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Concept: Middle class


Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls.

Concepts: Income, Household income in the United States, Middle class


In this prospective study of upper middle class youth, we document frequency of alcohol and drug use, as well as diagnoses of abuse and dependence, during early adulthood. Two cohorts were assessed as high school seniors and then annually across 4 college years (New England Study of Suburban Youth younger cohort [NESSY-Y]), and across ages 23-27 (NESSY older cohort [NESSY-O]; ns = 152 and 183 at final assessments, respectively). Across gender and annual assessments, results showed substantial elevations, relative to norms, for frequency of drunkenness and using marijuana, stimulants, and cocaine. Of more concern were psychiatric diagnoses of alcohol/drug dependence: among women and men, respectively, lifetime rates ranged between 19%-24% and 23%-40% among NESSY-Os at age 26; and 11%-16% and 19%-27% among NESSY-Ys at 22. Relative to norms, these rates among NESSY-O women and men were three and two times as high, respectively, and among NESSY-Y, close to one among women but twice as high among men. Findings also showed the protective power of parents' containment (anticipated stringency of repercussions for substance use) at age 18; this was inversely associated with frequency of drunkenness and marijuana and stimulant use in adulthood. Results emphasize the need to take seriously the elevated rates of substance documented among adolescents in affluent American school communities.

Concepts: Nicotine, Drug addiction, Addiction, High school, Stimulant, Recreational drug use, Middle class, Upper middle class


Since its initial discovery in anEscherichia coliisolate from China,mcr-1has also been detected inKlebsiella pneumoniaeandSalmonella enterica, and is rarely reported in other Enterobacteriaceae. Here, we report the isolation and identification of aShigella flexneristrain harboringmcr-1from stool samples in a pig farm in China from 2009. The minimum inhibitory concentration (MIC) to colistin of the isolate is 4 μg/mL. Conjugation assays showed the donorS. flexneristrain has functional and transferable colistin resistance. Sequencing revealed thatmcr-1was present on a putative composite transposon flanked by inverted repeats of ISApl1ImportanceThere are four species ofShigella,Shigella flexneriis the most frequently isolated species in Low and Middle Income Countries (LMICs). In this study, we report a functional, transferable, plasmid mediatedmcr-1inS.flexneriWe have shownmcr-1is located on a novel composite transposon which is flanked by inverted repeats of ISApl1The host strain is multi-drug resistant and this multidrug resistance is also transferable. The finding of functionalmcr-1inS. flexneri; a human associated Enterobacteriaceae is a cause for concern as infections due toS. flexneriare the mainShigellainfections in most Low and Middle Income Countries.

Concepts: Molecular biology, Antibiotic resistance, Escherichia coli, Report, Plasmid, Income, Household income in the United States, Middle class


Poor governance impedes the provision of equitable and cost-effective health care in many low- and middle-income countries (LMICs). Although systemic problems such as corruption and inefficiency have been characterized as intractable, “good governance” interventions that promote transparency, accountability and public participation have yielded encouraging results. Mobile phones and other Information and Communication Technologies (ICTs) are beginning to play a role in these interventions, but little is known about their use and effects in the context of LMIC health care.

Concepts: Health care, Mobile phone, Middle class, Information technology, Governance, Political corruption, Good governance, Worldwide Governance Indicators


A positive association of socioeconomic position and health is well established in high-income countries. In poorer nations, however, higher income individuals often have more cardiovascular risk factors (including obesity) than do those with less income. Our study goal was to estimate the effects of receiving a living wage (340% higher income) on short-term changes in consumption and cardiovascular risk factors among low-wage workers in a middle-income country.

Concepts: Disease, Cardiovascular disease, Economics, Middle class, Nation, Minimum wage, Country, Sovereign state


Is higher social class associated with greater happiness? In a large nationally representative U.S. sample (N = 1,519), we examined the association between social class (household income) and self-reported tendencies to experience 7 distinct positive emotions that are core to happiness: amusement, awe, compassion, contentment, enthusiasm, love, and pride. Consistent with past research indicating that social class underlies differential patterns of attending to the self versus orienting to others, higher social class was associated with greater self-oriented feelings of contentment and pride, and with greater amusement. In contrast, lower social class was associated with more other-oriented feelings of compassion and love, and with greater awe. There were no class differences in enthusiasm. We discuss that individuals from different social class backgrounds may exhibit different patterns of emotional responding due to their distinct social concerns and priorities. Whereas self-oriented emotions may follow from, foster, and reinforce upper class individuals' desire for independence and self-sufficiency, greater other-oriented emotion may enable lower class individuals to form more interdependent bonds to cope with their more threatening environments. (PsycINFO Database Record

Concepts: Sociology, Emotion, Household income in the United States, Middle class, Social class, Emotions, Working class, Social classes


This systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6–18 years) in school and community-based settings.

Concepts: Mental health, Youth, Income, Household income in the United States, Middle class, David Bowie


Brazil has reduced its smoking rate by about 50% in the last 20 y. During that time period, strong tobacco control policies were implemented. This paper estimates the effect of these stricter policies on smoking prevalence and associated premature mortality, and the effect that additional policies may have.

Concepts: Time, Medical statistics, Policy, Implementation, Income, Rate, Middle class, Periodization


Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs).

Concepts: Income, Middle class, Working class


Low and deficient levels of vitamin A are common in low and middle income countries where tuberculosis (TB) burden is high. We assessed the impact of baseline levels of vitamins A and carotenoids on TB disease risk.

Concepts: Fat, Vitamin, Tuberculosis, Vitamins, Vitamin A, Income, Household income in the United States, Middle class