Socio-economic inequalities in adolescent mental health in the UK: multiple socio-economic indicators and reporter effects

There are socio-economic inequalities in the experience of mental ill-health. However, less is known about the extent of inequalities by different indicators of socio-economic position (SEP). This is relevant for insights into the mechanisms by which these inequalities arise. For young people's mental health there is an additional layer of complexity provided by the widespread use of proxy reporters. Using data from the UK Millennium Cohort Study (N=10,969), we investigated the extent to which five objective SEP indicators (parent education, household income, household wealth, parent occupational status, and relative neighbourhood deprivation) predict adolescent internalising mental health and how this varies as a function of reporter. Both parent report and adolescent self-report were considered. Regression models demonstrated that whilst all five SEP indicators were associated with parent-reported adolescent mental health (regression coefficients for the most disadvantaged groups and adolescent mental health: parent education β=0.53 [0.44;0.62], household income β=0.56 [0.50;0.62], household wealth β=0.18 [0.10;0.27], parent occupational status β=0.40 [0.35;0.46], and relative neighbourhood deprivation β=0.41 [0.33;0.49]), only income (β=0.11 [0.04;0.17]), wealth (β=0.12 [0.02;0.21]), and occupational status (β=0.08 [0.03;0.13]) were associated with self-reported mental health. The magnitude of these effects was greater for parent-reported than self-reported adolescent internalising symptoms: SEP indicators jointly predicted 5.2% of the variance in parent-reported compared to 1.4% of the variance in self-reported internalising mental health. Income predicted the most variance in both parent (4.2% variance) and self-reported internalising symptoms (0.5% variance). Interestingly, the gradient of parent-reported adolescent mental health across SEP indicators mirrors that of parent's own mental health (for example, income predicted 7.3% variance). Our findings highlight that the relevance of different SEP indicators to adolescent internalising mental health differs between parent and adolescent reports. Therefore, it is important to consider the various perspectives of mental health inequalities gained from different types of reporters.

Relationship between Breast Cancer Surgical Treatment and Psychiatric Symptomatology: Which Sociodemographic and Clinical Factors Could Influence It? A Preliminary Study

This study aimed to investigate psychiatric symptomatology in a sample of patients affected by breast cancer undergoing surgery, evaluating the potential mediators on perceived stress levels, depression and hopelessness. The study was conducted on eighty-five patients with breast cancer, admitted consecutively to the Breast Unit of the IRCCS Ospedale Policlinico San Martino, between May 2018 and December 2019. Sociodemographic (age of diagnosis, gender, marital and occupational status, educational level, having children) and clinical (type and side of surgery, previous breast surgery, neoadjuvant chemotherapy and axillary dissection) characteristics were investigated through a semi-structured interview. The following rating scales were administered: Beck Depression Inventory, Beck Hopelessness Scale, and Perceived Stress Scale. Our findings indicate that the presence of children and of a partner was associated with a lower total score on the clinical dimensions evaluated. Furthermore, we found demolitive surgery to be a mediator between perceived stress and hopelessness, while history of previous breast surgery was found to be a mediator between demolitive surgery and perceived stress. In conclusion, patients affected by breast cancer undergoing more complex and demolitive surgery or with history of previous breast surgery should be mostly monitored from a psychological and psychiatric point of view from the beginning of treatments to evaluate the first manifestations of psychiatric symptomatology.

Examining Science Achievement in Chile: A Multilevel Model Approach

This study employed data from the 2015 Chilean sample of the Programme for International Student Assessment to examine the factors that influence science achievement and factors that may reduce the gender gap in science achievement. Our research was guided by Eccles’ Expectancy-Value Theory, which focused on motivational factors that influence gender differences in students’ achievement choices and performance. Our results indicate that socioeconomic status (SES), motivation, enjoyment of science, expected occupational status, school SES, and class size are related to higher science achievement. Also, anxiety was negatively associated with science achievement. Implications for Chilean policymakers and school administrators to improve Chilean girls’ science achievement are discussed.

Skin-lightening practices in India

Skin lightening involves various practices to bleach the skin or to reduce the normal skin tone. The practice of skin-lightening spans several continents throughout the centuries and cultures primarily aimed at improving the quality of life. The main aim of skin lightening in medieval times was to increase the sign of femininity and thereby its benefits. In India, skin lightening is preferred as a mark of class, caste, and richness. Dermatologists are faced with many problems dealing with requests to make skin fairer, while in the west, there is a problem dealing with skin conditions in skin of color. Many skin-lightening agents are sold as over-the-counter products and are popularized or advertised through magazines, social media, and celebrity influences. These products are self-prescribed and used rampantly despite the side effects. There is a strong equation between caste, social class, marital prospects, and occupational status based on skin color. Multinational skin-lightening cosmetic brands have a lucrative market. The most widely used topical agent in skin lightening is hydroquinone, while other non-hydroquinone agents are also frequently used. In general, combining skin-lightening agents have increased efficacy. Systemic agents such as glutathione, tranexamic acid, Vitamin C, and other miscellaneous agents are also popular. Several procedures ranging from chemical peels to lights and lasers are increasingly practiced for more effective skin lightening. In India, all skin-whitening creams can be bought without a prescription as OTC products. These products are not considered pharmaceutical products and are not subject to testing and regulations. In addition, the injudicious use of intravenous glutathione by unqualified personnel poses a threat to the lay public. In our role as dermatologists, we should develop a holistic approach in counseling and treating those patients on a quest for skin lightening.

The Gender Pay Gap: Income Inequality Over Life Course – A Multilevel Analysis

The gender pay gap has been observed for decades, and still exists. Due to a life course perspective, gender differences in income are analyzed over a period of 24 years. Therefore, this study aims to investigate income trajectories and the differences regarding men and women. Moreover, the study examines how human capital determinants, occupational positions and factors that accumulate disadvantages over time contribute to the explanation of the GPG in Germany. Therefore, this study aims to contribute to a better understanding of the GPG over the life course. The data are based on the German cohort study lidA (living at work), which links survey data individually with employment register data. Based on social security data, the income of men and women over time are analyzed using a multilevel analysis. The results show that the GPG exists in Germany over the life course: men have a higher daily average income per year than women. In addition, the income developments of men rise more sharply than those of women over time. Moreover, even after controlling for factors potentially explaining the GPG like education, work experience, occupational status or unemployment episodes the GPG persists. Concluding, further research is required that covers additional factors like individual behavior or information about the labor market structure for a better understanding of the GPG.

DETERMINANTS OF MORTGAGE LOAN REPAYMENT IN GHANA

The housing deficit in Ghana is an issue of concern for all. This study sought to analyse the determinants of the repayment of mortgage loans in Ghana. The study used both secondary and primary data. The mixed-method approach was used for the study. The data collection instruments were interviews, focus group discussions and questionnaires. The study revealed that socio-demographic characteristics of respondents, sex distribution of respondents, educational level of respondents, marital status of respondents, occupational status of respondents, household size of respondents, the income of respondents are some of the factors that affect the repayment of mortgage loans in Ghana. The study revealed that borrowers who earned higher income had a better repayment performance as compared to low income earning borrowers. In addition, higher household sizes have lower repayment capacity and lower household sizes have higher repayment capacity. The study recommends that the government of Ghana should institute state bodies responsible for providing liquidity to mortgages and mortgage properties and buying mortgages during periods of rising interest rates is a way of creating a secondary mortgage market for the Ghanaian mortgage industry. Keywords: Determinants, Mortgage, Repayment, Ghana.

LETTER TO THE EDITOR CONCERNING STEVELINK ET AL. (2021): “CHRONIC FATIGUE SYNDROME AND OCCUPATIONAL STATUS: A RETROSPECTIVE LONGITUDINAL STUDY”

Occupational Medicine recently published a paper from Stevelink et al. (2021) called “Chronic fatigue syndrome and occupational status: a retrospective longitudinal study.” Unfortunately, the paper features major technical and methodological errors that warrant urgent editorial attention.

Occupational-Seasonal Spine and Other Orthopaedic Injuries due to Fall from Java Plum Tree

Background: Falling from a Java Plum (Jamun) tree is one of the primary causes of Spine and other extremity fractures during the Monsoon season (when it is harvested) in Pakistan. Objective: To assess the distribution of patients with different facture types presented with the history of fall from Jamun tree during Monsoon season. Study Design: Retrospective study Place and Duration of Study: Department of Orthopaedics & Spine Surgery, Ghurki Trust Teaching Hospital, Lahore 1st May 2020 to 31st August 2020, Methodology: Forty two male patients age ranged from 12-55 years of age were enrolled. Information was obtained from the hospital’s trauma registry, and medical records were retrospectively reviewed for data about the type of fractures, occupational status, pre-hospital immobilization, time of presentation, and the time between fall and management and length of hospital stay were reviewed. Results: The average age of the patient was 34.6 years. Twenty four (57.14%) had spine fractures and 18 (42.8%) suffered other axial and skeletal fractures. Nearly three-fourths needed surgical intervention. In contrast, 26.1 % were managed conservatively. Conclusion: During monsoon season, we received 4.6% of extra patients with different injuries following fall from Jamun tree. In most cases, young men from lower socio-economic status suffer from varying degrees of disability and experience financial problems. Keywords: Fall, Java Plum, Mass awareness, Occupational-seasonal injury, Spine fractures

Association between Socioeconomic Status and Psychological Distress among Rwandan Refugees in Zambia: a Gender Perspective

Urban refugees face several challenges which affect their emotional, social, and psychological well-being. This study utilised a quantitative cross-sectional design. The study assessed the association between socioeconomic status (SES) and psychological distress from a gender perspective among Rwandan refugees in Lusaka, Zambia. Two hundred and sixty-seven refugees between 18 and 65(M=33.99 years) participated in the study. The sample comprised men (47.9%) and women (52.1%) who were selected from Lusaka townships using purposive and convenience sampling techniques. SES was measured by assessing participants’ educational attainment, occupational status or employment, income, and financial support, whereas subjective psychological distress was evaluated using the General Health Questionnaire (GHQ-28). Framed within the feminist and the ecological systems perspectives, the study established an association between SES and psychological distress. The proportions of female participants in the lower education and unemployment categories and lower-income bracket were considerably higher than males in the same category. Similarly, the study revealed that the proportion of females (27%) with severe depression was higher than males (19%). However, the gender difference was negligible with other subscales such as the somatic symptoms, anxiety and insomnia, and social dysfunction. Bivariate associations revealed well-established gender differences, where women with low education and financial support reported higher levels of psychological distress. Multivariate analysis revealed that employment predicted a lower level of psychological distress in both men and women. The findings highlight that refugees’ access to employment is an essential factor in determining psychological well-being. Well-defined intervention strategies by government and humanitarian bodies are critical and should aim to empower refugees towards easy access to formal and informal labour market opportunities.

Intergenerational Socioeconomic Mobility and Cognitive Impairment in Chinese Older Adults: Does Gender Matter?

The prevalence of dementia among older adults in mainland China is projected to increase rapidly in the next few decades. This study aimed to examine the impact of intergenerational socioeconomic mobility on the risk of cognitive impairment in a cohort of Chinese older adults, with a focus on potential gender differences. Data were derived from the 2011 wave of the Chinese Longitudinal Healthy Longevity Survey. Socioeconomic mobility in this study includes three dimensions: occupational mobility, educational mobility, and residential mobility. Cognitive impairment was assessed using the Chinese version of Mini-Mental State Examination. The final sample included 6,233 older adults aged 80 years and above. Logistic regression models were performed to assess the impact of the three dimensions of socioeconomic mobility on the risk of cognitive impairment in older men and women. For men, those with stable high occupational status across generations had the lowest risk of cognitive impairment. For women, those who received no education and lived in rural areas across generations had the highest risk of cognitive impairment. These findings lend support to the cumulative risk theory, which highlights the accumulation of risk factors that places individuals in jeopardy for negative health consequences in later life. The findings have implications for advancing supportive policies and practices related to maximizing the benefits of education and occupation for cognition in later life, especially for women in rural China.