Spatial inequalities leave micropolitan areas and Indigenous populations underserved by informal STEM learning institutions.
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ABSTRACT:
SUBMITTER: Short RA
PROVIDER: S-EPMC8262761 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.
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Project description:This article examines the beliefs and experiences of individuals living in underserved ethnically diverse communities in Cleveland, Ohio, regarding the influence of genetic, social, and environmental factors on health and health inequalities. Using a community-engaged methodological approach, 13 focus groups were conducted with African American, Hispanic, and White individuals residing in the Cleveland area to explore attitudes and beliefs about genetics, genetic research, and health disparities and inequalities. Results of this study highlight the range of meanings that individuals attach to genetic variation, genomic research, and gene-environment interactions, and their implications for addressing health inequalities. The majority of participants in all focus groups reported that social and environmental factors were more important than genetics in contributing to health inequalities. Most participants were unfamiliar with genetic research. These data have implications for how genetic information and research might be applied in conjunction with addressing social determinants of health to improve prevention strategies in underserved communities and ultimately reduce health inequalities.
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Project description:There has been an improvement in childhood vaccination coverage over the last two decades worldwide. However, inequities exist among different populations. Vaccination programs should focus not only on increasing coverage but as also in timeliness to ensure maximum protection. This study examined the levels, inequities, and trends of full and on-time vaccination coverage in two urban informal settlements in Nairobi. The study used longitudinal data from the Nairobi Urban Health and Demographic Surveillance System from 2003 to 2017 to estimate full and on-time vaccination coverage and assess inequalities by background characteristics. The frailty shared Cox model was used to assess time to full- and on-time- immunization coverage. Out of 32,018 children aged 12 to 59 months, less than half (46.7%) produced a vaccination card during the interview. Full and timely immunization coverage was higher in Viwandani site, among Kikuyu and Kamba ethnic groups, and children from the richest quintile. Timely vaccination was below 50% throughout the survey periods. After accounting for the intragroup correlations, for a given level of frailty, the hazard for being fully immunized was 10% more likely among the wealthiest compared to the poorest children. The hazard for being fully immunized was 16%, 16% to 19% less likely for Luhya, Luo, and others as compared to the Kikuyu ethnicity respectively. In conclusion, the study has shown that coverage has been increasing over the years but inequalities exist in immunization coverage among the most disadvantaged populations. More focused intervention approaches that target the disadvantaged groups are needed.
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Project description:Research efforts are necessary to identify strategies to increase colorectal screening in underserved patient populations. Racial, ethnic minorities and medically underserved individuals continue to experience disparities in colorectal cancer mortality despite the availability of screening tests that can detect tumors early when treatments are most effective.
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Project description:BackgroundThe economic cost of not breastfeeding in Indonesia is estimated at US$1.5-9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia.MethodThe costing methodology used is the adapted version of the World Bank methodology by Vilar-Compte et al, following pre-set steps to estimate costs using national secondary data. We used the 2018 Indonesian National Socio-Economic Survey to estimate the number of women working informally who gave birth within the last year. The population covered, potential cash transfer's unitary cost, the incremental coverage of the policy in terms of time and coverage, and the administrative costs were used to estimate the cost of MCT for the informal sector.ResultAt 100% coverage for 13 weeks of leave, the yearly financing need of MCT ranged from US$175million (US$152/woman) to US$669million (US$583/woman). The share of the yearly financing need did not exceed 0.5% of Indonesian Gross Domestic Product (GDP).ConclusionsThe yearly financing need of providing MCT for eligible WRA working in the informal sector is economically attractive as it amounts to less than 0.5% of GDP nominal of Indonesia. While such a program would be perceived as a marked increase from current public health spending at the onset, such an investment could substantially contribute to the success of breastfeeding and substantial corresponding public health savings given that more than half of working Indonesian WRA are employed in the informal sector. Such policies should be further explored while taking into consideration realistic budget constraints and implementation capacity.
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Project description:BACKGROUND:People with disabilities need rehabilitation interventions to improve their physical functioning, mental status, and quality of life. Many rehabilitation interventions can be delivered electronically ("digitally") via telehealth systems. For people with disabilities in underserved areas, electronically delivered rehabilitation interventions may be the only feasible service available for them. OBJECTIVE:The objective of this study was to evaluate the current status of digital interventions for people with disabilities in remote and underserved areas. METHODS:A systematic review was conducted on this topic. Keyword searches in multiple databases (PubMed, CINAHL, and Inspec) were performed to collect articles published in this field. The obtained articles were selected based on our selection criteria. Of the 198 identified articles, 16 duplicates were removed. After a review of the titles and abstracts of the remaining articles, 165 were determined to be irrelevant to this study and were therefore removed. The full texts of the remaining 17 articles were reviewed, and 6 of these articles were removed as being irrelevant to this study. The 11 articles remaining were discussed and summarized by 2 reviewers. RESULTS:These 11 studies cover a few types of disabilities, such as developmental disabilities and mobility impairments as well as several types of disability-causing disorders such as stroke, multiple sclerosis, traumatic brain injury, and facio-scapulo-humeral muscular dystrophy. Most of these studies were small-scale case studies and relatively larger-scale cohort studies; the project evaluation methods were mainly pre-post comparison, questionnaires, and interviews. A few studies also performed objective assessment of functional improvement. The intervention technology was mainly videoconferencing. Moreover, 10 of these studies were for people with disabilities in rural areas and 1 was for people in urban communities. CONCLUSIONS:A small number of small-scale studies have been conducted on digital interventions for people with disabilities in underserved areas. Although the results reported in these studies were mostly positive, they are not sufficient to prove the effectiveness of telehealth-based digital intervention in improving the situation among people with disabilities because of the small sample sizes and lack of randomized controlled trials.
| S-EPMC7380899 | biostudies-literature
Project description:Presently, a significant part of the world population does not have Internet access. The fifth-generation cellular network technology evolution (5G) is focused on reducing latency, increasing the available bandwidth, and enhancing network performance. However, researchers and companies have not invested enough effort into the deployment of the Internet in remote/rural/undeveloped areas for different techno-economic reasons. This article presents the result of a collaboration between Brazil and the European Union, introducing the steps designed to create a fully operational experimentation scenario with the main purpose of integrating the different achievements of the H2020 5G-RANGE project so that they can be trialed together into a 5G networking use case. The scenario encompasses (i) a novel radio access network that targets a bandwidth of 100 Mb/s in a cell radius of 50 km, and (ii) a network of Small Unmanned Aerial Vehicles (SUAV). This set of SUAVs is NFV-enabled, on top of which Virtual Network Functions (VNF) can be automatically deployed to support occasional network communications beyond the boundaries of the 5G-RANGE radio cells. The whole deployment implies the use of a virtual private overlay network enabling the preliminary validation of the scenario components from their respective remote locations, and simplifying their subsequent integration into a single local demonstrator, the configuration of the required GRE/IPSec tunnels, the integration of the new 5G-RANGE physical, MAC and network layer components and the overall validation with voice and data services.
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Project description:BACKGROUND: The objective of this study is to investigate the magnitude and nature of health inequalities between indigenous (Scheduled Tribes) and non-indigenous populations, as well as between different indigenous groups, in a rural district of Kerala State, India. METHODS: A health survey was carried out in a rural community (N?=?1660 men and women, 18-96?years). Age- and sex-standardised prevalence of underweight (BMI?<?18.5?kg/m2), anaemia, goitre, suspected tuberculosis and hypertension was compared across forward castes, other backward classes and tribal populations. Multi-level weighted logistic regression models were used to estimate the predicted prevalence of morbidity for each age and social group. A Blinder-Oaxaca decomposition was used to further explore the health gap between tribes and non-tribes, and between subgroups of tribes. RESULTS: Social stratification remains a strong determinant of health in the progressive social policy environment of Kerala. The tribal groups are bearing a higher burden of underweight (46.1 vs. 24.3%), anaemia (9.9 vs. 3.5%) and goitre (8.5 vs. 3.6%) compared to non-tribes, but have similar levels of tuberculosis (21.4 vs. 20.4%) and hypertension (23.5 vs. 20.1%). Significant health inequalities also exist within tribal populations; the Paniya have higher levels of underweight (54.8 vs. 40.7%) and anaemia (17.2 vs. 5.7%) than other Scheduled Tribes. The social gradient in health is evident in each age group, with the exception of hypertension. The predicted prevalence of underweight is 31 and 13 percentage points higher for Paniya and other Scheduled Tribe members, respectively, compared to Forward Caste members 18-30?y (27.1%). Higher hypertension is only evident among Paniya adults 18-30?y (10 percentage points higher than Forward Caste adults of the same age group (5.4%)). The decomposition analysis shows that poverty and other determinants of health only explain 51% and 42% of the health gap between tribes and non-tribes for underweight and goitre, respectively. CONCLUSIONS: Policies and programmes designed to benefit the Scheduled Tribes need to promote their well-being in general but also target the specific needs of the most vulnerable indigenous groups. There is a need to enhance the capacity of the disadvantaged to equally take advantage of health opportunities.
| S-EPMC3441884 | biostudies-other
Project description:Formal and informal institutions govern fisheries around the world. Yucatan's sea cucumber fishery is not an exemption, the sudden and fast development of the fishery in 2010 has motivated the creation of informal and illegal forms of organization. The prices, buyers' interest and the fishing effort substantially increased, being followed by illegal fishing-fishers and traders, creating informal fishing-trade channels and severe social and biological concerns. This article aims to give account of the emergence and dynamics of the informal institutions which currently dominate this fishery. It was sought to identify the extent to which rules and regulations are not being respected and how they are affecting fish resources and coastal communities. We considered the case of the port of Sisal, Yucatan, Mexico to illustrate our argument and here we applied a mixture of qualitative and quantitative methodologies including informal and in-depth interviews applied to 17 key informants, a questionnaire applied to 47 fishers and an estimation of the degree of compliance from three of the main management measures. Socio-biological negative impacts were identified in Yucatan's coastal communities and its fisheries. Foreign buyers and local middlemen exert high pressure on fishers to exceed the quota and catch the highest possible volumes facilitating the fisheries decline. This and the growing economic interest motivated the development of strong informal institutions supporting illegal fishing and informal trade. Social problems emerged and women were particularly affected. The economic power of the fishery is likely to overcome any type of governance structure. The enforcement of entry rules was not effective, so the governance base was around informality and illegal actions. Local and foreign buyers are exerting pressure to increase the catch volume thus it is recommended that rules and regulations be directed at buyers and exporting companies rather than at fishers.
| S-EPMC7996974 | biostudies-literature