Background: Mechanical low back pain (MLBP) is a leading cause of disability worldwide, with well-established risk factors such as obesity, occupational ergonomics, and core muscle strength. However, the role of pes planus (flat foot) as a contributing factor remains underrecognized. This study aims to investigate the association between flat foot and MLBP using Clarke’s angle as an objective measure of foot posture. Methods: A case-control study was conducted in South Timor Tengah Regency, East Nusa Tenggara, Indonesia, from December 2024 to February 2025. Fifty patients diagnosed with MLBP and 50 healthy controls were enrolled. Foot type assessment was performed using Clarke’s angle, with a cutoff of ≤30° indicating flat foot. Pain severity in the LBP group was recorded using the Numerical Rating Scale (NRS). Statistical analysis was conducted using chi-square and independent t-tests, with significance set at p < 0.05. Results: Flat foot was significantly more prevalent in the LBP group (58%) than in the control group (18%) (p = 0.000; OR: 6.29, 95% CI: 2.52-15.69), indicating that individuals with flat feet are over six times more likely to experience MLBP. No significant differences were observed between the groups regarding BMI, age, or gender. Conclusion: These findings suggest that flat foot is an independent risk factor for MLBP, likely due to altered spinal biomechanics and compensatory postural changes. Clinicians should consider foot posture assessments in MLBP patients and explore targeted interventions, such as orthotic support, to mitigate symptoms.

Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. Methods: This cross-sectional study was conducted from December 2023 to February 2024 among 372 nursing students enrolled in selected nursing colleges in Bangladesh. A purposive sampling technique was used, and data was collected using a semi-structured questionnaire. The questionnaire assessed socio-demographic characteristics, academic challenges, and psychological symptoms, with mental health stress measured using a Likert scale. Descriptive statistics and Chi-square tests were used to analyze the data, with a 95% confidence interval applied to all analyses. Results: The findings revealed that 31.7% of nursing students experienced severe stress, 23.9% reported moderate stress, and 16.7% had mild stress. Age, academic semester, and course load difficulties were significantly associated with stress levels (p < 0.05). Psychological symptoms such as anxiety, difficulty concentrating, and loss of interest in activities were also significantly linked to higher stress levels. Notably, students in their first semester and those reporting harder course loads were more likely to experience stress. However, gender was not significantly associated with stress levels. Conclusions: This study underscores the high prevalence of stress among nursing students in Bangladesh, driven by academic and clinical challenges and psychological symptoms. The findings highlight the need for targeted interventions, such as stress management training, enhanced mental health support, and policies to alleviate academic pressures. Future research should explore longitudinal trends in stress and evaluate the effectiveness of interventions to support a resilient nursing workforce.

Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.

Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A cross-sectional study was conducted in the University Hospital, where a total of 52 health record officers were purposively sampled. Relevant data were collected using the Short Form survey (SF-36v2) questionnaire. One-way ANOVA was used to determine mean group differences across the nine and the two QoL (physical and mental) summary domains based on respondents’ socio-demographics, while level of significance was set at 0.05. Results: All the QoL sections of the instrument used yielded an α-Cronbach’s score of > 0.70. Analysis of some QoL physical component dimensions showed that; Bodily pain (BP) was found to be significantly (P=0.032) associated with marital status, Physical functioning (PF) with gender (P=0.023), and general health (GH) with age group (P=00.025) and highest level of education (P=0.023). On the other hand, mental health component analysis revealed that Social Functioning (SF) was associated with age group (P=014), Role limitation (RE) with marital status (P=0.048), highest level of education (P=0.048) and years of service (P=0.015) etc. Conclusion: The QoL among HROs studied was generally above average, and demographic characteristics such as age, gender and marital status significantly influence QoL. Health managers and stakeholders should consider some of the factors identified in managing HROs.

Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. Conclusion: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.

Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.

Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.

Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. Results: Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. Conclusion: Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.

This paper examines the transformation of Yi women’s social status in Daliangshan, Sichuan Province. It analyzes historical practices—including child marriage (wawaqin) and the tradition of high bridal gifts—along with the role of education, economic modernization, and cultural advocacy initiatives. The study situates these developments within the framework of the United Nations Sustainable Development Goals (SDGs), focusing on gender equality, poverty alleviation, and equitable development. Field interviews, observations, and community-based projects inform this analysis, which highlights both progress and persisting challenges for Yi women.

Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a university in Metro Manila, Philippines, on the impact of SBL on their skills, emotional responses, and challenges encountered. A descriptive qualitative design was employed using purposive sampling of ten students who had participated in at least one SBL activity. Data were collected through semi-structured interviews and short written reflections and analyzed thematically following Braun and Clarke’s framework to capture nuanced experiences. Three major themes emerged from the analysis. First, students reported initial anxiety, nervousness, and stress during their early SBL experiences, which gradually transformed into confidence, adaptability, and resilience as they gained familiarity and competence. Second, SBL enhanced technical and cognitive skills such as clinical judgment, decision-making, teamwork, and patient-centered care, supporting students’ readiness for real-world practice. Third, students identified resource limitations, insufficient equipment, and time constraints as significant barriers to optimal learning, though these challenges also fostered creativity and perseverance. The findings demonstrate that SBL fosters technical competence, critical thinking, and professional growth but requires institutional support to address resource constraints and faculty development needs. This study underscores the importance of expanding SBL in Philippine nursing curricula to align with international best practices and to contribute to Sustainable Development Goals 3 (good health and well-being), 4 (quality education), and 5 (gender equality).

Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs.

Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. Methods: Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. Results: No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. Conclusion: Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.

Background: Educational attainment is strongly linked to increased employment opportunities, higher income, and greater financial security, making its inverse relationship with reliance on social welfare programs well-documented. However, consistent with the Minorities' Diminished Returns (MDRs) theory, the protective effects of education may be weaker for racial and ethnic minority groups compared to non-Latino Whites. This study examines whether the impact of educational attainment (measured as years of schooling) on social welfare use differs between Caribbean Black and White adults in the United States, focusing on outcomes since age 18 and in the past year. Objective: To investigate the relationship between years of schooling and the likelihood of using social welfare programs, while exploring whether this association varies between Caribbean Black and White adults, in alignment with the MDRs framework. Methods: Data were derived from the National Survey of American Life (NSAL), a nationally representative dataset with a robust sample of Black and White adults in the United States. The study focused on Caribbean Black and White participants aged 18 and older. Structural equation modeling (SEM) was employed to examine the relationship between years of schooling and social welfare use, adjusting for covariates including age, gender, employment status, and marital status. Interaction terms were used to assess potential differences in the returns of education across racial groups. Results: Higher educational attainment was associated with reduced likelihood of using social welfare programs overall. However, consistent with the MDRs framework, the protective effect of education was weaker for Caribbean Black individuals compared to their White counterparts. Caribbean Blacks with similar levels of education as Whites were more likely to report using social welfare programs since age 18 and in the past year, highlighting diminished returns on education for this population. Conclusion: This study extends the MDRs framework to Caribbean Black populations, a group rarely studied in the U.S., revealing significant disparities in the economic benefits of education. The findings underscore the need for policies that address systemic barriers limiting the economic returns of education for racial and ethnic minorities, including Caribbean Blacks, to promote greater equity in social and economic outcomes.

The anterior collateral ligament (ACL) is one of four ligaments in the knee, connecting the tibia and femur and acting as a key stabilizer. Factors influencing these injuries include playing surface, training programs, athlete strength, technique, and gender. Female athletes are at a higher risk of ACL injuries, being four to nine times more likely than males, often due to differences in biomechanics and training patterns. It ss important that rehab focuses on both legs, as overworking the injured leg increases the risk of injuries elsewhere. Prevention training, such as proprioceptive-balance and plyometric agility training, has been shown effectiveness in minimizing ACL injuries. Despite some limitations in research, these programs highlight the importance of improved training techniques. Kinesio taping might help reduce pain but lacks strong evidence for preventing ACL tears.

Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. Conclusion: Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.

Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. Results: Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. Conclusion: The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

Background: Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, and those living in disadvantaged areas. While MDRs have been documented for various marginalized demographic groups, the role of trauma in moderating socioeconomic outcomes remains underexplored. Objective: This study examines whether lifetime trauma exposure diminishes the positive association between educational attainment and poverty-to-income ratio (PIR), a key indicator of economic well-being. Methods: Using data from the National Survey of American Life (NSAL), we analyzed a nationally representative sample of 6,008 adults, including Black, White, Latino, and Other racial/ethnic groups. We employed linear regression models to evaluate the association between the independent variable educational attainment and the outcome PIR. We then tested lifetime trauma as a moderator of this association. Models controlled for age, gender, employment, and race/ethnicity. Results: Educational attainment was positively associated with PIR across all groups, but the strength of this association was significantly attenuated for individuals with a history of lifetime trauma. These effects were independent of covariates. Conclusions: These findings extend the MDRs framework by highlighting trauma as a potential contributor to diminished returns of education on socioeconomic wellbeing. Structural inequities that increase trauma exposure in minoritized populations may also limit the economic benefits of education, particularly for groups with multiple trauma exposures. Policies aimed at addressing economic inequality must integrate social policies that reduce trauma and stress.

Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing non-Latino White, Black, Latino, Asian, and Other racial/ethnic groups. BMI was the primary outcome. Key predictors were family SES, neighborhood SES, and inhibitory control. Multivariable regression models were stratified by race/ethnicity to identify group-specific associations. Results: Race/ethnic groups differed in psychosocial correlates of childhood BMI at age 9 and 10. Among non-Latino White children, higher family income (B = -0.086, p < 0.001), higher parental education (B = -0.069, p < 0.001), and living in a married household (B = -0.079, p < 0.001) were associated with lower BMI. Additionally, the presence of healthy food options in the zip code (B = -0.030, p = 0.032) was linked to lower BMI, while lack of planning (B = 0.032, p = 0.030) was associated with higher BMI. For non-Latino Black children, positive urgency (B = -0.068, p = 0.022) was negatively associated with BMI, while other factors such as family SES and neighborhood SES did not show significant associations. For Latino children, higher family income (B = -0.093, p = 0.001) and parental education (B = -0.099, p < 0.001) were associated with lower BMI. In this group, male gender (B = 0.043, p = 0.033) was associated with higher BMI. Among Asian children, higher family income (B = -0.199, p = 0.006) and parental education (B = -0.144, p = 0.037) were significantly associated with lower BMI. For children in the "Other" racial/ethnic category, higher family income (B = -0.101, p = 0.023), living in a married household (B = -0.076, p = 0.026), and higher median income in the zip code (B = -0.083, p = 0.013) were associated with lower BMI. In this group, male children had lower BMI compared to females (B = -0.089, p = 0.001). Conclusion: The findings highlight substantial racial/ethnic differences in the psychosocial and socioeconomic correlates of BMI in children. There is a need for tailored interventions that target social determinants of childhood high BMI. One size does not fit all.

Background: Parental education is a key determinant of academic performance, yet its protective effects may differ by race and ethnicity. The concept of Minorities’ Diminished Returns (MDRs) highlights the weaker association between socioeconomic resources and outcomes for marginalized populations, including Black and Latino youth. Objective: To investigate whether the positive association between parental education and school performance (letter grades) is weaker for Black and Latino youth compared to non-Latino White youth. Methods: Data were drawn from the Monitoring the Future (MTF) 2023 study. The sample included Black, Latino, and non-Latino White youth. The outcome was a nine-level continuous measure of academic performance based on self-reported letter grades, with higher scores indicating better performance. Multivariate regression models tested interactions between parental education and race/ethnicity in predicting grades, adjusting for confounders such as family income, gender, and school characteristics. Results: A total number of 7584 12^th graders entered the study. Parental education was positively associated with school performance across all groups, but the magnitude of this association was significantly smaller for Black and Latino youth compared to non-Latino White youth. Even after controlling for socioeconomic and contextual factors, the racial and ethnic differences in the strength of this association persisted. Conclusions: Our findings provide evidence of Minorities’ Diminished Returns (MDRs) in the academic domain, with Black and Latino youth experiencing weaker benefits of parental education on school performance. These disparities suggest that structural barriers and systemic inequities undermine the translation of parental educational attainment into academic success for marginalized groups. Policy interventions must address these structural barriers to promote equity in educational outcomes.

Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.

Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns of education among minoritized groups. However, few studies have tested the relevance of MDRs in American Indian and Alaska Native (AIAN) populations compared to non-Hispanic White adults. Objectives: This study aimed to examine the strength of the inverse association between educational attainment and hypertension prevalence, hypothesizing that the protective effect of education on hypertension risk is reduced among AIAN adults relative to non-Hispanic Whites. Methods: Using data from the 2023 National Health Interview Survey (NHIS), we analyzed a nationally representative sample of adults aged 18 and older. Logistic regression models examined the association between educational attainment and self-reported hypertension diagnosis, stratified by racial/ethnic group (AIAN vs. non-Hispanic White). Models were adjusted for key covariates, including age, gender, income, and insurance status. Results: Higher educational attainment was associated with a lower prevalence of hypertension in the combined sample of AIAN and non-Hispanic White adults. However, this protective association was significantly weaker among AIAN adults compared to non-Hispanic White adults, as evidenced by a significant interaction between race and education. Conclusion: AIAN adults exhibit a higher prevalence of hypertension even at higher levels of educational attainment compared to non-Hispanic White adults, supporting the relevance of MDRs for AIAN populations. This finding underscores the need for public health interventions that address structural barriers and contextual factors unique to AIAN populations. Policies focused solely on educational access may be insufficient to reduce hypertension risk among AIAN adults without addressing broader social and structural inequities.

Background: The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults. Objective: This study aims to identify the sociodemographic predictors of dual use of e-cigarettes and combustible cigarettes among U.S. adults using baseline data from the Population Assessment of Tobacco and Health (PATH) Study. Methods: We analyzed baseline data from the PATH Study, focusing on adult participants who reported the use of both e-cigarettes and combustible cigarettes. Logistic regression models were used to identify the associations between dual use and key sociodemographic variables, including age, gender, race/ethnicity, and education level. Results: The analysis revealed that dual use of e-cigarettes and combustible cigarettes was predominantly observed among young, female, non-Latino, White, and highly educated adults. Younger adults were more likely to engage in dual use compared to older age groups. Females showed higher rates of dual use compared to males. Non-Latino White individuals were more likely to be dual users than individuals from other racial/ethnic backgrounds. Additionally, higher educational attainment was associated with increased dual use, contrary to traditional smoking patterns. Conclusion: The findings highlight specific demographic groups that are at higher risk of dual use of e-cigarettes and combustible cigarettes, particularly younger, highly educated, non-Latino White females. These insights suggest the need for tailored public health interventions that address the unique needs and behaviors of these populations. Future research should explore the underlying motivations and contextual factors contributing to dual use to enhance the effectiveness of tobacco control policies and cessation programs.

Background: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to their White counterparts. Objective: This study aims to investigate racial and ethnic disparities in the association between years of schooling and self-rated health among U.S. adults, with a focus on understanding the reduced health benefits of education for Black and Latino individuals. Methods: Using data from the Understanding America Study (UAS; 2014), we conducted a cross-sectional analysis of adults aged 18 and older (N = 6,785). Self-rated health was the outcome, and years of schooling was the primary independent variable. We controlled for sociodemographic factors including age, gender, employment status, immigration status, and marital status. Stratified analyses were conducted by race/ethnicity (Non-Latino White, Non-Latino Black, and Latino). Linear regression models were used to examine the association between years of schooling and self-rated health, and interaction terms were included to assess variation in this relationship across racial/ethnic groups. Results: While years of schooling was positively associated with better self-rated health overall, the magnitude of this effect was weaker for Black and Latino individuals compared to White individuals. After adjusting for sociodemographic factors, Black and Latino adults reported worse self-rated health for each additional year of schooling, compared to their White counterparts, supporting the MDRs hypothesis. Conclusion: The findings suggest that while higher educational attainment is protective against worse self-rated health, this protection is not equally distributed across racial and ethnic groups. Black and Latino individuals experience diminished returns from their years of schooling in terms of self-rated health, likely due to structural barriers and social inequalities. Policies addressing health disparities must consider these diminished returns and aim to reduce structural racism and discrimination that undermine the benefits of education for minoritized populations.

Background: Educational attainment is a well-established social determinant of various domains of cognitive function across the lifespan. However, the theory of Minorities' Diminished Returns (MDRs) suggests that the health benefits of educational attainment tend to be weaker for ethnic minorities compared to non-Latino Whites. This phenomenon may reflect the impact of structural inequalities, social stratification, and historical disadvantage. Objective: This study examines whether the association between educational attainment and numeracy score, one domain of cognitive function, is weaker in Latino individuals compared to non-Latino individuals, as predicted by the MDRs framework. Methods: Data were drawn from the 2014 wave of the Understanding America Study (UAS), a national internet-based panel. Numeracy score, a domain of the cognitive function was measured using an 8-item measure. Linear regression models were used to analyze the association between educational attainment and numeracy score, with an interaction term for ethnicity x educational attainment to explore differences between Latino and non-Latino participants. Models were adjusted for age, gender, marital status, immigration, and employment, and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Results: Overall, 5,659 participants entered our analysis. Higher educational attainment was positively associated with higher numeracy score for both Latino and non-Latino participants (p < 0.001). However, the interaction between education and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller numeracy benefits from education compared to non-Latino individuals. These results support the MDRs framework, suggesting that structural barriers may reduce the numeracy returns of education for Latino individuals. Conclusion: This study provides evidence of diminished returns of educational attainment in terms of numeracy scores among Latino individuals. While education is a key determinant of cognitive abilities such as numeracy, its benefits are not equitably distributed across ethnic groups. Structural inequalities particularly in educational opportunities likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote cognitive equity for Latino populations.

Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in predictive modeling, comparative analysis, and policy development. This paper introduces the concept of Quantitative Intersectionality Scoring System (QISS), a novel approach that assigns numerical scores to intersecting identities, thereby enabling a more systematic and data-driven analysis of intersectional effects. We argue that QISS can substantially enhance the utility and predictive validity of quantitative models by capturing the complexities of multiple, overlapping social determinants. By presenting concrete examples, such as the varying impacts of socioeconomic mobility on life expectancy among different intersectional groups, we demonstrate how QISS can yield more precise and reliable forecasts. Such a shift would allow policymakers and service providers to dynamically assess economic and health needs, as well as the uncertainties around them, as individuals move through different social and economic contexts. QISS-based models could be more responsive to the complexities of intersecting identities, allowing for a more quantified and nuanced evaluation of policy interventions. We conclude by discussing the challenges of implementing QISS and emphasizing the need for further research to validate these quantifications using robust quantitative methods. Ultimately, adopting QISS has the potential to improve the accuracy of predictive models and the effectiveness of policies aimed at promoting social justice and health equity.

Good academic writing requires a good combination of cohesive ties and coherent features in the text. This study aimed to assess whether paragraph unity and coherence in writing were achieved among students of the Komenda College of Education concerning gender. Lakoff’s Theory underpinned the study. The quantitative approach and a descriptive research design were used in the study. The sample size was 60 (40 males and 20 females). Level 200 students from the Komenda College of Education Department of English were selected using census techniques. The instruments used for data collection were text items and questionnaires. Paragraphs written by the students were analysed using narratives, and quantitative data was analysed using mean, standard deviation and the independent samples t-test. The study revealed that male students have a higher mean score than female students. The study also concluded that there was no significant difference between male and female students regarding achieving paragraph unity and coherence in writing. In other words, gender does not influence how paragraph unity and coherence are achieved in writing – males and females are statistically the same. It is recommended that the principals of the various colleges of education in Ghana encourage the college tutors and the Student Representative Council (SRC) leadership to introduce a programme which engages college students in competitive writing without gender barriers. This programme will ensure that students compete by writing academic papers, demonstrating their knowledge of achieving unity and coherence in writing. This programme can be done every academic year, and an equal number of males and females are presented yearly.

Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education compared to their White counterparts, a phenomenon explained by the theory of Minorities' Diminished Returns (MDRs). Although MDRs have been documented in various countries, their relevance to caste-based disparities in India remains unexplored. Objective: This study aims to investigate the caste-based diminished returns of education on wealth in India. We hypothesize that the returns on educational attainment, in terms of wealth generation, will be weaker for individuals from Scheduled Castes (SCs) compared to those from higher castes, using data from the India Demographic and Health Surveys (DHS). Methods: This study was a cross-sectional analysis of DHS -2019/2021 data from India, examining the relationship between educational attainment and wealth across different caste groups (scheduled castes and non-scheduled castes). Multivariate regression models will be employed to assess the interaction between caste and education in predicting wealth outcomes, controlling for relevant covariates such as age, gender, and region. Results: The study is expected to find that the returns on education, in terms of wealth, are significantly weaker for individuals from Scheduled Castes compared to those from higher castes. This would indicate that caste-based discrimination continues to hinder the economic progress of Scheduled Castes, even when they achieve similar levels of education as their upper-caste counterparts. Conclusion: The findings of this study will extend the MDR framework to the Indian context, demonstrating that caste-based disparities result in diminished returns on education for wealth generation. This study underscores the need for targeted policies that address the specific barriers faced by Scheduled Castes in translating educational attainment into economic success and highlights the ongoing impact of caste-based discrimination in India.

Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents. Methods: We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use. Results: Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use. Conclusions: The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.

Background: High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. Methods: Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. Results: The study confirmed the role of our proposed serial mediators for Blacks’ weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. Conclusions: The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

This study examines concord errors in academic writing among first-year students at Offinso College of Education in Ghana, aiming to identify common errors and propose remedial strategies for improvement. The population sample consists of first-year students at the college, reflecting a gender-sensitive distribution. The study adopts a mixed-methods research design, combining qualitative and quantitative analyses to explore the effects of concord errors on academic writing. Sampling techniques include purposive, quota sampling, and simple random sampling methods. Research instruments include questionnaires, interviews, and writing assessments to evaluate students' language skills. Data analysis involves identifying concord errors in students' writing and assessing the impact on their academic performance. The study concludes by recommending strategies to mitigate concord errors, such as targeted language practice, timely feedback, and awareness of grammatical conventions, to enhance students' writing proficiency and academic success.

This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.

This study investigates the relationship between teacher-trainees' academic self-concept and performance in Colleges of Education in Ghana. Utilizing a mixed-methods approach, data were collected from teacher-trainees in Ada and Accra Colleges of Education through surveys and interviews. The study hypothesised that there is no significant relationship between academic self-concept and academic performance among teacher-trainees. Results revealed a statistically significant positive relationship between academic self-concept and performance, indicating that teacher-trainees with higher academic self-concepts tend to perform better academically. Furthermore, gender differences in academic self-concept and performance were explored, with findings suggesting no significant gender disparities in either domain. Institutional factors, such as school climate and resources, were also found to influence academic performance. Recommendations include promoting positive academic self-concept, implementing gender-responsive pedagogy, and creating supportive learning environments in Colleges of Education. By addressing these factors, teacher education programs can better prepare future educators for success in the classroom and contribute to the improvement of educational quality in Ghana.

The purpose of this study was to examine indicators of forgiving behaviour and intervention among adolescent students in Junior High School in Bimbilla in the Nanumba North Municipality of Ghana. This study adopted the Pragmatist philosophy. The mixed methods experimental design was used for the study. The study population comprised all adolescents in Junior High Schools in the Nanumba North Municipality of the Northern Region, Ghana. Purposive, random sampling techniques Krejcie and Morgan's table of determination of sample size were used for the schools and respondents for the study. Two major instruments were used for this study: a questionnaire and an interview guide. The interview schedule was used to gather the qualitative data whereas the quantitative data was gathered using the questionnaire. The study indicated that both the REACH model and Process model are efficacious in reducing the level of depression among adolescent students when their levels of forgiveness are increased through forgiveness counselling regardless of gender and age. The findings also revealed that both REACH and Process models were good interventions for the adolescents in showing greater emotional regulation (increased forgiveness, reduced anger and reduced depression, enhanced sense of well-being, positive feelings and positive thoughts towards the offender). It is recommended that counsellors organise training programmes with parents in conjunction with Non-governmental organisations on using the Process and REACH models. This will bring awareness of the interventions and encourage parents to seek assistance anytime their adolescents need assistance. It is once again recommended that teachers and school administrators consider forgiveness interventions (the Process model and REACH model) as a very effective strategy for treating unforgiveness to improve students' psychological well-being.

Fertility control is crucial to achieving improved health and socio-economic status of women. The main objective of the study was to explore fertility control behaviours among educated urban women in the Cape Coast Metropolis. The study adopted the interpretivist (qualitative) philosophy in social research. The population for the study comprised women who have at least secondary-level education, are married or in a stable union and are between the ages of 18 and 49 years. A snowball sampling technique was used to select thirty-two (32) respondents for the study. The respondents constituted the number that provided the required information at saturation. The main instrument for data collection was a semi-structured interview guide. Data was collected from educated women within the Cape Coast Metropolis. Five items open-ended questions under the heading Factors influencing fertility control among highly-educated urban women in the Cape Coast Metropolis. All transcribed data were then imported into NVivo 11, a computer-aided qualitative data analysis package with each transcript coded sentence by sentence. The codes were determined and constructed based on the content of the data. After the coding process, each code was described and memos attached as ideas about the themes emerged from social-cultural, economic to educational factors. The study underscores the adequate involvement of male partners in women’s fertility control practices, especially women’s contraceptive preferences. This demonstrates the authority of men over women in the domain of the family. Recognising that men have enormous powers regarding fertility issues tend to appreciate the need to promote and advance family needs and welfare. Also, the results indicate that other close associates or relatives are involved in women’s contraceptive lives. These close relations are what describes as a social network in Bronfenbrenner social-ecological framework. Besides, there are multiple socio-cultural and economic obstacles that could work against achieving desired fertility levels. It is recommended that family planning programmes should not focus on only women, but include male partners to enhance a change in behaviour and norms regarding power and gender roles that do not make them supportive partners. There is a need for a high-level promotion through civil society to encourage men to get involved in family planning matters. This will help women or couples to freely adopt their desired fertility control methods without hindrance.

Background: In December 2019, a cluster of patients with unexplained viral pneumonia was identified in Wuhan, China. Since March 11^th 2020 the WHO declared COVID 19 as a pandemic with rising number of cases all over the world. Aim of the work: The aim of the study was to measure the percentages of possible, probable and provisionally excluded cases among the first 500 attendants of the triage of Ain Shams University Hospital and describe their epidemiological and clinical characteristics. Patients and Methods: This was a retrospective descriptive case series study including the first 500 patients attending the triage of Ain Shams University Hospitals from March 29th to May 31st. A constructed questionnaire in the form of a scoring system was used and data was collected through interviewing the patients after appropriate consent. Results: As regard the scoring system, 72.2% of patients had new onset of cough or old worsened cough in the previous 3 days, 59.2% had sore throat and 59% had dyspnea. Out of the 500 cases 33.2% were probable, 38.2% were possible and 28.2% were provisionally excluded. Conclusion: COVID-19 pneumonia usually occurred at an age younger than 47 years and it was more predominant in the male gender. The most common initial clinical presentations were new dry cough or chronic cough with worsening over the last 3 days, sore throat and/or runny nose and fever. Thirty-eight percent were classified as possible COVID-19 cases, and 33% were classified as probable.

There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs and technology adoption in order to increase agricultural production and productivity, hence strengthening food security. The current opinion piece attempts to contribute to this debate by examining smallholder agriculture and its role to African food security. This discussion proposes a future paradigm shift toward a gendered climate-smart smallholder agriculture and food production and security conceptual framework based on the promotion and development of smallholder agriculture and food production and security. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For Africa, today’s predicament is to ensure food security for the anticipated rapid population expansion, while on the other hand handling an overall net adverse effect of worldwide global climate change, and increased socio-economic ills associated with gender inequality in smallholder agriculture and ensuring long-term agriculture sustainable development. The failure to address gender inequality in smallholder agriculture and food production and pontificate of global climate change effect has thrown Sub-Saharan Africa into a state of perpetual food scarcity and insecurity because of low agricultural productivity and food supply, and by force of circumstances exposing the agricultural communities and its people to extreme poverty and nutrition and food insecurity. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For this purpose, this discussion proposes a future paradigm shift towards a gendered climate-smart smallholder agriculture and food production and security conceptual framework hinged on the promotion and development of the micro-livestock and/or unconventional animal species sub-sector to strengthen food security on the continent. Overall, the discussion emphasizes the importance of taking immediate action to alleviate the negative effects of climate change and address gender inequality through promotion of micro livestock to assist in the development of long-term adaptation measures to maintain smallholder agricultural productivity.

One of the current issues facing humanity is ensuring sustained global food security in the face of devastating effects of climate change; this challenge is particularly pressing on the African continent. Here, I present an opinion piece identifying local animal genetic resources as "African leverage point" that provide the highest chances to cushion rural fork to climate change, enhance environmental sustainability and food security in Africa. When it comes to boosting food production, coping with climate change, or bolstering the delivery of a wide range of ecosystem services, I believe that African animal genetic resources are essential alternatives for the sustainable growth of the livestock industry and its contribution to food security. Africa needs to address the support and development of indigenous animal genetic resources in order to meet the basic food needs of more than 1 billion people, address numerous environmental issues with continental implications, and focus on more effective and resilient food systems with the greatest impact on food security. The indigenous animal resources diversity and support actions to this unique group could provide a boost in protein that is lacking to constitute healthy diets in Africa. The priorities of nonprofit organizations, foundations, governments, citizens' groups, and companies can be influenced by this leverage point in the African food system. Due to continuous food insecurity, which appears to be becoming worse with climate change and makes it even harder to accomplish the SDGs on the continent, Africa has paid a hefty price for being misled about the worth of its own animal genetic resources. To the contrary, it is highly improbable that a strategy to improve food security and rural livelihoods that undermines the utilization of indigenous animal genetic resources will be viable in long-term. If Africa makes an effort, is committed, and fully commits resources to putting indigenous animal genetic resources at the forefront of combating food insecurity and accelerating the achievement of SDGs, it can achieve more under the adverse prevailing climate change induce environmental conditions. Our personal opinion is that we would not have had the ongoing food problems, even in the face of climate change, if Africa had over the years implemented the necessary mechanisms to develop and promote local animal genetic resources. What lies ahead in terms of climate change effect on food security in Africa is anyone's guess – but whatever it is, promoting continental adapted indigenous animal genetic resources portfolio is ready to handle it. Development and promotion of African animal genetic resources should be part of a continental strategy to transform smallholder animal production by 2050, in line with the goals of achieving the SGDs, to improve rural household food security, and bringing rural economy prosperity, resilience, sustainability, and all other desired animal related food outcomes for rural healthy diets. African animal genetic resources are the most important but underutilized resource to address the issue of ongoing food insecurity. The responsible use of local animal genetic resources through climate smart animal husbandry practices also contributes to food security, rural development and increased employment opportunities. African genetic improvement programs involving indigenous animal genetic resources must be considered as regards to local agriculture and livestock development aspirations, appropriateness to local reality and livelihood security, as well as environmental friendliness. Animal agriculture will fill in the enormous gaps in the continent's food supply if this animal group receives adequate attention and is used integrated properly in crop and livestock systems which characterize smallholder farming sector in Africa. Because they have evolved over time to accommodate the various climatic conditions and environmental pressures on the continent, Africa's native animal genetic resources are particularly resilient. Indirectly, the impact of climate change offers a chance to use native animal genetics from Africa. The use of local animal genetic diversity has the potential to substantially improve Africa's food security landscape hence should be given special consideration for sociocultural, environmental, and economic aspects, and with regard for smallholder farmer-specific factors of interest. African animal genetic resources have contributed significantly to the food and nutrition security aspects of the millions of people in their communities of origin and custody in Africa. The purpose of the perception piece is to educate the reader about the fundamental mechanisms that control the use of continental animal genetic resources and how the outlook for these mechanisms can be manipulated in the future for the benefit of improving food security in Africa. The discussion provides in-depth insight into the pertinent literature in understanding the significance of local animal genetic resources in terms of their contribution to food security in Africa.

This paper brings to light efforts of male institutional leaders in the University of Education, Winneba in promoting the gender equality agenda and effects of their efforts in bridging the gender gaps in staff and students’ levels. It sheds further light on involving men in the gender mainstreaming efforts. Both primary and secondary data on gender equality and equity measures were used in this study. The study found that male Vice-Chancellors have over the years been devoted to promoting gender equality agenda in the University. The effects of their efforts are largely seen in the increase in the number of females that have benefited from the institutional mentorship and scholarship programmes, which has impacted positively on addressing the gender gaps in the University. It is recommended that new strategies be adopted in promoting gender equality agenda. These strategies include revision in gender policies to involve men as agents of change in gender mainstreaming activities; gender training for male staff and students of all levels and categories for effective gender work, offering specific trainings and interactive discussions on gender issues for men as volunteers for gender mainstreaming. The study further suggests among other things, the need to engage the university community in entertaining activities like cycling for the equality agenda to be made more real to men and court their interest to promote men’s involvement in gender work.

The importance of resistance training (Conley & Pennington, 2022; Pennington, 2020) cardiovascular fitness (Pennington, 2015; 2016), and anaerobic power (Pennington, 2014) cannot be overstated for individuals enlisted in our country’s armed forces. The Army Combat Fitness Test (ACFT) is the new branch wide fitness test designed to replace the outdated Army Physical Fitness Test (APFT) (USAPHC TG 358, n.d.). The APFT was implemented in 1980 as the measure of Service Member (SM) fitness. However, this test is very limited in scope and failed to tell unit commanders how ready their SMs were for the rigors of a combat environment (US Army ACFT Field Testing Manual, n.d.). The APFT was a gender-based test that consisted of three events: a two-minute pushup evaluation to measure upper body endurance. The second event was a two-minute sit up evaluation to measure core and hip flexor endurance. While the final evaluation was a two-mile timed run, which was designed to test aerobic endurance and leg endurance. This test was simple to set up and administer but, it was not a good metric to judge SM’s actual fitness in a combat environment. If a SM had good endurance than he or she would max the test with ease. This is not a complete reflection of what is required in a combat environment. In a combat environment the SM will be loaded down with a rifle, helmet, rucksack, plate carrier, water, and ammo which often exceeds 80 pounds. The new ACFT which is still being implemented into the forces as of the writing of this paper is a much better test as it has more events to it which measure soldier strength and ability to move while under load.

Health professionals are the base of the healthcare systems in all societies. Their daily contact with the patient in a context of demanding and difficult working conditions affect their general health. This research was carried out to describe the levels of general health among health professionals and their perceived levels of fatigue and social support. Additionally, the purpose of this study was to examine the above three variables in relation to demographic (education, gender) and employment factors (working hours, department). The research was conducted in 165 health professionals working in hospitals in the region of Eastern Macedonia-Thrace and in the urban centers of Athens and Thessaloniki. The General Health Questionnaire (GHQ-28), the Fatigue Assessment Scale (FAS) as well as the Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure the research variables. The processing and statistical analysis of the data was done using IBM SPSS. The majority of health professionals presented a high score in GHQ-28 subscales indicating low general health (avg 8.59≥5). One hundred thirty nine out of 165 health professionals (84%) were tired and 15 out of 165 (9%) were too tired. The perceived social support was at high levels (avg 5.57). Health professionals exhibit high fatigue and low levels of general health and quality of life. Instead, they receive high social support. Existence of circular hours and work in heavy part worsens the levels of fatigue and quality of life. Measures are needed to increase the number of health professionals and organizational and structural measures to improve their working conditions and strengthen their social work.

Everyone likes movies irrespective of color, gender, age, location, and race. The most important thing is how the users are getting our unique combinations of choices concerning the preferences of the movies. This article focuses on the creation of a movie recommendation system using item-based collaborative filtering.

The purpose of the study was to investigate the effect of computer-assisted instruction approach to the teaching and learning of photosynthesis on the performance of second year Senior High School (SHS 2) Biology students in science. The design for the study was a quasi-experimental research. This study was carried out in Sefwi Wiawso SHS and Asawinso SHS all at Sefwi Wiawso Municipal Assembly in the Western North Region of Ghana. They are all mixed institution. The purposive sampling techniques was used to schools, classes and students for the study. One-hundred one (101) electives biology participants were purposively selected, they consist of SHS 2 Science of (55) fifty-five students from Sefwi Wiawso SHS and SHS 2 Home economics of (46) forty-six students also from Asawinso SHS. The third years were not selected because they were preparing to write their WASSCE. The main instrument for data collection was questionnaire. The study collected only quantitative data and employed quantitative method of data analysis. Data obtained from participants in both experimental and control groups on the Test 2 were analysed statistically using independent-measures t-test. The independent-measures t-Test was used to investigate whether any differences existed between experimental and control groups’ mean scores on the Test 2. The study further revealed that computer-assisted instructions gives feedback to learners to have the opportunity to master computer-assisted instructional package tool used. It is recommended that, computer-assisted instruction method should be encouraged in many Biology classes in Wiawso Municipal Assembly, since it gives students opportunity to see links between concepts, summarise and organise their works, thoughts logically and sequentially. Both genders must be encouraged to use computer-assisted instruction method to studying Biology.

Background: Reproductive health is a critical component of overall health and development. Unmet contraceptive needs are one of the regularly cited measures of the efficacy of family planning (FP) initiatives. This study set out to determine the magnitude and associated factors of unmet need for FP among women of reproductive-aged (15-49 years) in the provincial areas of The Gambia. Methods: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 643 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level of p<0.05. Binary logistic regression analysis was performed to examine the effect of sociodemographic and cultural determinants on unmet FP need, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 24 was used for data entry and analysis. Results: The unmet need for FP among the study participants was 25.2%; unmet need for spacing and unmet need for limiting was 17.4% and 7.8%, respectively. The total demand for FP was 59.4%, while the satisfaction of demand for FP was 57.6%. The significant predictors of unmet need for FP were woman’s age at first pregnancy (aOR=0.899, p=0.033), LGA of origin (aOR=0.240, p=0.001) and frequency of using contraceptives (aOR=1.587, p=0.032). Conclusion: The present study demonstrated a high unmet need for FP among rural women in The Gambia, with the most often cited reason for non-use being fear of side effects. Hence, it is necessary to concentrate FP services for rural populations, stressing education regarding contraceptive side effects, service quality, and gender equality. Additionally, the study suggests that male participation and religious leaders' involvement in FP programs be strengthened and mainstreamed, as well as the establishment of a communication program that specifically promotes inter-spousal communication.

In February 2020, a family of four required between $14,196 pesos and $15,667 pesos per month to obtain a salary that exceeds the welfare or poverty line. This is an income that most Mexican households do not obtain. There is little social mobility in Mexico, where three quarters of the population born in households at the bottom of the social ladder do not manage to rise above the poverty line, even so, I believe that it is advisable to pursue undergraduate and especially graduate studies. By 2020, a person with a graduate degree will receive 6.6 times more than a person with a primary school education, 4.5 times more than a person with a secondary school education, 3.8 times more than a person with a high school education and 2 times more than a person with a bachelor's degree. In terms of gender, women with high school, undergraduate and graduate degrees receive the equivalent of 70% of the salary of men.In December 2021, more than 1.8 million Instituto Mexicano del Seguro Social (IMSS) affiliates receive a salary higher than $30,170 pesos, of which more than 830 thousand receive a salary higher than $47,140 pesos, corresponding to 3.2% and 1.5% of the 56.9 million people that make up the economically active employed population (formal and informal).

The purpose of the study was to investigate the factors contributing to domestic violence in Koforidua in the New Juaben Municipality of Ghana. The population of the study consisted of 340 men selected from four communities in Koforidua. Purposive sampling technique 4 communities. Using the Krejcie and Morgan table, a sample size of 340 men were selected which is appropriate for a population of 3428 with an alpha level of 5 percent in a quantitative study. The selection was based on the fact that these communities registered the highest cases of domestic violence in the Municipality. The main instrument used for the study was structured questionnaire. Data analysed using SPSS (Statistical Product for Service Solution, version 20). Statistical tools such as frequency distribution tables, percentages, charts and cross tabulation was used. The frequency tables were used to give the summary of the data for easy understanding and comparison. The study revealed that men perceive that factors like show of power, exposure to domestic violence, poor communication in marriage, unemployment and poverty, control of women through discipline and women’s low academic achievement are the triggers of domestic violence in a marital relationship. The study recommended that effort ought to be put in place to unravel the mystery surrounding male supremacy over women at both institutional and community levels by DOVVSU, Gender Advocacy Groups and other institutions to benefit humanity and society at large.

The average electricity consumption in Iranian households is higher than the world average. This can be due to price factors (such as cheap electricity in the country) and non-price factors (such as socio-demographic variables and psychological factors). In this study, non-price factors such as socio-demographic variables and psychological factors in the electricity consumption of urban households in Tehran were investigated. In this regard, using the theoretical foundations of behavioral economics and the psychology of planned behavior, this issue was analyzed. This study collected information on household electricity consumption behavior through a questionnaire and fieldwork from 2560 Tehran households. Results Using econometric techniques, linear regression was estimated, the dependent variable of which was electricity consumption (45 days in winter 2019) and its independent variables including socio-demographic variables (age, sex, number of household members, income) and The variables of the theory of planned behavior (attitude, mental norms and perceived behavioral control) showed that income and the number of household members have a significant and positive effect on electricity consumption, but gender has no significant effect. Of the psychological variables, only perceived behavioral control has a significant effect on electricity consumption. These results show that the consumer does not have a positive attitude towards saving, and mental and social norms do not encourage him to reduce electricity consumption, and they are not effective in consumption control. Finally, the study results were analyzed using behavioral biases that may cause attitudes and beliefs not to lead to action.