Web-based cognitive interventions on subjective cognitive impairment in cancer survivors:A systemic review

Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of web technologies,web-based cognitive interventions have been implemented in the management and the alleviation of the SCI,the psychosocial distress,and the emotional distress in cancer survivors.This review aimed to summarize the intervention contents of web-based cognitive interventions for SCI,and to explore the effects of the interventions on SCI,psychosocial status,and emotional health.Methods:Six databases(CINAHL Plus,Cochrane Library,Embase,APA PsycInfo,PubMed and CNKI)were searched from the establishment of databases up to December 2023.Literature references were also manually searched for related articles.Results:This review contained 21 studies that covered the contents of web-based cognitive interventions,such as computer-assisted cognitive training,online cognitive rehabilitation,cognitive behavior therapy with the Internet,telehealth physical exercise,and web-based mindfulness interventions.The effects of web-based cognitive interventions positively impacted SCI for cancer survivors.Also,these interventions showed varying degrees of effectiveness in alleviating psychosocial and emotional distresses.Conclusion:By summarizingfive types of cognitive intervention contents delivered via web technology,this review demonstrated that web-based cognitive interventions optimized SCI and overall psychosocial and emotional statuses for the cancer survivors.It is recommended that future research focus on the development of customized web-based cognitive interventions for individuals with SCI,along with their psychosocial and emotional statuses.

Socio-economic status and lifestyle factors are associated with achalasia risk: A population-based case-control study

AIM: To evaluate the association between various lifestyle factors and achalasia risk.METHODS: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sexmatched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios(OR) and 95% confidence interval(CI).RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia(OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socioeconomic class, was also associated with a reduced risk of achalasia(OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia(OR = 2.00, 95%CI: 1.17-3.42). Nochildhood household factors were associated with achalasia risk.CONCLUSION: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology.

Influence of socio-economic status and environmental factors on serologically diagnosed Japanese encephalitis cases in the state of West Bengal, India during 2005-2010

Objectives: The main aim of the current study is to examine the influence of socio-economic status and environmental factors on serologically diagnosed Japanese encephalitis cases in the state of West Bengal, India during 2005-2010. Materials and methods: A total of 648 blood/CSF specimens were collected and/or referred from the suspected AES cases, admitted in the different medical colleges and hospitals of the state during the year of 2005-2010. These specimens were subjected to JE Mac ELISA to determine the actual JE case amongst these AES. The association of the socio-economic status and environmental factors with the serologically diagnosed JE positive cases was studied by a statistical analysis through Normal Deviate test or Z test. Result: Out of 648 specimens, only 175 (27.0%) specimens were reactive to JE IgM antibody, of which 60.0% were from the male individuals and 40.0% from the female population. Major cases were observed in the age group of 0 - 10 years;followed by 11 - 20 years. Regarding literacy, only 58.3% cases had no education and 41.7% were from the literate with varying level of education, i.e., from primary level to post gra- duate level. A total of 65.7% cases were from low income group where as only 34.3% cases were from high income group. Regarding house type, 62.3% cases lived in mud house and 37.7% cases lived in the brick house. In most of the cases (74.3%), persons were living in close proximity to rice fields/lakes/ponds. 69.7% cases were found to occur in the monsoon and post-monsoon period whereas 30.3% cases were reported in the pre-monsoon period. Conclusion: Our study concludes that socio-economic status and environmental conditions were statistically significant contextual risk factors for serologically diagnosed JE incidences in West Bengal where JE is proved to be endemic in nature and such study constitutes a new report of this kind in the region.

Socio-Economic Status and Gender as Determinant of Dietary Practices of Secondary School Students’by Exposure to Pictorial Nutrition Education for Sustainability

Objectives:The study examined socio-economic status and gender as determinant of dietary practices of senior secondary school students in Edo South Senatorial district for healthy living and sustainability.Methodology:Quasi experimental research design was employed in the study.Three research questions were raised and formulated into hypotheses,tested at 0.05 level of significance.A multistage random sampling technique was used to sample 245 students from two public schools in Oredo local government areas within Edo south senatorial district.Two(2)instruments(questionnaire and achievement test)validated and reliability of 0.64 and 0.84 reliability co-efficient were obtained.The demographic data/SES,dietary practices(DDPSESQ)was used to obtain information on their dietary practices and socio-economic status,while the pictorial nutrition achievement test(PNAT)consisted of the pre-and post-test.The treatment package comprised planned lessons of 40 minutes each for six(6)weeks.The data collected were analyzed using inferential statistics;hypotheses 1 and 2 were tested using the independent t-test while hypothesis 3 was tested using One-Way ANOVA statistics.Findings:The study revealed that there is no significant difference in dietary practices of students of high,medium and low socio-economic status as a result of exposure to pictorial nutrition education.There was no significant difference in dietary practices by gender.The study concluded that socio-economic status does not determine dietary practices of secondary school students for responsible living.

An Investigation of Iranian Students＇ English Proficiency Test Scores in Relation to Socio-Economic Status and Gender

Every day many students apply for and enroll in language-teaching courses to achieve their aims through learning another language. However, learning another language does not occur identically among all students. Some students learn a language, even their own mother tongue earlier but some others may need to spend more time acquiring a language. Seeking out for the probable reasons for such a difference, the current study following the constructivist approach to language learning and bearing in mind the role of society and human communities in language learning, was concluded to investigate the probable impact（s） of some social variables （social status, attitudinal and motivational status of learners） on language learning outcomes of Iranian adult learners assessed through a standardized English proficiency test. The findings have revealed that the social milieu in which learners live may play a decisive role as far as learning opportunities, input and resources are concerned.

Research of the Socio-economic Development in Dalian Chengshantou Nature Reserve

For the purpose of accommodating the relationship between the protection of nature reserve and the development of local society and economy,this paper,taking Dalian Chengshantou Nature Reserve as a study area and PRA as a main research method,investigated and analyzed the status of social and economical development and the existing problems in the study area. The result shows that: the contradictory between the protection of nature reserve and the local development of social and economical activities are still prominent,and the principle of " integration of protection and reasonable development" proposed by the general plan of nature reserve has not reached the expected result.Therefore,further efforts should be made firstly to accommodating relationship between the protection of nature reserve and the local development activities,secondly to accelerating the development of eco-tourism and the relevant service industries in accordance with the local practical situations,and finally to promoting the sustainable development of both the protection of nature reserve and the local society and economy.

Validity of the Patient-Generated Subjective Global Assessment(PG SGA)in Colorectal Cancer Patients in China

Objective The patient-generated subjective global assessment(PG-SGA)is a nutritional assessment tool specially designed for cancer patients.This study tested the validity of the PG-SGA for the nutritional assessment of colorectal cancer(CRC)patients in China.Methods A total of 8,093 Chinese patients with any stage CRC were enrolled in this cross-sectional,observational study.Within the first 48 hours of admission,patients were evaluated using the PG-SGA,nutritional risk screening 2002(NRS 2002),Karnofsky Performance Status(KPS),and some anthropometric parameters,including the triceps skinfold thickness(TSF),mid-arm circumference(MAC),mid-arm muscle circumference(MAMC),hand grip strength(HGS),maximum left calf circumference(MLCC),and maximum right calf circumference(MRCC),among others.Spearman’s correlation test was performed to analyze item-total score correlations and correlations between the total PG-SGA score and other parameters or performance scores,further testing convergent validity.The discriminative ability of the PG-SGA was measured by comparing different characteristics between several nutritional groups.A principal component analysis was performed with selected parameters to evaluate the construct validity.Results The average total PG-SGA score of all patients was 5.69±4.46,and they had a median age of 59 years(interquartile range(IQR),51-67 years)and an average body mass index(BMI)of 22.57±3.29 kg/m^(2).The item-total correlations of the total PG-SGA score between the global PG-SGA rating(Spearman,r=0.94)and PG-SGA score(patient-generated)(Spearman,r=0.97)were strong.Significant correlations were also found between the total PG-SGA score and other nutritional screening tools,including the BMI(Spearman,r=-0.26),KPS(Spearman,r=-0.36),and NRS 2002(Spearman,r=-0.47).Well-nourished(41.2%),mildly or moderately malnourished(35.3%)and severely malnourished(23.5%)groups defined according to the PG-SGA had significantly different characteristics.Patients with a worse nutritional status tended to have a decreased BMI(well-nourished,23.32 kg/m^(2)vs.mildly or moderately malnourished,22.52 kg/m^(2)vs.severely malnourished,21.35 kg/m^(2);P<0.001),hemoglobin,body fat mass,muscle mass,protein mass,TSF,MAC,HGS,MAMC,and MLCC,and a dramatically increased C-reactive protein level.The Kaiser-Meyer-Olkin measure was>0.7,and the P value of Bartlett’s test of sphericity was<0.001.One component was extracted by the principal component analysis,and the analysis showed that the total PG-SGA score explained the total variances of 97.3%.Conclusion The PG-SGA is a valid tool for evaluating the nutritional status for Chinese CRC patients.

Family Status and Dilemma of HIV Positive Subjects

Objective To understand the family status and dilemma of HIV positive subjects and provide some related suggestions. Methods Constructured questionnaire and in-depth interview were used to survey their psychological needs of the 111 HIV positive subjects and AIDS patients from 4 provinces in China. Results HIV positive subjects and AIDS patients had strong mental stress. All of them hope to get support from their families; the most difficulty the subjects faced was economic poor. Conclusion It is a highlight to promote AIDS education to establish a good social environment in which HIV positive subjects and AIDS patients can live quietly and happily. And psychological support from their families and the society is very important to HIV positive subjects and AIDS patients.

Improvement in Socio-Economic Productivity of HIV Positive Individuals on Antiretroviral Treatment in a Private Setting in South India

PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women;median age was 38 years;67% were married;89 (78%) had heterosexual sex as HIV risk;40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%);12 (10%) unskilled labourers;27 (23%) housewives;26 (22%) pro-fessionals/blue collar job;1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P < 0.01);median body weight pre-post ART was 54 and 57 kg (P < 0.01);97% of the participants were 100% adherent. The mean Pre-ART total SES score was 37.06 (+/-10.2);and Post-ART SES score 40.62 (+10.1 P < 0.001) and these results were sustained over time and remained significant even when only monthly income was considered. Our data show a significant impact of ART on SES in a sustained manner in a developing world setting, which has policy level implications.

Extension Protocol for the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China(INSCOC)Study:2021 update

Background Malnutrition is common in patients with cancer,and this adversely affects the survival and quality of life of patients.Chinese Society for Nutritional Oncology issued a multi-center,large-scale,long-term follow-up prospective study,the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China(INSCOC study)since 2013.This is an extension to the previous 2013-2020 study protocol.This study still sought to:①address the prognostic impact of nutritional factors and quality of life on cancer patient survival;②describe the overall and cancer-specific incidence and/or distribution of malnutrition and different measurements of patient quality of life.Methods and study design This is an observational,multi-centered,hospital-based prospective cohort study.Data collection will be performed at baseline(within 48 hours after patient admission),during the hospital stay and 30 days after hospital admission.Follow-up will be conducted for 1-20 years after enrollment.The primary outcome will be the all-cause mortality/overall survival,and secondary outcomes will be the length of hospital stay and costs of hospitalization.Study factors will include demographic characteristics,tumor characteristics,information about chronic diseases,hematological measurements(e.g.,red blood cell count,total lymphocyte counts,hemoglobin,albumin,prealbumin,creatinine,C-reactive protein,IL-6),anthropometric measurements(e.g.,height,weight,arm circumference,arm muscle circumference,triceps skinfold thickness,and waist circumference),body composition parameters,PG-SGA scores,quality of life(as indicated by the QLQ-C30 questionnaire),muscle mass(as indicated by the calf circumference),muscle strength(as indicated by the handgrip strength),muscle function(as indicated by the six-meter walking speed test)and physical status assessments(as indicated by the Karnofsky Performance Status scores).This clinical study protocol was approved by local Ethics Committees of all the participating hospitals.Written informed consent is required for each subject included.Discussion This multi-center,large-scale,long-term follow up prospective study will help improve the diagnosis of malnutrition in cancer patients and identify the risk factors associated with adverse clinical outcomes.The anticipated results of this study will highlight the need for a truly scientific appraisal of nutrition therapy in Chinese oncology populations,and finally help treat the potentially reversible elements of malnutrition in cancer patients to improve their clinical outcomes in the future.

Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Subjective Social Status,Income Inequality and Subjective Perceptions of Mobility(2003-2013)

Using a sample of over 90,000 urban and rura1 residents from the Chinese Social Survey(CSS)and China Genera1 Social Survey(CGSS)from 2003 to 2013,we analyzed the structural features and influencing factors underlying subjective social status in China.Our findings indicate that over these years,such identification has consistently assumed the shape of a bowling pin:those who“identify with a low social status”account for more than half of respondents,a much higher proportion than in most countries.At the individual level,the net effect on subjective social status of such objective indicators as education,income and occupation has been relatively small,and lessened over the ten years.The correlation between subjective perceptions of mobility and subjective social status is quite strong,but the upward impetus provided by perceptions of upward mobility weakened over the period.At the macro-level,the tempo of economic growth failed to raise the level of class identification,and income inequality had a markedly negative effect.Our research findings further demonstrate that curbing the income gap and increasing opportunities for mobility are important for raising the level of class identification during the transition period.

The better future projections the more childbirth:the association between subjective social status and fertility desire of the Chinese population

Previous research has detailed how social status affects the willingness to have children.However,subjective social status(SSS)derived from a comparison with a reference group also has an important impact on fertility desire.This study explores the relationship between the past,present,and future SSS and fertility desire,using data from the Chinese General Social Survey,a nationally representative population survey conducted in 2017(N=4,864).The study found that the individual’s fertility desire is positively enhanced by the current SSS,the expected SSS in the future,and the upward trend of SSS throughout the course of life.Compared with the group with a low level of SSS and with little change in SSS,the fertility desire of the group with"Rising first and then stable"SSS and"Rising"SSS significantly increased.The results suggest that the expectation of positive changes in social status will stimulate fertility desires and produce long-term family plans.With the rapid development of China’s social economy and the positive response to the low fertility rate,social policies should be adopted to open up channels for the protection and improvement of the social status of citizens and to achieve an increase of fertility desire.

Comparison of two nutritional assessment methods in gastroenterology patients

AIM:To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods:subjective global assessment(SGA) and nutritional risk index(NRI).METHODS:The investigation was performed on 299 hospitalized patients,aged 18-84 years(average life span 55.57 ± 12.84),with different gastrointe-stinal pathology,admitted to the Department of Gastroenterohepatology,Clinical and Hospital Center "Bezanijska Kosa" during a period of 180 d.All the patients,after being informed in detail about the study and signing a written consent,underwent nutritional status analysis,which included two different nutritional indices:SGA and NRI,anthropometric parameters,bioelectrical impedance analysis,and biochemical markers,within 24 h of admission.RESULTS:In our sample of 299 hospitalized patients,global malnutrition prevalence upon admission varied from 45.7% as assessed by the SGA to 63.9% by NRI.Two applied methods required different parameters for an adequate approach:glucose level(5.68 ± 1.06 mmol/L vs 4.83 ± 1.14 mmol/L,F = 10.63,P = 0.001);body mass index(26.03 ± 4.53 kg/m2 vs 18.17 ± 1.52 kg/m2,F = 58.36,P < 0.001);total body water(42.62 ± 7.98 kg vs 36.22 ± 9.32 kg,F = 7.95,P = 0.005);basal metabolic rate(1625.14 ± 304.91 kcal vs 1344.62 ± 219.08 kcal,F = 9.06,P = 0.003) were very important for SGA,and lymphocyte count was relevant for NRI:25.56% ± 8.94% vs 21.77% ± 10.08%,F = 11.55,P = 0.001.The number of malnourished patients rose with the length of hospital stay according to both nutritional indices.The discriminative function analysis(DFA) delineated the following parameters as important for prediction of nutritional status according to SGA assessment:concentration of albumins,level of proteins,SGA score and body weight.The DFA extracted MAMC,glucose level and NRI scores were variables of importance for the prediction of whether admitted patients would be classif ied as well or malnourished.CONCLUSION:SGA showed higher sensitivity to predictor factors.Assessment of nutritional status requires a multidimensional approach,which includes different clinical indices and various nutritional param eters.

Gender differences in the impact on subjective well-being in China

This article examines the relationship among subjective well-being(SWB),income and education in China through self-perceived social status.Men and women appear to use different socioeconomic markers to determine their self-perceived social status,which ultimately affects their subjective reports of well-being.By using the data from the 2010 China General Social Survey(CGSS),this study finds a positive association between income and SWB for women.The result also shows a positive association between education and SWB for men.Moreover,for women self-perceived social status is a strong mediator of income and happiness;while for men,selfperceived social status mediates the relationship between education and SWB.This study highlights the importance of the cultural influence in understanding the differences in self-perceived social status outcomes by gender and how these differences ultimately influence the subjective measures of well-being in China.

Determinants of inequality in health care seeking for childhood illnesses:insights from Nairobi informal settlements

Background:An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies.The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi,Kenya.Methods:Data from the second Nairobi Cross-Sectional Slum Survey(NCSS 2012)was examined.The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index(CI).The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status.Results:A total of 2027 qualified women were included in this study.About 16.6% of children born of younger mothers aged<20 years had diarrhea and a similar proportion of children(16.3%)was observed among mothers who were unemployed.The CI of-0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor(95% confidence interval:-0.028 to-0.023).Conclusion:Occupation of parents,age of mothers,ethnicity,marital status and children's age were major deter-minants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses.Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.

Non-Random Distribution of Human Orofacial Clefts in Ghana: Gene-Environment Interactions

Human orofacial clefts (OFCs) are congenital anomalies that result from the breakdown of normal mechanisms that regulate the formation of the human face. They could be syndromic or non-syndromic, with a global incidence of 1:700 per live births. Environmental and genetic factors are thought to play various roles in the aetiology of OFCs. This study seeks to establish the diversity, distribution and pattern of inheritance of OFCs as well as environmental and other risk factors associated with OFCs in a Ghanaian population. A family-based, descriptive cross-sectional study that employed an interview-based survey questionnaire was used to obtain information from 467 families with history of OFCs. We employed chi-square statistics to analyse the data and used graphs to interpret the data. All previously reported subphenotypes of OFCs were observed by the present study. Clinically, about 12% of clefts in the study population were syndromic. The most common syndromic forms observed were Pierre Robin Sequence, cleft-with-club foot abnormalities and Van der Woude Syndrome. Only about 5% of clefts in the study cohort were familial. The study also established that lower level of education of parents, poverty, late antenatal care and dietary folate deficiency are major environmental factors associated with clefts in the Ghanaian population. In conclusion, OFCs are non-randomly distributed in Ghana and folate deficiency could likely be a source of genetic mutations and “epimutations” that cause OFCs, since folate is essential for DNA methylation, replication and repair as well as histone modification.

Journalism Teacher Assessment of Education Inhibitors

Combining,, cultural-historical theory＇ of human development with research pinpointing education inhibitors, a survey was developed to investigate how journalism teachers evaluated the effects of five education inhibitors on their students＇ learning. The list of inhibitors included electronic gadgets, lack of nutrition, parental education levels, family support levels, and racial subcultures. Results showed that use of electronic gadgets and lack of parental edxlcation were perceived as having the most negative influence on learning, while students＂ subcultures were perceived as having the smallest effect. Respondents also knew the least about their students＇ nutritional intake. Further, school size and student socio-economic status seem to play some role in teacher awareness of education inhibitors, and this is an important finding. It shows that while increasing teacher awareness of various education inhibitors, demographic factors also must be considered when targeting specific inhibitors.

The Social Context of Antibiotic Resistance

There are various socio-economic （poverty, self medication, and non-compliance to prescribed therapy） and behavior factors that affects the way of antibiotic use, which consequently brings the development of antibiotic resistance in patients. In the study, some of these social factors that might have an impact on the resistance of antibiotics in patients of regional of Vlora hospital during the period 2011-2012 were examined. The study was conducted using structured interviews on patients who were previously examined for bacterial cultures and sensitivity. The antibiotic resistance resulted really high in these patients. It is found out that the organisms with higher resistance were Streptococcus and Escherichia coli. 75% of the patients, whose cultures were positive, were resistant to at least one antibiotic and 31% to three or more antibiotics. A significant correlation between the structure of antibiotic resistance and the upper socio economic levels, the low educational level of the patients, self medication and the frequency of antibiotic use was found. These data have influence in the development of the awareness strategies in risky groups in order to clarify the concepts on the proper use of antibiotics.

Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey

Background: Many studies examined and reported oral and general health inequalities in clinical health, SROH and SRH. Objectives: The study aims to explore the social influences, gradients and predictors of self-rated oral health (SROH) and self-rated health (SRH) and wellbeing in Greek adults. Methods: Cross-sectional study, of men and women, aged 65 years and over (N = 743) in Greece. Descriptive and statistical analyses were performed for dentate and edentulous participants. For the association between socioeconomic exposures and binary outcomes, logistic regression was performed to estimate Odds Ratios and 95% Confidence Intervals (OR, 95% CI);levels of association and Cramer’s V were applied to calculate associations and p-values. Results: The objective socioeconomic measures, such as household income, education level and last main occupation were significant predictors and determinants of both SROH and self-rated health (SRH). For Satisfaction with life (SWL), there was a diversity in the results analogous to the dental status of the participants. Household income and SSS were predictors of SWL in dentate participants. In the total sample Household income, occupation and SSS, were predictors of SWL, while in edentulous participants only occupation and SSS were statistically significant (p < 0.05). Subjective social status was statistically significant for SROH, SRH and SWL (p < 0.01). More men than women reported their SROH and SRH as good. Household income and SSS were predictors of SWL, in dentate participants, thus the better the income and the higher the relative social status, the higher feeling of SWL was recorded. Place of residence had significant associations only with SWL. Household income, education, occupation and SSS had significant levels of association with SROH and SRH in dentate participants (p < 0.05). Conclusion: There are socioeconomic gradient inequalities in SROH and SRH in Greek adults living in Attica area. Subjective social status is a predictor of SROH, SRH and SWL. The need to prioritize interventions to eliminate disparities and inequalities in oral and general health and wellbeing of elders is evident.