Background Evidence about the impact of the COVID-19 pandemic on existing health inequalities is emerging. This study explored differences in mental health, sense of coherence (SOC), sense of community coherence (SOCC), sense of national coherence (SONC), and social support between low and high socioeconomic (SES) groups, and the predictive value of these predictors for mental health. participants and procedure A cross-sectional study was conducted using an online survey in the Netherlands in October 2021, comprising a total of 91 respondents (n = 41, low SES; n = 50, high SES). results There were no differences in mental health, SOC, SOCC, SONC, and social support between the groups. SOC was a predictor for mental health in both groups and SOCC for the low SES group. conclusions We found that both SOC and SOCC predict mental health during the pandemic. In the article we reflect on possible pathways for strengthening these resources for mental health.
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Background Ethnic differences in colon cancer (CC) care were shown in the United States, but results are not directly applicable to European countries due to fundamental healthcare system differences. This is the first study addressing ethnic differences in treatment and survival for CC in the Netherlands. Methods Data of 101,882 patients diagnosed with CC in 1996–2011 were selected from the Netherlands Cancer Registry and linked to databases from Statistics Netherlands. Ethnic differences in lymph node (LN) evaluation, anastomotic leakage and adjuvant chemotherapy were analysed using stepwise logistic regression models. Stepwise Cox regression was used to examine the influence of ethnic differences in adjuvant chemotherapy on 5-year all-cause and colorectal cancer-specific survival. Results Adequate LN evaluation was significantly more likely for patients from ‘other Western’ countries than for the Dutch (OR 1.09; 95% CI 1.01–1.16). ‘Other Western’ patients had a significantly higher risk of anastomotic leakage after resection (OR 1.24; 95% CI 1.05–1.47). Patients of Moroccan origin were significantly less likely to receive adjuvant chemotherapy (OR 0.27; 95% CI 0.13–0.59). Ethnic differences were not fully explained by differences in socioeconomic and hospital-related characteristics. The higher 5-year all-cause mortality of Moroccan patients (HR 1.64; 95% CI 1.03–2.61) was statistically explained by differences in adjuvant chemotherapy receipt. Conclusion These results suggest the presence of ethnic inequalities in CC care in the Netherlands. We recommend further analysis of the role of comorbidity, communication in patient-provider interaction and patients’ health literacy when looking at ethnic differences in treatment for CC.
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The prevalence of type 2 diabetes (T2D) is relatively high among people with a low socioeconomic status (SES). As lifestyle is crucial in T2D management, patients are advised to live healthily, but incorporating lifestyle changes in daily life is not easy. It may be even more difficult for people with a low SES, as they often struggle with more urgent issues in daily life that supersede healthy lifestyle. How to promote a healthy lifestyle such that the needs of low SES patients are met? A boundary condition is a thorough understanding of the target group, and of the differences between individuals in this group. Too often, people with a low SES receive either general advice, or advice targeted to literacy level or ethnic background, whereas the diversity within the low SES population is much wider than that. We developed personas to identify archetypes of the target group, each reflecting a distinct pattern in goals, attitudes and behaviours, to help grasp the diversity of the target group. Ten interviews with low SES T2D-patients revealed their perceptions and experiences related to what is important in life, a healthy lifestyle, living with diabetes, and lifestyle advice. Following Goodwin’s persona development methodology (2011), three groups were qualitatively extracted from the data. In short, the personas are: 1) the worrisome caregiver: wants to live healthier, but is incapable of incorporating advices into one’s life; caring for others is first priority; 2) the conscious self-confident: willing and able to follow up advice in order to reduce medication use; 3) the selfwilled survivor: dealing with multiple (health) issues, and dedicated to solve things one’s own way. Each persona likely responds differently to health promoting strategies. Additional research is needed to enrich the set of personas, for example by verifying them with the target group’s family or health professionals.
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The COVID-19 crisis impacts populations globally. This impact seems to differ for groups with low- and high-socioeconomic status (SES). We conducted a qualitative study in the Netherlands using a salutogenic perspective to examine experiences with stressors and coping resources during the pandemic among both SES groups to gain insight on how to promote the health and well-being of these groups. We conducted 10 focus group discussions and 20 interviews to explore the experiences, including resources and stressors, of respondents from low- (N = 37) and high-SES (N = 38) groups (25-55 years, Dutch speaking). We analyzed the findings at individual, community, and national levels. The results show that coping depends on government-imposed measures and the way individuals handle these measures; restriction to the home context with positive and negative consequences for work and leisure; psychological negative consequences and resourcefulness; and social effects related to unity (e.g. social cohesion or support) and division (including polarization). Respondents with lower SES expressed more problems with COVID-19 measures and experienced more social impact in their neighborhood than those with higher SES. Where low-SES groups especially mentioned the effects of staying at home on family life, high-SES groups mentioned effects on work life. At last, psychological consequences seem to differ somewhat across SES groups. Recommendations include consistent government-imposed measures and government communication, support for home schooling children, and strengthening the social fabric of neighborhoods.
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Specific approaches are needed to reach and support people with a lower socioeconomic position (SEP) to achieve healthier eating behaviours. There is a growing body of evidence suggesting that digital health tools exhibit potential to address these needs because of its specific features that enable application of various behaviour change techniques (BCTs). The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP, and which of these BCTs coincide with improved eating behaviour. The systematic search was performed in 3 databases, using terms related to e/m-health, diet quality and socioeconomic position. A total of 17 full text papers were included. The average number of BCTs per intervention was 6.9 (ranged 3–15). BCTs from the cluster ‘Goals and planning’ were applied most often (25x), followed by the clusters ‘Shaping knowledge’ (18x) and ‘Natural consequences’ (18x). Other frequently applied BCT clusters were ‘Feedback and monitoring’ (15x) and ‘Comparison of behaviour’ (13x). Whereas some BCTs were frequently applied, such as goal setting, others were rarely used, such as social support. Most studies (n = 13) observed a positive effect of the intervention on eating behaviour (e.g. having breakfast) in the low SEP group, but this was not clearly associated with the number or type of applied BCTs. In conclusion, more intervention studies focused on people with a low SEP are needed to draw firm conclusions as to which BCTs are effective in improving their diet quality. Also, further research should investigate combinations of BCTs, the intervention design and context, and the use of multicomponent approaches. We encourage intervention developers and researchers to describe interventions more thoroughly, following the systematics of a behaviour change taxonomy, and to select BCTs knowingly.
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PURPOSE: The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.METHODS: A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).RESULTS: The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.CONCLUSIONS: The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
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It is generally assumed that in the countryside of Northeast Netherlands children enter primary school with a language delay. Despite the apparent consensus, unequivocal evidence demonstrating that the number of young children with language delays and the magnitude of these delays is, however, lacking. The first aim of this dissertation was, therefore, to examine whether children in Northeast Netherlands indeed enter primary school with language delays, compared to national norms and to same-aged children in other parts of the country. The second aim was to examine the role of socioeconomic and cultural determinants of language development in young children at the beginning stages of primary education.The findings revealed that there are no overall language delays in young children at the beginning stage of primary education in Northeast Netherlands. The predominant image that young children in this region start primary school with a language delay, needs to be adjusted. However, there are clear indications that within the general population in Northeast Netherlands, a relatively large group of children suffers from persistent language delays. It is suggested that changing demographic composition of the villages in the northeastern countryside is related to the differences in language skills that are indicated in this research. Empirical evidence is found for this assumption: this research has revealed that the relationship of socioeconomic factors such as maternal education and language skills of young children are mediated by cultural factors such as the literacy use of parents, their beliefs about child rearing and education, and their expectations regarding children’s academic achievement
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This paper explores country-level macro-structural conditions that are associated with social capital, measured as individuals’ access to social resources. To explain differences in social capital across societies, we formulate hypotheses based on welfare state generosity, cultural orientations (collectivism vs. individualism), and income inequality. We test our hypotheses using data from the International Social Survey Programme (ISSP) 2017, which comprises a total sample size of 50,010 individuals living in 33 countries. We use the position generator survey instrument to build two composite measures of social capital: the diversity and the socio-economic status of social contacts. Multilevel regression models reveal that diversity of social contacts is generally greater among individuals in countries with generous welfare states, while access to contacts of a higher socio-economic status is generally better among individuals in countries with higher levels of individualism. A country’s income inequality is not associated with the social capital of its citizens. However, the association between a person’s socioeconomic status and the diversity of their social capital is moderated by income inequality. As such, our study serves to demonstrate that macro-social conditions at the country level do influence individual social capital and have different implications depending on the dimension considered.
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Mexican oregano is a non-timber forest product harvested in natural vegetation and represents an important source of income for rural families. Recent reports have highlighted decreases in natural populations caused by increased harvest intensity. Oregano leaf harvesting is a complex problem, involving different components and views, and has a clear spatial dimension. We proposed an analytical framework based on multi-criteria-multi-objective analyses. GIS tools were used as the platform for managing, displaying and analyzing ecological and socioeconomic information from different sources in order to evaluate land suitability of three different management strategies for two competing land objectives: oregano Harvest and oregano Regeneration. The incorporation of environmental evaluation criteria in the analysis allowed the identification of new potential oregano harvesting areas which were neither reported by harvesters, nor registered during harvesting trips. Socio-economic criteria, such as land tenure, highlighted the fact that a substantial proportion of current oregano harvesting areas are located outside ejido limits resulting in potential conflicts for resource access. The proposed Balanced oregano management strategy, in which the same proportion of suitable area (50%) was assigned to both objectives, represents the most favorable management strategy. This option allows harvesters to continue earning an income from oregano leaf harvest; and at the same time helps in the selection of the best areas for oregano regeneration. It also represents a management strategy with a smaller impact on oregano populations and on the harvesters ́ income, as well as lower monitoring costs. The proposed analytical frame-work may contribute to advance the application of systematic approaches for solving decision-making problems in areas where oregano leaves and other NTFP are harvested.
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This explanatory sequential mixed methods study explores the perceptions of academic and administrative managers responsible for teacher training at a public university in Colombia, as well as their views on improving such training after learning about the performance of teachers student teachers in the 2019 Saber Pro test, the differences in their test scores, and the relationships and statistical correlations between these outcomes and the students’ personal, family, socioeconomic and academic characteristics. Our findings show significant differences in the student teachers’ mean scores and performance when data are grouped according to personal, socioeconomic and academic conditions; a significant relationship between performance and student teacher characteristics; and correlations between critical reading scores and the other competencies assessed. Our data also highlight the lack of knowledge among academic and administrative managers about students’ life circumstances and the diversity of factors that may impact their performance; the importance of correlational data; the difference between expected and true outcomes; the inequity under which students seem to pursue their education; the limitations in access to resources; the training required for teachers to be able to analyze quantitative data and use specific software; the impact of teachers’ critical reading skills on student outcomes; the importance of data-driven decision-making; and the need for teachers to engage in quantitative research practices.
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