treatment and maintaining stronger health systems.

Objective: The aim of this study was to examine the trend in socioeconomic inequalities in child undernutrition in Nigeria. Methods: The study analysed cross-sectional data from the Nigeria Demographic and Health Survey (NDHS) 2003 to 2013. The outcome variables were stunting, wasting and underweight among children under-five years. The magnitude of child undernutrition in Nigeria was estimated via a concentration index, and the socioeconomic factors contributing to child undernutrition over time were determined using the decomposition method. Results: The concentration index showed an increase in childhood wasting and underweight in Nigeria over time. The socioeconomic factors contributing to the increase in child undernutrition were: child’s age (0–23 months), maternal education (no education), household wealth index (poorest household), type of residence (rural) and geopolitical zone (North East, North West). Conclusions: To address child undernutrition, there is a need to improve maternal education and adopt effective social protection policies especially in rural communities in Nigeria. [ABSTRACT FROM AUTHOR]

Aim: To gain a better understanding of the complex relationships of different measures of social position, educational level and income with alcohol consumption in England. Method: Between March 2014 and April 2018 data were collected on n = 57,807 alcohol drinkers in England taking part in the Alcohol Toolkit Study (ATS). Respondents completed the AUDIT-C measure of frequency of alcohol consumption, amount consumed on a typical day and binge drinking frequency. The first two questions were used to derive a secondary measure of quantity: average weekly unit consumption. Socio-economic factors measured were: social-grade (based on occupation), employment status, educational qualifications, home and car ownership and income. Models were constructed using ridge regression to assess the contribution of each predictor taking account of high collinearity. Models were adjusted for age, gender and ethnicity. Results: The strongest predictor of frequency of alcohol consumption was social-grade. Those in the two lowest occupational categories of social grade (e.g. semi-skilled and unskilled manual workers, and unemployed, pensioners, casual workers) has fewer drinking occasions than those in professional-managerial occupations (β = -0.29, 95%CI -0.34 to -0.25; β = -0.31, 95%CI -0.33 to -0.29). The strongest predictor of consumed volume and binge drinking frequency was lower educational attainment: those whose highest qualification was an A-level (i.e. college/high school qualification) drank substantially more on a typical day (β = 0.28, 95%CI 0.25 to 0.31) and had a higher weekly unit intake (β = 3.55, 95%CI 3.04 to 4.05) than those with a university qualification. They also reported a higher frequency of binge drinking (β = 0.11, 95%CI 0.09 to 0.14). Housing tenure was a strong predictor of all drinking outcomes, while employment status and car ownership were the weakest predictors of most outcomes. Conclusion: Social-grade and educational attainment appear to be the strongest socioeconomic predictors of alcohol consumption indices in England, followed closely by housing tenure. Employment status and car ownership have the lowest predictive power. [ABSTRACT FROM AUTHOR]

Most research on consumer attitudes does not consider that attitudes are likely influenced by people with whom we have some relationship even though socioeconomic, psychological and political theories recognize the importance of referent individuals’ opinions in attitude formation. Knowledge on the role of referent individuals’ opinions in attitude formation could improve the understanding of consumer acceptance of foods frequently associated with health or other concerns. This article examines the association of attitudes towards genetically modified (GM) crops and foods between young adults and their referent individuals using data collected in 2016 via surveys from the Czech Republic, Russia and Ukraine. Loglinear models of cell counts in contingency tables reveal a positive association of GM food attitudes between young adults and their referent individuals. This association was stronger in Russia and the Czech Republic than it was in Ukraine and stronger between female young adults and their referent individuals than between males and their referent individuals. Concordance in GM food attitudes with mothers is significantly stronger than concordance with best friends but not significantly different from concordance with fathers. [ABSTRACT FROM AUTHOR]

Introduction: In many Sub-Saharan African countries, women with infertility search relentlessly for treatment. Guided by the Partners for Applied Social Sciences model for health seeking behaviour and access to care research, this study aims to understand the health seeking behaviour of women with infertility in the West Coast region of The Gambia and the influence of aetiological beliefs on health seeking paths. Methodology: A qualitative approach was used to generate both primary and secondary data for thematic analysis. The data collection methods included in-depth interviews (36), observations (18), informal conversations (42), group discussion (7) and made use of pile-sorting exercises. Sources of secondary data included government and non-governmental reports and media outputs. Results: The health seeking approaches of women living in both rural and urban areas were extremely complex and dynamic, with women reporting that they looked for biomedical treatment as well as seeking indigenous treatment provided by local healers, sacred places and kanyaleng groups. While treatment choice was related to the perceived aetiology of infertility, it was also strongly influenced by the perceived effectiveness of the treatment available and the duration of the fertility problems. Other relevant factors were the affordability, accessibility and availability of treatment and respondents’ family and social networks, whereby access to the biomedical health sector was strongly influenced by people’s socio-economic background. Conclusion: On the basis of this analysis and our wider research in the area, we see a need for health authorities to further invest in providing information and counselling on issues related to infertility prevention and treatment. The availability of locally applicable guidelines for the management of infertility for both men and women at all levels of the health system would facilitate such work. In addition, the public sphere should provide more space for alternative forms of social identity for both men and women. [ABSTRACT FROM AUTHOR]

Objectives: Moderately and late preterm children (MLPs, 32.0–36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs. Study design: This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status. Results: We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33–35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72. Conclusions: In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially. [ABSTRACT FROM AUTHOR]

Background: Malaria continues to be a leading cause of morbidity and mortality in most countries in Sub-Saharan Africa. Insecticide-treated bed nets (ITNs) is one of the cost-effective interventions for preventing malaria in endemic settings. Ghana has made tremendous efforts to ensure widespread ownership and use of ITNs. However, national coverage statistics can mask important inequities that demand targeted attention. This study assesses the disparities in ownership and utilization of ITNs among reproductive-aged women in a rural impoverished setting of Ghana. Methods: Population-based cross-sectional data of 3,993 women between the age of 15 and 49 years were collected in seven districts of the Upper East region of Ghana using a two-stage cluster sampling approach. Bivariate and multivariate regression models were used to assess the social, economic and demographic disparities in ownership and utilization of ITN and to compare utilization rates among women in households owning at least one ITN. Results: As high as 79% of respondents were found to own ITN while 62% of ITN owners used them the night preceding the survey. We identified disparities in both ownership and utilization of ITNs in wealth index, occupational status, religion, and district of residence. Respondents in the relative richest wealth quintile were 74% more likely to own ITNs compared to those in the poorest quintile (p-value< 0.001, CI = 1.29–2.34) however, they were 33% less likely to use ITNs compared to the poorest (p-value = 0.01, CI = 0.50–0.91). Conclusion: Interventions aimed at preventing and controlling malaria through the use of bed nets in rural Ghana and other similar settings should give more attention to disadvantage populations such as the poor and unemployed. Tailored massages and educational campaigns are required to ensure consistent use of treated bed nets. [ABSTRACT FROM AUTHOR]

Background: There are many types of disabilities, and each type has a variety related to socioeconomic factors. Such factors affect to many health problems of the disabled. However, surveys of the oral health status of the disabled in Korea are rare. Objective: The purpose of this study was to estimate oral health disparity through comparing oral health status of the disabled to the non-disabled, adjusted for the net effect of the disability on oral health status. Methods: A cross-sectional study was conducted among the disabled in urban and suburban areas in Korea from June to September 2016. People with physical, mental, and multiple disabilities took part in this survey. The clinical examinations were carried out by trained dentists. Statistical analysis was performed to quantify the association between oral health and socioeconomic status after restricting the analysis using a propensity score matching method. Results: The disabled had more DMFT, DT, and MT, fewer FT, and fewer teeth than the non-disabled based on entire groups (P<0.01). No difference in the ratio of periodontitis was observed. The subjects with mental disabilities (MD) scored 3.09 (95% CI, 1.07–8.97), and those with multiple disabilities scored 4.37 (95% CI, 1.16–16.37) for edentulous status. The MD had an odds ratio of 1.34 (95% CI, 1.03–1.74), and those with multiple disabilities had an odds ratio of 1.75 (95% CI, 1.11–2.76) for the DMFT index. Conclusions: These results represent poor oral health status of the disabled compared to the non-disabled. Consequentially, we can verify that not only the existence of disability but also the type of disability has a decisive effect on oral health condition. This comparison is necessary to widen our approach to evaluate the actual status condition of the disabled. [ABSTRACT FROM AUTHOR]

Background: There are major socio-economic gradients in health that could be influenced by increasing personal resources. Welfare rights advice can enhance resources but has not been rigorously evaluated for health-related impacts. Methods: Randomised, wait-list controlled trial with individual allocation, stratified by general practice, of welfare rights advice and assistance with benefit entitlements, delivered in participants’ homes by trained advisors. Control was usual care. Participants were volunteers sampled from among all those aged ≥60 years registered with general practices in socio-economically deprived areas of north east England. Outcomes at 24 months were: CASP-19 score (primary), a measure of health-related quality of life; changes in income, social and physical function, and cost-effectiveness (secondary). Intention to treat analysis compared outcomes using multiple regression, with adjustment for stratification and key covariates. Qualitative interviews with purposive samples from both trial arms were thematically analysed. Findings: Of 3912 individuals approached, 755 consented and were randomised (381 Intervention, 374 Control). Results refer to outcomes at 24 months, with data available on 562 (74.4%) participants. Intervention was received as intended by 335 (88%), with 84 (22%) awarded additional benefit entitlements; 46 did not receive any welfare rights advice, and none of these were awarded additional benefits. Mean CASP-19 scores were 42.9 (Intervention) and 42.4 (Control) (adjusted mean difference 0.3 [95%CI -0.8, 1.5]). There were no significant differences in secondary outcomes except Intervention participants reported receiving more care at home at 24m (53.7 (Intervention) vs 42.0 (Control) hours/week (adjusted mean difference 26.3 [95%CIs 0.8, 56.1]). Exploratory analyses did not support an intervention effect and economic evaluation suggested the intervention was unlikely to be cost-effective. Qualitative data from 50 interviews suggested there were improvements in quality of life among those receiving additional benefits. Conclusions: We found no effects on health outcomes; fewer participants than anticipated received additional benefit entitlements, and participants were more affluent than expected. Our findings do not support delivery of domiciliary welfare rights advice to achieve the health outcomes assessed in this population. However, better intervention targeting may reveal worthwhile health impacts. [ABSTRACT FROM AUTHOR]

Background: Neonatal mortality contributes to nearly half of under-five mortality in Ethiopia. Treatment seeking for newborn danger signs remains low despite correlations with neonatal mortality. This study tests a theoretical model of factors affecting mothers’ treatment seeking intention for neonatal danger signs in northwest Ethiopia. Method: A cross sectional study was conducted from March 3–18, 2016 in northwest Ethiopia. A total of 2,158 pregnant women and women who had delivered in the past 6 months were interviewed. Latent variables; knowledge of neonatal danger signs (KDS), household level women empowerment (HLWE) and positive perception toward the behavior of health care providers (PPBHCP) were measured using a Five Point Likert Scale. Socioeconomic status (SES), number of antenatal care attendance, perceived cost of treatment (PCT), average distance to health facilities (ADHF) and treatment seeking intention (TSI) were observed variables in the study. A structural equation modeling was applied to test and estimate the hypothesized model of relationships among latent and observed variables and their direct and indirect effects on TSI. Result: KDS, PPBHCP, HLWE, and PCT showed direct, positive and significant association with TSI (β = 0.41, p<0.001, β = 0.08, p<0.002, β = 0.18, p<0.001, and β = 0.06, p<0.002, respectively). SES was not directly associated with TSI. However, it indirectly influenced TSI through three pathways; KDS, number of ANC attendance and HLWE (β = 0.05, p<0.05, β = 0.08, p<0.001 and β = 0.13, p<0.001, respectively). Number of antenatal care was not directly associated with TSI. But indirectly, it affected TSI through its direct effect on KDS and PPBHCP (β = 0.05, p<0.05, β = 0.14, p<0.001, respectively). PPBHCP and HLWE also showed indirect association with TSI through their direct effect on KDS (β = 0.37, p<0.001, β = 0.36, p<0.001, respectively). All in all, the model fitted the sample data and explained 31% of the variance in TSI. Conclusion: PPBHCP, HLWE, PCT and KDS were associated with mothers’ TSI for newborn danger signs. [ABSTRACT FROM AUTHOR]

Music listening is an inherently cultural behavior, which may be shaped by users’ backgrounds and contextual characteristics. Due to geographical, socio-economic, linguistic, and cultural factors as well as friendship networks, users in different countries may have different music preferences. Investigating cultural-socio-economic factors that might be associated with between-country differences in music preferences can facilitate music information retrieval, contribute to the prediction of users’ music preferences, and improve music recommendation in cross-country contexts. However, previous literature provides limited empirical evidence of the relationships between possible cross-country differences on a wide range of socio-economic aspects and those in music preferences. To bridge this research gap, and drawing on a large-scale dataset, LFM-1b, this study examines the possible relationship between cross-country differences in artist, album, and genre listening frequencies as well as the cross-country distance in geographical, socio-economic, linguistic, cultural, and friendship connections using the Quadratic Assignment Procedure. Results indicate: (1) there is no significant relationship between geographical and economic distance on album, artist, and genre preferences’ distance at the country-level; (2) the cross-country distance of three cultural dimensions (masculinity, long-term orientation, and indulgence) is positively associated with both the album and artist preferences distances; (3) the between-country distance in main languages has a positive relationship with the album, artist, and genre preferences distances across countries; (4) the density of friendship connections among countries negatively correlates to the cross-country preference distances in terms of artist and genre. Findings from this study not only expand knowledge of factors related to music preferences at the country level, but also can be integrated into real-world music recommendation systems that consider country-level music preferences. [ABSTRACT FROM AUTHOR]

Many studies have demonstrated the existence of simple, unidimensional socioeconomic gradients in body mass index (BMI). However, in the present paper we move beyond such traditional analyses by simultaneously considering multiple demographic and socioeconomic dimensions. Using the Spanish National Health Survey 2011–2012, we apply intersectionality theory and multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to analyze 14,190 adults nested within 108 intersectional strata defined by combining categories of gender, age, income, educational achievement and living situation. We develop two multilevel models to obtain information on stratum-specific BMI averages and the degree of clustering of BMI within strata expressed by the intra-class correlation coefficient (ICC). The first model is a simple variance components analysis that provides a detailed mapping of the BMI disparities in the population and measures the accuracy of stratum membership to predict individual BMI. The second model includes the variables used to define the intersectional strata as a way to identify stratum-specific interactions. The first model suggests moderate but meaningful clustering of individual BMI within the intersectional strata (ICC = 12.4%). Compared with the population average (BMI = 26.07 Kg/m2), the stratum of cohabiting 18-35-year-old females with medium income and high education presents the lowest BMI (-3.7 Kg/m2), while cohabiting 36-64-year-old females with low income and low education show the highest BMI (+2.6 Kg/m2). In the second model, the ICC falls to 1.9%, suggesting the existence of only very small stratum specific interaction effects. We confirm the existence of a socioeconomic gradient in BMI. Compared with traditional analyses, the intersectional MAIHDA approach provides a better mapping of socioeconomic and demographic inequalities in BMI. Because of the moderate clustering, public health policies aiming to reduce BMI in Spain should not solely focus on the intersectional strata with the highest BMI, but should also consider whole population polices. [ABSTRACT FROM AUTHOR]

Socioeconomic inequalities are major health determinants. To monitor and understand them at local level, ecological indexes of socioeconomic deprivation constitute essential tools. In this study, we describe the development of the updated version of the European Deprivation Index for Portuguese small-areas (EDI-PT), describe its spatial distribution and evaluate its association with a general health indicator–all-cause mortality in the period 2009–2012. Using data from the 2011 European Union–Statistics on Income and Living Conditions Survey (EU-SILC), we obtained an indicator of individual deprivation. After identifying variables that were common to both the EU-SILC and the census, we used the indicator of individual deprivation to test if these variables were associated with individual-level deprivation, and to compute weights. Accordingly, eight variables were included. The EDI-PT was produced for the smallest area unit possible (n = 18084 census block groups, mean/area = 584 inhabitants) and resulted from the weighted sum of the eight selected variables. It was then categorized into quintiles (Q1-least deprived to Q5-most deprived). To estimate the association with mortality we fitted Bayesian spatial models. The EDI-PT was unevenly distributed across Portugal–most deprived areas concentrated in the South and in the inner North and Centre of the country, and the least deprived in the coastal North and Centre. The EDI-PT was positively and significantly associated with overall mortality, and this relation followed a rather clear dose-response relation of increasing mortality as deprivation increases (Relative Risk Q2 = 1.012, 95% Credible Interval 0.991–1.033; Q3 = 1.026, 1.004–1.048; Q4 = 1.053, 1.029–1.077; Q5 = 1.068, 1.042–1.095). Summing up, we updated the index of socioeconomic deprivation for Portuguese small-areas, and we showed that the EDI-PT constitutes a sensitive measure to capture health inequalities, since it was consistently associated with a key measure of population health/development, all-cause mortality. We strongly believe this updated version will be widely employed by social and medical researchers and regional planners. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer remains an important public health problem that is responsible for high morbidity and mortality rates, especially in developing countries. Objective: To analyze the socioeconomic and access disparities related to breast cancer mortality in 399 cities in the state of Parana, Brazil. Methods: Ecological, descriptive and analytical cross-sectional study based on secondary data from the Mortality Information System from 2009 to 2012 in the state of Parana. Breast cancer mortality rate was calculated considering the mortality cases and women population of each municipality, both based on women older than 20 years old. Moran global and local analyses were used to verify the presence of spatial autocorrelation and spatial regression modeling (Spatial Lag—SAR) with the purpose of analyzing the association between socioeconomic indicators, access and mortality rates for breast cancer. Results: Significant positive spatial autocorrelation was found for breast cancer mortality rates (I = 0.5432, p = 0.001). In the spatial regression analysis, the model explained 61% of the variance of the mortality rates for breast cancer. The mortality rate for breast cancer was negatively associated with the illiteracy rate (Coefficient = -0.0279) and positively associated with the access index (Coefficient = 12.9525). Conclusion: The lower illiteracy rate has not been sufficient to reduce the specific mortality rate by breast cancer, and the higher the score of accessibility to cancer services, the higher the specific mortality due to breast cancer. The results show that in the state of Parana, the problem is not related to a lack of education of the patients or the distance walked, but rather with the organization of services. These conclusions have important political implications on the organization and quality of the services provided for the diagnosis and treatment of breast cancer in the state of Parana. [ABSTRACT FROM AUTHOR]

A common two-tier structure for social networks is based on partitioning society into two parts, referred to as the elite and the periphery, where the “elite” is the relatively small but well-connected and highly influential group of powerful individuals around which the society is centered, and the “periphery” consists of the rest of society. It is observed that the relative sizes of economic and social elites in various societies appear to be continually declining. One possible explanation is that this is a natural social phenomenon, resembling Price’s “square root” law for the fraction of good scientists in the scientific community. We try to assess the validity of this explanation by studying the elite-periphery structure via introducing a novel axiom-based model for representing and measuring the influence between the elite and the periphery. The model is accompanied by a set of axioms that capture the elite’s dominance, robustness and density, as well as a compactness property. Relying on the model and the accompanying axioms, we are able to draw a number of insightful conclusions about the elite-periphery structure. In particular, we show that in social networks that respect our axioms, the size of a compact elite is sublinear in the network size. This agrees with Price’s principle but appears to contradict the common belief that the elite size tends to a linear fraction of society (recently claimed to be around 1%). We propose a natural method to create partitions with nice properties, based on the key observation that an elite-periphery partition is at what we call a ‘balance point’, where the elite and the periphery maintain a balance of powers. Our method is based on setting the elite to be the k most influential nodes in the network and suggest the balance point as a tool for choosing k and therefore the size of the elite. When using nodes degrees to order the nodes, the resulting k-rich club at the balance point is the elite of a partition we refer to as the balanced edge-based partition. We accompany these findings with an empirical study on 32 real-world social networks, which provides evidence that balanced edge-based partitions which satisfying our axioms commonly exist. [ABSTRACT FROM AUTHOR]

Each year, evidence-based clinical guidelines gain more space in the health professionals’ practice and in services organization. Due to the scarcity of scientific publications focused on diseases of poverty, the development of well-founded clinical guidelines becomes more and more important. In view of that, this paper aims to evaluate the quality of Brazilian guidelines for those diseases. The AGREE II method was used to evaluate 16 guidelines for poverty-related diseases (PRD) and 16 guidelines for global diseases whose treatment require high-cost technologies (HCD), with the ultimate aim of comparing the results. It was found that, in general, the guideline development quality standard is higher for the HCD guidelines than for the PRD guidelines, with emphasis on the "rigour of development" (48% and 7%) and "editorial independence" (43% and 1%) domains, respectively, which had the greatest discrepancies. The HCD guidelines showed results close to or above international averages, whereas the PRD guidelines showed lower results in the 6 domains evaluated. It can be concluded that clinical protocol development priorities need some redirecting in order to qualify the guidelines that define the healthcare organization and the care of vulnerable populations. [ABSTRACT FROM AUTHOR]

Introduction: Vector Borne Diseases (VBDs) have a major impact on public health and socio-economic development. Inter-sectoral collaboration was recommended as one of the key elements of Integrated Vector Management (IVM), however limited evidence measures the effect and contribution of intersectoral approaches including but not only IVM. This systematic review aims to assess the existing evidence on all forms of inter-sectoral collaboration in VBD control and prevention, identify any gaps and develop a framework from a global perspective. Methods: Articles were identified through a search of PUBMED, Science of Direct, Web of Knowledge, Google Scholar and WHO archives using key words and excluded duplications (n = 2,034). The exclusion of non-VBDs control and prevention interventions resulted in 194 eligible titles/abstract/keywords for full text assessment. Further exclusion of non-peer reviewed articles, non-declaration of ethical clearance, reviews and expert opinion articles resulted in 50 articles finally being included for analysis with the extraction of data on outcome, factor/s influencing the effectiveness, indicators of collaboration and sustainability. Results: Of the 50 articles included in the analysis, 19 articles were categorized as of moderate-strong quality. All articles compared pre- and post-intervention outcomes against disease or vector variables. Three papers included outcome variables on intersectoral collaboration and participation indicator. However, no paper undertook component analysis by different sectors or different activities. Only one paper compared cost data for community-intersectoral intervention for IRS and traditional “vertical” IRS. Six factors were identified as influencing the effectiveness of inter-sectoral collaboration. Five of six factors are the main ones, namely the approach (37/47), resources (34/47), relationships (33/47), management (29/47) and shared vision (20/47) factors. A conceptual framework has been developed based on this review. Conclusion: This review shows the importance of inter-sectoral collaboration to reduce VBDs or vector densities. However, very few studies measured how much inter-sectoral collaboration contributes to the impact. Further high-quality studies using inter-sectoral collaboration indicators are recommended to be undertaken. [ABSTRACT FROM AUTHOR]

Objectives: In countries with universal health coverage (UHC), national public health insurances cover 70% of health expenditures on average, but health care user fees and out-of-pocket expenditures have been neglected in empirical patient-centered health inequality research. This study is the first to investigate how health care-related factors are associated with health status among middle-aged and elderly people—vulnerable groups for the burden of illness—in countries with UHC. Design: Longitudinal observational cohort study. Setting: Population-based cohort Survey of Health, Ageing and Retirement in Europe (SHARE) in twelve countries with UHC. Participants: Non-institutionalized people aged 50 and older (n = 29,260). Two subsamples were also used: participants without global activity limitation at baseline (n = 16,879) and participants without depression at baseline (n = 21,178). Main outcome measures: Risk of death, risk of global activity limitations, and risk of depression. We used mixed-effects Cox proportional hazards regressions to estimate hazard ratios (HR) for all-cause mortality, physical limitations, and depression. Results: Having a voluntary private insurance to cover health expenses not included in the public health care system (44.1% of the total sample) was a protective factor for all outcomes (HR≤0.91), controlling for a large range of socio-economic variables. On the contrary, having out-of-pocket expenditures (62.4%) was a risk factor (HR≥1.12). Conclusions: UHC systems are not free from health inequalities: there is a potential effect of lack of voluntary private insurance and out-of-pocket expenditures on mortality and health. Health care-related factors should be at focus in future researches designed to understand and address health inequalities. Reducing out-of-pocket expenditures and developing voluntary private insurance may protect against premature illness and death. [ABSTRACT FROM AUTHOR]

Background: Globally, preterm birth (PTB) and low infant birth weight (LBW) are leading causes of maternal and child morbidity and mortality. Inadequate water and sanitation access (WASH) are risk factors for PTB and LBW in low-income countries. Physical stress from carrying water and psychosocial stress from addressing sanitation needs in the open may be mechanisms underlying these associations. If so, then living in a community with strong social capital should be able to buffer the adverse effects of WASH on birth outcomes. The objective of this study is to assess the relationships between WASH access and social conditions (including harassment and social capital) on PTB and LBW outcomes among Indian women, and to test whether social conditions modified the association between WASH and birth outcomes. Methods and findings: This cohort study examined the effect of pre-birth WASH and social conditions on self-reported PTB status and LBW status for 7,926 women who gave birth between 2004/2005 and 2011/2012 Waves of the India Human Development Survey. PTB and LBW occurred in 14.9% and 15.5% of women, respectively. After adjusting for maternal biological and socioeconomic conditions, PTB was associated with sharing a building/compound latrine (Odds Ratio (OR) = 1.55; 95% Confidence Interval (CI) = 1.01, 2.38) versus private latrine access, but suggested an effect in the opposite direction for sharing a community/public latrine (OR = 0.67; CI = 0.45, 1.01). Open defecation, type of drinking water source, minutes per day spent fetching water, and one-way time to a drinking water source were not associated with PTB. LBW was associated with spending more than two hours per day fetching water compared to less than two hours (OR = 1.33; CI = 1.05, 1.70) and suggested an association with open defecation (OR = 1.22; CI = 1.00, 1.48), but was not associated with other types of sanitation, type of drinking water source, or time to a drinking water source. Harassment of women and girls in the community was associated with both PTB (OR = 1.33; CI = 1.09, 1.62) and LBW (OR = 1.26; CI = 1.03, 1.54). The data also showed a possible association of local crime with LBW (OR = 1.30; CI = 1.00, 1.68). Statistically significant (p<0.05) evidence of effect modification was only found for collective efficacy on the association between type of sanitation access and PTB. In addition, stratified analyses identified differences in effect size for walking time to the primary drinking water source and PTB by crime, sanitation access and PTB by harassment, and total hours per day fetching water and LBW by collective efficacy. Limitations of this observational study include risk of bias, inability to confirm causality, reliance on self-reported outcomes, and limited sub-group sample sizes for testing effect modification. Conclusions: The relationship between adverse birth outcomes and sanitation access, domestic water fetching, crime, and gender-based harassment suggests physical and psychosocial stress are possible mechanisms by which WASH access affects PTB and LBW among Indian women. Interventions that reduce domestic responsibilities related to water and sanitation and change social norms related to gender-based harassment may reduce rates of PTB and LBW in India. [ABSTRACT FROM AUTHOR]

During the last years, the new science of cities has been established as a fertile quantitative approach to systematically understand the urban phenomena. One of its main pillars is the proposition that urban systems display universal scaling behavior regarding socioeconomic, infrastructural and individual basic services variables. This paper discusses the extension of the universality proposition by testing it against a broad range of urban metrics in a developing country urban system. We present an exploration of the scaling exponents for over 60 variables for the Brazilian urban system. Estimating those exponents is challenging from the technical point of view because the Brazilian municipalities’ definition follows local political criteria and does not regard characteristics of the landscape, density, and basic utilities. As Brazilian municipalities can deviate significantly from urban settlements, urban-like municipalities were selected based on a systematic density cut-off procedure and the scaling exponents were estimated for this new subset of municipalities. To validate our findings we compared the results for overlaying variables with other studies based on alternative methods. It was found that the analyzed socioeconomic variables follow a superlinear scaling relationship with the population size, and most of the infrastructure and individual basic services variables follow expected sublinear and linear scaling, respectively. However, some infrastructural and individual basic services variables deviated from their expected regimes, challenging the universality hypothesis of urban scaling. We propose that these deviations are a product of top-down decisions/policies. Our analysis spreads over a time-range of 10 years, what is not enough to draw conclusive observations, nevertheless we found hints that the scaling exponent of these variables are evolving towards the expected scaling regime, indicating that the deviations might be temporally constrained and that the urban systems might eventually reach the expected scaling regime. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the relationship between nutritional status and Parkinson's Disease (PD) features in association with depression, anxiety and quality of life in people with PD. Materials and methods: This study was conducted on 96 patients with idiopathic PD to whom the following scales were applied: Unified Parkinson’s Disease Rating Scale (UPDRS), 39-item PD questionnaire (PDQ-39), Hospital Anxiety and Depression Score (HADS), Mini Nutritional Assessment (MNA). The scales and measurements were applied to patients at their first assessment. Patients with malnutrition or at risk of malnutrition were assessed by the dietitian and nutrition nurse. These patients received nutritional support through personalized diet recommendations and appropriate enteral nutritional products, considering factors such as age, comorbidity, socioeconomic and cultural conditions. At the end of 6 weeks, the scales and measurements applied during the first visit were again applied to the patients. Results: A significant and inverse correlation was determined between mental (Spearman r:-0.510, p<0.001), activities of daily living (Spearman r:-0.520, p<0.001), motor (Spearman r:-0.480, p<0.001), complications (Spearman r:-0.346, p<0.001) UPDRS subdivisions and total scores (Spearman r:-0.644, p<0.001) and total MNA score. A significant and inverse correlation was found between all PDQ-39 subdomains and total MNA score (p<0.05). The highest inverse correlations were found in mobility (Spearman r:-0.690, p<0.001) and stigma (Spearman r:-0.570, p<0.001). Both depression (Spearman r:-0.631, p<0.001) and anxiety (Spearman r:-0.333, p<0.001) scores were determined to be inversely correlated with total MNA score. At the 6-week control visit, significantly lower scores were found in all subdivisions and in the total UPDRS score, PDQ-39 score and in the patients' anxiety and depression scores (p<0.05). MNA scores were found to be significantly higher in the assessment performed after 6 weeks of support for patients who had abnormal nutritional status at inception (p<0.001). Conclusion: PD motor and nonmotor functions, disease duration and severity are related to nutritional status. Quality of life was also shown to be affected by changes in the nutritional status. These results show that nutritional status assessment should be a standard approach in the PD treatment and follow-up processes. [ABSTRACT FROM AUTHOR]

This study examines the association between childhood socioeconomic position and objective physical capability including new functional measures of potential relevance to a population in late-middle age. The study population covers two Danish birth cohorts followed-up in the Copenhagen Aging and Midlife Biobank (age 48–58 years, 2009–2011, N = 4,204). Results from linear regression models revealed that being born in higher socioeconomic position was associated with higher jump height: Paternal occupational class four = 0.19 cm (95% confidence interval (CI): -0.44, 0.82), three = 0.59 cm (95% CI: -0.02, 1.19), two = 1.29 cm (95% CI: 0.64, 1.94), and one = 1.29 cm (95% CI: 0.45, 2.13) (reference = five); medium parental social class = 0.88 cm (95% CI: 0.03, 1.72) and high = 1.79 cm (95% CI: 0.94, 2.63) (reference = low). Higher childhood socioeconomic position was also associated with better chair rise performance and hand grip strength, while among women it was related to reduced flexibility: Medium parental social class = -1.31 cm (95% CI: -3.05, 0.42) and high = -2.20 cm (95% CI: -3.94, -0.47) (reference = low); unwed mother = 1.75 cm (95% CI: 0.36, 3.14) (reference = married). Overall, the findings suggest that higher childhood socioeconomic position is primarily related to moderately better scores in the most strenuous physical capability measures and hand grip strength among healthy adults in late-middle age. [ABSTRACT FROM AUTHOR]

The community of Pygmies settled in Vyegwa-Gika provides an exceptional case study to test the role of trust in the evolution of altruism. The Vyegwa-Gika Pygmies were forced to migrate from rainforests to the savanna, changing quickly their environment, culture, and socio-economic situation. Despite the high level of poverty they suffer in this new settlement, we found evidence of strong altruistic attitudes toward trustees when playing an economic game. In addition, Vyegwa-Gika Pygmies keep small personal trust networks despite the fact they share frequent social interactions within the community. These results indicate the great effectiveness of personal trust in fostering altruism, even if the circumstances make it difficult to establish such kind of affective bonds. A theory of the evolution of altruism should therefore also account for the evolution of psychology of trust, as a key element in the process. [ABSTRACT FROM AUTHOR]

Background: We examined the equivalence of the individual and the country-level factor structure of the Belief in a Zero-Sum Game (BZSG) scale, a tool designed to measure antagonistic beliefs about social relations (i.e., perceived social antagonism) in the struggle for limited resources. Aims: In this article we focused on a test of construct isomorphism in a multilevel modeling approach. It was hypothesized that the BZSG measure satisfies all requirements for a strong level of configural isomorphism, and thus that it is useful to investigate BZSG at both the individual and the country levels. The relationships between the BZSG at a country level with other macro-socio-economic indicators were also investigated. Method: Multilevel confirmatory factor analysis (MCFA) was carried out on a cross-country sample composed of 11,368 participants from 43 different countries. We also used the country-level latent BZSG factor in each country as an indicator of a property that we attributed to a particular culture: cultural dimension (collectivism-individualism), macroeconomic indicators (GDP per capita and GNI per capita) and macrosocial indicators (Human Development Index and Democracy Index) describing societies. Results: The results revealed an isomorphic factor structure of perceived social antagonism (measured by BZSG scale), defined in terms of the equivalence factor structure at the both individual and country levels. Furthermore, the relationship between the perceived social antagonism, gross national income per capita, and collectivism were confirmed. Conclusions: Our study supports the usefulness of the BZSG scale for cross-cultural comparison, in the case of its isomorphic structure. At the country level, antagonistic beliefs emerge in hierarchical collectivist societies with lower income. The main contribution of this article is the presentation of the test of construct isomorphism. We made an effort to present a full perspective on construct isomorphism putting together two different but very recent approaches. [ABSTRACT FROM AUTHOR]

There has been evidence demonstrating that China has had a persistently low and below-replacement level fertility since early 1990s, causing concerns of a rapidly aging population and sustainability of the Chinese economy. To avoid adverse effects of excessively low fertility, the Chinese government has recently changed its family planning policy from "one-child policy" to "two-child policy." Nonetheless, the effectiveness of the newly initiated two-child policy is questionable if women's average desired number of children or desired fertility for their lifetime is below the threshold fertility allowed by the two-child policy. Therefore, this study argues that it would be interesting and pertinent to know women's fertility desires under the circumstances of no policy restrictions and understand major factors that may affect their desired fertility. Based on a multi-stage stratified cluster sampling survey with 2,516 women respondents in rural Shaanxi, this study tries to estimate desired fertility of rural women and evaluate the impact of important socioeconomic factors on their desired fertility. The results of this study reveal that the average lifetime desired fertility for rural women of childbearing age in Shaanxi is about 1.71, below the total fertility rate at the replacement level. The findings of this study suggest that women's marriage age, the pecuniary costs of having children, women's income forgone for having children, and social security benefits available for rural residents at retirement age, are significantly and negatively related to desired fertility. However, rural women's cultural views towards fertility are significantly but positively related to their desired fertility. This study further confirms that China has entered an era of low fertility, and thus, any policy restrictions on fertility may no longer be necessary. Instead, government programs which support childbearing and childrearing are needed to prevent excessive low fertility and rapid aging of the population. [ABSTRACT FROM AUTHOR]

Objectives: To investigate changes in children’s television and computer time according to three socio-economic status (SES) indicators. Design: Prospective cohort study. Methods: Data were drawn from the European Youth Heart Study and included longitudinal data collected in 1997 and 2003 in Denmark. Television and computer time were self-reported by children. Parental education, income and ethnicity were parent-reported. Baseline data were available for 549 children (47.0% boys, 9.6 years). Generalized linear mixed models analyzed whether changes in television and computer time from baseline to follow-up differed according to the SES-indicators. Result: TV viewing time increased with 25% over time (ExpB = 1.25, 95% CI = 1.04–1.50). At both time points, children with two higher educated parents viewed 25% less hours of television than children with no higher educated parents (ExpB = 0.75, 95% CI = 0.60–0.94) and one higher educated parent (ExpB = 0.75, 95%CI = 0.59–0.97). Among children with no higher educated parents the odds of being in a higher category of computer time increased with 80% over time (OR = 1.80, 95% CI = 1.24–2.60). Among children with two higher educated parents the odds of being in a higher category of computer time decreased with 45% over time (OR = 0.55, 95% CI = 0.32–0.94). The association with ethnicity showed that white children had 42% lower odds (OR = 0.58; 95% CI = 0.34–1.00) of being in a higher category of computer time than non-white children. No significant associations were found for parental income. Conclusions: The most important SES measure of screen-based behaviors in children was parental education. Ethnicity was only associated with computer time. Financial resources were less relevant for changes in television viewing and computer use. [ABSTRACT FROM AUTHOR]

Field-based data collection provides an extraordinary opportunity for comparative research. However, the demands of pursuing research away from home creates an expectation of unburdened individuals who have the temporal, financial, and social resources to conduct this work. Here we examine whether this myth of the socially unencumbered scholar contributes to the loss of professionals and trainees. To investigate this, we conducted an internet-based survey of professional and graduate student anthropologists (n = 1025) focused on the challenges and barriers associated with developing and maintaining a fieldwork-oriented career path and an active family life. This study sought to determine how (1) family socioeconomic status impacts becoming an anthropologist, (2) expectations of field-based research influence family planning, and (3) fieldwork experiences influence perceptions of family-career balance and stress. We found that most anthropologists and anthropology students come from educated households and that white men were significantly more likely to become tenured professionals than other demographic groups. The gender disparity is striking because a larger number of women are trained in anthropology and were more likely than men to report delaying parenthood to pursue their career. Furthermore, regardless of socioeconomic background, anthropologists reported significant lack of family-career balance and high stress associated with the profession. For professionals, lack of balance was most associated with gender, age, SES, tenure, and impacts of parenting on their career, while for students it was ethnicity, relative degree speed, graduate funding, employment status, total research conducted, career impact on family planning, and concern with tenure (p < .05). Anthropology bridges the sciences and humanities, making it the ideal discipline to initiate discussions on the embedded structural components of field-based careers generalizable across specialties. [ABSTRACT FROM AUTHOR]

Background: Gender-related norms and poverty remain important structural barriers to secondary school attendance among adolescent girls in southern India. We analyse how gender norms interact with family deprivation and dynamics to result in girls dropping out of school; we identify the main facilitators of school retention and changes to gender socialisation. Methods: Longitudinal qualitative case studies with 36 girls were nested within a cluster randomized trial to evaluate the Samata intervention targeting adolescent girls in Bagalkote and Vijayapura districts in northern Karnataka. We used two rounds of in-depth interviews, conducted in 2014 at a time when respondents were in 8th standard at the age of 13 to 14 and sixteen months later. We combined thematic and narrative analyses. Results: Our study found that poverty and socioeconomic realities at the household level strongly affect conformity with discriminatory gender practices such as restricting girls’ mobility. The value placed on education by parents clearly differentiates the regular school goers from those frequently absent and others who dropped out. With active encouragement of the girls’ educational and career aspirations, parents engendered the girl’s agency to communicate openly both at home and at school, allowing subtle changes to gender performance while resisting the pressure of social sanctions. In contrast, where educational aspirations were weak, parents invested more intensely in enforcing correct performance of gender, prioritising her well-being by aiming to secure her future in a good marriage. Among poorer families, girls’ domestic duties came at the cost of schooling with concerns about protecting her sexual purity predominating. Conclusions: In contexts where a strong gender ideology of virginity before marriage rules, subtle shifts in harmful gender practices are possible. Interventions aiming to improve education need to target the most deprived families, focussing on trust building through open communication. [ABSTRACT FROM AUTHOR]

Scientific mobility can stimulate entrepreneurship and intrapreneurship, acting as a catalyst for reducing imbalances between local and global science and the resulting socio-economic damage. This study evaluates both whether scientific mobility effectively promotes these concepts and the fundamental reasons to articulate effective policies for scientific mobility. Toward this end, a survey has been prepared following the methodology of Global Entrepreneurship Monitor (GEM) and current scientific literature. A total of 364 researchers involved in Spanish scientific mobility took part in the study: Spanish scientists abroad (135) and scientists returned to Spain (52), as mobile groups, and young researchers in Spain (177), as a group of scientists who could go abroad, but that have not yet begun to leave. The results demonstrate that scientific mobility does promote entrepreneurship and, especially intrapreneurship. Moreover, since permanent positions are scarce for these groups and their mobility decisions largely depend on job opportunities, the involved Spanish authorities and agents can improve scientific mobility by means suitable policies that make the most of this potential to the benefit of economic growth and job creation. [ABSTRACT FROM AUTHOR]

Prenatal health care interventions are effective ways to improve maternal and neonatal health. There have been few large investigations conducted on the inequalities in maternal health services utilization in Shaanxi Province of west China since the health care reform in 2009. This study examined the inequalities and determinants of maternal health services utilization in Shaanxi Province. A household survey was conducted from August to November in 2013. By using a multistage sampling method, local women aged 15–49 who had given birth in the preceding three years were recruited. Information including social-demographic characteristics and maternal health services utilization was collected through a face-to-face interview. A concentration index approach was used to measure inequalities in maternal health services utilization. A logistic regression model was employed to investigate the determinants of maternal health services utilization. There were 8,488 women from urban areas and 18,724 women from rural areas enrolled in this study. The concentration index for all the indicators of maternal health services utilization showed significance in these two areas. In urban areas, the concentration index of having 5 or more prenatal visits, receiving the first prenatal visit within 12 weeks, delivering at secondary- or higher-level health facilities and delivering by C-section were 0.0356, 0.0166, 0.0177 and 0.0591, respectively, while in rural areas, the corresponding figures were 0.0385, 0.0183, 0.0334 and 0.0566, respectively. The determinants related to maternal health services utilization were women’s age at delivery, educational level, employment status, parity, health problems during pregnancy and household income. Inequalities in maternal health services utilization still exist in Shaanxi Province. Providing maternal health services for younger, less educated, unemployed, high parity and poorer women, especially in rural areas, is expected to reduce the inequalities in maternal health services utilization. [ABSTRACT FROM AUTHOR]

Background: In national samples drawn from the USRDS, female patients utilize the hospital ED and inpatient services at a higher rate than their male counterparts and have a higher rate of re-hospitalization. We wanted to explore the association of sex with avoidable ED visits made by a cohort of patients on hemodialysis in a mostly minority, lower socioeconomic status (SES), population in the Bronx to test the applicability of the USRDS findings. Methods: We used Montefiore’s clinical database to build a cohort of patients on hemodialysis with a first ED visit between 2013 and 2017. All ED visits after the index ED visit and those within one year prior to the index visit were recorded. None of the ED visits resulted in a hospitalization and were thus labeled “avoidable”. Bivariate analysis tested the association of demographic and clinical variables with sex. We used negative binomial regression to test the association of each variable with avoidable ED visit count. The multivariate model used negative binomial regression with avoidable ED visit count as outcome and sex as the exposure variable and included ancestral variables age and race. Potential mediators were added to the model to measure their effects on the association of sex with avoidable ED visits. Results: Four thousand six hundred and seventy three subjects on hemodialysis were identified as having at least one avoidable ED visit, in the period of 2013–2017 at one of four ED sites affiliated with Montefiore Medical Center in the Bronx. Over 5 years (2012–2017), the median number of ED visits made by the study sample was 4 (25–75% IQR: 2–8). Female patients on hemodialysis in our cohort were older, more commonly black, had lower SES scores, less commonly had commercial insurance and were less commonly married than their male counterparts. Female sex was not significantly associated with a higher rate of avoidable ED visits in the total cohort.(1.053(0.99–1.12) Female sex was significantly associated with outcome in non-Hispanic whites only and in those subjects younger than 44 years old.(IRR 1.30(1.06–1.69), 1.17(1.00–1.38) in non-Hispanic White and younger age group, respectively.) Marital status, SES and hemoglobin levels possibly mediated the association of sex and outcome in our population. (>25% change in the coefficient for sex with respect to outcome when variable added to the model). Conclusion: In this single center study of a lower-socioeconomic status, mostly minority dialysis population, the association of female sex with avoidable ED visits was not significant. These results suggest the association of sex with hospitalization outcomes, described by national datasets that determine quality indicators, are not consistent across different types of populations with some mediation possible by SES and marital status in poorer neighborhoods. [ABSTRACT FROM AUTHOR]

Background: The incidence of canine rabies cases in El Salvador has decreased in the last decade since the establishment of intense control programs, such as massive vaccination campaigns implemented by the Ministry of Health. Socioeconomic crises in recent years have limited the access to certain areas across the country and have impacted surveillance and prevention campaigns, which places the country at risk for a resurgence of canine rabies.We aimedto describe the spatiotemporal patterns of canine rabies and its association with critical social factors in El Salvador from 2005 to 2014. Method: We included 459 cases of canine rabies. Several socioeconomic, demographic, and surveillance variables were modeled using a Poisson regression to evaluate their associations with the incidence of canine rabies. Spatial scan statistics were adjusted or unadjusted with covariates and applied to identify statistically significant clusters of canine rabies. Finally, a canine rabies risk map was created. Results: A positive association and higher risk of canine rabies were found for low poverty zones, where it is suspected that urban slums contribute to ongoing rabies transmission (RR = 7.74). Violence had a negative association with rabies (RR = 0.663), which is likely due to reporting bias. Significant clusters were identified in all five epidemiological regions, and the Eastern region had the highest risk (RR = 50.62). The influences of the selected variables in cluster detection were confirmed by the adjusted analysis. Higher-risk townships were distributed from the Western to the Eastern regions of the country. Conclusion: Social factors are determinants of rabies in El Salvador and play a major role in national spatial patterns of the disease. There are high-risk areas for canine rabies across the country, and there were two persistent rabies foci during the study period. Examining the role of social factors can provide better insight into rabies in vulnerable countries, and socioeconomic factors can be key elements in developing better policies and interventions for rabies control. [ABSTRACT FROM AUTHOR]

Payments for ecosystem services (PES) often serve multiple objectives, such as carbon emission reduction and poverty alleviation. However, the effectiveness of PES as an instrument to achieve these multiple objectives, in particular in a conservation-development context, is often questioned. This study adds to the very limited empirical evidence base and investigates to what extent Vietnam’s move to PES has helped protect forest ecosystems and improve local livelihoods and income inequality. We zoom in on Lam Dong province, where PES was first introduced in Vietnam in 2009. Changes in forest cover are analysed using satellite images over a period of 15 years (2000–2014). Socio-economic impacts are assessed based on rural household interviews with PES participants and non-participants as a control group over a period of 7 years (2008–2014). Our results show that PES contributes significantly to forest cover, the improvement of local livelihoods, and the reduction of income inequality. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to investigate associations between caregiving and adiposity using a representative UK longitudinal study. We also investigated whether associations differed by age, gender and caregiving characteristics. Methods: Data on 9,421 participants aged 16+ from three waves (2009–2012) of the UK Household Longitudinal Study were used. Body mass index, waist circumference and percentage body fat were assessed. Caregiving and caregiving characteristics (hours per week, number of people cared for, co-resident caregiving and combining working and caregiving) was available from the prior wave. Gender-stratified associations between caregiving/caregiving characteristics with adiposity were tested. Covariates included caregiver’s health, socioeconomic position, parenthood and partnerships. Results: Caregiving was associated with higher adiposity for women but not men. Younger women caregivers had particularly higher levels of adiposity. Men combining part-time paid work with caregiving had higher levels of adiposity than men working full-time and not caregiving. Women aged 16–44 or 65+ had particularly high levels of adiposity when combining full-time work and caregiving, compared to full-time work alone. Conclusion: The health of caregivers should be a public health priority, particularly for younger women and those combining paid work with caregiving responsibilities. [ABSTRACT FROM AUTHOR]

The literature of social class and inequality is not only diverse and rich in sight, but also complex and fragmented in structure. This article seeks to map the topic landscape of the field and identify salient development trajectories over time. We apply the Latent Dirichlet Allocation topic modeling technique to extract 25 distinct topics from 14,038 SSCI articles published between 1956 to 2017. We classified three topics as “hot”, eight as “stable” and 14 as “cold”, based on each topic’s idiosyncratic temporal trajectory. We also listed the three most cited references and the three most popular journal outlets per topic. Our research suggests that future effort may be devoted to Topics “urban inequalities, corporate social responsibility and public policy in connected capitalism”, “education and social inequality”, “community health intervention and social inequality in multicultural contexts” and “income inequality, labor market reform and industrial relations”. [ABSTRACT FROM AUTHOR]

Over the last few decades, public life has taken center stage in urban studies, but that is about to change. At times, indoor activities have been shown to matter more than what is publicly visible (they have been found to be more predictive of future crimes, for example). Until recently, however, data has not been available to study indoor activities at city scale. To that end, we propose a new methodology that relies on tagging information of geo-referenced pictures and unfolds in three main steps. First, we collected and classified a comprehensive set of activity-related words, creating the first dictionary of urban activities. Second, for both London and New York City, we collected geo-referenced Flickr tags and matched them with the words in the dictionary. This step produced both a systematic classification (our activity-related words were best classified in eleven categories) and two city-wide indoor activity maps which, when compared to open data of public amenities and sensory maps of smell and sound matched theoretical expectations. Third, we studied, for the first time, activities happening indoor in relation to neighborhood socio-economic conditions. We found the very same result for both London and New York City. In deprived areas, people focused on any of the activity types (leading to specialization), and it did not matter on which one they did so. By contrast, in well-to-do areas, people engaged not in one type of activity but in a variety of them (leading to diversification). [ABSTRACT FROM AUTHOR]

The analyses of geographic variations in the prevalence of major chronic conditions, such as overweight and obesity, are an important public health tool to identify “hot spots” and inform allocation of funding for policy and health promotion campaigns, yet rarely performed. Here we aimed at exploring, for the first time in Luxembourg, potential geographic patterns in overweight/obesity prevalence in the country, adjusted for several demographic, socioeconomic, behavioural and health status characteristics. Data came from 720 men and 764 women, 25–64 years old, who participated in the European Health Examination Survey in Luxembourg (2013–2015). To investigate the geographical variation, geo-additive semi-parametric mixed model and Bayesian modelisations based on Markov Chain Monte Carlo techniques for inference were performed. Large disparities in the prevalence of overweight and obesity were found between municipalities, with the highest rates of obesity found in 3 municipalities located in the South-West of the country. Bayesian approach also underlined a nonlinear effect of age on overweight and obesity in both genders (significant in men) and highlighted the following risk factors: 1. country of birth for overweight in men born in a non-European country (Posterior Odds Ratio (POR): 3.24 [1.61–8.69]) and women born in Portugal (POR: 2.44 [1.25–4.43]), 2. low educational level (secondary or below) for overweight (POR: 1.66 (1.06–2.72)] and obesity (POR:2.09 [1.05–3.65]) in men, 3. single marital status for obesity in women (POR: 2.20 [1.24–3.91]), 4.fair (men: POR: 3.19 [1.58–6.79], women: POR: 2.24 [1.33–3.73]) to very bad health perception (men: POR: 15.01 [2.16–98.09]) for obesity, 5. sleeping more than 6 hours for obesity in unemployed men (POR: 3.66 [2.02–8.03]). Protective factors highlighted were: 1. single marital status against overweight (POR: [0.60 (0.38–0.96)]) and obesity (POR: 0.39 [0.16–0.84]) in men, 2. the fact to be widowed against overweight in women (POR: [0.30 (0.07–0.86)], as well as a non European country of birth (POR: 0.49 [0.19–0.98]), tertiary level of education (POR: 0.34 [0.18–0.64]), moderate alcohol consumption (POR: 0.54 [0.36–0.90]) and aerobic physical activity practice (POR: 0.44 [0.27–0.77]) against obesity in women. A double burden of environmental exposure due to historic mining and industrial activities and past economic vulnaribility in the South-West of the country may have participated to the higher prevalence of obesity found in this region. Other demographic, socioeconomic, behavioural and health status covariates could have been involved as well. [ABSTRACT FROM AUTHOR]

Purpose: Social inequalities are widely accepted to have a deleterious effect on children’s mental health, and those with lower socioeconomic status generally experience more mental health issues. In this study, we examine the impact of socioeconomic situations of children’s families during their early childhood on the children’s social adaptation in Japanese elementary school. Methods: The current investigation consisted of two sets of data relating to two separate years (with a one-year interval). The participants included preschoolers aged five years at Time 1 (the first year) and first graders aged six years at Time 2 (the second year); 1,712 met the inclusion criteria for both years. Parents of the participants completed a self-reported questionnaire regarding their SES (i.e., family economy and mother’s education) and their children’s mental health. Mental health was assessed using the Child Behavior Checklist/4–18, Parent Report. Results: For each SES indicator, we found an inverse relationship across all the symptom dimensions. Specifically, bivariate analyses revealed that lower family income, maternal education level, and paternal education level predict all three domains of behavioral problems (i.e., internalized problems, externalized problems, and total behavioral problems). Further, multivariate analyses revealed that lower family income consistently predicts all domains of behavioral problems, lower maternal education level predicted externalized problems and total behavioral problems, and paternal education level did not predict any clinically significant behavioral problems. Conclusion: In this sample, we found that, for children, family income and parental education when entering preschool were significant predictors of mental health problems after elementary school enrollment; in particular, low income and low maternal educational achievement predicted a high probability of the development of a psychiatric disorder. A greater understanding of the mechanisms of these associations could contribute to improvements in interventions aimed at preventing child maladjustment. [ABSTRACT FROM AUTHOR]

Introduction: Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized. This study investigates the prevalence and factors associated with underutilization of ANC services with a focus on the differences between rural and urban residences in Nigeria. Methods: We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for the sampling weight and the cluster design of the survey. The prevalence of underutilization of ANC was assessed using frequency tabulation while associated factors were examined using Chi-Square test and multivariable logistic regression analysis. Results: The prevalence of underutilization of ANC was 46.5% in Nigeria, 61.1% in rural residence and 22.4% in urban residence. The North-West region had the highest prevalence of ANC underuse in Nigeria at 69.3%, 76.6% and 44.8% for the overall, rural and urban residences respectively. Factors associated with greater odds of ANC underuse in rural residence were maternal non-working status, birth interval < 24 months, single birth type, not listening to radio at all, lack of companionship to health facility and not getting money for health services. In urban residence, mothers professing Islam, those who did not read newspaper at all, and those who lacked health insurance, had greater odds of ANC underuse. In both rural and urban residence, maternal and husband’s education level, region of residence, wealth index, maternal age, frequency of watching television, distance to- and permission to visit health facility were significantly associated with ANC underuse. Conclusions: Rural-urban differences exist in the use of ANC services, and to varying degrees, factors associated with underuse of ANC in Nigeria. Interventions aimed at addressing factors identified in this study may help to improve the utilization of ANC services both in rural and urban Nigeria. Such interventions need to focus more on reducing socioeconomic, geographic and regional disparities in access to ANC in Nigeria. [ABSTRACT FROM AUTHOR]

Evaluation of agricultural intensification requires comprehensive analysis of trends in farm performance across physical and socio-economic aspects, which may diverge across farm types. Typical reporting of economic indicators at sectorial or the “average farm” level does not represent farm diversity and provides limited insight into the sustainability of specific intensification pathways. Using farm business data from a total of 7281 farm survey observations of English and Welsh dairy farms over a 14-year period we calculate a time series of 16 key performance indicators (KPIs) pertinent to farm structure, environmental and socio-economic aspects of sustainability. We then apply principle component analysis and model-based clustering analysis to identify statistically the number of distinct dairy farm typologies for each year of study, and link these clusters through time using multidimensional scaling. Between 2001 and 2014, dairy farms have largely consolidated and specialized into two distinct clusters: more extensive farms relying predominantly on grass, with lower milk yields but higher labour intensity, and more intensive farms producing more milk per cow with more concentrate and more maize, but lower labour intensity. There is some indication that these clusters are converging as the extensive cluster is intensifying slightly faster than the intensive cluster, in terms of milk yield per cow and use of concentrate feed. In 2014, annual milk yields were 6,835 and 7,500 l/cow for extensive and intensive farm types, respectively, whilst annual concentrate feed use was 1.3 and 1.5 tonnes per cow. For several KPIs such as milk yield the mean trend across all farms differed substantially from the extensive and intensive typologies mean. The indicators and analysis methodology developed allows identification of distinct farm types and industry trends using readily available survey data. The identified groups allow the accurate evaluation of the consequences of the reduction in dairy farm numbers and intensification at national and international scales. [ABSTRACT FROM AUTHOR]

Social and economic systems produce complex and nonlinear relationships in the indicator variables that describe them. We present a Bayesian methodology to analyze the dynamical relationships between indicator variables by identifying the nonlinear functions that best describe their interactions. We search for the ‘best’ explicit functions by fitting data using Bayesian linear regression on a vast number of models and then comparing their Bayes factors. The model with the highest Bayes factor, having the best trade-off between explanatory power and interpretability, is chosen as the ‘best’ model. To be able to compare a vast number of models, we use conjugate priors, resulting in fast computation times. We check the robustness of our approach by comparison with more prediction oriented approaches such as model averaging and neural networks. Our modelling approach is illustrated using the classical example of how democracy and economic growth relate to each other. We find that the best dynamical model for democracy suggests that long term democratic increase is only possible if the economic situation gets better. No robust model explaining economic development using these two variables was found. [ABSTRACT FROM AUTHOR]

Background: Evictions may have serious consequences for individuals’ health and wellbeing. Even though an eviction may be experienced as a significant crisis for the family, there is little previous knowledge on consequences for evicted children. This study represents the first attempt to examine to what extent children from evicted households were separated from their parents and placed in out-of-home care (foster family or residential care) using population-based data, net of observed confounding factors related to the socioeconomic and psychosocial circumstances of their parents. Methods: This study takes advantage of information from a Swedish national database, consisting of about 8 000 evicted individuals and a random sample of 770 000 individuals from the national population, linked to individual-level, longitudinal data from Swedish national registers. Our analytical sample consists of information for more than 250 000 children born in 1995–2008, including 2 224 children from evicted households. We used binary logistic regression based on the Karlson/Holm/Breen method to account for observed imbalances at baseline between evicted and non-evicted children. Results: Compared to non-evicted children, the crude odds ratio for placement in out-of-home care in evicted children was 12.10 (95% CI 8.54–17.14). Net of observed confounding factors related to the socioeconomic and psychosocial circumstances of the parents, evicted children had a twofold elevated risk of being placed in out-of-home care (odds ratio 2.26, 95% CI 1.55–3.27). Crude OR for evicted children in comparison with children under threat of eviction (eviction not formally executed) was 1.71 (95% CI 1.17–2.49) and adjusted OR 1.58 (95% CI 1.06–2.35). Conclusion: Children who experience eviction constitute a disadvantaged group and are at significant risk of being separated from their parents and placed in out-of-home care. These results demonstrate the importance of providing support for these children and their parents. Strategies to prevent households with children from being evicted seem to be an important and viable intervention path. [ABSTRACT FROM AUTHOR]

Childbearing intentions are primary predictor of childbearing behaviors, particularly in low fertility societies. This study examined the role of relative status of women in childbearing intentions in Iran where fertility has been declining since 1986 and it has been around the replacement level during the last two decades. Data from the 2010 Iran’s Multiple Indicator Demographic and Health Survey (IrMIDHS) were used to estimate the effect of relative status of women on intention to have more children among women with one child and those with two children. The results showed modest effect of relative status of women on future childbearing intentions at both parity one and two controlling for socioeconomic and demographic factors. One implication from this finding is that within low fertility regimes where fertility level is around or below replacement level, the relative status of women is no more as important determinant of childbearing intention as in situations of high fertility regimes. This interpretation is consistent with the fact that most of the studies showing strong effect from relative status of women on childbearing are based on data from the situations where fertility level has been at the pre-transitional level. [ABSTRACT FROM AUTHOR]

Adapting community-based protected areas to local context and evaluating their success across a range of possible socio-economic and ecological outcomes depends, in part, on understanding the perceptions of local actors. This article presents results from a mixed methods study that focuses on how and why religious identity, a prominent aspect of Ghanaian culture, is related to perceptions of the performance of several Community Resource Management Areas (CREMAs). CREMAs are a form of Ghanaian protected area that emphasizes community participation and a range of socio-economic and ecological objectives. Using importance-satisfaction analysis, large-scale survey results show that respondents that identify as Christians consistently assign greater importance to CREMA outcomes than do those that identify with Traditional religions. Education and whether respondents were native to an area (both of which were correlated with religious identity) were also systematically related to perceptions of CREMA importance, with those that are educated and non-native to an area tending to assign higher importance to CREMA outcomes. Follow up focus group participants from the Avu Lagoon CREMA suggest that the patterns result from differing ‘openness’ to new ideas, relative dependence on natural resources, acceptance of Traditional practices associated with conservation, and a sense, for some, that ecological conditions are divinely ordained. Christianity, education and non-nativity are associated with much larger performance gaps, particularly with respect to socio-economic impacts. The article concludes with a discussion of the implications for conservation interventions and the use of perceptions in assessing protected area performance. [ABSTRACT FROM AUTHOR]