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Open Access May 10, 2023

Knowledge of Obstetric Warning Signs and Associated Risks among Saudi Pregnant Women

Abstract Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care [...] Read more.
Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care maternity set-up in Riyadh City. Data for this cross-sectional study were obtained using a structured questionnaire from eligible pregnant women admitted to King Saud Medical City (KSMC) between August 2020 and March 2021. Data were analyzed using descriptive and inferential statistics. Out of a minimum estimated sample size of 170, researchers recruited 362 participants. As observed, only 92 people, or 25.4%, had enough knowledge about various educational levels. The majority (91.2%) lived in villages, had no history of chronic disease (74.0%), and said that it took them at least 30 minutes to commute from their home to the hospital (69.3%). Two hundred two (55.7%) lacked appropriate knowledge, although most women (76.2%) had one to four pregnancies. Poor psychological health resulted from 37 people's (10.2%) inadequate Awareness. Even though 139 (38.4%) had spent more than 15 minutes receiving education from medical staff and 200 (61.5%) had attended the prenatal care clinic more than four times, most lacked adequate knowledge. The variables education level (P=0.000), working status (P=0.022), and place of residence (P=0.044) showed a statistically significant association with the knowledge level, also only education level statistically significantly affected the likelihood of knowledge gaps. In conclusion, early identification of obstetric warning signs and associated risk factors of pregnancy complications is integral to prevention.
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Article
Open Access October 01, 2025

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

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 March 20, 2025

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

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

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.
Article
Open Access March 09, 2025

Place-Based Diminished Returns of Parental Education on Adolescents’ Inhalant Use in Rural Areas

Abstract Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer [...] Read more.
Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.
Article
Open Access November 19, 2024

Influence of Physical Features of Housing Environment on Students Halls of Residence

Abstract The purpose of the study was to examine the Influence of Physical Features of the Housing Environment on Students' Halls of Residence at the University of Cape Coast in the central region of Ghana. Quantitatively, a descriptive survey research design was adopted for the study. Housing Deficit Theory underpins the study. The study population comprised three hundred and eight one (381) level 100 [...] Read more.
The purpose of the study was to examine the Influence of Physical Features of the Housing Environment on Students' Halls of Residence at the University of Cape Coast in the central region of Ghana. Quantitatively, a descriptive survey research design was adopted for the study. Housing Deficit Theory underpins the study. The study population comprised three hundred and eight one (381) level 100 students in the Halls of Residence at the University of Cape Coast. Stratified proportionate random and simple random sampling techniques were used to select the eight (8) halls of residence and three hundred and eight one (381) level 100 students. The main instrument for data collection was a questionnaire. Cronbach's alpha was used in the study to assess the reliability of the variables. Descriptive statistics were used to analyse the data and show the direction of the responses. The study revealed that the students were satisfied with the physical features of the halls of residence, which influenced their contentment. Features such as recreational facilities, fire service systems, and relaxation facilities were vital in reaching such satisfaction. The study also indicated that the students were satisfied with how much their housing environment influenced their contentment. Students' relationship with their colleagues, the proximity of their halls of residence to the lecture halls and the serenity of the environment of the halls of residence all proved helpful in aligning the students' contentment to such an extent. It is recommended that the hall management should maintain the present physical features and facilities in the halls of residence for students' satisfaction. It is also recommended that the university management take into consideration the proximity of the halls of residence to the lecture theatres and the serenity of the environment of halls of residence in any future halls of residence construction.
Article
Open Access May 30, 2024

Assessing the Socio-Economic Implications of Free Senior High School (SHS) Policy on Tertiary Institutions in Ghana: A Case Study of the Western Region

Abstract Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of Goal 4 [...] Read more.
Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of Goal 4 of the United Nations Sustainable Development Goals (SDGs). While many studies have been conducted on the policy’s impact on beneficiaries, little is known about its impact on tertiary institutions. The purpose of this study is to evaluate the socioeconomic effects of the Free SHS policy on tertiary institutions in Ghana's Western Region. We also provide suggestions on how to improve the policy's efficacy and lessen any obstacles to its incorporation into higher education. Methodologically, 103 employees of Takoradi Technical University and the University of Mines and Technology were sampled using a purposive sampling technique. According to the report, despite the lack of adequate facilities such as lecture halls, dorms, and residence halls on campus, the Free SHS policy has increased enrollment at the postsecondary level. This has resulted in a high student-to-lecturer ratio, increased utility bills, a high cost of living on campus, and a rise in the opening of businesses on campus. To address some of these socioeconomic impacts, respondents proposed that the government should improve infrastructure in the country's higher institutions, hire more lecturers, boost incentives for lecturers, and foster partnerships with private institutions to support infrastructure development.
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Open Access February 25, 2022

Claiming the Place; Informal Placemaking, Power and Territorial Identity in Heliopolis, Cairo

Abstract The bottom-up or informal placemaking process is “illegal”, practised only by the “poor” and “unintellectual” classes. The author argues that various classes practise informal placemaking regardless of their economic status or educational level. Studying the spatial manifestation of informal placemaking helps to understand the concrete needs of the residents and reconsider their role in [...] Read more.
The bottom-up or informal placemaking process is “illegal”, practised only by the “poor” and “unintellectual” classes. The author argues that various classes practise informal placemaking regardless of their economic status or educational level. Studying the spatial manifestation of informal placemaking helps to understand the concrete needs of the residents and reconsider their role in identifying places. Aiming to comprehend informal placemaking and its importance, this study investigates informal placemaking in Sheraton Residence, Heliopolis, Cairo. The area is chosen for its formality, socio-economic and cultural patterns. Cases of informal placemaking in Sheraton Residence are described and analysed to pinpoint their role in creating a sense of place, territorial identity and comprehending their meaning. A comparison with cases in informal low-income housing is conducted to construct diversities and similarities. The study encourages the re-thinking of the public role in placemaking as a place of negotiation and belonging. We can improve their urban quality by re-thinking informal placemaking and looking at how people use the place. The general impression that only informal housing and low-educated classes practise informal placemaking is incorrect.
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