Geospatial Analysis of the Proportion of Persons Defined as Underrepresented in Medicine for Each Medical School and Their Surrounding Core-Based Statistical Area.

Background: The current approach to increasing diversity in medical education fails to consider local community demographics when determining medical school matriculation. Purpose: We propose that medical schools better reflect their surrounding community, both because racially/ethnically concordant physicians have been shown to provide better care and to repair the historical and current racist impacts of these institutions that have criminalized, displaced, and excluded local Black and Brown communities. Methods and Results: In this study, we used geospatial analysis to determine that medical school enrollments generally fail to reflect their surrounding community, represented as their core-based statistical area, within which the individual medical schools reside.

Mapping the Postpartum Experience Through Obstetric Patient Navigation for Low-Income Individuals.

Background: Although the postpartum period is an opportunity to address long-term health, fragmented care systems, inadequate attention to social needs, and a lack of structured transition to primary care threaten patient wellbeing, particularly for low-income individuals. Postpartum patient navigation is an emerging innovation to address these disparities. Methods: This mixed-methods analysis uses data from the first year of an ongoing randomized controlled trial to understand the needs of low-income postpartum individuals through 1 year of patient navigation. We designed standardized logs for navigators to record their services, tracking mode, content, intensity, and target of interactions. Navigators also completed semistructured interviews every 3 months regarding relationships with patients and care teams, care system gaps, and navigation process. Log data were categorized, quantified, and mapped temporally through 1 year postpartum. Qualitative data were analyzed using the constant comparative method. Results: Log data from 50 participants who received navigation revealed the most frequent needs related to health care access (45.4%), health and wellness (18.2%), patient-navigator relationship building (14.8%), parenting (13.6%), and social determinants of health (8.0%). Navigation activities included supporting physical and mental recovery, accomplishing health goals, connecting patients to primary and specialty care, preparing for health system utilization beyond navigation, and referring individuals to community resources. Participant needs fluctuated, yielding a dynamic timeline of the first postpartum year. Conclusion: Postpartum needs evolved throughout the year, requiring support from various teams. Navigation beyond the typical postpartum care window may be useful in mitigating health system barriers, and tracking patient needs may be useful in optimizing postpartum care. Clinical Trial Registration: Registered April 19, 2019, enrollment beginning January 21, 2020, NCT03922334, https://clinicaltrials.gov/ct2/show/NCT03922334.

Did Descriptive and Prescriptive Norms About Gender Equality at Home Change During the COVID-19 Pandemic? A Cross-National Investigation.

Using data from 15 countries, this article investigates whether descriptive and prescriptive gender norms concerning housework and child care (domestic work) changed after the onset of the COVID-19 pandemic. Results of a total of 8,343 participants (M = 19.95, SD = 1.68) from two comparable student samples suggest that descriptive norms about unpaid domestic work have been affected by the pandemic, with individuals seeing mothers' relative to fathers' share of housework and child care as even larger. Moderation analyses revealed that the effect of the pandemic on descriptive norms about child care decreased with countries' increasing levels of gender equality; countries with stronger gender inequality showed a larger difference between pre- and post-pandemic. This study documents a shift in descriptive norms and discusses implications for gender equality-emphasizing the importance of addressing the additional challenges that mothers face during health-related crises.

Toward Language Justice in Environmental Health Sciences in the United States: A Case for Spanish as a Language of Science.

BACKGROUND: Increasingly, marginalized communities are disproportionately facing the worsening effects of environmental hazards, including air pollution, water pollution, and climate change. Language isolation and accessibility has been understudied as a determinant of health. Spanish, despite being the second-most common language in the United States with some 41.8 million speakers, has been neglected among environmental health scientists. Building capacity in high-quality Spanish-language science communication, both for scientific and nonscientific audiences, can yield improvements in health disparities research, public health literacy, international collaborations, and diversity and inclusion efforts. OBJECTIVES: In this article, we discuss the context of language diversity in environmental health sciences and offer recommendations for improving science communication in Spanish. DISCUSSION: English is currently the predominant language for scientific discourse, but Spanish and other non-English languages are routinely used by many environmental health science students and professionals, as well as much of the public. To more effectively conduct and communicate environmental health work in Spanish, we suggest that researchers and scientific institutions a) foster structural changes, b) train emerging scholars and support established researchers, c) tap into community ways of knowing, and d) leverage emerging technologies. https://doi.org/10.1289/EHP12306.

Rates of breastfeeding initiation and duration in the United States: data insights from the 2016-2019 Pregnancy Risk Assessment Monitoring System.

Introduction: While breastfeeding rates in the United States have been increasing, they remain low by international standards with substantial racial, income and education disparities. This study uses recent population-based data to analyze sociodemographic differences in breastfeeding initiation, duration, and exposure to information and education. Methods: We used the 2016-2019 Pregnancy Risk Assessment Monitoring System (PRAMS) to compare breastfeeding duration among a representative population from 43 states and the District of Columbia. We modeled the likelihood of never initiating breastfeeding by respondent's age, race and ethnicity, language, marital status, household income, educational attainment, parity and insurance status. We also compared sources of information and education for respondents who never breastfed to those who breastfed up to 6 months. Results: Among 142,643 new mother respondents, representing an estimated population of 7,426,725 birthing individuals, 12.6% never breastfed, 60.4% reported breastfeeding at 3 months and 54.7% at 6 months. While 75.8% of college graduates reported breastfeeding at 3 months, this was only 37.8% of respondents with high school or less. Among those with the lowest six-month rates were non-Hispanic Black participants (36.3%) and those age < 20 (25.5%). Respondents with Medicaid coverage for their delivery were 25% more likely to have never breastfed than the privately insured. Respondents reporting household income <$20,000 were 57% more likely to have never breastfed as compared to those with household income>$85,000. While 64.1% of those breastfeeding at 6 months reported receiving information from "my" doctor', this was only 13.0% of those who never breastfeed. Discussion: Improved breastfeeding rates could have significant effects on reducing health disparities in the United States. Clinical and public health policy initiatives need to include culturally sensitive breastfeeding education before and after childbirth, with psychological and direct support from obstetrics and primary care providers. Health plans should support home and community-based in-person and telelactation consulting services. Public policies such as paid family and medical leave and workplace accommodations will also be critical. Given the huge implications of breastfeeding rates on the development of infant immune defenses and a healthy microbiome, improving breastfeeding rates should be a much more important public health priority in the United States.

Needs assessment and planning for a clinic-community-based implementation program for hypertension control among blacks in New York City: a protocol paper.

BACKGROUND: Hypertension (HTN) control among Blacks in the USA has become a major public health challenge. Barriers to HTN control exist at multiple levels including patient, physician, and the health system. Patients also encounter significant community-level barriers, such as poor linkage to social services that impact health (unstable housing, food access, transportation). We describe a multi-component needs assessment to inform the development, implementation, and evaluation of a program to improve HTN management within a large healthcare system in New York City (NYC). METHODS: Guided by the Community-Based Participatory Research (CBPR) and Consolidated Framework for Implementation Research (CFIR) frameworks, data will be collected from four main sources: (1) quantitative surveys with health systems leadership, providers, and staff and with community-based organizations (CBOs) and faith-based organizations (FBOs); (2) qualitative interviews and focus groups with health systems leadership, providers, and staff and with CBOs and FBOs; (3) NYC Community Health Survey (CHS); and (4) New York University (NYU) Health system Epic Electronic Health Record (EHR) system. The data sources will allow for triangulation and synthesis of findings. DISCUSSION: Findings from this comprehensive needs assessment will inform the development of a clinic-community-based practice facilitation program utilizing three multi-level evidence-based interventions (nurse case management, remote blood pressure (BP) monitoring, and social determinants of health (SDoH) support) integrated as a community-clinic linkage model for improved HTN control in Black patients. Integration of stakeholders' priorities, perspectives, and practices into the development of the program will improve adoption, sustainability, and the potential for scale-up. TRIAL REGISTRATION: NCT05208450; registered on January 26, 2022.

Assessment tools for measurement of dementia-friendliness of a community: A scoping review.

BACKGROUND: A quantitative assessment of the dementia-friendliness of a community can support planning and evaluation of dementia-friendly community (DFC) initiatives, internal review, and national/international comparisons, encouraging a more systematic and strategic approach to the advancement of DFCs. However, assessment of the dementia-friendliness of a community is not always conducted and continuous improvement and evaluation of the impact of dementia-friendly initiatives are not always undertaken. A dearth of applicable evaluation tools is one reason why there is a lack of quantitative assessments of the dementia-friendliness of communities working on DFC initiatives. PURPOSE: A scoping review was conducted to identify and examine assessment tools that can be used to conduct quantitative assessments of the dementia-friendliness of a community. DESIGN AND METHODS: Peer-reviewed studies related to DFCs were identified through a search of seven electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, EMCare, HealthSTAR, and AgeLine). Grey literature on DFCs was identified through a search of the World Wide Web and personal communication with community leads in Australia, Canada, New Zealand, the United Kingdom, and the United States. Characteristics of identified assessment tools were tabulated, and a narrative summary of findings was developed along with a discussion of strengths and weaknesses of identified tools. RESULTS: Forty tools that assess DFC features (built environment, dementia awareness and attitudes, and community needs) were identified. None of the identified tools were deemed comprehensive enough for the assessment of community needs of people with dementia.

Bridging the postpartum gap: best practices for training of obstetrical patient navigators.

The postpartum period represents a critical window of opportunity to improve maternal short- and long-term health, including optimizing postpartum recovery, providing effective contraception, caring for mood disorders, managing weight, supporting lactation, initiating preventive care, and promoting cardiometabolic health. However, inadequate postpartum care, especially for individuals facing social and structural barriers, is common in the United States and contributes to suboptimal health outcomes with lasting consequences. Patient navigation is a patient-centered intervention that uses trained personnel to identify financial, cultural, logistical, and educational obstacles to effective healthcare and to mitigate these barriers to facilitate comprehensive and timely access to needed health services. Given the emerging evidence suggesting that patient navigation may be a promising method to improve health among postpartum individuals, our team developed a postpartum patient navigator training guide to be used in the Navigating New Motherhood 2 and other obstetrical navigation programs. Navigating New Motherhood 2 is a randomized trial exploring whether patient navigation by a trained, lay postpartum navigator for individuals with a low income can improve health and patient-reported outcomes during and after the postpartum period. Hiring and training patient navigators without health professional degrees are integral components of initiating a navigation program. However, patient navigator training is highly variable, and no guideline regarding key elements in such a training program exists for obstetrics specifically. Thus, this paper aimed to describe the core principles, content, and rationale for each element in a comprehensive postpartum patient navigator training program. Training should be centered around the following 6 core elements: (1) principles of patient navigation; (2) knowledge of pregnancy and postpartum care; (3) health education and health promotion principles; (4) cultural sensitivity and health equity; (5) care coordination and community resources; and (6) electronic medical record systems. These core elements can serve as a basis for the development of adaptable curricula for several institutions and contexts. In addition, we offer recommendations for the implementation of a navigator training program. A curriculum with built-in flexibility to meet community and institutional needs may promote the effective and sustainable use of patient navigation in the postpartum context.

Measurable Residual Disease Assessment and Allogeneic Transplantation as Consolidation Therapy in Adult Acute Lymphoblastic Leukemia in Colombia.

INTRODUCTION: Detectable minimal residual disease (MRD) after therapy for acute lymphoblastic leukemia (ALL) is the strongest predictor of hematologic relapse. The objective of the study was to assess disease-free survival (DFS) and overall survival (OS) of patients with ALL according with MRD status at the end of induction therapy in a Colombian population. PATIENTS AND METHODS: We assessed a retrospective cohort to compare DFS and OS in adults with de novo ALL according to MRD status at the end of induction chemotherapy, and the type of postinduction consolidation strategy used. RESULTS: A total of 165 adults with ALL were included in the MRD part of the study, 73 patients in the MRD-negative group and 92 in the MRD-positive group. Median DFS for the MRD-positive group was 11 months (95% confidence interval, 11.7-22.2) and was not reached for the MRD-negative group (P < .001). At 3 years, DFS was 18% and 55%, respectively (P < .001). The median OS for MRD-positive patients was 16 months (95% confidence interval, 8.8-23.15) and was not reached in the MRD-negative group. At 3 years, OS was 26% and 51% for the former and latter group, respectively. Among subjects who did not receive a transplant, median DFS was 21 months for MRD-negative patients and 9 months for MRD-positive patients (P < .001). The median DFS was not reached in either group, whereas 3-year DFS was 64% for MRD-negative and 70% for MRD-positive patients who underwent transplantation in first remission (P = .861). CONCLUSION: MRD status at the end of induction is an independent prognostic factor for DFS and OS in adult ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD.

Improving the Relationship of Medicaid Home and Community-Based Services Home Care Aides and Clients Through Health Interviewing.

Medicaid home and community-based services (HCBS) care plans should be person-centered, yet there is little research on how to ascertain this information in practice. The purpose of this study was to investigate the feasibility of a home care aide (HCA)-led health interview with clients during usual HCBS. We provided interview training, and HCAs (n = 21) conducted five interviews with one client each using a card sort methodology to elicit client care preferences. HCAs audio-recorded interviews and photographed card sorts for analysis. We used a mixed-methods approach of semistructured interviews and focus groups with clients and HCAs to evaluate the health interviewing experience and client surveys of Your Health Orientation, Willingness to Communicate, and PROMIS (Patient-Reported Outcomes Measurement Information System) global health and HCA surveys of the Active Empathetic Listening Scale. We used t tests to investigate changes in survey outcomes pre and post interviews. Results show HCAs can conduct health interviews, and doing so contributes new knowledge on client preferences for care. Clients desire HCAs who provide empathy, compassion, and motivation, and HCAs felt interviewing clients helped them to better understand their care recipient's needs.

Developing a health interview tool for Medicaid home and community-based services clients and home care aides through a community-engaged approach.

We describe a community-engaged approach to develop and pilot a home care aide (HCA) administered health interview with Medicaid Home and Community-based Services clients. Stakeholders identified five priority health topics and selected a card sorting methodology for interviews. A barrier to interviewing clients was decreased communication skills among HCAs, and we modified health interview training to include communication training. Stakeholders reported the interview methodology was feasible within usual care, acceptable to clients, and contributed to increased knowledge on providing person-centered care. Stakeholder engagement resulted in valuable insights regarding the health interview methodology and relevant training needs.

The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders.

OBJECTIVES: Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders' reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders. METHODS: Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income. Additionally, cultural and family values were assessed by acculturation and the 'family as referents' dimension of familism, which refers to the belief that family members' behaviour should meet with familial expectations. RESULTS: Statistical analysis using hierarchical regression indicated that 'family as referents' and acculturation predicted loneliness, but not social network. CONCLUSIONS: This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders. CLINICAL IMPLICATIONS: Findings highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders.

Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.

We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.

Human papillomavirus (HPV) detection and Papanicolaou cytology in low-resource women in Posadas city, Misiones, Argentina / Detección del virus papiloma humano (HPV) y citología de Papanicolaou en mujeres de bajos recursos de la ciudad de Posadas, Misiones, Argentina

The objective of this study was to determine the prevalence of HPV infection and cervical lesions present in women who attended a health center in a low-resource area of the city of Posadas, Misiones, Argentina. Cervical cell samples (n = 163) were processed for Papanicolaou cytology and HPV-PCR tests. Socio-cultural risk factors were estimated using the odds ratio (OR, CI 95 %). Cervical lesions were detected in 14.7 % of women. The general prevalence of HPV infection was of 38 %. The most common types among the total population were HPV-16 (9.8 %) and HPV-33 (9.3 %). HPV-16 was detected in association with 29.2 % and 6.5 % of women with and without cervical lesions, respectively, the OR being 5.3 (1.8-15.8). Risk factors for HPV-16 infection were a smoking habit and a history of previous sexually-transmitted diseases. These data are important for the implementation of prevention programs, including an appropriate introduction of vaccination and the baseline for virological surveillance in the vaccine era.

El objetivo de este estudio fue determinar la prevalencia de la infección por HPV y de lesiones cervicales en mujeres asistidas en un centro de salud situado en un área de bajos recursos de la ciudad de Posadas, Misiones, Argentina. Las muestras (n = 163) fueron examinadas mediante las pruebas de Papanicolaou y de PCR para HPV. Los factores socio-culturales de riesgo fueron identifcados mediante el cálculo de la odds ratio (OR, IC 95 %). Se detectaron lesiones cervicales en el 14,7 % de las mujeres. La prevalencia de infección por HPV fue de 38 %. Los tipos más frecuentes en la población total fueron HPV-16 (9,8 %) y HPV-33 (9,3 %). El HPV-16 se detectó asociado al 29,2 % y al 6,5 % de las mujeres con lesiones del cuello uterino y sin ellas, respectivamente, con un OR de 5,3 (1,8-15,8). Los factores de riesgo para la infección por HPV-16 fueron el hábito de fumar y el antecedente de enfermedades de transmisión sexual. Estos datos son importantes para la ejecución de los programas de prevención, incluyendo una introducción adecuada de la vacunación y la línea de base para la vigilancia virológica en la era de la vacuna.

Human papillomavirus (HPV) detection and Papanicolaou cytology in low-resource women in Posadas city, Misiones, Argentina.

The objective of this study was to determine the prevalence of HPV infection and cervical lesions present in women who attended a health center in a low-resource area of the city of Posadas, Misiones, Argentina. Cervical cell samples (n = 163) were processed for Papanicolaou cytology and HPV-PCR tests. Socio-cultural risk factors were estimated using the odds ratio (OR, CI 95 %). Cervical lesions were detected in 14.7 % of women. The general prevalence of HPV infection was of 38 %. The most common types among the total population were HPV-16 (9.8 %) and HPV-33 (9.3 %). HPV-16 was detected in association with 29.2 % and 6.5 % of women with and without cervical lesions, respectively, the OR being 5.3 (1.8-15.8). Risk factors for HPV-16 infection were a smoking habit and a history of previous sexually-transmitted diseases. These data are important for the implementation of prevention programs, including an appropriate introduction of vaccination and the baseline for virological surveillance in the vaccine era.

Fluorescent benzofurazan-cholic acid conjugates for in vitro assessment of bile acid uptake and its modulation by drugs.

One of the most common mechanisms of hepatotoxicity is drug-induced cholestasis. Hence, new approaches for screening the cholestatic potential of drug candidates are desirable. In this context, we describe herein the use of synthetic 4-nitrobenzo-2-oxa-1,3-diazole (NBD) fluorescent conjugates of cholic acid (ChA) at positions 3alpha, 3beta, 7alpha, and 7beta for in vitro assessment of bile acid uptake. All the conjugates show a strong absorption band between 400 and 550 nm and have a fluorescence quantum yield of approximately 0.45, with an emission maximum centered at approximately 530 nm. After their photophysical characterization, 3alpha-, 3beta-, 7alpha-, and 7beta-NBD-ChA were used to monitor uptake in freshly isolated rat hepatocytes by means of a previously optimized flow cytometry technique. Transport of the cholic acid derivatives inside the cell was detected and quantified by measuring the increase of NBD green fluorescence within cells over time. The effect of troglitazone, a well-known inhibitor of bile acid uptake by the sodium taurocholate co-transporting polypeptide, supports the specificity of fluorescent NBD-ChA transport. According to the final intracellular fluorescence level attained and the uptake rate, 3alpha-NBD-ChA was found to be the most efficient derivative. Furthermore, sodium valproate, cyclosporin A, and chlorpromazine decreased the uptake of 3alpha-NBD-ChA, in agreement with their relative in vivo potency as cholestatic compounds; in contrast, sodium citrate (the negative control) had no effect. These results support the suitability of the in vitro flow cytometric assay with NBD-ChA to detect compounds that affect bile acid uptake.

Extubation in the operating room after Fontan's procedure: effect on practice and outcomes.

BACKGROUND: Timely extubation is a well-accepted strategy in the postoperative intensive care unit management of Fontan patients to minimize the deleterious effects of positive-pressure ventilation. In October 2002, this strategy was extended to extubating selective Fontan patients in the operating room (EOR). This retrospective study examines how EOR has affected outcomes and practice in our Fontan population. METHODS: Between October 2002 and June 2006, 112 patients underwent primary Fontan procedures; 38 (34%) were EOR and 74 (66%) were non-EOR. These two cohorts were not different (p < 0.05) in age, weight, surgery time, dominant ventricular morphology, hypoplastic left heart syndrome, prior bidirectional Glenn, concomitant procedures, atrioventricular valve regurgitation, and ventricular function. Analysis of variance was used to compare mean pulmonary artery pressure, mean arterial blood pressure, and mean common atrial pressure as a function of time. RESULTS: During the first 12 hours postoperatively, mean pulmonary artery pressure and mean common atrial pressure were significantly lower and mean arterial blood pressure was significantly higher in the EOR group than the non-EOR group (p < 0.05). No EOR patient required reintubation. Mean durations of inotropic agents (1.1 versus 2.4 days), chest tubes (5.8 versus 7.2 days), intensive care unit stay (3 versus 4.7 days), and hospital stay (8.6 versus 11.3 days) for EOR patients were shorter than for non-EOR patients (p < 0.05). Intensive care unit and hospital costs for EOR patients were 35% and 31% lower, respectively, than for non-EOR patients (p < 0.05). Kaplan-Meier survival for EOR patients (3 years, 100%) was not different (p = 0.3) than for non-EOR patients (1 and 3 years, 96%). CONCLUSIONS: After the Fontan procedure, selective EOR can be performed safely and improves postoperative hemodynamics, decreases hospital resource utilization, and reduces hospital recovery time.

¿Quiénes son los adolescentes que no van a la escuela? Encuesta de hogares en la ciudad de Pachuca, Hgo / Adolescents who do not attend scholl, who are they? Results from household survery conducted in Pachuca, Hgo

Las encuestas en hogares son un excelente apoyo porque brindan la posibilidad de captar a aquéllos adolescentes que por una u otra razón no se encuentran estudiando en la actualidad, y que, por lo tanto, quedan fuera de las encuentas de las escuelas. En este trabajo se compararon dos grupos: 240 adolescentes que estudiaban y 73 adolescentes que no asitían a la escuela. El estudio se llevó a cabo en una muestra fueron entrevistados en su hogar y la duración promedio de la entrevista fue de una hora, obteniéndose una tasa de no respuesta inferior al 5 por ciento. El instrumento, elaborado especificamante para adolescentes entre 15 y 17 años, entrevistados en sus hogares, fue un cuestionario estandarizado, aplicado individualmente, cuya validez y confiabilidad ha sido ampliamente probada, añadiéndose indicadores específicos e interés para este estudio. La muestra de adolescentes entre 15 y 17 años quedó constituida finalmente por 313 entrevistas completas en el hogar de las cuales 45 por ciento [141] se le hicieron a hombres y 55 por ciento [171] a mujeres. El 76.6 por ciento era estudiante y el 23.4 por ciento no estudiaba en el momento de entrevistarlos. Entres los adolescentes que no estudiaban, el grado escolar más alto que alcanzó la mayoría fue de escuela primaria (51.4 por ciento), y uno dijo no haber recibido ningún tipo de educación formal. La mitad de los adolescentes que no estudiaba (51 por ciento) estaba trabajando, mientras que el resto dijo simplemente haber abandonado los estudios (26 por ciento) o considerarse como desempleados (15 por ciento). El nivel socioeconómico de los menores que abandonaron la escuela era inferior al de los que sí iban a la escuela. En cuanto a las actividades que acostumbran practicar durante su tiempo libre, las más frecuentes fueron "algún deporte" y "salir a pasear con la familia", con diferencias estadísticamante significativas entre uno y otro grupo. La única opción estadísticamente significativa que tienen los adolescentes que no estudian es "no hacer nada y aburrirse". También llama la atención: "ayudar en las labores de la casa", "jugar Nintendo, maquinitas o juegos electrónicos" e "ir a beber con los amigos". Los datos que se tienen con los primeros que se tiene sobre los adolescentes que no asisten a la escuela