Maternal and foetal risks associated with teenage pregnancy - a comparative retrospective study in Turkey.

BACKGROUND: Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. METHODS: The records of a total of 960 pregnant women (480 pregnant adolescents aged 15-19 years and 480 pregnant adult women aged 20-26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. RESULTS: Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). CONCLUSIONS: This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.

In this study, we examine the risks of adolescent pregnancies. Adolescent pregnancy is a public health problem, and it is more common in underdeveloped or developing countries. We believe that non-governmental organisations and governments should take precautions regarding adolescent pregnancies and protect this legally vulnerable sociodemographic group from pregnancy. For healthier and more conscientious pregnancy experiences, mothers must be of appropriate age, having passed the period of adolescence. Adolescent pregnancies, which come with many risks, and especially risks of preeclampsia, premature birth, and maternal death, should be minimised or prevented.

Age, but not education, affects social decision-making in the ultimatum game paradigm.

BACKGROUND: Social decision-making (SDM) is often studied through gaming paradigms, in which participants allocate resources among themselves and others based on predefined rules. In an adapted version of the ultimatum game (UG), SDM behavior was modulated in response to the degree of fairness of monetary offers and the social context of opponents, designed to generate either prosocial or punishing behaviors. OBJECTIVE: To investigate whether SDM evaluated by the UG is affected by age and schooling, as it is relevant to know whether sociodemographic variables may bias UG results. METHODS: A total of 131 healthy adults participated: 35 young university students and 96 participants in Universidade de São Paulo's USP 60+ program (formerly known as Universidade Aberta à Terceira Idade, a program for people aged ≥ 60 years to attend university). The sample was divided into 3 age groups (17-22, 60-69, and 70-79 years) and 3 schooling groups (4-8, 9-11, and ≥ 12 years of schooling). RESULTS: Age and schooling did not affect performance in fair monetary offers. Differences were observed in the unfair conditions. The oldest group (70-79 years) accepted less frequently the baseline unfair offers (without social context), when compared with the 17-22 and the 60-69 years groups (17-22 = 60-69 > 70-79). Regarding the prosocial unfair and punishing unfair conditions, older adults accepted such offers more frequently (17-22 < 60-69 = 70-79). Schooling effects were not observed. CONCLUSION: In the context of SDM, older adults may show prosocial behaviors more frequently than younger adults. The findings suggest performance in the UG is affected by age, but not by schooling.

ANTECEDENTES: A tomada de decisão social (TDS) é frequentemente estudada por meio de paradigmas de jogo, em que os participantes alocam recursos entre si e outros com base em regras predefinidas. Em uma versão adaptada do jogo do ultimato (JU), o comportamento de TDS foi modulado em resposta ao grau de justiça das ofertas monetárias e ao contexto social dos oponentes, projetado para produzir comportamentos pró-sociais ou punitivos. OBJETIVO: Investigar se a TDS avaliada pelo JU é afetada pela idade e escolaridade, pois é relevante saber se variáveis sociodemográficas podem influenciar os resultados do JU. MéTODOS: Participaram 131 adultos saudáveis, sendo 35 jovens universitários e 96 participantes do programa USP 60+ (antigo Universidade Aberta à Terceira Idade). A amostra foi dividida em 3 faixas etárias (17­22, 60­69 e 70­79 anos) e 3 faixas de escolaridade (4­8, 9­11 e ≥ 12 anos). RESULTADOS: Idade e escolaridade não afetaram o desempenho em ofertas monetárias justas. Diferenças foram observadas nas condições injustas. O grupo mais velho (70­79 anos) aceitou menos as ofertas injustas de referência (sem contexto social), quando comparado com o grupo de 17­22 e o de 60­69 anos (17­22 = 60­69 > 70­79). Em relação às condições pró-sociais injustas e punitivas injustas, os idosos aceitaram com maior frequência tais ofertas (17­22 < 60­69 = 70­79). Efeitos da escolaridade não foram observados. CONCLUSãO: No contexto da TDS, os idosos podem apresentar comportamentos pró-sociais com mais frequência do que os adultos mais jovens. Os resultados sugerem que o desempenho no JU é afetado pela idade, mas não pela escolaridade.

[Educational attainment increases the risk of developing allergic rhinitis and (or) eczema: a Mendelian randomization study based on genome-wide association studies in European patients].

Objective: To determine the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema using Mendelian randomization (MR) analyses. Methods: This study was a secondary data analysis based on the summary data of genome-wide association studies (GWAS), which involved 293 723 participants (educational attainment) from the Social Science Genetics Association Consortium and 462 013 participants [allergic rhinitis and (or) eczema] from the UK Biobank. Genetic variants that were closely related to educational attainment were identified as instrumental variables. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger regression, weighted median method and weighted model-based estimation, were performed to investigate the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, in which the odds ratio (OR) values were used as indicators. Results: A total of 70 single-nucleotide polymorphisms (SNPs) were chosen as instrumental variables. The MR-Egger regression results suggested that the genetic pleiotropy was unlikely to bias our results (P=0.107). In the univariable MR analyses, IVW regression showed that the risk of allergic rhinitis and (or) eczema was OR=1.044 (95%CI: 1.020-1.069, P<0.001) and OR=1.170 (95%CI: 1.074-1.256, P<0.001), respectively, for the increase in the duration of education by one year or one standard deviation (SD) (3.71 years). In the reverse MR analysis, IVW regression showed little evidence that allergic rhinitis and (or) eczema affected educational attainment (OR=1.020, 95%CI: 0.927-1.023, P=0.683). The results of the weighted median method and weighted mode-based estimation were consistent with the results of IVW. Conclusion: This study suggests that there is a positive causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, which means that educational attainment can increase the occurrence of allergic rhinitis and (or) eczema.

Spatial Variation and Determinants of Inadequate Minimum Meal Frequency among Children Aged 6-23 Months in Ethiopia: Spatial and multilevel analysis using Ethiopian Mini Demographic and Health Survey (EMDHS) 2019.

Introduction: Minimum meal frequency is the number of times children eat in a day. Without adequate meal frequency, infants and young children are prone to malnutrition. There is little information on the spatial distribution and determinants of inadequate meal frequency at the national level. Therefore, we aimed to investigate the spatial distribution and determinants of inadequate meal frequency among young children in Ethiopia. Methods: The most recent Ethiopian demographic and health survey data was used. The analysis was conducted using a weighted sample of 1,610 children aged 6-23 months old. The Global Moran's I was estimated to assess the regional variation in minimum meal frequency. Further, a multivariable multilevel logistic regression model was fitted to identify factors associated with inadequate meal frequency. The AOR (adjusted odds ratio) at 95% CI (confidence interval) was computed to assess the strength and significance of the relationship between explanatory variables and the outcome variable. Factors with a p-value of <0.05 are declared statistically significant. Results: This study revealed that the prevalence of inadequate meal frequency was found to be 30.56% (95% CI: 28.33-32.88). We identified statistically significant clusters of high inadequate meal frequency, notably observed in Somalia, northern Amhara, the eastern part of southern nations and nationalities, and the southwestern Oromia regions. Child age, antenatal care (ANC) visit, marital status, and community level illiteracy were significant factors that were associated with inadequate meal frequency. Conclusion: According to the study findings, the proportion of inadequate meal frequency among young children in Ethiopia was higher and also distributed non-randomly across Ethiopian regions. As a result, policymakers and other concerned bodies should prioritize risky areas in designing intervention. Thus, special attention should be given to the Somalia region, the northern part of Amhara, the eastern part of Southern nations and nationalities, and southwestern Oromia.

Aperiodic component of EEG power spectrum and cognitive performance are modulated by education in aging.

Recent studies have shown a growing interest in the so-called "aperiodic" component of the EEG power spectrum, which describes the overall trend of the whole spectrum with a linear or exponential function. In the field of brain aging, this aperiodic component is associated both with age-related changes and performance on cognitive tasks. This study aims to elucidate the potential role of education in moderating the relationship between resting-state EEG features (including aperiodic component) and cognitive performance in aging. N = 179 healthy participants of the "Leipzig Study for Mind-Body-Emotion Interactions" (LEMON) dataset were divided into three groups based on age and education. Older adults exhibited lower exponent, offset (i.e. measures of aperiodic component), and Individual Alpha Peak Frequency (IAPF) as compared to younger adults. Moreover, visual attention and working memory were differently associated with the aperiodic component depending on education: in older adults with high education, higher exponent predicted slower processing speed and less working memory capacity, while an opposite trend was found in those with low education. While further investigation is needed, this study shows the potential modulatory role of education in the relationship between the aperiodic component of the EEG power spectrum and aging cognition.

Factors influencing use of contraceptives among literate married women in Ogbomoso South Local Government Area, Oyo State.

Background: Contraceptives uses are issues of concern around the world due to the adverse effects of unsafe sexual behaviours, such as unwanted pregnancies and sexually transmitted diseases among women. Objective: To investigate the factors influencing use of contraceptives among literate married women in Ogbomoso South Local Government Area, Oyo State. The study also examined whether the variables of age, religion and educational qualification would influence the respondent's view. Methods: Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 210 respondents. A questionnaire was used to collect data for the study. Mean and rank order was used to answer the research question while Analysis of Variance was used to test the hypotheses at 0.05 level of significance. Results: Findings revealed that factors influencing contraceptive use among literate married women are educational qualification, health condition and number of children among others. Findings also revealed that there were no significant differences in the factors influencing use of contraceptives among literate married women based on age and religious affiliation while significant difference was found in educational qualification. Conclusion: Majority of the respondents attested to the factors influencing contraceptive use among literate married women. Based on the findings of the study, it was recommended that contextual and cultural considerations are recommended for comprehensive understanding of factors influencing contraceptive use among Nigerian women, educative interventions by service providers on the necessity of continuous contraception even at older age before menopause should be recommended.

Cohort differences between preschool development of in vitro fertilization and naturally conceived infants.

To explore the differential cohort situation between preschool development of in vitro fertilization (IVF) and naturally conceived infants. From April 2014 to June 2022, 60 preschool IVFs were selected as the research subjects for follow-up at the pediatric health clinic of hospital's prevention and health department. They were set as the experimental group (Group S), and 60 naturally conceived infants of the same age were selected as the control group (Group Z). Data from both groups were collected through telephone follow-up and other methods. No significant difference showed between the 2 groups in age specific height, age specific weight, Gesell developmental score, Denver developmental screening test screening results, intellectual development index, and motor development index (P > .05). The influence of birth environment factors such as family background and maternal education level on children's height and weight was not significant (P > .05), while maternal education level had a significant impact on children's intellectual development index (P < .05). No significant difference showed in the development of preschool children in IVF compared to naturally conceived children, and the level of parental education has a significant impact on children's mental and motor development.

A Mendelian randomization study: Years of education and nonalcoholic fatty liver disease.

Though years of education have been connected to nonalcoholic fatty liver disease (NAFLD), the exact mechanism underlying this linkage is still unknown. To investigate the causal association between years of education and NAFLD, we will use a 2-sample Mendelian randomization (MR) technique. : Genome-wide association studies data on years of education (n = 766,345) and genome-wide association studies data on nonaffiliated mental illness (n = 778,614) were screened for genetic variations as instrumental variables in the Mr-Base database. MR-Egger regression, weighted median, and inverse variance weighted were used in the MR analysis. Years of education (odds ratio = 0.63; 95% confidence interval: 0.47-0.79; P = 1.28 × 10-8) might be protective against the development of NAFLD. Among the sensitivity analyses were the following: the MR-Egger intercept test revealed P > .05, suggesting that there was no horizontal pleiotropy in the MR analysis and that the inverse variance weighted results were trustworthy; the Cochran Q test revealed P > .05, suggesting that there was no heterogeneity between the 2 samples; Funnel plot results demonstrated that there was no bias in the link between the measure of variability and the impact size. Leave-1-out analysis results demonstrated that no 1 single nucleotide polymorphism had a significant effect on the study's results, showing that the MR results were stable. This study has investigated the connection between years of education and NAFLD, offering novel suggestions for NAFLD treatment and prevention.

Prevalence and correlates of female genital mutilation among young women in selected sub-Saharan African countries: A pooled analysis.

A deeper understanding of the factors associated with female genital mutilation remains important in the fight against this practice, particularly in developing countries. This study focused on young women (15-35 years) and pooled analysis using DHS data (2015-2019) for selected sub-Saharan African countries was done. The weighted study sample was 26289 and the data were analysed using univariate, bivariate and multivariate regression analysis. The results are based on information at the time of the survey. The overall prevalence of FGM among young women from the selected countries was 71.5%. Sierra Leone had the highest prevalence (83.7%), followed by Tanzania (80.8%), Ethiopia (73.0%), and Gambia (72.4%). The prevalence in Senegal and Guinea were both below 60%. We found that age, level of education, age at first marriage, parity, employment status, media exposure, and type of place of residence were statistically associated with FGM. This calls for targeted interventions focusing on increasing awareness, education, and empowerment for young women with low socio-economic status.

Une compréhension plus approfondie des facteurs associés aux mutilations génitales féminines reste importante dans la lutte contre cette pratique, en particulier dans les pays en développement. Cette étude s'est concentrée sur les jeunes femmes (15-35 ans) et une analyse groupée utilisant les données DHS (2015-2019) pour certains pays d'Afrique subsaharienne a été réalisée. L'échantillon pondéré de l'étude était de 26 289 et les données ont été analysées à l'aide d'une analyse de régression univariée, bivariée et multivariée. Les résultats sont basés sur les informations disponibles au moment de l'enquête. La prévalence globale des MGF parmi les jeunes femmes des pays sélectionnés était de 71,5 %. La Sierra Leone avait la prévalence la plus élevée (83,7 %), suivie par la Tanzanie (80,8 %), l'Éthiopie (73,0 %) et la Gambie (72,4 %). La prévalence au Sénégal et en Guinée était inférieure à 60 %. Nous avons constaté que l'âge, le niveau d'éducation, l'âge au premier mariage, la parité, la situation professionnelle, l'exposition aux médias et le type de lieu de résidence étaient statistiquement associés aux MGF. Cela nécessite des interventions ciblées axées sur la sensibilisation, l'éducation et l'autonomisation des jeunes femmes ayant un statut socio-économique faible.

The relationship between health literacy and family planning attitude in women in Kirsehir province, Turkey.

To develop positive attitudes towards family planning, health literacy is important. This study aimed to investigate a relationship between health literacy and family planning attitudes among married women. 657 married women volunteered to participate in this cross-sectional, correlational and descriptive study. The Türkiye Health Literacy - 32 scale and the Family Planning Attitude Scale were used in the study. According to the results, the women's general health literacy score was 34.5±8.7 out of 50 points, which was adequate, and the family planning attitude score was 128.9±17.7 out of 170 points, which was above the average. It is found a weak positive relationship between health literacy and family planning attitudes. Educational status, occupation and income level affect health literacy and family planning attitude. It is noteworthy that 84.4% of women with inadequate health literacy were using modern family planning methods, while this rate was 77.1% among women with adequate health literacy. To improve women's attitudes towards family planning, it is recommended that health literacy is improved, effective media content is developed and women are encouraged to use primary health care services.

Pour développer des attitudes positives à l'égard de la planification familiale, il est important d'avoir des connaissances en matière de santé. Cette étude visait à examiner la relation entre les connaissances en matière de santé et les attitudes à l'égard de la planification familiale chez les femmes mariées. 657 femmes mariées se sont portées volontaires pour participer à cette étude transversale, corrélationnelle et descriptive. L'échelle Türkiye Health Literacy - 32 et l'échelle Family Planning Attitude Scale ont été utilisées dans l'étude. Selon les résultats, le score général des femmes en matière de santé était de 34,5±8,7 sur 50 points, ce qui est adéquat, et le score de l'attitude de planification familiale était de 128,9±17,7 sur 170 points, ce qui est supérieur à la moyenne. Il existe une faible relation positive entre les connaissances en matière de santé et les attitudes à l'égard de la planification familiale. Le niveau d'éducation, la profession et le niveau de revenu influencent les connaissances en matière de santé et l'attitude à l'égard de la planification familiale. Il convient de noter que 84,4 % des femmes dont les connaissances en matière de santé sont insuffisantes utilisent des méthodes modernes de planification familiale, alors que ce taux est de 77,1 % chez les femmes dont les connaissances en matière de santé sont suffisantes. Pour améliorer l'attitude des femmes à l'égard de la planification familiale, il est recommandé d'améliorer les connaissances en matière de santé, de développer un contenu médiatique efficace et d'encourager les femmes à utiliser les services de soins de santé primaires.

Factors Affecting Patients' Atttendance for Periodontal Follow-up Visits after Crown Lengthening Surgery.

PURPOSE: To assess adherence to follow-up maintenance visits among patients who had previously undergone crown-lengthening surgery and investigate the different factors impacting their compliance. MATERIALS AND METHODS: A total of 314 patients were identified for follow-up appointments. Based on their responses, participants were categorised into four groups: attendees, non-attendees, refusals, and unreachable. Furthermore, data on sociodemographic factors (age, sex, nationality, marital status, education, occupation, and residential area), medical history, dental history (including missing teeth, implants, or orthodontic treatment history), and past appointment attendance (average yearly appointments, missed appointment percentage, and last appointment date) were collected and analysed to understand their influence on patient compliance. RESULTS: In a sample of 314 patients, 102 (32.5%) attended the appointments successfully. Improved attendance rates were significantly associated with being female, Saudi Arabian, married, and employed (p < 0.05). Moreover, patients with a high frequency of annual appointments and a recent history of appointments exhibited better compliance. None of the analysed dental factors affected the attendance rates. CONCLUSION: About one-third of patients who had undergone crown lengthening surgery were compliant with the follow-up visits. Different factors influenced this compliance pattern to varying extents, with more efforts needed to enhance patients' commitment to these visits.

Trends in socioeconomic inequalities in life expectancy and lifespan variation in Chile.

Background: Socioeconomic disparities in life expectancy are well-documented in various contexts, including Chile. However, there is a lack of research examining trends in life expectancy inequalities and lifespan variation over time. Addressing these gaps can provide crucial insights into the dynamics of health inequalities. Methods: This study utilizes data from census records, population surveys, and death certificates to compare the life expectancy and the lifespan variation at age 26 of individuals according to their rank in the distribution of years of education within their own birth cohort. The analysis spans three periods (1991, 2002, and 2017) and focuses on two educational groups: individuals in the first (lowest) quintile and tenth (highest) decile of educational attainment. Changes in life expectancy are disaggregated by major causes of death to elucidate their contributions to overall trends. Results: Consistent with existing literature, our findings confirm that individuals with lower education levels experience lower life expectancy and higher lifespan variation compared to their more educated counterparts. Notably, by 2017, life expectancy for individuals in the lowest quintile of education has caught up with that of the top decile in 1991, albeit with contrasting trends between genders. Among women, the gap has reduced, while it has increased for males. Moreover, lifespan variation decreased (increased) over time for individuals in the tenth decile (first quintile). The leading causes of death that explain the increase in life expectancy in women and men in the tenth decile as well as women in the first quintile are cardiovascular, cancer, respiratory and digestive diseases. In the case of males in the first quintile, few gains have been made in life expectancy resulting from cancer and a negative contribution is associated with digestive conditions. Conclusions: This study underscores persistent socioeconomic disparities in life expectancy in Chile, emphasizing the importance of ongoing monitoring of health inequalities across different demographic segments. The gender-specific and educational gradient trends highlight areas for targeted interventions aimed at reducing health disparities and improving overall population health outcomes. Further research is warranted to delve into specific causes of death driving life expectancy differentials and to inform evidence-based policy interventions.

Normative Cognitive Scores in Western India, Stratified by Age, Rurality, Cognitive Domains, and Psychiatric Comorbidity.

BACKGROUND AND OBJECTIVES: Indian ethnic and educational diversities necessitate obtaining normative cognitive data in different populations. We aimed to evaluate cognitive scores using a Marathi translation of the Kolkata cognitive battery (KCB) and to study the association of KCB components with depression and sociodemographic variables. MATERIALS AND METHODS: We studied 2,651 individuals aged ≥40 years without preexisting neuropsychiatric conditions from urban (Mumbai) and rural districts of Maharashtra. For each component of KCB, the lowest 10th percentile score was used to define cognitive impairment. RESULTS: We studied 1,435 (54%) rural and 1,216 (46%) urban residents equally divided by gender (1,316 women and 1,335 men), average age 54 years. KCB scores were significantly lower with female sex, older age, illiteracy, and depression. The largest effect sizes attributable to these factors were in the domains of calculation (gender), visuoconstructional ability (VCA) (rurality), and verbal fluency (VF) (depression). Scores remained significantly lower in rural residents after controlling for age, sex, and education, particularly for VCA, immediate recall, and calculation. CONCLUSION: This Marathi KCB, having been validated on large urban as well as rural samples, may be used to study cognition in Marathi-speaking populations with appropriate cutoffs tailored to the degree of urbanization of the population.

Inverse probability weighting for self-selection bias correction in the investigation of social inequality in mortality.

BACKGROUND: Empirical evaluation of inverse probability weighting (IPW) for self-selection bias correction is inaccessible without the full source population. We aimed to: (i) investigate how self-selection biases frequency and association measures and (ii) assess self-selection bias correction using IPW in a cohort with register linkage. METHODS: The source population included 17 936 individuals invited to the Copenhagen Aging and Midlife Biobank during 2009-11 (ages 49-63 years). Participants counted 7185 (40.1%). Register data were obtained for every invited person from 7 years before invitation to the end of 2020. The association between education and mortality was estimated using Cox regression models among participants, IPW participants and the source population. RESULTS: Participants had higher socioeconomic position and fewer hospital contacts before baseline than the source population. Frequency measures of participants approached those of the source population after IPW. Compared with primary/lower secondary education, upper secondary, short tertiary, bachelor and master/doctoral were associated with reduced risk of death among participants (adjusted hazard ratio [95% CI]: 0.60 [0.46; 0.77], 0.68 [0.42; 1.11], 0.37 [0.25; 0.54], 0.28 [0.18; 0.46], respectively). IPW changed the estimates marginally (0.59 [0.45; 0.77], 0.57 [0.34; 0.93], 0.34 [0.23; 0.50], 0.24 [0.15; 0.39]) but not only towards those of the source population (0.57 [0.51; 0.64], 0.43 [0.32; 0.60], 0.38 [0.32; 0.47], 0.22 [0.16; 0.29]). CONCLUSIONS: Frequency measures of study participants may not reflect the source population in the presence of self-selection, but the impact on association measures can be limited. IPW may be useful for (self-)selection bias correction, but the returned results can still reflect residual or other biases and random errors.

Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.

Background: Maternal health service uptake remains an important predictor of maternal outcomes including maternal mortality. This systematic review and meta-analysis aimed to summarize the available evidence on the uptake of maternal health care services in developing countries and to assess the impact of place of residence, education status, and wealth index on the uptake of these services. Methods: We examined the databases MEDLINE, Web of Science, Global Index Medicus, and Scopus until June 14, 2022. Cross-sectional studies done between 2015 and 2022 were considered. Mothers of reproductive age and all states of health were included in the study. Independently, two authors determined the eligibility of studies, extracted data, evaluated the risk of bias, and ranked the evidence's degree of certainty. To combine the data, we performed a random-effects meta-analysis. The PROSPERO registration ID is CRD42022304094. Results: We included 51 studies. Mothers living in urban areas were three times more likely to receive antenatal care (OR 2.95; 95% CI 2.23 to 3.89; 15 studies; 340,390 participants) than rural mothers. Compared with no education, those with primary education were twice as likely to utilize antenatal care (OR 2.36; 95% CI 1.80 to 3.09; 9 studies; 154,398 participants) and those with secondary and higher education were six and fourteen times more likely to utilize antenatal care, respectively. Mothers in the second wealth index were twice as likely as mothers in the lowest wealth index to utilize antenatal care (OR 1.62; 95% CI 1.36 to 1.91; 10 studies; 224,530 participants) and antenatal care utilization increased further among mothers in the higher wealth index. We observed similar relative inequalities in skilled delivery care and postnatal care utilization based on the pace of residence, education, and wealth index. Conclusion: In developing countries, the problem of inequity in utilizing maternal health care services persists and needs considerable attention.

Research on cognitive impairment and potential risk factors in peritoneal dialysis patients: An observational study.

The objective of this study is to investigate the associated risk factors and their effects on cognitive impairment (CI) in patients undergoing peritoneal dialysis. A retrospective analysis was conducted on the basic information of 268 patients who underwent continuous ambulatory peritoneal dialysis (CAPD) at our hospital from January 2020 to September 2023. Cognitive function was assessed using the Montreal Cognitive Assessment Scale during their subsequent dialysis visits. Participants were categorized into a CI group and a cognitively normal group. Blood and other biological samples were collected for relevant biomarker analysis. Subsequently, we analyzed and compared the factors influencing CI between the 2 groups. The prevalence of CI among CAPD patients was 58.2%. Compared to the cognitively normal group, the CI group had a higher prevalence of alcohol consumption, lower levels of education, and reduced serum uric acid levels (P < .05). There was also a higher incidence of autoimmune diseases such as systemic lupus erythematosus in the CI group (P < .05). In terms of dialysis efficacy, the residual kidney Kt/V and residual kidney Ccr were significantly lower in the CI group compared to the cognitively normal group. In blood parameters, the CI group showed elevated total cholesterol levels and lower serum calcium concentrations (P < .05). Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05). Additionally, in this patient cohort, dialysis duration and residual renal function were protective factors against CI (P < .05). CI is prevalent among PD patients. Elevated high-sensitivity C-reactive protein levels, male gender, older age, lower educational attainment, and hypercholesterolemia constitute an independent risk factor for CI in CAPD patients, whereas residual renal function acts as a protective element.

A Global Perspective on Cardiovascular Risk Factors by Educational Level in CHD Patients: SURF CHD II.

Background: Clinical guidelines recommend lifestyle modifications and medication use to control cardiovascular risk factors in coronary heart disease (CHD) patients. However, risk factor control remains challenging especially in patients with lower educational level. Objective: To assess inequalities by educational level in the secondary prevention of CHD in the Survey of Risk Factors in Coronary Heart Disease (SURF CHD II). Methods: SURF CHD II is a cross-sectional clinical audit on secondary prevention of CHD, conducted during routine clinical visits in 29 countries. The easy-to-perform design of the survey facilitates its implementation in settings with limited resources. We reported risk factor recording, attainment of guideline-defined risk factor targets, and treatment in CHD patients. Differences by educational level in target attainment and treatment were assessed with logistic regression stratified for high- (HIC), upper middle- (UMIC), and lower middle-income (LMIC) countries. Results: SURF CHD II included 13,884 patients from 2019 to 2022, of which 25.0% were female and 18.6% had achieved only primary school level. Risk factor recording ranged from 22.2% for waist circumference to 95.6% for smoking status, and target attainment from 15.9% for waist circumference to 78.7% for smoking. Most patients used cardioprotective medications and 50.5% attended cardiac rehabilitation.Patients with secondary or tertiary education were more likely to meet targets for smoking, LDL cholesterol and physical activity in HICs and LMICs; for physical activity and triglycerides in UMICs; but less likely to meet targets for blood pressure in HICs and LDL <1.4mmol/L in UMICs. Higher education was positively associated with medication use and cardiac rehabilitation participation. Conclusion: CHD patients generally have poor attainment of risk factor targets, but patients with a higher educational level are generally more likely to participate in cardiac rehabilitation, use medication, and meet targets. Main messages: Target attainment and participation in cardiac rehabilitation are poor in CHD patients globally.Patients with higher education are more likely to meet risk factor targets, showing health inequities in secondary prevention of CHD.The association between education and risk factor target attainment and treatment varies with country income level.

Prevalence and associated factors of malnutrition among under-five children living in slum areas of Bahir Dar Town, Ethiopia.

Introduction: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City. Methods: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis. Results: a total of 680 children participated. The prevalence of stunting, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% (95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother's educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition. Conclusion: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.

Social-emotional problems in 3-to 5-year-old children: a cross-sectional study of highly educated migrants in a Chinese urban area.

Background: Previous research has primarily examined the mental well-being of children from labor migrant families, yet there is a lack of understanding regarding the mental well-being of children from highly educated migrant backgrounds. This study investigated the social-emotional problems of 3-5-year-olds from highly educated migrant families residing in an urban area of China, as well as explored potential differences in demographic variables. Methods: A cross-sectional study was conducted in Qiantang District, Hangzhou, China, with 1,494 (53.3% boys) children selected via a convenient sampling method. The Ages & Stages Questionnaires: social-Emotional, Second Edition (ASQ:SE-2) was used to measure social-emotional problems. Results: The results showed that 23.6% of the children were at risk for social-emotional problems. More boys (26.7%) than girls (20.1%) had scores above the cut-off. Additionally, more children in the low socioeconomic status (29.9%) had scores above the cut-off than those in the high socioeconomic status (18.9%). There were three common issues among all age groups: "being more active than others," "excessive attachment to parents," and "being overly friendly with strangers. Conclusion: The social-emotional development of children from highly educated migrant families is a significant aspect that deserves recognition, contributing valuable insights to the existing literature on this topic.

Knowledge of BRCA gene among young Pakistani adults: A short report.

A total of 271 young Pakistani adults responded to a selfdesigned multiple choice-based questionnaire (α = 0.83) which was then used to assess the levels of knowledge regarding breast cancer susceptibility (BRCA) gene mutation. Overall knowledge levels were assessed using the sum score of each response; any possible significance between knowledge scores and educational backgrounds as well as gender were also tested. The results show that 161 (63.9%) of the sample population had awareness about BRCA gene mutation. Knowledge scores were comparable across both groups (medical and non-medical educational backgrounds) with 20 (13.8%) of medical and 14 (13.5%) of non-medical respondents demonstrating a high level of knowledge about the BRCA gene mutation and its testing. Neither gender nor educational background had a significant influence on knowledge scores. The results from this report suggest that awareness regarding BRCA gene was adequate, while knowledge levels were noted to be poor among the sample population.