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Open Access February 21, 2025

Diminished Returns of Educational Attainment on Unpaid and Paid Maternity Leave of Mothers Giving Birth in Poverty

Shervin Assari, Mojgan Azadi, Hossein Zare

Universal Journal of Obstetrics and Gynecology 2025, 4(1), 1-11. DOI: 10.31586/ujog.2025.1240

Abstract Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ [...] Read more.

Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ Diminished Returns (MDRs) posits that structural racism, segregation, and labor market discrimination limit the benefits of socioeconomic resources, such as education, for Black and Latino individuals. This suggests that the effects of education on maternity leave may not be uniform across racial and ethnic groups. Objective: This study aimed to examine the MDRs of education on access to unpaid and paid maternity leave among Black and Latino mothers compared to White mothers giving birth while living in poverty. Methods: We utilized baseline data from the Baby’s First Years Study (BFY), a longitudinal investigation of the effects of poverty on child development. The sample consisted of 1,050 mothers living in poverty who had recently given birth. Maternity leave (paid and unpaid) was assessed via self-report, and educational attainment was measured in years of schooling. Structural equation modeling (SEM) and interaction terms were employed to analyze racial and ethnic differences in the relationship between education and access to maternity leave. Results: Educational attainment was positively associated with access to unpaid maternity leave for the overall sample of mothers giving birth in poverty, but this association was weaker for Black and Latino mothers compared to non-Latino White mothers. Education did not significantly increase the likelihood of paid maternity leave, and there were no group differences for this association. Conclusion: This study highlights the urgent needs to address structural racism, labor market discrimination, and residential segregation that diminish the impact of education on living conditions for Black and Latino mothers, compared to non-Latino White mothers, even for those living under poverty. Policymakers and practitioners should develop targeted interventions to reduce racial and ethnic disparities in access to paid and unpaid maternity leave and other critical resources, particularly for new mothers living in poverty. Addressing these inequities is essential for improving maternal and newborn health outcomes and promoting social justice.

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Open Access February 04, 2025

The Use of Differentiated Instruction to Achieve Culturally Responsive Teaching

Monica Gakii Ituma

Open Journal of Educational Research 2025, 5(1), 13-30. DOI: 10.31586/ojer.2025.1234

Abstract With an increasing diversity of learners in today’s educational set-ups, there is an insurmountable need to cater for individual differences including the cultural variations among learners. It is therefore necessary for educators to develop culturally responsive teaching that enhances intercultural competencies of learners. As educators strive to provide inclusive learning environments in which [...] Read more.

With an increasing diversity of learners in today’s educational set-ups, there is an insurmountable need to cater for individual differences including the cultural variations among learners. It is therefore necessary for educators to develop culturally responsive teaching that enhances intercultural competencies of learners. As educators strive to provide inclusive learning environments in which learners from diverse cultural backgrounds learn equitably, differentiated instruction becomes a practical tool. This paper explores how differentiated instruction can support and enhance culturally responsive teaching by examining how tailored instructional approaches can bridge cultural gaps and enhance educational outcomes. The aim is to provide a comprehensive understanding of how educators can effectively integrate differentiated instructional methodologies to achieve the goals of Culturally Responsive Teaching. The study used a descriptive survey design to determine the use of differentiated instruction by junior school teachers in Kenya and a systematic review of literature, practical examples, and studies on teachers’ practices in culturally responsive teaching. The study outcomes indicated that teachers used various differentiated instructional strategies with flexible grouping being the most commonly used strategy. However, there arises a concern, that teachers were not very familiar with cultural variations of learners in their classrooms even as they developed their differentiated instructional strategies. Literature provided the principles and practices of culturally responsive teaching. The combination of these results were used to formulate a conceptual framework for Culturally Responsive Differentiated Instruction (CRDI) that provides insights for practitioners to develop and implement culturally responsive differentiated instructional strategies. The study recommends that a framework to support teachers in the implementation of inclusive and equitable curriculum through CRDI be developed, CRDI be integrated into the teaching processes and the teachers be trained on providing for learner differences through CRDI.

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Open Access September 19, 2023

Lonely No More: Investigating the Connection between Family Health, Social Support, and Well-being in Chinese “Empty Nest Youth”

Yan-yan Wang

Current Research in Public Health 2023, 3(2), 90-104. DOI: 10.31586/crph.2023.771

Abstract Background: The phenomenon of "empty nest youth" is becoming increasingly ubiquitous, capturing the attention of society at large. However, few studies have been conducted in recent years on this group, especially focusing on their family and mental health. As such, this study investigates the correlation between family health and well-being among "empty nest youth," as well as the function of social support and loneliness in this relationship. Methods: A cross-sectional survey was conducted from June to August 2022 across 32 provinces, municipalities, and autonomous regions in China, utilizing a multi-stage sampling technique. And we screened individuals who were unmarried, living alone, and between 22-44 years old, resulting in a valid sample size of 908 cases; multiple regression analysis, mediation effect testing, and moderation effect testing are used to examine research hypotheses. Results: The regression analysis results show that family health not only has a direct impact on well-being (β = 0.36, p < 0.001) but also indirectly affects well-being through social support [β = 0.23, 95% CI: 0.19 0.28]. Additionally, the loneliness moderates the predictive impact of not only family health on social support (β = -0.13, p < 0.001) but also social support on well-being (β = -0.06, p [...] Read more.

Background: The phenomenon of "empty nest youth" is becoming increasingly ubiquitous, capturing the attention of society at large. However, few studies have been conducted in recent years on this group, especially focusing on their family and mental health. As such, this study investigates the correlation between family health and well-being among "empty nest youth," as well as the function of social support and loneliness in this relationship. Methods: A cross-sectional survey was conducted from June to August 2022 across 32 provinces, municipalities, and autonomous regions in China, utilizing a multi-stage sampling technique. And we screened individuals who were unmarried, living alone, and between 22-44 years old, resulting in a valid sample size of 908 cases; multiple regression analysis, mediation effect testing, and moderation effect testing are used to examine research hypotheses. Results: The regression analysis results show that family health not only has a direct impact on well-being (β = 0.36, p < 0.001) but also indirectly affects well-being through social support [β = 0.23, 95% CI: 0.19 0.28]. Additionally, the loneliness moderates the predictive impact of not only family health on social support (β = -0.13, p < 0.001) but also social support on well-being (β = -0.06, p < 0.001). Conclusions: These findings underscore the significance of directing policymakers and healthcare professionals towards the "empty nest youth's" familial and social support systems. It underscores the need for the development of policies aimed at addressing their emotional and material requirements by leveraging these familial and social networks. This approach ultimately contributes to the enhancement of their overall psychological well-being, promoting a more coherent and logical pathway for intervention and support.

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Open Access February 09, 2023

Adolescents' Psychosomatic Symptoms and Family Affluence in the Czech Republic: Based on National Evidence

Yi Huang

Current Research in Public Health 2023, 3(1), 37-45. DOI: 10.31586/crph.2023.590

Abstract Family affluence associates with adolescents' psychosomatic symptoms. However, the strength of the association varies across countries. As there was no related national evidence in the Czech Republic, this study aimed to investigate the relationship between family affluence and adolescents' psychosomatic symptoms. The current research adopted the data from a national survey Health Behaviours of [...] Read more.

Family affluence associates with adolescents' psychosomatic symptoms. However, the strength of the association varies across countries. As there was no related national evidence in the Czech Republic, this study aimed to investigate the relationship between family affluence and adolescents' psychosomatic symptoms. The current research adopted the data from a national survey Health Behaviours of School-Aged Children (HBSC). 12166 observations were included in the binary-choice analysis. It was found that low family affluence background was a risk factor for adolescents' psychosomatic health. Compared to boys, girls were more likely to demonstrate psychosomatic symptoms. Furthermore, parent-adolescent communications might mediate the relationship between family affluence and psychosomatic complaints. The results suggest health inequity for adolescents from low-income families. Moreover, I also advocate related interventions aiming to improve parent-adolescent communication quality to decrease poor adolescents' psychosomatic health risks.

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Open Access December 30, 2025

Elimination of HIV Transmission Risks through Viral Suppression: Undetectable=Untransmittable and its Impact among People Living with HIV

Evelyn Foster-Pagaebi, Tamunomiebi Douglas, Solomon Nduka Enebeli, Pagaebi Garcia Ezeke, Oluwafunmilayo Ogundeko-Olugbami, Izibeya Kikile, Buniminaki Nimi James, Prisca Omonigho Odion, Amavie Oboku-Aganaba

Global Journal of Epidemiology and Infectious Disease 2025, 5(1), 54-69. DOI: 10.31586/gjeid.2025.6245

Abstract The principle of Undetectable = Untransmittable (U=U) posits that people living with the human immunodeficiency virus (HIV) who are able to achieve and maintain a viral load of <200 copies/mL by regularly taking antiretroviral drugs (ARVs) are considered virally suppressed and cannot transmit the HIV virus to other individuals through sex. This groundbreaking message has emerged as a key HIV [...] Read more.

The principle of Undetectable = Untransmittable (U=U) posits that people living with the human immunodeficiency virus (HIV) who are able to achieve and maintain a viral load of <200 copies/mL by regularly taking antiretroviral drugs (ARVs) are considered virally suppressed and cannot transmit the HIV virus to other individuals through sex. This groundbreaking message has emerged as a key HIV prevention strategy for eliminating transmission risks and enhancing the quality of life of people living with HIV. This narrative review explores the clinical foundation of U=U, the level of awareness and acceptance of the message globally, and the psychosocial impact on people living with HIV. It has been discovered that this message minimizes stigma, improves mental health, promote treatment adherence and good disclosure behaviors among people living with HIV. Evidence has shown that despite the U=U revolution for HIV prevention, there are significant differences in awareness and acceptance of the message among different population groups. The challenges noted were poor communication by healthcare providers, limitations in the health system, and stigma issues. Nevertheless, the inclusion of U=U in mainstream HIV services has proven to increase awareness and enhance its adoption. The urgent need in the present review is to advocate for strategies to increase the equitable distribution of U=U to harness its full potential in public health.

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Review Article

Open Access December 22, 2025

Reimagining Mathematical Modeling for a Responsive and Integrated Future in Infectious Disease Epidemiology

Olabisi Promise Lawal, Debra Ukamaka Okeh, Patra Chisom Ezeamii, Adepeju Kafayat Olowookere, Ismaila Muhammed, Chukwuebuka Victor Ugwu, Ayodele Blessing Ayo-ige

Global Journal of Epidemiology and Infectious Disease 2025, 5(1), 43-53. DOI: 10.31586/gjeid.2025.6242

Abstract Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. [...] Read more.

Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. Rather than critiquing modeling as a discipline, this perspective argues for a reorientation of infectious disease modeling toward a more responsive, equity-centered, and participatory paradigm. We propose a conceptual framework built on three interrelated principles: adaptability through real-time data integration, transparency via open-source and reproducible practices, and relevance through interdisciplinary and co-produced model design. Drawing on illustrative examples from COVID-19 and dengue control efforts, we highlight how integrating behavioral dynamics, local knowledge, and policy feedback can improve model usefulness and public trust. Reconceptualizing models as dynamic systems of inquiry rather than static forecasting tools can enhance decision-making and promote more equitable and effective responses to future public health emergencies.

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Brief Review

Open Access October 21, 2025

Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023

Shervin Assari, Babak Najand, John Ashley Pallera, Ali Farhoudian

Global Journal of Epidemiology and Infectious Disease 2025, 5(1), 28-42. DOI: 10.31586/gjeid.2025.6202

Abstract Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been [...] Read more.

Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.

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Open Access October 20, 2025

From Subordination to Empowerment: The Journey of Yi Women in Daliangshan

Kam Lo

Universal Journal of Social Sciences and Humanities 2025, 5(1), 18-25. DOI: 10.31586/ujssh.2025.6198

Abstract This paper examines the transformation of Yi women’s social status in Daliangshan, Sichuan Province. It analyzes historical practices—including child marriage (wawaqin [...] Read more.

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.

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Open Access October 01, 2025

Place-Based Diminished Returns of Economic Resources in Rural America: A Framework for Understanding Geography-Conditioned Inequality

Shervin Assari, John Ashley Pallera, Babak Najand, Mojgan Azadi, Hossein Zare

Journal of Social Mathematical & Human Engineering Sciences 2025, 4(1), 1-14. DOI: 10.31586/jsmhes.2025.6067

Abstract Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from [...] Read more.

Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.

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Perspective Article

Open Access August 22, 2025

Status Epilepticus in Sub-Saharan Africa: A Literature Review on Epidemiological Challenges, Socio-Cultural Barriers, and Public Health Impact

Marcellin Bugeme, Olivier Mukuku *, Emmanuel Kiyana Muyumba, Béatrice Koba Bora

Open Journal of Neuroscience 2025, 3(1), 23-40. DOI: 10.31586/ojn.2025.6161

Abstract This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this [...] Read more.

This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this region is often hindered by constraints in medical infrastructure, inadequate access to specialist diagnostics such as electroencephalogram, and limited availability of essential anti-epileptic drugs, which are frequently out of reach for rural populations. These challenges are further exacerbated by the social stigma and cultural beliefs surrounding epilepsy, impeding access to care and widening inequalities. Moreover, the scarcity of qualified medical personnel undermines the efficient and prompt management of this neurological emergency. The review underscores the pressing need to enhance healthcare infrastructures, boost the capabilities of healthcare professionals, and conduct community awareness initiatives to destigmatize epilepsy and lessen prejudice. Additionally, practical recommendations are put forward for enhancing local capacity, fostering equity in care access, and mitigating regional health disparities in SSA.

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Literature Review

Open Access May 30, 2025

Advancing Women's Soccer: Historical Growth and Challenges Concerning Athlete Health and Diversity

Maxwell Prempeh, Colin G. Pennington

Universal Journal of Sport Sciences 2025, 5(1), 18-23. DOI: 10.31586/ujss.2025.6102

Abstract This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among [...] Read more.

This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among female players and the persistent underrepresentation of Black women. The review highlights the biomechanical factors contributing to these issues, emphasizing the need for footwear designed to accommodate the specific anatomical and functional requirements of female athletes. Furthermore, it explores the systemic barriers that contribute to the lack of diversity within the sport, advocating for equitable opportunities and support for Black women. This review concludes by underscoring the necessity for innovative, interdisciplinary approaches to ensure the continued growth and well-being of all participants in women's soccer, and identifies critical areas for future research in kinesiology and related fields.

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Review Article

Open Access May 05, 2025

Persistent Social Welfare Needs Among Educated Caribbean Black Individuals: Evidence of Minorities' Diminished Returns

Shervin Assari, Babak Najand, Hossein Zare, Amanda Sonnega

Journal of Biomedical and Life Sciences 2025, 5(1), 98-109. DOI: 10.31586/jbls.2025.1189

Abstract 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 [...] Read more.

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.

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Open Access May 05, 2025

Educated Yet Unhealthy? Diminished Returns of Education for Immigrants in the USA

Shervin Assari, Babak Najand, Hossein Zare

Journal of Biomedical and Life Sciences 2025, 5(1), 84-97. DOI: 10.31586/jbls.2025.1106

Abstract Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study [...] Read more.

Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study tested MDRs of education on various health and cognitive outcomes, including self-rated health (SRH), cognitive function, numeracy, number of chronic medical conditions, and limitations in activities of daily living (ADLs) among immigrants compared to non-immigrants in the United States. Objective. To examine whether educational attainment confers weaker protective effects on SRH, cognitive function, numeracy, chronic medical conditions, and ADLs in immigrants compared to non-immigrants, confirming the presence of MDRs across these domains. Methods: We used data from the Understanding America Study (UAS), a nationally representative survey of U.S. adults. We tested the association between educational attainment and five outcomes—SRH, cognitive function, numeracy, number of chronic medical conditions, and limitations in ADLs—across immigrant and non-immigrant groups. Multivariate regression models were employed, adjusting for key sociodemographic covariates. Results: The protective effects of education on a range of health outcomes were significantly weaker for immigrants compared to non-immigrants. Education level showed weaker associations with SRH, cognitive function, numeracy, number of chronic conditions, and ADLs among immigrants. These findings suggest that even at higher levels of educational attainment, immigrants experience poorer health and cognitive functioning than their U.S.-born counterparts. Conclusion: This study offers strong evidence for the MDRs of education on multiple health outcomes among U.S. immigrants. One possible explanation is that, despite achieving higher levels of education, immigrants often face structural barriers—such as discrimination, limited access to resources, and economic inequities—that constrain the health-related benefits typically associated with educational attainment. Additionally, a portion of immigrant education may be acquired outside the United States, where credentials may not be fully recognized or rewarded within the U.S. labor market. These findings highlight the importance of policies aimed at addressing systemic inequities and improving access to healthcare, employment opportunities, and social support for immigrant communities. Future research should further explore the mechanisms underlying these diminished returns and identify policy solutions to reduce their impact. Keywords: Educational Attainment, Immigrants, Nativity, Self-Rated Health, Chronic Disease, Activities of Daily Living (ADL), Cognitive Function

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Original Article

Open Access May 05, 2025

To Be Twice as Good to Get Half

Shervin Assari, John Ashley Pallera, Hossein Zare

Journal of Biomedical and Life Sciences 2025, 5(1), 67-83. DOI: 10.31586/jbls.2025.1158

Abstract “To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits [...] Read more.

“To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”

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Article

Open Access April 09, 2025

Color of Poverty Matters: Socioeconomic Resources and Health of Mothers Giving Birth to Children into Poverty

Shervin Assari, Mojgan Azadi, Hossein Zare

Universal Journal of Obstetrics and Gynecology 2025, 4(1), 12-23. DOI: 10.31586/ujog.2025.1237

Abstract Background: Childhood poverty is a critical determinant of developmental, health, and behavioral outcomes. However, racial and ethnic differences in how families experience and navigate poverty suggest that a one-size-fits-all approach may not be an effective approach for alleviating disparities. Understanding baseline demographic, socioeconomic, health, and behavioral characteristics among [...] Read more.

Background: Childhood poverty is a critical determinant of developmental, health, and behavioral outcomes. However, racial and ethnic differences in how families experience and navigate poverty suggest that a one-size-fits-all approach may not be an effective approach for alleviating disparities. Understanding baseline demographic, socioeconomic, health, and behavioral characteristics among families in poverty is crucial to designing equitable interventions. Objective: To examine racial and ethnic differences in baseline demographic, socioeconomic, health, and behavioral characteristics among families living in poverty, using data from the Baby's First Years (BFY:2018-2019) Study. Methods: This analysis used baseline data from the BFY study, a randomized controlled trial (RCT) designed to evaluate the effects of monthly cash assistance on children’s developmental outcomes. The sample included 1,050 children and their families, consisting of mothers and, when available, fathers. Descriptive analyses were conducted to compare demographic, socioeconomic, health, and behavioral outcomes across racial and ethnic groups, focusing on Black, Hispanic, and other mothers. Results: Significant racial and ethnic differences were observed. Regarding demographic factors, Hispanic mothers were older than White mothers. In terms of socioeconomic factors, Hispanic mothers had fewer years of education compared to White mothers, while Black mothers were more likely to receive food stamps than mothers from other groups. Regarding health and behaviors, Black mothers reported worse self-rated health but were less likely to plan for breastfeeding compared to White mothers. In contrast, Hispanic mothers reported lower levels of depression and were more likely to plan for breastfeeding. Conclusion: These findings highlight the heterogeneity of experiences among families living in poverty, with significant differences across racial and ethnic groups. Such disparities underscore the importance of tailoring anti-poverty policies to the unique needs of diverse populations. Future research should explore how the effects of interventions, such as cash assistance or guaranteed income, may differ across racial and ethnic groups to inform equitable and effective policy development.

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Open Access March 29, 2025

How Stigma Affects Patients Seeking Help for Drug Addiction

Rusette de Leon Tesani

World Journal of Nursing Research 2025, 4(1), 31-46. DOI: 10.31586/wjnr.2025.1272

Abstract Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research [...] Read more.

Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.

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Essay

Open Access March 20, 2025

Weaker Effects of Parental Education on Oral Nicotine Use of High School Students in Rural Areas: Marginalization-Related Diminished Returns

Shervin Assari, Gandom Assari, and Hossein Zare

Open Journal of Educational Research 2025, 5(2), 75-88. DOI: 10.31586/ojer.2025.6042

Abstract Background: Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In [...] Read more.

Background: Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In particular, place-based marginalization—such as neighborhood economic disadvantage and school-level poverty—may attenuate the benefits of parental education. This study examines MDRs in the relationship between parental educational attainment and nicotine pouch/gummy/candy use among non-Latino White 12th graders in the 2024 Monitoring the Future (MTF) study. Methods: This study analyzed nationally representative data from the 2024 MTF study, focusing on non-Latino White 12th graders who reported parental education levels and adolescents’ use of nicotine pouch/gummy/candy. Structural equation modeling (SEM) was used to estimate the effects of parental education on adolescents’ use of nicotine pouches, gummies, and candies, while adjusting for demographic covariates. Place-based marginalization was operationalized using rural vs urban /suburban residence. Interaction terms tested whether the effect of parental education varied based on place of residence. Results: Higher parental educational attainment was associated with lower use of nicotine pouches, gummies, and candies. However, this effect was significantly weaker in rural areas. Conclusion: Public health interventions should account for place-based disparities rather than assuming a uniform effect of SES factors. This study highlights the need for policy responses that address structural inequities beyond individual family SES.

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Original Article

Open Access March 12, 2025

Academic Aspirations of 12th Grade Students in the United States: Place-Based Diminished Returns of Parental Education in Rural Areas

Shervin Assari, Gandom Assari, Hossein Zare

Open Journal of Educational Research 2025, 5(2), 65-74. DOI: 10.31586/ojer.2025.6040

Abstract Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This [...] Read more.

Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This study examines the association between parental education and aspirations for graduate or professional education among non-Latino White adolescents, with a specific focus on urban-suburban versus rural differences. Methods: Using data from the 12th-grade cohort of the Monitoring the Future (MTF) 2024 survey, we conducted multivariate analyses to assess the relationship between parental education and aspirations for graduate or professional education. We further examined whether this association was moderated by geographic location (urban-suburban vs. rural) to identify place-based MDRs. Results: Higher parental education was associated with greater aspirations for advanced education; however, this effect was weaker in rural areas compared to urban and suburban settings. These findings highlight that even among non-Latino White adolescents, rural residence diminishes the benefits of socioeconomic resources, providing evidence of place-based MDRs. Conclusion: Rural residents face a dual disadvantage—both lower socioeconomic status and weaker returns on those resources—necessitating targeted interventions beyond resource allocation. To address disparities in educational aspirations in rural areas, policymakers should focus on improving equitable access to educational opportunities and ensuring that these resources translate into comparable outcomes across different social and geographic contexts.

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Article

Open Access March 09, 2025

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms

Payam Sheikhattari, Rifath Ara Alam Barsha, Shervin Assari

Journal of Biomedical and Life Sciences 2025, 5(1), 30-41. DOI: 10.31586/jbls.2025.6017

Abstract 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 [...] Read more.

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.

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Article

Open Access December 22, 2023

Cloud Based Payment Processing and Merchant Services: A Scalable and Secure Framework for Digital Transactions in a Globalized Economy

Jai Kiran Reddy Burugulla

Universal Journal of Finance and Economics 2023, 3(1), 32-45. DOI: 10.31586/ujfe.2023.1290

Abstract In today’s world of a globalized economy and ubiquitous digital transactions, businesses are hungry for ways to increase transaction efficiency and security. In the real economy, solutions that scale to fit transaction volume or velocity are equally valuable. This is true for clearing and settlement and for the day-to-day needs of buyers and sellers alike. Clever observers of both cash and digital [...] Read more.

In today’s world of a globalized economy and ubiquitous digital transactions, businesses are hungry for ways to increase transaction efficiency and security. In the real economy, solutions that scale to fit transaction volume or velocity are equally valuable. This is true for clearing and settlement and for the day-to-day needs of buyers and sellers alike. Clever observers of both cash and digital transactions can spot cases where technology that supports transaction security or safety can strengthen consumer-borrower ties, mitigate default risks, and reduce recidivism. In general, a cloud solution for payment processing and merchant services solves two major barriers to optimum business technology: lack of scalability and lack of security [1]. The extension of current practice has its advantages, but new solutions unlock significant opportunities for both consumers and financial institutions [2]. The focus of this work is on the provisioning of cloud-based payment processing and merchant services to financial institutions and established global organizations, although the options available with these services mean they are potentially applicable to a wide range of group entities, including non-trading organizations, pension administrators, and group treasurers. With the increased attention to cybersecurity, a mass of data is available to assist the IT departments of the major payment processors, merchants, and acquirers to get cybersecurity on the radar of C-level executives [3]. The case is put forward for the increased targeting of and reporting to the Board’s Audit, Risk, and Liability Committees of publicly held payment processors and merchants to reduce fraud losses and mitigate the reputation and class action lawsuit risk due to data breaches. The progress of technology in the payment sector requires all stakeholders to have a collective approach in order to mitigate fraud and cybersecurity-related risks in new products and services to enhance consumer confidence and the proportion of retail cashless transactions [4].

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Review Article

Open Access February 26, 2025

Lower Successful Quit Rate of Menthol Tobacco Users in a Tobacco Cessation Program: An Explanatory Analysis in Search of Potential Mechanisms

Payam Sheikhattari, Rifath Ara Alam Barsha, Shervin Assari

Global Journal of Cardiovascular Diseases 2025, 4(1), 70-78. DOI: 10.31586/gjcd.2025.1279

Abstract Background: Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. [...] Read more.

Background: Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. Aims: This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. Methods: Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. Results: Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. Conclusions: Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.

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Article

Open Access February 19, 2025

The CEASE Tobacco Cessation Controlled Trial for Low-Income Racial and Ethnic Minority Participants: Key Predictors of Success

Shervin Assari, Rifath Ara Alam Barsha, Chidubem Egboluche, Payam Sheikhattari

Global Journal of Cardiovascular Diseases 2025, 4(1), 59-69. DOI: 10.31586/gjcd.2025.1246

Abstract 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 [...] Read more.

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.

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Article

Open Access February 17, 2025

Gender Differences in the Association Between Socioeconomic Status and Cardiometabolic Health: National Health and Nutrition Examination Survey

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 50-58. DOI: 10.31586/gjcd.2025.1198

Abstract 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 [...] Read more.

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.

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Article

Open Access February 16, 2025

Uneven Impact of Maternal Education at Birth on High School Grades of Black and White Students

Shervin Assari, Maria Jahromi, Hossein Zare

Open Journal of Educational Research 2025, 5(1), 54-64. DOI: 10.31586/ojer.2025.1169

Abstract Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black [...] Read more.

Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black youth and whether this association aligns with the MDRs framework. Methods: Data were drawn from the Future of Families and Child Wellbeing Study also known as Fragile Families and Child Wellbeing Study (FFCWS) baseline and 22nd year follow-up (1990-2022). This study included 1873 Black or White participants who were followed from birth to age 22. Linear regression models were used to assess the association between maternal education and high school GPA, adjusting for sociodemographic covariates. Analyses focused on the differential effects of maternal education across racial groups, particularly among Black youth. Results: While maternal education was positively associated with high school GPA, this effect was weaker for Black students compared to their White counterparts. Specifically, each additional year of maternal education corresponded to a lower GPA increase in Black students, consistent with the MDRs hypothesis. Conclusion: Findings support the MDRs theory, indicating that maternal education has a reduced protective effect on high school GPA among Black youth. These results underscore the need for policies that address structural factors beyond education to promote equitable academic achievement.

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Article

Open Access February 14, 2025

Trauma Erodes Financial Returns of Educational Attainment

Shervin Assari, Alexandra Donovan

Open Journal of Educational Research 2025, 5(1), 40-53. DOI: 10.31586/ojer.2025.1199

Abstract 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, [...] Read more.

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.

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Article

Open Access February 13, 2025

Psychosocial Correlates of Childhood Body Mass Index: Racial and Ethnic Differences

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 34-49. DOI: 10.31586/gjcd.2025.1180

Abstract 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 [...] Read more.

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.

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Open Access February 12, 2025

Unequal Benefits: How Parental Education Falls Short for Black and Latino Youth

Shervin Assari, Maria Jahromi, Hossein Zare

Open Journal of Educational Research 2025, 5(1), 26-39. DOI: 10.31586/ojer.2025.1232

Abstract 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 [...] Read more.

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.

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Open Access February 09, 2025

The Future of Longevity Medicine from the Lens of Digital Therapeutics

Akshay Ramakrishnan, Raju Rhee, Gunjan Lath, Riya Ramakrishnan

Journal of Artificial Intelligence and Big Data 2025, 5(1), 29-37. DOI: 10.31586/jaibd.2025.1265

Abstract Digital therapeutics (DTx) are emerging as a pivotal tool in promoting longevity by addressing non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, and mental health disorders. These software-driven interventions offer personalized, evidence-based treatments that can be accessed via digital devices, making healthcare more accessible and scalable. One of the key advancements [...] Read more.

Digital therapeutics (DTx) are emerging as a pivotal tool in promoting longevity by addressing non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, and mental health disorders. These software-driven interventions offer personalized, evidence-based treatments that can be accessed via digital devices, making healthcare more accessible and scalable. One of the key advancements in DTx is the integration of artificial intelligence (AI) and machine learning (ML) to tailor interventions based on individual health data. This personalization enhances the effectiveness of treatments and supports preventive care by identifying risk factors early. The need for digital therapeutics is underscored by the rising prevalence of NCDs, which are responsible for a significant portion of global mortality and healthcare costs. Traditional healthcare systems often struggle to provide timely and personalized care, especially in low-resource settings. DTx can bridge this gap by offering cost-effective solutions that are easily scalable. Moreover, digital therapeutics can address health inequities by providing low-cost interventions to underserved populations, thereby reducing the burden of NCDs and improving overall health outcomes. As technology continues to evolve, the potential for DTx to enhance longevity and quality of life becomes increasingly promising. Recent advancements in longevity medicine and technology have focused on extending both lifespan and healthspan, ensuring that people not only live longer but also maintain good health throughout their extended years. This review article highlights these advancements that are contributing to this compelling subject of Longevity.

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Open Access February 07, 2025

CEASE Tobacco Cessation Program: Validation of Self-Rated Quit with Fagerstrom Test for Nicotine Dependence

Payam Sheikhattari, Rifath Ara Alam Barsha, Chidubem Egboluche, Adriana Foster, Shervin Assari

Global Journal of Cardiovascular Diseases 2025, 4(1), 22-33. DOI: 10.31586/gjcd.2025.1190

Abstract Background: Despite advancements in smoking cessation interventions, few programs have demonstrated sustained effectiveness among low-income, underserved populations. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program was developed to address this gap and support tobacco cessation in these communities. However, it remains unclear whether self-reported [...] Read more.

Background: Despite advancements in smoking cessation interventions, few programs have demonstrated sustained effectiveness among low-income, underserved populations. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program was developed to address this gap and support tobacco cessation in these communities. However, it remains unclear whether self-reported outcome measures in this context are in line with more objective outcome measures. Aims: This study aimed to validate self-reported quit rates using the Fagerström Test for Nicotine Dependence (FTND) as a gold standard outcome measure for evaluation of the effectiveness of the CEASE smoking cessation intervention compared to a self-help approach among low-income, underserved adult smokers. Methods: A quasi-experimental design was employed to evaluate this community-based intervention. Although participants were initially assigned to three groups, this report focuses on two arms that show the major difference in the efficacy of the program: (1) the self-help group (reference; Arm 1) and (2) the in-person CEASE group (Arm 2). Outcomes included successful quitting, assessed through self-reports, and changes in FTND scores. To examine the concordance between these measures, we tested whether changes in FTND scores fully explained the relationship between the intervention and self-reported quitting. Potential confounders included demographic, socioeconomic, and health-related variables. Data were analyzed using regression and structural equation modeling (SEM). Results: The majority of participants were Black Americans, followed by White individuals and those of other racial backgrounds. The CEASE intervention (Arm 2) demonstrated effectiveness in reducing nicotine dependence (measured by FTND) and increasing self-reported quit rates compared to the self-help group. Importantly, changes in FTND scores fully explained the effect of the CEASE intervention on self-reported quitting, highlighting the program’s impact on addiction severity. Conclusion: Successful quitting measured using self-report is in line with the decline in nicotine addiction severity among low-income racial minority populations. CEASE holds promise as a scalable solution to address smoking disparities in underserved communities.

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Article

Open Access January 24, 2025

High Socioeconomic Status Black Adolescents Attend Worse Schools than Whites

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2025, 5(1), 1-12. DOI: 10.31586/ojer.2025.1160

Abstract Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, [...] Read more.

Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, Minorities’ Diminished Returns (MDRs) theory suggests that Black families may not experience the same benefits of high family SES due to structural barriers. This study examines the association between family SES and school characteristics, focusing on racial disparities in access to high-quality educational environments. Objective: To investigate the relationship between family SES (parental education and household income) and multiple school characteristics (poverty, teacher experience, graduation rates, and college enrollment), and to assess racial differences in these associations. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, a national sample of US adolescents, was analyzed. We used multivariate regression models to examine associations between family SES and school characteristics and to test for interactions by race, specifically comparing Black and White adolescents. Results: Higher family SES was associated with positive school characteristics overall, including lower school poverty, greater teacher experience, and increased graduation and college enrollment rates. However, these positive effects of high family SES on school characteristics were significantly weaker for Black adolescents than for White adolescents. Black adolescents from high-income families were more likely than White adolescents from similar backgrounds to attend schools with higher poverty rates, less experienced teachers, and reduced graduation and college enrollment rates. Conclusion: Our findings highlight persistent racial inequities in access to educational opportunities, even among families with comparable socioeconomic resources. The diminished returns of family SES for Black adolescents underscore the role of structural barriers in limiting access to high-quality schools. These findings emphasize the need for policy interventions to address systemic inequalities that hinder Black families from fully leveraging their SES to access favorable educational environments.

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Open Access January 23, 2025

Weaker Effects of Educational Attainment on Chronic Medical Conditions in American Indian Alaska Native, Black, and Latino Adults: National Health Interview Survey 2023

Shervin Assari, Hossein Zare

Open Journal of Medical Sciences 2025, 5(1), 1-12. DOI: 10.31586/ojms.2025.1150

Abstract Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors [...] Read more.

Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors contributing to these disparities. While higher socioeconomic status is generally associated with better health outcomes, this benefit may be diminished for racialized and minoritized populations. Objective: This study investigates the protective effects of educational attainment and income-to-poverty ratio on the prevalence of chronic medical conditions and examines whether these effects vary across racial and ethnic groups, specifically among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino White adults. Methods: Using data from the 2023 National Health Interview Survey (NHIS), this cross-sectional study analyzed the association between educational attainment and chronic medical conditions across racial and ethnic groups. Logistic regression models were employed to assess whether the strength of the relationship between education and chronic medical conditions differed by racial/ethnic group, controlling for key demographic and socioeconomic covariates. Sample size was 29,373 which was reflective of 256,566,689 US population. Results: Consistent with the theory of Minorities' Diminished Returns, findings showed that the protective effects of higher educational attainment on chronic medical conditions were significantly weaker for Black, Latino, and American Indian and Alaska Native adults than for their non-Latino White counterparts. Even among individuals with higher education, Black, Latino, and American Indian and Alaska Native adults faced elevated risks of chronic medical conditions. Conclusion: While educational attainment generally reduces the prevalence of chronic medical conditions, this protective effect is moderated by racial and ethnic background. Structural barriers limit the health benefits of educational attainment. This underscores the need for policies that address structural inequities—such as low-quality education and occupational segregation—that constrain the protective health effects of educational attainment for minoritized groups.

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Open Access January 23, 2025

Diminished Returns of Educational Attainment on Hypertension Prevalence among American Indian and Alaska Native Adults: National Health Interview Survey 2023

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 11-21. DOI: 10.31586/gjcd.2025.1148

Abstract 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 [...] Read more.

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.

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Open Access November 21, 2024

Financial Strain Partially Explains Diminished Returns of Parental Education in the ABCD Study

Shervin Assari, Hossein Zare

Open Journal of Neuroscience 2024, 2(1), 25-34. DOI: 10.31586/ojn.2024.1129

Abstract Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, [...] Read more.

Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, this study examines whether high financial strain contributes to the diminished returns of parental education for Black children, using data from the Adolescent Brain Cognitive Development (ABCD) Study. We hypothesized that: (1) there would be a positive effect of parental education on total cortical volume, (2) this effect would be weaker for Black than White children, and (3) higher household financial strain in Black families would mediate the diminished returns of parental education on total cortical volume for Black children. Methods: Data were drawn from the baseline ABCD Study, focusing on 7,936 9- and 10-year-old children identified as either Black (n = 1,775) or White (n = 6,161). Parental education was the key independent variable, covariates included age, sex, household income, and marital status, race was the moderator, financial strain was the mediator, and total cortical volume was the outcome. Structural Equation Models (SEMs) were employed to examine the associations between parental education and cortical volume, with financial strain as a mediator and race as a moderator. Results: Higher parental education was associated with greater cortical volume in the pooled sample. However, this effect was significantly weaker for Black children. Financial strain partially mediated the observed diminished returns of parental education. Conclusion: High financial strain experienced by middle-class Black families partially explains why the association between parental education and child development is weaker in Black than White families. Interventions aimed at enhancing educational quality, increasing employability, expanding access to higher-paying jobs, and reducing labor market discrimination against Black individuals may help address racial inequities in child development in the U.S. Efforts to reduce financial strain should extend beyond low-income populations to also support higher-educated minority families.

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Open Access November 21, 2024

Diminished Returns of Educational Attainment on Body Mass Index Among Latino Populations: Insights from UAS Data

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 92-104. DOI: 10.31586/gjeid.2024.1096

Abstract Background: Educational attainment is a well-established predictor of physical health outcomes, including body mass index (BMI). However, according to the theory of Minorities' Diminished Returns (MDRs), the health benefits of education tend to be weaker for ethnic minorities compared to non-Latino Whites, due to structural inequalities and social disadvantages. Objective: [...] Read more.
Background: Educational attainment is a well-established predictor of physical health outcomes, including body mass index (BMI). However, according to the theory of Minorities' Diminished Returns (MDRs), the health benefits of education tend to be weaker for ethnic minorities compared to non-Latino Whites, due to structural inequalities and social disadvantages. Objective: This study examines whether the association between educational attainment and BMI is weaker among Latino individuals compared to non-Latino individuals, in line with the MDRs framework. Methods: Data were drawn from the 2014 wave of the Understanding America Study (UAS), a nationally representative internet-based panel. Body mass index (BMI) was the outcome of interest. Linear regression models were used to analyze the association between educational attainment and BMI, with an interaction term for ethnicity to explore differences in the relationship between Latino and non-Latino people. Models were adjusted for age, sex, marital status, and labor market participation and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Results: Higher educational attainment was associated with lower BMI for both Latino and non-Latino participants (p < 0.001). However, the interaction between educational attainment and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller reductions in BMI because of higher education compared to non-Latino people. Conclusion: This study provides evidence of diminished returns from educational attainment on BMI among Latino individuals. These findings support the MDRs framework, suggesting that structural barriers may limit the health benefits of education for Latino populations. While education is a key determinant of physical and mental health, its benefits are not equitably distributed across ethnic groups. Structural inequalities, chronic stress, poor neighborhood environments, and adverse educational and occupational conditions likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote health equity for Latino populations.

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Open Access November 21, 2024

Unequal Returns: Education Fails to Fully Prepare Black and Latino Americans for Retirement

Shervin Assari, Babak Najand, Hossein Zare, Amanda Sonnega

Open Journal of Educational Research 2024, 4(6), 392-401. DOI: 10.31586/ojer.2024.1104

Abstract Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement [...] Read more.
Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement preparedness, as it is linked to higher earnings, better financial literacy, and improved decision-making. However, the Minorities' Diminished Returns (MDRs) theory suggests that the economic, cognitive, and behavioral benefits of education are weaker for racial and ethnic minorities compared to non-Latino Whites. Objective: This study aims to examine the relationship between educational attainment and retirement preparedness, focusing on whether this association differs among Black, Latino, and non-Latino White individuals, using data from the Understanding America Study (UAS). Methods: Data were drawn from the UAS, a nationally representative internet-based panel survey. The sample included participants from diverse racial and ethnic backgrounds. Linear regression models were used to evaluate the association between educational attainment, measured in years of schooling, and retirement preparedness. Interaction terms were included to test whether the association varied by race and ethnicity. Models were adjusted for potential confounders, including age, sex, marital status, employment status, and immigration. Results: In the overall sample, higher educational attainment was significantly and positively associated with better retirement preparedness (p < 0.001). However, consistent with the MDRs framework, the strength of this association was significantly weaker for Black and Latino participants compared to non-Latino White participants (p < 0.05). Non-Latino Whites with higher education levels reported substantially better retirement preparedness, while the same level of education yielded smaller gains in retirement preparedness for Black and Latino individuals. Conclusion: The findings support the Minorities' Diminished Returns theory, showing that although educational attainment enhances retirement preparedness for all groups, Black and Latino individuals derive fewer benefits compared to their non-Latino White counterparts. These disparities point to persistent structural inequalities and systemic barriers within the education system and labor market, as well as the effects of segregation and discrimination, which undermine the economic benefits of education for marginalized populations. Addressing these disparities requires targeted policy interventions aimed at eliminating racial and ethnic inequalities in retirement outcomes and ensuring equitable benefits from educational attainment for all groups.

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Open Access November 19, 2024

The Cost of Opportunity: Anti-Black Discrimination in High Resource Settings

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(2), 92-110. DOI: 10.31586/jbls.2024.1128

Abstract Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental [...] Read more.
Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental education, and their interaction are associated with perceived school discrimination, which in turn reduces their cognitive, academic, and emotional wellbeing. We also hypothesize that Black children with high socioeconomic status (SES) report high perceived school discrimination in high-COI settings. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which measures a wide range of educational, cognitive, and emotional outcomes. At the same time, the ABCD children are sampled across areas with vast differences in COI rankings, that can be classified into these five categories: very high, high, average, low, and very low educational COIs. Our structural equation models (SEM) tested the additive and interactive effects of race and educational attainment on perceived school discrimination, and the effects of school discrimination on various cognitive abilities (reading proficiency, picture vocabulary, and list sorting working memory), school suspension, as well as depressed mood. Our multi-group SEM assessed how these relationships vary across educational COI levels. Results: Our findings showed that high SES Black children report highest school discrimination in residential areas with highest COIs. This is based on the observation that the interaction between race and parental education on experiences of school discrimination were only significant in areas with highest COI. Across residential areas with different COI levels, students who experienced higher school discrimination had higher suspension, worse depression, and worse cognitive performance. Conclusion: While higher COIs are associated with better academic outcomes, Black-White gaps exist in the role of increased COI through increased racial bias that children perceive. These findings underscore the complexity of educational equity, suggesting that improving COI alone is insufficient for eliminating racial disparities in school experiences. Policies should be in place to reduce school-based discrimination against Black students in high COI settings.

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Open Access November 18, 2024

Technological Caring Competence for Nursing Education (TCCNE) in Filipino Nurse Educators: Toward the Development of Basis for a Training Plan

Roison Andro Narvaez, Elaine Alamo-Lim, Stephen Nifras, Ronalyn Topacio, Ma. Elizabeth Baua, Jesus Pizarro, Tetsuya Tanioka

World Journal of Nursing Research 2024, 3(1), 73-85. DOI: 10.31586/wjnr.2024.1171

Abstract Background: Nowadays, integrating online and remote instruction into education presents unique challenges, particularly in nursing education, where combining technology with the core value of caring is essential. Nurse educators must address students’ holistic needs, as their circumstances can influence overall learning development. Objectives: This study aims to ascertain the [...] Read more.
Background: Nowadays, integrating online and remote instruction into education presents unique challenges, particularly in nursing education, where combining technology with the core value of caring is essential. Nurse educators must address students’ holistic needs, as their circumstances can influence overall learning development. Objectives: This study aims to ascertain the technological caring competence of nurse educators Methodology: A descriptive design using an adapted tool on technological caring competence for nursing education (TCCNE) Results: A total of 243 Filipino nursing educators participated in this study. Overall, the participants’ perceived level of TCCNE was quite high. This sample representative of nursing educators holds strong perceptions of their TCCNE with the values of being considerate, supportive, and respectful to their students as the highest rated competency. This result implies that the educators keep the essence of what nursing is about as they model the importance of caring even in an academic setting considering that these teachers are using remote instruction. Conclusion: The study opens up a discussion on assessing the TCCNE of nursing education in an academic setting. Thus, its advocacy could start from implementing the research training plan. Further, the nurse educators should strengthen in balancing care with appropriate technology is viewed as a necessary step to maintain the essence of nursing, which is on caring that can be modeled out not just in clinical practice alone, but in nursing education.

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Open Access November 05, 2024

Diminished Returns of Educational Attainment on Numeracy Score of Latino Populations: Insights from UAS Data

Shervin Assari, Hossein Zare, Golnoush Akhlaghipour, Mario F Mendez

Open Journal of Neuroscience 2024, 2(1), 14-24. DOI: 10.31586/ojn.2024.1098

Abstract 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 [...] Read more.
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.

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Open Access November 05, 2024

Black-White Gap Across Levels of Educational Childhood Opportunities: Findings from the ABCD Study

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2024, 4(6), 365-380. DOI: 10.31586/ojer.2024.1124

Abstract Objective: This study examines racial disparities in educational outcomes—including reading proficiency, grade point average (GPA), school discrimination, and school disciplinary actions—across regions with different levels of educational childhood opportunity index (COI). Our aim is to explore how these racial gaps between Black and White students vary in areas with differing educational [...] Read more.
Objective: This study examines racial disparities in educational outcomes—including reading proficiency, grade point average (GPA), school discrimination, and school disciplinary actions—across regions with different levels of educational childhood opportunity index (COI). Our aim is to explore how these racial gaps between Black and White students vary in areas with differing educational opportunities. We hypothesize that higher COI is associated with smaller academic achievement gaps but may also correspond with greater racial bias in unfair school treatment. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which provides comprehensive measures of educational outcomes, cognitive performance, and COI. National COI rankings were used to classify regions into five categories: very high, high, average, low, and very low educational opportunity. We analyzed racial gaps in reading proficiency, and experiences of discrimination and suspension across these COI categories. Multi-group Structural Equation Models (SEM) were used to assess how the relationship between race and educational outcomes varies across COI levels. Results: Our findings confirmed that Black-White gaps in reading proficiency and cognitive test performance (Flanker task) were less pronounced in regions with higher COI. However, racial disparities in school disciplinary actions and experiences of discrimination were more pronounced in higher-opportunity areas. Specifically, the effect of Black race was stronger in regions with the highest COI, where Black students experienced a disproportionately higher rate of unfair school treatment, including both school discrimination and suspensions, compared to their White peers. Conclusion: This exploratory study supports that while higher educational opportunities are associated with smaller academic achievement gaps between Black and White students, they might be linked to increased racial bias in school disciplinary actions and discriminatory treatment. These findings underscore the complexity of educational equity, suggesting that improving access to quality education alone is insufficient to eliminate racial disparities in school experiences. Addressing school-based bias and discrimination must accompany efforts to enhance educational opportunities.

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Open Access November 04, 2024

In-Person versus Virtual CEASE Smoking Cessation Interventions

Payam Sheikhattari, Rifath Ara Alam Barsha, Chidubem Egboluche, Adriana Foster, Shervin Assari

Journal of Biomedical and Life Sciences 2024, 4(2), 71-80. DOI: 10.31586/jbls.2024.1107

Abstract Background: Smoking cessation interventions are critical for underserved populations, particularly among low-income individuals who may benefit from tailored support. However, the effectiveness of different intervention formats remains unclear, particularly as virtual and hybrid models gain popularity. Aims: This study compares the effectiveness of three smoking cessation intervention [...] Read more.

Background: Smoking cessation interventions are critical for underserved populations, particularly among low-income individuals who may benefit from tailored support. However, the effectiveness of different intervention formats remains unclear, particularly as virtual and hybrid models gain popularity. Aims: This study compares the effectiveness of three smoking cessation intervention arms in a quasi-experimental design: Self-help group (Arm 1), In-person group (Arm 2), and Virtual/hybrid group (Arm 3). The primary outcome was the rate of successful quit across these different intervention modalities. Methods: The study utilized a community-based intervention approach, controlling for potential confounders. The communities were randomized, and this process was blinded. The effectiveness of the In-person group and the Virtual/hybrid group was compared to the Self-help group. The odds ratio (OR) for successful quit rates was calculated for each group, with corresponding 95% confidence intervals (CIs). Results: Participants included 50.4% of women, 82.8% were Black Americans, 11.6% Whites, and 3.4% other races. In-person group (Arm 2) showed a higher rate of successful quit compared to the Self-help group (OR = 2.67, 95% CI = 1.05, 6.79). Virtual/hybrid group (Arm 3) was not associated with a significantly higher quit rate compared to the Self-help group (OR = 1.48, 95% CI = 0.57, 3.83). Conclusion: The In-person group, which utilizes the CEASE curriculum and incorporates peer motivation, proved to be significantly more effective than both the Self-help and Virtual/hybrid groups. The findings suggest that low-income, underserved smokers may not be fully prepared to benefit from virtual interventions, or the current curriculum may need adaptation to better serve their needs in a virtual format.

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Open Access October 31, 2024

The Long Shadow of Early Poverty: Poverty at Birth, Epigenetic Changes at Age 15, And Youth Outcomes at Age 22

Shervin Assari, Mohammad Dezfuli, Amirreza Peyrovinasab, Hossein Zare

Current Research in Public Health 2024, 4(1), 26-40. DOI: 10.31586/crph.2024.990

Abstract Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age [...] Read more.

Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age 15, and subsequent self-rated health, school discipline, depression, and school dropout at age 22. We explored sex differences in these paths. Methods: Data were drawn from the Fragile Families and Child Wellbeing Study (FFCWS), which included 733 youth with comprehensive follow-up data up to age 22. Structural Equation Modeling (SEM) was employed to assess the pathways from race/ethnicity and poverty at birth to epigenetic aging (GrimAge) at age 15, and subsequently to self-rated health and school discipline at age 22. The model controlled for potential confounders including sex, family structure, and parental education. Results: Race/ethnicity and poverty at birth were significantly associated with higher GrimAge scores at age 15 (p < 0.05). Higher GrimAge scores were predictive of poorer self-rated health (β = -0.08, p < 0.05) and increased instances of school discipline (β = 0.13, p < 0.01) at age 22. The indirect effects of race/ethnicity and poverty at birth on self-rated health and school discipline through GrimAge were also significant (p < 0.05), suggesting that epigenetic aging partially mediates these relationships. Sex differences were also observed. Poverty at birth predicted faster epigenetic aging at age 15 for males not females. We also observed that faster epigenetic aging at age 15 was predictive of school discipline of male not female participants at age 22. In contrast, faster epigenetic aging at age 15 was predictive of self-rated health (SRH) of female not male participants at age 22. Conclusions: This study provides evidence that with some sex differences, race/ethnicity and poverty at birth contribute to accelerated epigenetic aging (GrimAge) by age 15, which in turn predicts poorer self-rated health and increased school discipline issues by age 22. These findings emphasize the importance of early interventions targeting social determinants to mitigate long-term health and behavioral disparities. Addressing these early life conditions is crucial for improving health equity and outcomes in young adulthood.

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Open Access October 30, 2024

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data

Shervin Assari, Payam Sheikhattari

Journal of Biomedical and Life Sciences 2024, 4(2), 60-70. DOI: 10.31586/jbls.2024.1070

Abstract Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers [...] Read more.

Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Methods: Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. Results: The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. Conclusions: This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.

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Open Access October 30, 2024

Smokers with Multiple Chronic Disease Are More Likely to Quit Cigarette

Shervin Assari, Payam Sheikhattari

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 60-68. DOI: 10.31586/gjeid.2024.1068

Abstract Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population [...] Read more.

Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, using data from Waves 1 to 6. Only current daily smokers were included in our analysis. The independent variable was the number of chronic medical conditions, defined as zero, one, or two or more. The outcome was becoming a former smoker (quitting smoking). Using multivariate regression analyses, we assessed the association between the number of chronic conditions and tobacco cessation over the six waves. We controlled for potential confounding variables, including demographic factors and socioeconomic status. Results: Our analysis revealed a significant association between the number of chronic medical conditions and the likelihood of quitting smoking. Specifically, individuals with two or more chronic conditions exhibited a greater probability of quitting smoking compared to those with no chronic conditions. The results remained significant after adjusting for potential confounders. Conclusions: Multiple chronic medical conditions may act as a catalyst for smoking cessation among U.S. adults. This suggests that the presence of multimorbidity, defined as multiple chronic disease diagnoses, may serve as “teachable moments,” prompting significant health behavior changes. These findings highlight the potential for leveraging chronic disease management and healthcare interventions to promote tobacco cessation, particularly among individuals with multiple chronic conditions.

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Open Access October 19, 2024

Quantitative Intersectionality Scoring System (QISS): Opportunities for Enhancing Predictive Modeling, Comparative Analysis, Health Needs Assessment, and Policy Evaluation

Shervin Assari, Hossein Zare

Journal of Social Mathematical & Human Engineering Sciences 2024, 3(1), 49-61. DOI: 10.31586/jsmhes.2024.1066

Abstract 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 [...] Read more.

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.

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Perspective

Open Access September 04, 2024

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(1), 36-46. DOI: 10.31586/jbls.2024.1035

Abstract Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the [...] Read more.

Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Results: Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. Conclusion: This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.

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Original Research

Open Access August 11, 2024

Walking the Divide: A Public Health Journey from Manhattan to Harlem

Gandom Assari, Hossein Zare, Shervin Assari

Journal of Social Mathematical & Human Engineering Sciences 2024, 3(1), 7-14. DOI: 10.31586/jsmhes.2024.1018

Abstract This perspective article discusses the striking contrasts and inequalities observed during a walk from Manhattan to Harlem in New York City, highlighting the significant social and economic differences that have profound implications for public health and social policy. Through this journey, we explore various aspects including racial segregation, the composition of shops, smoking habits, street [...] Read more.

This perspective article discusses the striking contrasts and inequalities observed during a walk from Manhattan to Harlem in New York City, highlighting the significant social and economic differences that have profound implications for public health and social policy. Through this journey, we explore various aspects including racial segregation, the composition of shops, smoking habits, street cleanliness, police presence, unemployment, real estate disparities, and the pervasive sense of insecurity. The transition from a predominantly White Manhattan to a predominantly Black and Hispanic Harlem underscores the historical and systemic inequalities that continue to shape the city's demographic and economic landscape. These disparities, rooted in discriminatory housing policies, economic disparities, and social exclusion, manifest in poorer health outcomes, higher rates of substance use, and limited economic opportunities for minority populations. By addressing these structural issues through targeted policies and sustained interventions, we can work towards reducing health disparities and promoting racial equity. This paper also highlights the concept of Minorities' Diminished Returns (MDRs), where the benefits of education and income are less pronounced for minority individuals compared to their White counterparts, further perpetuating cycles of disadvantage. Comprehensive efforts to dismantle systemic inequities are essential for fostering a more equitable and healthy society.

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Perspective

Open Access July 31, 2024

Black-White Differences in The Effects of Parental Education on College Students’ Beliefs about Racial Discrimination

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2024, 4(4), 164-173. DOI: 10.31586/ojer.2024.997

Abstract Background: Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. Objectives: This study aims to examine the [...] Read more.

Background: Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. Objectives: This study aims to examine the multiplicative effects of race and parental education on beliefs about the persistence of racial discrimination among Black and White college students. We hypothesize that Black students, particularly those with highly educated parents, will exhibit stronger beliefs in the persistence of racial discrimination as a significant issue compared to their White peers. Methods: Data were drawn from the Higher Education Research Institute (HERI) study, which includes a national sample of Black and White young adults on college campuses across the United States. We conducted statistical analyses to explore the influence of race and parental education on students' beliefs about racial discrimination. Results: Black students demonstrated stronger beliefs in the persistence of racial discrimination compared to White students. Additionally, students with higher parental education levels were more likely to recognize racial discrimination as a significant issue than those with lower parental education. The impact of parental education on these beliefs was more pronounced for Black students compared to White students. Discussion: Black college students, especially those from higher SES backgrounds, exhibit a heightened awareness of racial discrimination due to their lived experiences and educational exposure. High SES Black individuals often face increased visibility and prejudice in predominantly White environments, further reinforcing their beliefs about the persistence of discrimination. These findings highlight the need for targeted interventions to support Black students in higher education and promote awareness of racial discrimination. Policy solutions should include comprehensive anti-discrimination policies, increased diversity and inclusion efforts, and educational curricula that address systemic racism and social justice. The cross-sectional nature of the data limits causality inference, and self-reported measures may be subject to bias. Despite these limitations, the study's large and diverse sample enhances the generalizability of the findings. Race and parental education have multiplicative effects on college students' beliefs about the persistence of racial discrimination. Black students, particularly those from high SES backgrounds, are more likely to perceive racial discrimination as a continuing problem. Addressing these disparities through targeted policies and interventions is essential for creating equitable and inclusive educational environments.

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Article

Open Access July 27, 2024

Paradoxical Effects of Income and Income Inequality on Racial Health Disparities

Shervin Assari, Hossein Zare

Journal of Social Mathematical & Human Engineering Sciences 2024, 3(1), 1-6. DOI: 10.31586/jsmhes.2024.998

Abstract The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a [...] Read more.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

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Perspective

Open Access July 12, 2024

Race, Poverty Status at Birth, and DNA Methylation of Youth at Age 15

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 8-19. DOI: 10.31586/gjeid.2024.988

Abstract Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future [...] Read more.

Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future of Families and Child Wellbeing Study (FFCWS) cohort, with GrimAge used as a measure of DNAm levels and epigenetic aging. Our analysis included 854 racially and ethnically diverse participants followed from birth to age 15. Structural equation modeling (SEM) examined the relationships among race, SEP at birth, and epigenetic aging at age 15, controlling for sex, ethnicity, and family structure at birth. Findings indicate that race was associated with lower SEP at birth and faster epigenetic aging. Specifically, income to poverty ratio at birth partially mediated the effects of race on accelerated aging by age 15. The effect of income to poverty ratio at birth on DNAm was observed in male but not female youth at age 15. Thus, SEP partially mediated the effect of race on epigenetic aging in male but not female youth. These results suggest that income to poverty ratio at birth partially mediates the effects of race on biological aging into adolescence. These findings highlight the long-term biological impact of early-life poverty in explaining racial disparities in epigenetic aging and underscore the importance of addressing economic inequalities to mitigate these disparities. Policymakers should focus on poverty prevention in Black communities to prevent accelerated biological aging and associated health risks later in life. Interventions aimed at eliminating poverty and addressing racial inequities could have significant long-term benefits for public health. Future research should explore additional factors contributing to epigenetic aging and investigate potential interventions to slow down the aging process. Further studies are needed to understand the mechanisms underlying these associations and to identify effective strategies for mitigating the impact of SEP and racial disparities on biological aging.

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Open Access July 12, 2024

Racial Gap in Household Income Explains Black-White Disparities in the Intergenerational Transmission of Educational Attainment

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2024, 4(3), 137-148. DOI: 10.31586/ojer.2024.962

Abstract Background: Racial disparities in educational outcomes persist in the United States, with Black individuals experiencing lower levels of educational attainment and a higher rate of school disciplinary actions compared to their White counterparts. Parental education is a known predictor of offspring educational attainment, but its effects may vary by race. Understanding the role of household [...] Read more.

Background: Racial disparities in educational outcomes persist in the United States, with Black individuals experiencing lower levels of educational attainment and a higher rate of school disciplinary actions compared to their White counterparts. Parental education is a known predictor of offspring educational attainment, but its effects may vary by race. Understanding the role of household income in mediating these effects is crucial for developing targeted policy interventions to reduce educational inequalities. Objectives: This study aimed to examine the role of household income in mediating the differential effects of maternal education on two youth educational outcomes (educational attainment by age 22 and school disciplinary action) in Black and White families. Methods: Data were drawn from the 22 years of follow-up of the Future of Families and Child Wellbeing Study (FFCWS), a longitudinal study following a cohort of children born in large U.S. cities between 1998 and 2000. Participants included 1,647 Black and 689 White young adults who were followed from birth to age 22. Maternal education, household income, family structure, and paternal incarceration were assessed at baseline (birth), and two youth educational outcomes, namely educational attainment and any school disciplinary action, were assessed at age 22 (emerging adulthood). Using structural equation modeling (SEM), mediation analysis was conducted to examine whether household income partially mediates the effects of maternal education on youth educational outcomes, with race (Black vs. White) as the moderator. Results: The results indicated that maternal education was positively associated with youth educational attainment and negatively associated with school disciplinary actions in the pooled sample that included both Black and White families. However, the effect of parental education on educational attainment at age 22 was weaker for Black than White families. Household income partially mediated racial differences in the effect of maternal education on youth educational attainment. The results suggest that lower household income in Black families is why we observe a weaker effect of parental education on youth educational attainment for Black youth compared to White youth. Conclusions: Findings suggest that the lower household income of families is one of the reasons high maternal education levels are associated with lower youth educational attainment in Black than White families. Addressing income disparities through tax policies may help reduce racial disparities in education and promote educational equity for Black youth.

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Open Access October 22, 2023

An Appraisal of Work-Family Conflict on Management Staff of Star-Rated Hotels

Samuel Otoo, Anthony Bordoh, Kate Gyasi, Shirley Dankwa

Universal Journal of Business and Management 2023, 3(1), 28-45. DOI: 10.31586/ujbm.2023.804

Abstract The objective of this research was to investigate work-family conflict among management staff of hotels in the Accra Metropolis of Ghana. The study employs the pragmatism approach and Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. Stratified, random and convenient sampling techniques [...] Read more.

The objective of this research was to investigate work-family conflict among management staff of hotels in the Accra Metropolis of Ghana. The study employs the pragmatism approach and Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. Stratified, random and convenient sampling techniques were used to select 182 out of 356 respondents. One hundred (100) were sampled using a formula and a table determination of sample size based on the confidence level needed from a given population as provided by Krejcie and Morgan in 1970 for the study. Ten managers were conveniently interviewed on the issues of work-family conflict. The main instruments for data collection were a questionnaire and a semi-structured interview guide. This study adopted factor analysis and a structural equation model to examine factors that influence work-family conflict. This statistical technique was used in the research to investigate the factorability of the variables of work-related and family-related factors separately and a structural equation model was used to combine both factors to better understand the relationship. Linear regression was used to determine the relationship between work-family conflict. Pearson product-moment Correlation and structural equation model were used to determine the consequences of work-family conflict. It can be concluded that both work-related such as work overload, job type and involvement as well as family-related factors such as life cycle stage, and childcare arrangement predict work-family conflict among managers of hotels in the Accra metropolis. It is also deducted WFC affect managers’ performance on the job, exhaust them emotionally and also influences their intentions to leave the job for another. Managers usually feel fatigued to prepare for work and physically drained after work. They also feel depressed and emotionally drained sometimes. It is recommended that top management of hotels should allocate a budget to build an organisational culture that encourages work-family balance. Frontline managers should be trained to be aware of the benefit of providing support in the work environment that will help staff balance work and family. It is also recommended that hotel jobs be redesigned by the human resource unit to reduce workload and make it more interesting for managers so they may not feel overworked. Overworking of managers will enhance their intentions to quit the job and this will be costly for hotels.

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Open Access December 23, 2022

A Problem of Accuracy of Computer Calculations

Rostyslav V. Bilous, Ivan H. Krykun

Universal Journal of Computer Sciences and Communications 2022, 1(1), 35-40. DOI: 10.31586/ujcsc.2022.531

Abstract The paper presented the results of the research related to the analysis of the reliability of computer calculations. Relevant examples of incorrect program operation were demonstrated: both quite simple and much less obvious, such as S. Rump's example. In addition to mathematical explanations, authors focused on purely software capabilities for controlling the accuracy of complex calculations. For [...] Read more.

The paper presented the results of the research related to the analysis of the reliability of computer calculations. Relevant examples of incorrect program operation were demonstrated: both quite simple and much less obvious, such as S. Rump's example. In addition to mathematical explanations, authors focused on purely software capabilities for controlling the accuracy of complex calculations. For this purpose, examples of effective use of the functionality of the decimal and fraction modules in Python 3.x were given.

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Review Article

Open Access December 14, 2022

Clinical Approach to Diagnosing and Treatment of Neck Pain

Yusak Mangara Tua Siahaan

Open Journal of Medical Sciences 2022, 2(1), 17-23. DOI: 10.31586/ojms.2022.526

Abstract Background: Neck pain is one of the most common reasons patients seek treatment in the hospital. The causes of neck pain vary widely, trigger misdiagnosis, and often result in mistreatment. Misdiagnoses and mistreatment-related neck pain diagnoses are often associated with a diagnosis of cervical herniated disc. The implication of the misdiagnosis is the use of excessive investigations and [...] Read more.

Background: Neck pain is one of the most common reasons patients seek treatment in the hospital. The causes of neck pain vary widely, trigger misdiagnosis, and often result in mistreatment. Misdiagnoses and mistreatment-related neck pain diagnoses are often associated with a diagnosis of cervical herniated disc. The implication of the misdiagnosis is the use of excessive investigations and inappropriate therapy. This review aims to determine the causes of neck pain often obtained in daily practice and how to diagnose and treat it. Method: Search relevant articles on clinical diagnosis of neck pain with the keywords neck pain diagnostic therapy using Medline and PubMed databases. Results: Neck pain can be in the form of axial pain, which is mostly related to disorders of the joints and muscles of the neck, or in the form of pain in the roots and spinal cord. Investigations and therapy must be related to the clinical diagnosis of neck pain experienced by patients with a history of neck pain. Conclusion: Neck pain is one of the most common complaints encountered in outpatient department settings, associated with reduced quality of life. Patients may come with differing degrees of pain, various symptoms, and aetiologies making it quite challenging to treat them into complete remission. Despite being frequently encountered, some patients with neck pain are underdiagnosed and undertreated due to failure to understand the clinical symptoms before deciding possible aetiologies.

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Review Article

Open Access November 29, 2022

An Evaluation of Gender Mainstreaming Efforts in a Public University in Ghana: A Case Study of University of Education, Winneba (UEW)

Eva Annan

Open Journal of Educational Research 2022, 2(6), 367-380. DOI: 10.31586/ojer.2022.434

Abstract 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 [...] Read more.

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.

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Open Access August 21, 2021

Decision Makers for Online Purchases of Fashion Products on Reebonz Online Shopping Sites

Fajar Rezeki Ananda Lubis, Rini Anggriani, Dinda Amanda Zuliestiana, Onita Sari Sinaga, Acai Sudirman

Universal Journal of Business and Management 2021, 1(1), 62-71. DOI: 10.31586/ujbm.2021.010105

Abstract The level of business competition in several online shopping sites for fashion products is currently experiencing quite crucial dynamics. Competitive match will indirectly affect consumer purchasing decisions. This research explores what factors are dominantly influencing the level of product purchase decisions on online shopping sites in terms of product variety, price, brand image and promotion [...] Read more.

The level of business competition in several online shopping sites for fashion products is currently experiencing quite crucial dynamics. Competitive match will indirectly affect consumer purchasing decisions. This research explores what factors are dominantly influencing the level of product purchase decisions on online shopping sites in terms of product variety, price, brand image and promotion aspects. This research design uses a quantitative research design. Determination of the sample in this study using the convenience sampling method with a total of 110 respondents. Data collection uses a questionnaire distributed online during the period from May to June 2021. This study concludes that product variations and brand image have a positive and significant influence on purchasing decisions. Then for the effect of price and promotion on purchasing decisions obtained a positive but not significant impact. This study confirms the importance of paying attention to aspects of pricing and product promotion strategies on the Reebonz online shopping site.

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Article

Open Access August 15, 2021

Physicians’ Perception of E-Cigarettes as a Smoking Cessation Tool in Bangladesh

Merajul Islam, Samia Amin

Current Research in Public Health 2021, 1(1), 8-12. DOI: 10.31586/crph.2021.010102

Abstract The popularity of e-cigarette is growing worldwide. Its health hazards and role in smoking cessation is controversial. There is no doubt that health care professionals can play a vital role in assisting patients who wish to use e-cigarettes to quit smoking but there is a gap in the evidence. The present study aimed to reveal the perception of e-cigarettes as a quit smoking tool and its health [...] Read more.

The popularity of e-cigarette is growing worldwide. Its health hazards and role in smoking cessation is controversial. There is no doubt that health care professionals can play a vital role in assisting patients who wish to use e-cigarettes to quit smoking but there is a gap in the evidence. The present study aimed to reveal the perception of e-cigarettes as a quit smoking tool and its health hazards among physicians in Bangladesh. A cross-sectional study was conducted by means of a survey via self-administered structured questionnaires in Bangladesh. Data was collected from September 2019 to February 2020 and analysed by descriptive frequency and chi-square test using SPSS. A total of 145 physicians have participated in this study, 88.9% provided professional advice on quit smoking to their patients. Total 51.7%, 51.9%, 41.3%, 52.4%, 42.8%, and 47.6% physicians mentioned that e-cigarettes may cause throat irritations, cough, headache, dryness of mouth, cardiovascular disease, and cancer respectively. Chi-square test revealed that there is no association between a physician’s professional advice for quit smoking and perception of e-cigarettes as a smoking cessation tool. The physician’s perception of e-cigarettes is crucial for reducing any type of tobacco consumption. Evidence based e-cigarette related public health intervention for physicians are required to mitigate the use of e-cigarette to quit smoking.

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Open Access August 14, 2021

An Economic Evaluation of the use of Wind Farms in Iran, Taking into Account the Effect of Energy Price Liberalization Policy

Nima Norouzi, Zahra Bashashjafarabadi, Seyyed Mohammad Yahya Meybodi

Universal Journal of Business and Management 2021, 1(1), 49-61. DOI: 10.31586/ujbm.2021.010104

Abstract In this study, the effect of energy cost liberalization policies on the cost-effectiveness of wind farms compared to gas power plants has been investigated. To calculate the cost of electricity generation from various sources, including wind energy and fossil fuels, the “levelized cost” method has been used as the most acceptable economic method to compare different types of electricity generation [...] Read more.

In this study, the effect of energy cost liberalization policies on the cost-effectiveness of wind farms compared to gas power plants has been investigated. To calculate the cost of electricity generation from various sources, including wind energy and fossil fuels, the “levelized cost” method has been used as the most acceptable economic method to compare different types of electricity generation technologies. In addition, calculations related to the cost of electricity, different fuel prices, different technologies of wind farms, and different prices of different types of fuel are considered. Based on the results of this research, it was found that by targeting fuel prices in the country, wind farms are quite cost-effective, and considering the cost of the opportunity to use diesel in the country, the construction of these power plants can provide the possibility of exporting this fuel. This cost also increases with the production of valuable equipment in the country. The important point is that the macro policy should localize the wind turbine industry with priority to its valuable parts and components due to fuel price changes. This policy will continue to make this type of power plant cost-effective in the country and the employment of specialists in the country.

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Open Access August 12, 2021

Responding to the Call through Translating Science into Impact: Building an Evidence-Based Approaches to Effectively Curb Public Health Emergencies [Covid-19 Crisis]

Olalekan Morufu Raimi, Kalada Godson Mcfubara, Oyeyemi Sunday Abisoye, Clinton Ifeanyichukwu Ezekwe, Olawale Henry Sawyerr, Gift Aziba-anyam Raimi

Global Journal of Epidemiology and Infectious Disease 2021, 1(1), 12-45. DOI: 10.31586/gjeid.2021.010102

Abstract COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from [...] Read more.

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission.

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Review Article

Open Access December 27, 2020

Enhancing Pharmaceutical Supply Chain Efficiency with Deep Learning-Driven Insights

Venkata Obula Reddy Puli, Tulasi Naga Subhash Polineni

Journal of Artificial Intelligence and Big Data 2021, 1(1), 126-138. DOI: 10.31586/jaibd.2020.1186

Abstract The growing complexity of the operating environment urges pharmaceutical innovation. This essay addresses the need for the integration of advanced technologies in the pharmaceutical supply chain. It justifies the value proposition and presents a concrete use case for the integration of deep learning insights to make data-driven decisions. The supply chain has always been a priority for the [...] Read more.

The growing complexity of the operating environment urges pharmaceutical innovation. This essay addresses the need for the integration of advanced technologies in the pharmaceutical supply chain. It justifies the value proposition and presents a concrete use case for the integration of deep learning insights to make data-driven decisions. The supply chain has always been a priority for the pharmaceutical industry; research and development recognizes companies' increasing investment in big data strategies, with plans for a CAGR in big data tool adoption. The work presented herein has a preliminary explorative character to recuperate and integrate evidence from partly overlooked practical experience and know-how. The practical relevance of the essay is directed toward practitioners in pharmaceutical production, supply chain management, logistics, and regulatory agencies. The literature has shown a long-term concern for enhanced performance in the pharmaceutical supply chain network. This essay demonstrates the application of deep learning-driven insights to reveal non-evident flow dependencies. The main aim is to present a comprehensive insight into deep learning-driven decision support. The supply chain is portrayed in a holistic manner, seeking end-to-end visibility. Implications for public policy are discussed, such as data equity: many countries are protecting their populations and economic growth by building resilience and efficiency to ensure the capacity to move goods across supply chains. The implementation strategy is covered. The combined reduction of variability, efficiency as matured richness, reliability (on stochastic flows and their understanding through deep learning and data), and system noise (increased dampening through the inclusiveness of all stakeholders) results in increased responsiveness of supply chains for pharmaceutical products. Future work involves the integration of external data, closing the loop between planning and its application in reality.

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Review Article

Open Access February 22, 2023

Navigating the Pharmaceutical Supply Chain: Key Strategies for Balancing Demand and Supply

Manas Gorani

Global Journal of Medical Case Reports 2023, 3(1), 1-6. DOI: 10.31586/gjmcr.2023.1210

Abstract The pharmaceutical industry is fundamental to global healthcare, providing essential medicines that improve health outcomes and quality of life. However, the demand and supply dynamics within this sector are highly complex, shaped by various factors including demographic changes, evolving disease burdens, technological advancements, regulatory challenges, and economic pressures. This manuscript [...] Read more.

The pharmaceutical industry is fundamental to global healthcare, providing essential medicines that improve health outcomes and quality of life. However, the demand and supply dynamics within this sector are highly complex, shaped by various factors including demographic changes, evolving disease burdens, technological advancements, regulatory challenges, and economic pressures. This manuscript explores the intricate relationship between pharmaceutical medicine demand and supply, focusing on key strategies that can help companies effectively navigate these challenges. The demand for pharmaceutical products is driven by several factors, such as population growth, the aging population, the rise of chronic diseases, and the emergence of new health threats. Additionally, healthcare accessibility, affordability, and policy changes significantly impact the consumption of medicines, while innovations in medical technologies and therapies create new treatment needs. On the supply side, pharmaceutical companies face challenges related to manufacturing capacity, raw material availability, distribution logistics, and compliance with ever-evolving global regulatory frameworks. To address these challenges, the manuscript discusses strategic approaches to managing both demand and supply in the pharmaceutical sector. Key strategies include advanced demand forecasting through data analytics, optimizing supply chains for efficiency and resilience, implementing just-in-time inventory models, and investing in flexible manufacturing systems. Furthermore, global collaboration and partnerships, as well as effective risk management practices, are highlighted as essential to ensuring the availability of medicines, particularly in times of crisis or global health emergencies. This manuscript also delves into the role of policy advocacy and regulatory harmonization in stabilizing the pharmaceutical market, ensuring that medicines are accessible to all populations. In conclusion, the pharmaceutical industry must continually adapt to meet the evolving challenges of demand and supply, embracing innovation and collaboration while maintaining a focus on patient access and global healthcare equity. Through strategic planning and adaptive solutions, the pharmaceutical sector can ensure the continuous availability of critical medicines worldwide, meeting both current and future health needs.

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Case Report

Open Access December 26, 2020

Green Cloud Computing: Strategies for Building Sustainable Data Center Ecosystems

Ravi Kumar Vankayalapati, Shakir Syed

Online Journal of Engineering Sciences 2020, 1(1), 1-15. DOI: 10.31586/ojes.2020.1229

Abstract Green cloud computing is part of endeavors to develop sustainable data center ecosystems and, more importantly, nurtures a mindful alignment between environmental considerations and our cloud computing practices. This view is reinforced with the requirements of resource and energy minimization, as well as clean computing. This paper surveys the current practices, strategies, and significant [...] Read more.

Green cloud computing is part of endeavors to develop sustainable data center ecosystems and, more importantly, nurtures a mindful alignment between environmental considerations and our cloud computing practices. This view is reinforced with the requirements of resource and energy minimization, as well as clean computing. This paper surveys the current practices, strategies, and significant aspects involved in moving towards green cloud computing, providing energy-efficient data centers. The energy efficiency criteria call for unified strategies in power-proportional components, big data storage, server systems, and power supply units to save holistic energy. In addition, there are significant challenges in moving towards green cloud computing for service providers and data center operators. We address various energy-conscious resource management technologies and discuss the importance of developing innovative, effective green management solutions. Data centers are ubiquitous but inherently more conspicuous to begin to see the urgency of making them sustainable in our ecological environment. With this in mind, this paper encapsulates the multidimensional issues and increased complexities of bringing up green solutions in cloud computing practices and provides guidance and potential strategies. We outline, realign, and insist on adopting strategies in practice not only from the technical aspect but also in strengthening partnerships and investigating strategies to further dissect challenges, converge solutions, and consider our impact in even more areas of study.

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Review Article

Open Access December 26, 2021

Architectural Frameworks for Large-Scale Electronic Health Record Data Platforms

Sasi Kumar Kolla

Current Research in Public Health 2021, 1(1), 1-19. DOI: 10.31586/crph.2021.1372

Abstract Architectural frameworks for large-scale Electronic Health Record (EHR) data platforms are described. Existing EHR data platform architectures often leverage multiple cloud-based solutions blended with institutional infrastructures to manage and analyze clinical data at scale. Key design principles governing the scale of existing EHR data architecture include model design, governance structure, [...] Read more.

Architectural frameworks for large-scale Electronic Health Record (EHR) data platforms are described. Existing EHR data platform architectures often leverage multiple cloud-based solutions blended with institutional infrastructures to manage and analyze clinical data at scale. Key design principles governing the scale of existing EHR data architecture include model design, governance structure, data access management, data security/policy/protection, data-information-language-based standardization, and analytics tool alignment, among others. The rapidly evolving technology landscape and the unprecedented volume of incident and retrospective clinical data being collected and generated within healthcare organizations have led to the emergent need for a dedicated architectural framework to support large-scale computing in the health informatics domain. The application areas of large-scale computing in health informatics include real-time predictive analytics, risk stratification, patient cohort analytics, development of predictive models for specific institutions or population groups, and many more. The use of EHR data for a multitude of decision-making processes in both clinical and non-clinical settings has prompted the establishment of policies prescribing the conditions of access and use of EHR data for non-employed individuals in the organization. Consequently, the demand for accessing, using, and managing EHR data at scale has impacted the over.

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