Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan

PubMed Central

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient’s economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households. PMID:29445672

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan.

PubMed

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient's economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households.

Understanding Head Start Children's Problem Behaviors in the Context of Arrest or Incarceration of Household Members

ERIC Educational Resources Information Center

Ziv, Yair; Alva, Soumya; Zill, Nicholas

2010-01-01

Using data from the nationally representative Head Start Family and Child Experiences Survey (FACES), the relationships between living in a household where a household member had been arrested or incarcerated and conduct problems of preschool children enrolled in Head Start were examined. Children who lived in such households showed more…

5 CFR 9001.106 - Restrictions resulting from employment of family and household members.

Code of Federal Regulations, 2014 CFR

2014-01-01

... relationships. Within 30 calendar days of the spouse, child, parent, sibling, or member of the employee's... a party if the regulated entity employs as an employee or a consultant his or her spouse, child, parent, or sibling, or member of his or her household unless the DAEO has authorized the employee to...

5 CFR 9001.106 - Restrictions resulting from employment of family and household members.

Code of Federal Regulations, 2013 CFR

2013-01-01

... relationships. Within 30 calendar days of the spouse, child, parent, sibling, or member of the employee's... a party if the regulated entity employs as an employee or a consultant his or her spouse, child, parent, or sibling, or member of his or her household unless the DAEO has authorized the employee to...

5 CFR 9001.106 - Restrictions resulting from employment of family and household members.

Code of Federal Regulations, 2012 CFR

2012-01-01

... relationships. Within 30 calendar days of the spouse, child, parent, sibling, or member of the employee's... a party if the regulated entity employs as an employee or a consultant his or her spouse, child, parent, or sibling, or member of his or her household unless the DAEO has authorized the employee to...

5 CFR 9001.106 - Restrictions resulting from employment of family and household members.

Code of Federal Regulations, 2011 CFR

2011-01-01

... relationships. Within 30 calendar days of the spouse, child, parent, sibling, or member of the employee's... a party if the regulated entity employs as an employee or a consultant his or her spouse, child, parent, or sibling, or member of his or her household unless the DAEO has authorized the employee to...

Consumption patterns and levels among households with HIV positive members and economic impoverishment due to medical spending in Pune city, India.

PubMed

Sharma, Varun; Krishnaswamy, Divya; Mulay, Sanjeevanee

2015-01-01

HIV infection poses a serious threat to the economy of a household. Out of pocket (OOP) health spending can be prohibitive and can drag households below poverty level. Based on the data collected from a cross-sectional survey of 401 households with HIV+ members in Pune city, India, this paper examines the consumption levels and patterns among households, and comments on the economic impoverishment resulting from OOP medical spending. Analysis reveals that households with HIV members spend a major portion of their monthly consumption expenditure on food items. Medical expenditure constitutes a large portion of their total consumption spending. Expenditure on children's education constitutes a minor proportion of total monthly spending. A high proportion of medical expenditure has a bearing on the economic condition of households with HIV members. Poverty increases by 20% among the studied HIV households when OOP health spending is adjusted. It increases 18% among male-headed households and 26% among female-headed households. The results reiterate the need of greater support from the government in terms of accessibility and affordability of health care to save households with HIV members from economic catastrophe.

The household-level economic burden of heart disease in India.

PubMed

Karan, Anup; Engelgau, Michael; Mahal, Ajay

2014-05-01

To estimate healthcare use and financial burden associated with heart disease among Indian households. Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD)-affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used. Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT$ (International Dollars) 232 (P < 0.01) per member on inpatient care annually, had lower non-medical spending (by INT$5 (P < 0.01) per member for a 15-day reference period), had a share of out-of-pocket health spending in total household expenditure that was 16.5% higher (P < 0.01) and relied more on borrowing and asset sales to finance inpatient care (32.7% vs. 12.8%, P < 0.01). Members of CVD-affected households had lower employment rates than members of control households (43.6% vs. 46.4%, P < 0.01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk. Non-communicable conditions such as CVD can impose a serious economic burden on Indian households. © 2014 John Wiley & Sons Ltd.

Thyroid remnant ablation with 1110MBq of 131I in outpatients: measurement of effective dose to household members and establishment of safety precautions.

PubMed

Yoshimura, M; Tsutsui, H; Ikeda, N; Koizumi, K

2013-03-01

The aim of this study was to establish and confirm the safety of administering 1110MBq of 131I to outpatients. Total radiation exposure from patients to household members was hypothesized from the measured dose rate at 1 m when the patient is released. Actually we also measured the effective dose to household members who assisted outpatients during the first 7 days after the administration of 131I by personal dosimeter. A list of radiation safety precautions is given to the patient and household members. Behavioral reports about the distances and times of close contact throughout the 7 days are requested of each household member. The effective dose measured using the personal dosimeter to all household members employing several safety precautions was confirmed to be lower than the hypothesized dose calculated using our formula. And the mean whole-body effective dose rate over the 7 days in household members was 0.05±0.08 (range, 0.05 to 0.43) mSv, which specify that radiation exposure to household members of the outpatients who have just received ablative radiation therapy must be below 5.0 mSv/event. Remnant thyroid ablation with 1110MBq for outpatients showed that the radiation doses to household members were within the recommended constraint dose according to several safety precautions. The method of returning home after remnant thyroid ablation is thought to be the most important factor that determines the effective dose to household members of outpatients.

The effect of leprosy-induced deformity on the nutritional status of index cases and their household members in rural South India: a socio-economic perspective.

PubMed

Diffey, B; Vaz, M; Soares, M J; Jacob, A J; Piers, L S

2000-08-01

To determine whether the socioeconomic and nutritional status of cured leprosy patients with residual deformity, and their household members, was lower than that of cured leprosy patients without deformity. Cross-sectional study. One hundred and fifty-five index cases with deformity, 100 without deformity. Also 616 household members comprising 48% of the total members enumerated. Nutritional status was evaluated using anthropometry. Disease characteristics, socio-economic parameters and household information were recorded using a questionnaire. Index cases with deformity had lower community acceptance (P<0.001), and employment (P<0.001) than those cases without deformity. Households of index cases with deformity had a lower income (P<0.01) and a lower expenditure on food (P<0.05). The presence of deformity (odds ratio (OR): 2.1-3.2, P<0.01), unemployment (OR: 2.3-4.3, P<0.01) and female gender (OR: 2.4, P<0. 01) significantly increased the risk of index cases being undernourished, as judged by body mass index (BMI) alone, or BMI and mid-upper arm circumference. A low BMI (<18.5) in the index case significantly increased the odds of other adults (OR 2.2), adolescents (OR 2.9-3.8) and children (OR 2.2) in the household being undernourished. Cured leprosy index cases with physical deformity are more undernourished than index cases without deformity. This is associated with a reduced expenditure on food, possibly brought on by increased unemployment, and a loss of income. Undernutrition in the index case increases the risk of undernutrition in other members of the family. European Journal of Clinical Nutrition (2000) 54, 643-649.

Horse-Related Injuries among Agricultural Household Members: Regional Rural Injury Study II (RRIS-II)

ERIC Educational Resources Information Center

Erkal, Sibel; Gerberich, Susan G.; Ryan, Andrew D.; Alexander, Bruce H.; Renier, Colleen M.

2009-01-01

Purpose: To determine the incidence, associated consequences, and potential risk factors for horse-related injuries among youth and adults residing in Midwestern agricultural households. Methods: Demographic, injury, and exposure data were collected for 1999 and 2001 among randomly selected agricultural households within a 5-state region. A causal…

Young Adult Obesity and Household Income: Effects of Unconditional Cash Transfers†

PubMed Central

Akee, Randall; Simeonova, Emilia; Copeland, William; Angold, Adrian

2014-01-01

We investigate the effect of household cash transfers during childhood on young adult body mass indexes (BMI). The effects of extra income differ depending on the household’s initial socioeconomic status (SES). Children from the initially poorest households have a larger increase in BMI relative to children from initially wealthier households. Several alternative mechanisms are examined. Initial SES holds up as the most likely channel behind the heterogeneous effects of extra income on young adult BMI. (JEL D14, H23, H75, I12, J13, J15) PMID:24707346

Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review.

PubMed

Jary, Hannah; Simpson, Hope; Havens, Deborah; Manda, Geoffrey; Pope, Daniel; Bruce, Nigel; Mortimer, Kevin

2016-01-01

Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities. Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms. From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis. A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults. CRD42015028042.

Screening Household Members of Acute Brucellosis Cases in Endemic Areas and Risk Factors for Brucellosis.

PubMed

Deniz, Secil; Baykam, Nurcan; Celikbas, Aysel; Yilmaz, Sirin Menekse; Guzel, Tugba Cirkin; Dokuzoguz, Basak; Ergonul, Onder

2015-08-01

Early diagnosis and treatment of acute brucellosis cases were targeted by screening the household members of the index cases. We also aimed to describe the causal relations of brucellosis in an endemic region. A cross-sectional study was performed among household members (29 index cases, 113 household members). Brucellosis was diagnosed on the basis of clinical findings, serum agglutinin titer of ≥1/160 in standard tube agglutination test (STA), or a positive blood culture. Index cases were defined as patients who had been admitted to the clinic on suspicion of brucellosis and then confirmed as brucellosis cases. The people who lived in the same house as the index cases were defined as household members. The risk factors for seropositivity were studied by multivariate analysis. Independent variables of gender, consuming fresh cheese, blood groups, dealing with husbandry, and contact with the placenta of infected animals were included to the model. Backward and forward selections were performed. Nineteen out of 113 (17%) screened individuals had agglutination titers ≥1/160. The mean ages of index cases and household members were 43 years (standard deviation [SD] 18) and 29 years (SD 19), respectively. In multivariate analysis, consuming fresh cheese (odds ratio [OR]=3.1, confidence interval [CI] 1.07-9.68, p=0.049), blood group A (OR=2.6, CI 1.18-5.96, p=0.018), contact with the placenta of the infected animals (OR=3.7, CI 1.42-9.68, p=0.007), and age >30 years (OR=2.8, CI 1.25-6.51, p=0.13) were found to be associated with brucellosis. In univariate analysis, the individuals with blood group B were protected from brucella infection (p=0.013). In conclusion, screening of the people in brucellosis-endemic areas should be considered for early diagnosis and treatment. To our knowledge, blood groups were studied for the first time by this study. Higher prevalence of brucellosis among the individuals with blood group A and less prevalence among the individuals with

Community and household socioeconomic factors associated with pesticide-using, small farm household members' health: a multi-level, longitudinal analysis

PubMed Central

2011-01-01

Background Longitudinal studies using multi-level models to examine health inequalities in lower and middle income countries (LMICs) are rare. We explored socio-economic gradients in health among small farm members participating in a pesticide-related health and agriculture program in highland Ecuador. Methods We profiled 24 communities through key informant interviews, secondary data (percent of population with unsatisfied basic needs), and intervention implementation indicators. Pre (2005) and post (2007) surveys of the primary household and crop managers included common questions (education, age, and the health outcome - digit span scaled 0-10)) and pesticide-related practice questions specific to each. Household assets and pesticide use variables were shared across managers. We constructed multi-level models predicting 2007 digit span for each manager type, with staged introduction of predictor variables. Results 376 household managers (79% of 2005 participants) and 380 crop managers (76% of 2005 participants) had complete data for analysis. The most important predictor of 2007 digit span was 2005 digit span: β (Standard Error) of 0.31(0.05) per unit for household and 0.17(0.04) for crop managers. Household asset score was next most important: 0.14(0.06) per unit for household and 0.14(0.05) for crop managers. Community percent with unsatisfied basic needs was associated with reductions in 2007 digit span: -0.04(0.01) per percent for household and -0.03(0.01) for crop managers. Conclusions The important roles of life endowments and/or persistent neurotoxicity were exemplified by limited change in the health outcome. Gradients by household assets and community deprivation were indicative of ongoing, structural inequities within this LMIC. PMID:22094171

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

PubMed Central

2016-01-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

PubMed

Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

2016-03-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.

Which family members use the best nets? An analysis of the condition of mosquito nets and their distribution within households in Tanzania.

PubMed

Tsuang, Angela; Lines, Jo; Hanson, Kara

2010-07-22

Household ownership of insecticide-treated mosquito nets (ITNs) is increasing, and coverage targets have been revised to address universal coverage with ITNs. However, many households do not have enough nets to cover everyone, and the nets available vary in physical condition and insecticide treatment status. Since 2004, the Government of Tanzania has been implementing the Tanzania National Voucher Scheme (TNVS), which distributes vouchers for ITNs through antenatal clinics to target pregnant women and their infants. This analysis aimed to determine the following: (1) coverage patterns of bed nets within households according to physical condition and treatment status; (2) who might be at risk if mosquitoes were diverted from occupants of untreated nets to those not using nets? (3) the degree to which those at highest risk of malaria use the most protective nets. Data from the 2006 TNVS household survey were analysed to assess within-household distribution of net use. The associations between net characteristics and net user were also evaluated. Multivariate analysis was applied to the relationship between the number of holes per net and user characteristics while adjusting for confounders. In households with a net:person ratio better than 1:4 (one net for every four household members), more than 80% of the people in such households reported using a net the previous night. ITNs were most likely to be used by infants, young children (1-4 y), and women of childbearing age; they were least likely to be used by older women (>or=50 y), older children (5-14 y), and adult men. The nets used by infants and women of childbearing age were in better-than-average physical condition; the nets used by older women and older children were in worse-than-average condition; while young children and adult men used nets in intermediate (average) condition. When adjusted for confounders, the nets used by young and older children had more holes than nets used by infants. Infants and other

Determinants of intra-household food allocation between adults in South Asia - a systematic review.

PubMed

Harris-Fry, Helen; Shrestha, Niva; Costello, Anthony; Saville, Naomi M

2017-06-21

Nutrition interventions, often delivered at the household level, could increase their efficiency by channelling resources towards pregnant or lactating women, instead of leaving resources to be disproportionately allocated to traditionally favoured men. However, understanding of how to design targeted nutrition programs is limited by a lack of understanding of the factors affecting the intra-household allocation of food. We systematically reviewed literature on the factors affecting the allocation of food to adults in South Asian households (in Afghanistan, Bangladesh, Bhutan, India, Islamic Republic of Iran, Maldives, Nepal, Pakistan, Sri Lanka) and developed a framework of food allocation determinants. Two reviewers independently searched and filtered results from PubMed, Web of Knowledge and Scopus databases by using pre-defined search terms and hand-searching the references from selected papers. Determinants were extracted, categorised into a framework, and narratively described. We used adapted Downs and Black and Critical Appraisal Skills Programme checklists to assess the quality of evidence. Out of 6928 retrieved studies we found 60 relevant results. Recent, high quality evidence was limited and mainly from Bangladesh, India and Nepal. There were no results from Iran, Afghanistan, Maldives, or Bhutan. At the intra-household level, food allocation was determined by relative differences in household members' income, bargaining power, food behaviours, social status, tastes and preferences, and interpersonal relationships. Household-level determinants included wealth, food security, occupation, land ownership, household size, religion / ethnicity / caste, education, and nutrition knowledge. In general, the highest inequity occurred in households experiencing severe or unexpected food insecurity, and also in better-off, high caste households, whereas poorer, low caste but not severely food insecure households were more equitable. Food allocation also varied

Quality of life of middle-aged adults in single households in South Korea.

PubMed

Song, Hyun Jin; Park, Susan; Kwon, Jin-Won

2018-04-18

The number of single households has increased worldwide with middle-aged people in such households indicating the highest increase. However, there is a lack of studies on the topic. This study estimated the quality of life (QOL) by household type for middle-aged Korean adults. We used the Korea National Health and Nutrition Examination Survey data from 2007 to 2015. QOL was analyzed using EQ-5D 3-level, and demographic and health-related variables were included as confounders. The households were divided into single household, married couple without child, other one-generation, married couple with child, single parent with child, other two-generation, and three-generation. Logistic regression using level, strata, and sample weight of data was performed based on average QOL. This study included 18,147 responders aged 45-64 years, with single households constituting 5.7%. Single households having average or less QOL were 48.4%, with men and women constituting 40.1 and 53.3%, respectively. After adjusting socioeconomic factors and health-related factors, the odds ratio (OR) of single households was 1.375 (95% CI 1.122-1.684) compared to the three-generation group. According to the sex, the OR of single households with men was higher (OR 1.552, 95% CI 1.121-2.149). However, no significance was found in women. The study results revealed that middle-aged people in single households had low QOL than those in multi-person households. The trend was significantly observable in men than in women. Because middle-aged adults might transform into elderly with low QOL, program development and social support for middle-aged adults in single households should be provided.

Measuring child awareness for adult symptomatic HIV using a verbal assessment tool: concordance between adult-child dyads on adult HIV-associated symptoms and illnesses.

PubMed

Becker, Elisabeth; Kuo, Caroline; Operario, Don; Moshabela, Mosa; Cluver, Lucie

2015-11-01

This study assessed children's awareness for adult HIV-associated symptoms and illnesses using a verbal assessment tool by analysing inter-rater reliability between adult-child dyads. This study also evaluated sociodemographic and household characteristics associated with child awareness of adult symptomatic HIV. A cross-sectional survey using a representative community sample of adult-child dyads (N=2477 dyads) was conducted in KwaZulu-Natal, South Africa. Analyses focused on a subsample (n=673 adult-child dyads) who completed verbal assessment interviews for symptomatic HIV. We used an existing validated verbal autopsy approach, originally designed to determine AIDS-related deaths by adult proxy reporters. We adapted this approach for use by child proxy reporters for reporting on HIV-associated symptoms and illnesses among living adults. Analyses assessed whether children could reliably report on adult HIV-associated symptoms and illnesses and adult provisional HIV status. Adult-child pairs concurred above the 65th percentile for 9 of the 10 HIV-associated symptoms and illnesses with sensitivities ranging from 10% to 100% and specificities ranging from 20% to 100%. Concordant reporting between adult-child dyads for the adult's provisional HIV status was 72% (sensitivity=68%, specificity=73%). Children were more likely to reliably match adult's reports of provisional HIV status when they lived in households with more household members, and households with more robust socioeconomic indicators including access to potable water, food security and television. Children demonstrate awareness of HIV-associated symptoms and illnesses experienced by adults in their household. Children in households with greater socioeconomic resources and more household members were more likely to reliably report on the adult's provisional HIV status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mental Wellbeing of Family Members of Autistic Adults

ERIC Educational Resources Information Center

Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

2017-01-01

Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer's wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic…

Adults' food skills and use of gardens are not associated with household food insecurity in Canada.

PubMed

Huisken, Anne; Orr, Sarah K; Tarasuk, Valerie

2017-03-01

To determine the extent to which Canadian adults' food preparation and cooking skills and use of home or community gardens relate to their household food insecurity status; and to compare the food shopping and cooking behaviours of adults in food-secure and food-insecure households. Data were drawn from two Rapid Response Modules appended to the Canadian Community Health Survey in 2012 and 2013. The analytic sample comprised 16,496 respondents 18 years and older. Multivariable logistic regression analyses were conducted to determine the association between food insecurity and adults' self-rated cooking abilities, food preparation skills score, use of gardens, food shopping behaviours, and cooking behaviours, while adjusting for socio-demographic characteristics. Adults in food-insecure households did not differ significantly from others with respect to their food preparation skills or cooking ability, and neither variable predicted the odds of household food insecurity when socio-demographic characteristics were taken into account. Adults in food-insecure households were less likely to use a garden for food, but gardening was unrelated to the odds of food insecurity. Shopping with a budget was more common among adults in food-insecure households, but no other differences in food shopping behaviours were observed after adjustment for socio-demographic characteristics. Adults in food-insecure households were as likely as others to adjust recipes to make them healthier, but they had higher odds of adjusting recipes to reduce their fat content. Our findings suggest that household food insecurity in Canada is not a problem of insufficient food skills.

Clinical and Virological Study of Dengue Cases and the Members of Their Households: The Multinational DENFRAME Project

PubMed Central

Dussart, Philippe; Baril, Laurence; Petit, Laure; Beniguel, Lydie; Quang, Luong Chan; Ly, Sowath; Azevedo, Raimunda do Socorro Silva; Meynard, Jean-Baptiste; Vong, Sirenda; Chartier, Loïc; Diop, Aba; Sivuth, Ong; Duong, Veasna; Thang, Cao Minh; Jacobs, Michael; Sakuntabhai, Anavaj; Nunes, Marcio Roberto Teixeira; Huong, Vu Ti Que; Buchy, Philippe; Vasconcelos, Pedro Fernando da Costa

2012-01-01

Background Dengue has emerged as the most important vector-borne viral disease in tropical areas. Evaluations of the burden and severity of dengue disease have been hindered by the frequent lack of laboratory confirmation and strong selection bias toward more severe cases. Methodology A multinational, prospective clinical study was carried out in South-East Asia (SEA) and Latin America (LA), to ascertain the proportion of inapparent dengue infections in households of febrile dengue cases, and to compare clinical data and biological markers from subjects with various dengue disease patterns. Dengue infection was laboratory-confirmed during the acute phase, by virus isolation and detection of the genome. The four participating reference laboratories used standardized methods. Principal Findings Among 215 febrile dengue subjects—114 in SEA and 101 in LA—28 (13.0%) were diagnosed with severe dengue (from SEA only) using the WHO definition. Household investigations were carried out for 177 febrile subjects. Among household members at the time of the first home visit, 39 acute dengue infections were detected of which 29 were inapparent. A further 62 dengue cases were classified at early convalescent phase. Therefore, 101 dengue infections were found among the 408 household members. Adding these together with the 177 Dengue Index Cases, the overall proportion of dengue infections among the study participants was estimated at 47.5% (278/585; 95% CI 43.5–51.6). Lymphocyte counts and detection of the NS1 antigen differed significantly between inapparent and symptomatic dengue subjects; among inapparent cases lymphocyte counts were normal and only 20% were positive for NS1 antigen. Primary dengue infection and a specific dengue virus serotype were not associated with symptomatic dengue infection. Conclusion Household investigation demonstrated a high proportion of household members positive for dengue infection, including a number of inapparent cases, the frequency of

Household demographics and perceived insufficient sleep among US adults.

PubMed

Chapman, Daniel P; Wheaton, Anne G; Perry, Geraldine S; Sturgis, Stephanie L; Strine, Tara W; Croft, Janet B

2012-04-01

It has become increasingly recognized that insufficient sleep is associated with adverse health outcomes. Studies have observed that sleep duration and daytime sleepiness varies by sex and marital status. Few studies have examined the impact of the number of children on sleep. To evaluate the association of marital status and number of children with insufficient sleep and in a large national sample. We analyzed data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) survey, a population-based telephone survey of non-institutionalized US adults (N = 395,407), in which respondents were asked, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?" We used sex-specific, multivariate logistic regression analyses to assess the associations of marital status (married, previously married, never married) and the number of children in the household with frequent insufficient sleep (≥14 days in past 30 days) after adjusting for age, race/ethnicity, and education. In this study population, 23% were never married, 60% were married, and 17% were previously married. Forty-three percent reported having children aged <18 years in the household. Married men (24.3%) were less likely to report frequent insufficient sleep than never married men (28.0%) or previously married men (28.8%). Never married women (33.4%) were more likely to report frequent insufficient sleep than currently married (29.0%) or previously married women (29.0%). The likelihood of frequent insufficient sleep increased in a linear fashion with the number of children in the household for all subgroups (P < 0.05) except among never married men. These findings suggest that the presence of children in the household often increases the frequency of insufficient rest or sleep among the adults with whom they reside. Thus, health care providers may wish to consider the presence of children under 18 years of age a potential "risk factor" for

Mental Wellbeing of Family Members of Autistic Adults.

PubMed

Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

2017-11-01

Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer's wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic relative with co-occurring mental health difficulties and who they reported as unprepared for the future, self-reported higher levels of worry, depression, anxiety and stress, and poorer quality of life. These findings emphasise the importance of support for family members of autistic adults, whether through external services to support their relative or individual mental health support for the carer.

Adult Education in the 1990s: A Report on the 1991 National Household Education Survey. Working Paper Series.

ERIC Educational Resources Information Center

Kopka, Teresita L. Chan; Schantz, Nancy Borkow; Korb, Roslyn Abrevaya

The 1991 National Household Education Survey adult education component, a household-based data collection, provided estimates of adult education participation. About 32 percent of adults participated in adult education during the prior 12 months to the 1991 survey. Adults 25-54 years old, persons with a bachelor's degree or higher, and employed…

Household composition and suicidal behaviour in the adult population of Belgium.

PubMed

Gisle, Lydia; Van Oyen, Herman

2013-07-01

We aimed to estimate the prevalence of suicidal behaviours, i.e. ideation and attempt, in the adult population of Belgium, and to explore their association with household composition. Data of 4,459 adults (25-64 years) from the 2004 Belgian Health Interview Survey were used for analyses. Bivariate and multivariate logistic regressions were used to calculate the odds of engaging in suicidal behaviours according to household type, further controlling for age, sex, income, employment status and social support. Lifetime prevalence of ideation and attempts was 14 and 4.7 %, respectively. Current prevalence of ideation was 4.0 % and past year prevalence of attempts was 0.5 %. Compared to other household compositions, living alone (A) and as lone parent (P) increased the odds of lifetime and current suicidal thoughts (ORA 2.3, 95 % CI 1.7-2.9 and ORP 3.8, 95 % CI 1.9-7.7) and lifetime attempts (ORA 2.3, 95 % CI 1.4-3.6 and ORP 4.5, 95 % CI 2.4-8.5). When controlling for confounders, single person and single parent households still presented increased adjusted-odds of lifetime and current suicidal thoughts (a-ORA 1.8, 95 % CI 1.1-2.9 and a-ORP 2.3, 95 % CI 1.0-5.5). The likelihood of ever attempted suicide was also higher among single parent households (a-ORP 4.5, 95 % CI 2.4-8.5) after adjustment, but not among those living alone (a-ORA 1.4, 95 % CI 0.8-2.8). Living alone or as lone parent place adults at higher risk for suicide behaviour, and this is only partly explained by lower socio-economic status or poor perceived support.

High vulnerability to household food insecurity in a sample of Canadian renter households in government-subsidized housing.

PubMed

Fafard St-Germain, Andrée-Anne; Tarasuk, Valerie

2017-06-16

To determine the prevalence and severity of household food insecurity and examine household material circumstances related to food insecurity in a sample of renter households in government-subsidized housing. Cross-sectional data from the 2010 Survey of Household Spending were used to determine the food insecurity status of 455 renter households living in the 10 provinces and receiving a government housing subsidy. Multivariable logistic regressions were conducted to examine the relationship between household characteristics describing material circumstances and food insecurity. One in two households was food insecure. Marginal, moderate and severe food insecurity affected 9.0%, 23.3% and 18.5% of households respectively. Household economic resources, as captured with after-tax income, after-rent income, or total expenditure, had an independent, inverse relationship with food insecurity. Among the other characteristics examined, more adults or children in the household, presence of a member with disability, and receipt of social assistance increased the odds of food insecurity, but receipt of social assistance lost statistical significance when controlling for total expenditure. Presence of a senior in the household was independently associated with lower odds of food insecurity. Our findings suggest that more effective income-based interventions are needed to address food insecurity among low-income households receiving government housing subsidies. A better integration of housing and income-based policies is necessary to support household food security among government-subsidized renter households.

National Household Education Survey. Adult and Course Data Files User's Manual.

ERIC Educational Resources Information Center

Brick, J. Michael; And Others

This manual provides documentation and guidance for users of the public release data files (adult file and course file) for Adult Education (AE) component of the 1991 National Household Education Survey (NHES:91). The NHES:91 was a random-digit dial telephone survey developed by the National Center for Education Statistics (NCES) and conducted by…

A Household Is Not a Person: Consistency of Pro-Environmental Behavior in Adult Couples and the Accuracy of Proxy-Reports

PubMed Central

Seebauer, Sebastian; Fleiß, Jürgen; Schweighart, Markus

2016-01-01

Studies on environmental behavior commonly assume single respondents to represent their entire household or employ proxy-reporting, where participants answer for other household members. It is contested whether these practices yield valid results. Therefore, we interviewed 84 couples, wherein both household members provided self- and proxy-reports for their partner. For use of electrical household appliances, consumption of hot water, space heating, everyday mobility, and environmental values, many variables fail to achieve criteria for validity. Consistency (agreement between self-reports of household members) is higher if behaviors are undertaken jointly or negotiated between partners. Accuracy (agreement of proxy-reports with corresponding self-reports) is higher for routine behaviors and for behaviors easily observable by the partner. Overall, indices perform better than items on single behaviors. We caution against employing individual responses in place of the entire household. Interventions for energy conservation should approach the specific person undertaking the target behavior. PMID:28670000

Household demand for preventive HIV/AIDS vaccines in Thailand: do husbands' and wives' preferences differ?

PubMed

Whittington, Dale; Suraratdecha, Chutima; Poulos, Christine; Ainsworth, Martha; Prabhu, Vimalanand; Tangcharoensathien, Viroj

2008-01-01

The aims of this study were to estimate household demand in the general population of Thailand for a (hypothetical) preventive HIV vaccine; to determine whether spouses in the same household would purchase the same number of vaccines for household members and have the same demand function; to determine whether spouses would allocate vaccines to the same household members; and to estimate household and per capita average willingness to pay (WTP) for an HIV vaccine price. The data come from a national contingent valuation survey of 2524 residents (aged 18-20 years) of 1235 households in Thailand during the period 2000 to 2001. In a subsample of 561 households, both head of household and spouse completed independent (separate) interviews. Respondents were asked whether they would purchase an HIV vaccine for themselves and for other household members if one were available at a specified price. For the full sample, average household WTP for the vaccine was substantial (US$610 at 50% vaccine effectiveness, US$671 at 95% effectiveness); the average per capita WTP for household members was US$220 at 50% effectiveness and US$242 at 95% effectiveness. Although spouses reported that they would purchase the same total number of vaccines, and had essentially the same demand functions, at lower vaccine prices wives were significantly more likely than husbands to allocate vaccines to their daughters than to sons. Because wives are more likely to allocate vaccines to daughters, vaccination programs aimed at women and girls might have different outcomes than programs directed at males or at all potential adults without regard to sex.

Female children with incarcerated adult family members at risk for lifelong neurological decline.

PubMed

Brewer-Smyth, Kathleen; Pohlig, Ryan T; Bucurescu, Gabriel

2016-07-01

A secondary analysis of data from adult female prison inmates in the mid-Atlantic United States defined relationships between having incarcerated adult family members during childhood and neurological outcomes. Of 135 inmates, 99 (60%) had one or more incarcerated adult family members during childhood. Regression analyses revealed that having incarcerated adult family members was related to greater frequency and severity of childhood abuse and higher incidence of neurological deficits in adulthood, especially related to traumatic brain injuries, compared to those without incarcerated adult family members. Along with being role models, adult family members impact the neurological health of children throughout their life-span.

Economic Well-Being Among Older-Adult Households: Variation by Veteran and Disability Status

PubMed Central

Wilmoth, Janet M.; London, Andrew S.; Heflin, Colleen M.

2015-01-01

This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with household-level poverty and material hardship among older adults. Compared to households that do not include a person with a disability or veteran, disabled non-veteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency. The implications for social work practice are discussed. PMID:25750998

Adult education and child mortality in India: the influence of caste, household wealth, and urbanization.

PubMed

Singh-Manoux, Archana; Dugravot, Aline; Smith, George Davey; Subramanyam, Malavika; Subramanian, S V

2008-03-01

Although socioeconomic position is generally found to be related to health, the associations can be different for different measures of socioeconomic position. We examined the association between adult education and child mortality, and the influence of other socioeconomic markers (caste, household wealth, and urbanization) on this association. Data were drawn from the 1998-1999 Indian National Family Health Survey, conducted in 26 states and comprising 66,367 children age 5 years or under. Adult education, for the head of household and spouse, was categorized into 0, 1-8, and 9 or more years of schooling. We used logistic regression to estimate associations between education and child mortality in analysis adjusted for other socioeconomic markers. Effect modification by caste, household wealth, and urbanization was assessed by fitting an interaction term with education. Compared with those who had no education, 9 or more years of education for the head of household and for the spouse were associated with lower child mortality (odds ratio [OR] = 0.54; 95% confidence interval [CI] = 0.48-0.62 and OR = 0.44; 95% CI = 0.36-0.54, respectively) in analyses adjusted for age, sex, and state of residence. Further adjustments for caste and urbanization attenuated these associations slightly; when adjustments were made for household wealth the associations were attenuated more substantially. Nevertheless, in fully adjusted models, 9 or more years of education for the head of household (OR = 0.81; 95% CI = 0.70-0.93) and the spouse (OR = 0.75; 95% CI = 0.60-0.94) remained associated with lower child mortality. There was no effect modification of this association by caste, household wealth, and urbanization. Adult education has a protective association with child mortality in India. Caste, household wealth, and urbanization do not modify or completely attenuate this association.

Association of household and community characteristics with adult and child food insecurity among Mexican-origin households in colonias along the Texas-Mexico border.

PubMed

Sharkey, Joseph R; Dean, Wesley R; Johnson, Cassandra M

2011-05-13

Food insecurity is a critical problem in the United States and throughout the world. There is little published data that provides insights regarding the extent and severity of food insecurity among the hard-to-reach Mexican-origin families who reside in the growing colonias along the Texas border with Mexico. Considering that culture, economics, and elements of the environment may increase the risk for food insecurity and adverse health outcomes, the purpose of this study was to examine the relation between household and community characteristics and food insecurity. The study used data from the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA). The data included 610 face-to-face interviews conducted in Spanish by promotoras (indigenous community health workers) in forty-four randomly-identified colonias near the towns of Progreso and La Feria in Hidalgo and Cameron counties along the Texas border with Mexico. C-HCFRA included demographic characteristics, health characteristics, food access and mobility, food cost, federal and community food and nutrition assistance programs, perceived quality of the food environment, food security, eating behaviors, and alternative food sources. 78% of participants experienced food insecurity at the level of household, adult, or child. The most severe - child food insecurity was reported by 49% of all households and 61.8% of households with children. Increasing levels of food insecurity was associated with being born in Mexico, increasing household composition, decreasing household income, and employment. Participation in federal food assistance programs was associated with reduced severity of food insecurity. Greater distance to their food store and perceived quality of the community food environment increased the odds for food insecurity. The Mexican-origin population is rapidly expanding; record numbers of individuals and families are experiencing food insecurity; and for those living in rural or

Pleural mesothelioma in household members of asbestos-exposed workers in Friuli Venezia Giulia, Italy.

PubMed

D' Agostin, Flavia; de Michieli, Paola; Negro, Corrado

2017-05-08

Malignant mesothelioma is closely associated to asbestos exposure. One such exposure may occur through contact with occupationally exposed household members and their belongings. This study examines the features of pleural mesothelioma attributable only to asbestos brought home by another family member. The data sources were 1063 mesothelioma cases diagnosed between 1995 and 2014, from the Friuli Venezia Giulia Mesothelioma Register. In all cases the diagnosis of mesothelioma was based on the pathology report. Exposure information and demographic data were acquired by an occupational medical standardized questionnaire/interview. Household-exposure mesothelioma cases included 33 women and 2 men. Relationships were: wives (N = 22), daughters (N = 9), sons (N = 2), and mothers (N = 2). Asbestos exposure in the workers predominantly occurred in shipyards. Out of the 35 pleural cases, 19 were epithelial, 9 biphasic, 3 sarcomatoid, and 4 not specified. The mean age at diagnosis was 77 years old. The mean latency was 59 years, with wives having a significant shorter latency than offspring. Latency was not significantly related to morphology and asbestosis. The overall mean survival was 16 months (median 11 months) but treatment was beneficial (mean 16 months vs. 7 months). Biphasic/sarcomatoid histology and presence of asbestosis were associated with a decreased survival, although not with statistical significance. Our data confirms that household exposure increases the risk for pleural mesothelioma amongst women with no history of occupational asbestos exposure. This is an ongoing problem in many countries, as well as in Italy, where the evaluation of a framework for the compensation of these cases is under debate. Int J Occup Med Environ Health 2017;30(3):419-431. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Household transmission of SARS, 2003

PubMed Central

Wilson-Clark, Samantha D.; Deeks, Shelley L.; Gournis, Effie; Hay, Karen; Bondy, Susan; Kennedy, Erin; Johnson, Ian; Rea, Elizabeth; Kuschak, Theodore; Green, Diane; Abbas, Zahid; Guarda, Brenda

2006-01-01

Background In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households. Methods A retrospective cohort of SARS-affected households was studied to determine risk factors for household transmission. Questionnaires addressed characteristics of the index case, the household and behaviours among household members. Potential risk factors for secondary transmission of infection were assessed in regression models appropriate to the outcome (secondary cases) and nonindependence of household members. Results The 74 households that participated included 18 secondary cases and 158 uninfected household members in addition to the 74 index cases. The household secondary attack rate was 10.2% (95% confidence interval [CI] 6.7%–23.5%). There was a linear association between the time the index patient spent at home after symptom onset and the secondary attack rate. Infected health care workers who were index cases had lower rates of household transmission. Interpretation SARS transmission in households is complex and increases with the length of time an ill person spends at home. Risk of transmission was lower when the index case was a health care worker. Rapid case identification is the public health measure most useful in minimizing exposure in the home. PMID:17098951

Female children with incarcerated adult family members at risk for life-long neurological decline

PubMed Central

Brewer-Smyth, Kathleen; Pohlig, Ryan T.; Bucurescu, Gabriel

2016-01-01

A secondary analysis of data from adult female prison inmates in the mid-Atlantic United States defined relationships between having incarcerated adult family members during childhood and neurological outcomes. Of 135 inmates, 99(73%) had one or more incarcerated adult family members during childhood. Regression analyses revealed that having incarcerated adult family members was related to greater frequency and severity of childhood abuse and higher incidence of neurological deficits in adulthood, especially related to traumatic brain injuries, compared to those without incarcerated adult family members. Along with being role models, adult family members impact the neurological health of children throughout their lifespan. PMID:26788781

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults.

PubMed

Giskes, Katrina; Turrell, Gavin; Bentley, Rebecca; Kavanagh, Anne

2011-06-01

To examine associations between individual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. Individual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the individual and household levels may be an important determinant of alcohol consumption among Australian adults. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso.

PubMed Central

Su, Tin Tin; Kouyaté, Bocar; Flessa, Steffen

2006-01-01

OBJECTIVE: To quantify the extent of catastrophic household health care expenditure and determine the factors responsible for it in Nouna District, Burkina Faso. METHODS: We used the Nouna Health District Household Survey to collect data on 800 households during 2000-01 for our analysis. The determinants of household catastrophic expenditure were identified by multivariate logistic regression method. FINDINGS: Even at very low levels of health care utilization and modest amount of health expenditure, 6-15% of total households in Nouna District incurred catastrophic health expenditure. The key determinants of catastrophic health expenditure were economic status, household health care utilization especially for modern medical care, illness episodes in an adult household member and presence of a member with chronic illness. CONCLUSION: We conclude that the poorest members of the community incurred catastrophic health expenses. Setting only one threshold/cut-off value to determine catastrophic health expenses may result in inaccurate estimation leading to misinterpretation of important factors. Our findings have important policy implications and can be used to ensure better access to health services and a higher degree of financial protection for low-income groups against the economic impact of illness. PMID:16501711

Household air pollution, chronic respiratory disease and pneumonia in Malawian adults: A case-control study.

PubMed

Jary, Hannah R; Aston, Stephen; Ho, Antonia; Giorgi, Emanuele; Kalata, Newton; Nyirenda, Mulinda; Mallewa, Jane; Peterson, Ingrid; Gordon, Stephen B; Mortimer, Kevin

2017-01-01

Background: Four million people die each year from diseases caused by exposure to household air pollution. There is an association between exposure to household air pollution and pneumonia in children (half a million attributable deaths a year); however, whether this is true in adults is unknown. We conducted a case-control study in urban Malawi to examine the association between exposure to household air pollution and pneumonia in adults. Methods: Hospitalized patients with radiologically confirmed pneumonia (cases) and healthy community controls underwent 48 hours of ambulatory and household particulate matter (µg/m 3 ) and carbon monoxide (ppm) exposure monitoring. Multivariate logistic regression, stratified by HIV status, explored associations between these and other potential risk factors with pneumonia. Results: 145 (117 HIV-positive; 28 HIV-negative) cases and 253 (169 HIV-positive; 84 HIV-negative) controls completed follow up. We found no evidence of association between household air pollution exposure and pneumonia in HIV-positive (e.g. ambulatory particulate matter adjusted odds ratio [aOR] 1.00 [95% CI 1.00-1.01, p=0.141]) or HIV-negative (e.g. ambulatory particulate matter aOR 1.00 [95% CI 0.99-1.01, p=0.872]) participants. Chronic respiratory disease was associated with pneumonia in both HIV-positive (aOR 28.07 [95% CI 9.29-84.83, p<0.001]) and HIV-negative (aOR 104.27 [95% CI 12.86-852.35, p<0.001]) participants. Conclusions: We found no evidence that exposure to household air pollution is associated with pneumonia in Malawian adults. In contrast, chronic respiratory disease was strongly associated with pneumonia.

Household food insecurity is associated with anemia in adult Mexican women of reproductive age.

PubMed

Fischer, Nils C; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael

2014-12-01

Anemia is a major cause of maternal mortality. Household food insecurity (HFI) may increase the risk of anemia among women of reproductive age although this hypothesis remains largely untested in representative samples from low- and middle-income countries. Our objective was to investigate the association of HFI with anemia in a nationally representative, cross-sectional sample of Mexican women of reproductive age (12-49 y old). We tested the association between HFI and anemia among 16,944 women of reproductive age using the multiple logistic regression among adolescent (12-20 y) and adult women (21-49 y). HFI was measured with the use of the Latin American and Caribbean Food Security Scale. Hemoglobin was measured with capillary hemoglobin with the use of HemoCue photometer (HemoCue, Inc.) and anemia was defined with the use of WHO standards. The association of HFI and anemia was not significant (P > 0.05) for adolescent women (12-20 y), whereas in adult women (21-49 y), the adjusted odds of having anemia were 31-43% higher among those living in mild to severely food insecure households than adult women residing in food secure households (P < 0.05). HFI is associated with anemia among adult Mexican women. Programs that reduce HFI may also be effective at reducing the risk of anemia among Mexican women. © 2014 American Society for Nutrition.

"Negotiating fairness": a study on how lesbian family members evaluate, construct, and maintain "fairness" with the division of household labor.

PubMed

Esmail, Ashraf

2010-01-01

In this article, I examine how dual-earner lesbian families construct and evaluate an equal division of household labor through their perceptions of "fairness." Through 22 interviews of dual-earner lesbian families (a total of 44 subjects), I identify that lesbian partners use social comparisons with heterosexual families with whom they have contact, as well as their former heterosexual and homosexual families as an important link to justify what they believe to be a fair division of household labor. Childhood socialization and parental models, however, were not shown to adequately explain how members of a lesbian family construct a perception of equality concerning household division of labor.

Nutritional Status and Tuberculosis Risk in Adult and Pediatric Household Contacts.

PubMed

Aibana, Omowunmi; Acharya, Xeno; Huang, Chuan-Chin; Becerra, Mercedes C; Galea, Jerome T; Chiang, Silvia S; Contreras, Carmen; Calderon, Roger; Yataco, Rosa; Velásquez, Gustavo E; Tintaya, Karen; Jimenez, Judith; Lecca, Leonid; Murray, Megan B

2016-01-01

Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children. We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used Cox proportional regression analyses to estimate hazard ratios for incident TB infection and disease. We enrolled 14,044 household contacts, and among 6853 negative for TB infection and disease at baseline, 1787 (26.1%) became infected. A total of 406 contacts developed secondary TB disease during follow-up. Body mass index did not predict risk of TB infection but overweight household contacts had significantly decreased risk of TB disease (HR 0.48; 95% CI 0.37-0.64; p <0.001) compared to those with normal weight. Among adults, body mass index ≥ 35 kg/m2 continued to predict a lower risk of TB disease (HR 0.30; 95% CI 0.12-0.74; p 0.009). We found no association between high body mass index and TB infection or disease among children under 12 years of age. High body mass index protects adults against TB disease even at levels ≥ 35 kg/m2. This protective effect does not extend to TB infection and is not seen in children.

Household food diversity and nutritional status among adults in Brazil.

PubMed

Bezerra, Ilana N; Sichieri, Rosely

2011-03-27

The aims of this study were to evaluate whether a diversity of healthy foods in a household would decrease the availability of unhealthy foods and to evaluate the association between a healthy dietary diversity score (DDS) and nutritional status among adults. Data from the 2002-2003 Brazilian Household Budget Survey were used. This nationwide survey used a two-stage sampling technique: households were selected after selection of primary sample units (PSUs). Analyses were based on 3,393 PSUs, evaluating 659,816 records of food items purchased by 35,237 households. The DDS was based on the healthy food groups according to Brazilian food guidelines. Per capita acquisition of sugar, sweets, sugar-sweetened beverages and crackers, cookies and cakes (unhealthy food groups) in PSUs was also calculated. Individual weight and height were measured at household. Multivariate linear regression models estimated the association of underweight and overweight and obesity (excess weight) with the PSUs' DDS. Greater acquisition of unhealthy food groups was associated with higher DDS. A high PSU's DDS was negatively associated with underweight (β = -0.38; p-value = 0.04) and positively associated with excess weight (β = 0.98; p-value = 0.05) after adjustment for availability of unhealthy food groups and socioeconomic variables. Our data indicate that there was no replacement of unhealthy food groups by healthy food groups, therefore a healthy diet message for obesity prevention should be combined with a message focused on eating less.

Evaluation of heterosexual partners, children, and household contacts of adults with AIDS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fischl, M.A.; Dickinson, G.M.; Scott, G.B.

Forty-five adults with the acquired immunodeficiency syndrome (AIDS) and their 45 spouses, 109 children, and 29 household contacts were studied for evidence of heterosexual, perinatal, and household spread of human T-cell lymphotropic virus type III (HTLV-III) infection. Of the 45 spouses enrolled, 26 (58%) had antibody to HTLV-III, including 12 (71%) of 17 male spouses and 14 (50%) of 28 female spouses. Of the 12 seropositive male spouses, nine were seropositive at enrollment and three had seroconversion. Of the 14 seropositive female spouses, four were seropositive at enrollment and ten seroconverted. Lack of barrier contraceptive use and oral sex weremore » associated with seroconversion. Of the 109 children enrolled, 15 had AIDS or an AIDS-related illness, two had evidence of passive transfer of maternal antibodies, and two had HTLV-III infection acquired outside the household. None of the 90 seronegative children seroconverted. Of 29 household contacts studied, nondeveloped antibody to HTLV-III.« less

National Prevalence of PTSD Among Sexually Revictimized Adolescent, College, and Adult Household-Residing Women

PubMed Central

Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

2012-01-01

Context Despite empirical links between sexual revictimization (i.e., experiencing two or more sexual assaults) and posttraumatic stress disorder (PTSD), no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. Objective Estimate the prevalence of sexual revictimization and PTSD among three national female samples (adolescent, college, adult household probability). Design Surveys were used to collect data from The National Women’s Study – Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women’s Study-Replication (2006; household probability). Setting Households and college campuses across the U.S. Participants 1,763 adolescent girls, 2,000 college women, and 3,001 household-residing adult women. Main Outcomes Behaviorally specific questions assessed unwanted sexual acts occurring over the lifespan due to use of force, threat of force, or incapacitation via drug or alcohol use. PTSD was assessed with a module validated against the criterion standard, Structured Clinical Interview for DSM-IV. Results 52.7% of victimized adolescents, 50.0% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20.0% of revictimized adolescents, 40.0% of revictimized college women, and 27.2% of revictimized household-residing women. Compared to non-victims, odds of meeting past 6-month PTSD were 4.3–8.2 times higher for revictimized respondents and 2.4–3.5 times higher for single victims. Conclusions Population prevalence estimates suggest that 769,000 adolescent girls, 625,000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154,000 sexually revictimized adolescents, 250,000 sexually

Communes and Changing Family Norms: Marriage and Life-Style Choice among Former Members of Communal Groups.

ERIC Educational Resources Information Center

Aidala, Angela A.

1989-01-01

Examined by follow-up interviews the attitudes and behavior about marriage, parenting, and lifestyle among former commune members (N=344) previously interviewed in 1974-76. Found ex-commune members: (l) less likely to have married, (2) more likely to live in multi-adult households and, (3) more receptive to possible collective living arrangements…

45 CFR 286.90 - How many hours per week must an adult or minor head-of-household participate in work-related...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false How many hours per week must an adult or minor... must an adult or minor head-of-household participate in work-related activities to count in the numerator of the work participation rate? During the month, an adult or minor head-of-household must...

45 CFR 286.90 - How many hours per week must an adult or minor head-of-household participate in work-related...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false How many hours per week must an adult or minor... must an adult or minor head-of-household participate in work-related activities to count in the numerator of the work participation rate? During the month, an adult or minor head-of-household must...

Household Structure and Living Conditions in Nigeria

ERIC Educational Resources Information Center

Mberu, Blessing Uchenna

2007-01-01

Data on 7,632 households from the 1999 Nigeria Demographic and Health Survey are used to examine household structure and living conditions in Nigeria. The study finds significant disadvantage in living conditions of single-adult, female- and single-adult, male-headed households relative to two-parent households. Extended households show no…

45 CFR 286.90 - How many hours per week must an adult or minor head-of-household participate in work-related...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true How many hours per week must an adult or minor head... must an adult or minor head-of-household participate in work-related activities to count in the numerator of the work participation rate? During the month, an adult or minor head-of-household must...

45 CFR 286.90 - How many hours per week must an adult or minor head-of-household participate in work-related...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true How many hours per week must an adult or minor head... must an adult or minor head-of-household participate in work-related activities to count in the numerator of the work participation rate? During the month, an adult or minor head-of-household must...

When Bigger Is Better: Household Size, Abuse Injuries, Neglect, and Family Response in Novosibirsk, Russia.

PubMed

Emery, Clifton R; Eremina, Tatiana; Arenas, Carmen; Kim, Jaeyop; Chan, Ko Ling

2017-02-01

Although previous research has demonstrated larger households to be at higher risk of physical abuse and neglect of children, we argue that unilateral conceptualization of larger households as a risk factor is inappropriate. Application of resource dilution theory must capture the possibility that larger families may have more members with both the agency and will to intervene against child maltreatment. We hypothesized a negative interaction between household size and protective informal social control by family members in predicting abuse injuries and neglect. A three-stage probability proportional to size cluster sample representative of Novosibirsk, Russia, was collected from 306 cohabiting couples. One parent in each household was interviewed. A focal child was selected using most recent birthday. When responses limited to families with minor children (below age 18) were selected, 172 families remained in the data. Physical abuse and neglect were measured using the Conflict Tactics Scales (CTS). Protective informal social control by family members was measured using the Informal Social Control of Child Maltreatment (ISC_CM) Scale. Models were tested using random effects regression and logistic regression. Nearly 7% of focal children were injured in the last year, 10% were neglected. Consistent with previous research, protective informal social control was associated with lower odds of injury and fewer instances of neglect. The significant negative interaction between household size and protective control is consistent with the idea that larger households may be protective when adult family members intervene against maltreatment to protect children. Replication and further investigation of protective ISC_CM in Western populations is much needed. Future research should not conceptualize or measure household size as a unilateral risk factor.

Household motor vehicle use and weight status among Colombian adults: are we driving our way towards obesity?

PubMed

Parra, Diana C; Lobelo, Felipe; Gómez, Luis Fernando; Rutt, Candace; Schmid, Thomas; Brownson, Ross C; Pratt, Michael

2009-01-01

To determine the associations between household motor vehicle ownership and weight status among Colombian adults. Secondary analysis of data from the 2005 Demographic and HealthSurvey of Colombia. Height, weight and waist circumference were objectively measured in 49,079 adults, ages 18 to 64 that resided in urban settings. Abdominal obesity was defined as a waist circumference >80 cm in women and >90 cm in men. Prevalence was 19.9% for motor vehicle ownership in household, 33.1% for BMI between 25 and 29.9 kg/m(2), 14.4% for BMI>30 kg/m(2), and 46% for abdominal obesity. Males reporting any household motor vehicle ownership were more likely to be overweight or obese, and to have abdominal obesity (p for genderexposure variables interaction=<0.001). Household motor vehicle ownership is associated with overweight, obesity, and abdominal obesity among Colombian men but not women.

Household ventilation and tuberculosis transmission in Kampala, Uganda.

PubMed

Chamie, G; Wandera, B; Luetkemeyer, A; Bogere, J; Mugerwa, R D; Havlir, D V; Charlebois, E D

2013-06-01

To test the feasibility of measuring household ventilation and evaluate whether ventilation is associated with tuberculosis (TB) in household contacts in Kampala, Uganda. Adults with pulmonary TB and their household contacts received home visits to ascertain social and structural household characteristics. Ventilation was measured in air changes per hour (ACH) in each room by raising carbon dioxide (CO₂) levels using dry ice, removing the dry ice, and measuring changes in the natural log of CO₂ (lnCO2) over time. Ventilation was compared in homes with and without co-prevalent TB. Members of 61 of 66 (92%) households approached were enrolled. Households averaged 5.4 residents/home, with a median of one room/home. Twelve homes (20%) reported co-prevalent TB in household contacts. Median ventilation for all rooms was 14 ACH (interquartile range [IQR] 10-18). Median ventilation was 12 vs. 15 ACH in index cases' sleeping rooms in households with vs. those without co-prevalent TB (P = 0.12). Among smear-positive indexes not infected by the human immunodeficiency virus (HIV), median ventilation was 11 vs. 17 ACH in index cases' sleeping rooms in homes with vs. those without co-prevalent TB (P = 0.1). Our findings provide evidence that a simple CO₂ decay method used to measure ventilation in clinical settings can be adapted to homes, adding a novel tool and a neglected variable, ventilation, to the study of household TB transmission.

Unrecognized pediatric and adult family members of children with acute brucellosis.

PubMed

Çiftdoğan, Dilek Yılmaz; Aslan, Selda

Brucellosis is an infectious, contagious and zoonotic disease that occurs worldwide. The family members of an index case of brucellosis may be especially susceptible, due to sharing the same source of infection and similar risk factors for brucellosis. In this study, we propose to screen pediatric and adult family members of brucellosis index cases for detecting additional unrecognized infected family members. 114 family members of 41 pediatric patients with brucellosis were evaluated. All family members completed a brief questionnaire and were tested by a standard tube agglutination test (STA). The majority of family members (n=96, 84.2%) were children. Among the 114 family members, 42 (36.8%) were seropositive, and 15 (35.7%) were symptomatic. The majority of the symptomatic seropositive family members (n=12, 80%) had STA titers (≥1:640) higher than asymptomatic seropositive family members (n=9, 33%; p=0.004). The routine screening of both pediatric and adult family members of index cases is a priority in endemic areas. Using this screening approach, unrecognized family members who are seropositive for brucellosis will be identified earlier and be able to receive prompt treatment. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Longitudinal study of household smoking ban adoption among Korean Americans.

PubMed

Hughes, Suzanne C; Corcos, Isabel A; Hofstetter, C Richard; Hovell, Melbourne F; Irvin, Veronica L

2009-11-01

Few longitudinal studies have examined the adoption of bans on smoking in private homes. This longitudinal study examined: (1) the prevalence of home smoking bans at baseline, (2) the incidence and predictors of new ban implementation by follow-up, and (3) the reasons for banning smoking and the difficulties with enforcement. The sample consisted of 1360 adults of Korean descent residing in California who were interviewed by telephone (in English/Korean) at baseline during 2001-2002 and re-interviewed in 2006-2007. Data analyses were conducted in 2007-2008. The proportion of respondents with a complete household smoking ban grew from 59% at baseline to 91% by the follow-up interview. Among the 552 respondents who did not have a ban at baseline, 84% had adopted a ban by follow-up. Three baseline factors independently predicted ban adoption during the follow-up period: the presence of a nonsmoking respondent or spouse, the presence of nonsmoking family members, and respondent's belief that secondhand smoke caused lung cancer. The most highly rated reasons for banning smoking were as follows: because smoke annoys others, to protect family members, to avoid the odor, to discourage youth from smoking, and to encourage smokers to quit. Finally, respondents indicated that they would find it most difficult to ask their parent-in-law not to smoke. The proportion of households with smoking bans increased substantially, but households with smokers or family members who smoke remained less likely to implement bans. The importance of culturally sensitive programs to promote household bans cannot be overstated.

Correlates of Intra-Household ITN Use in Liberia: A Multilevel Analysis of Household Survey Data.

PubMed

Babalola, Stella; Ricotta, Emily; Awantang, Grace; Lewicky, Nan; Koenker, Hannah; Toso, Michael

2016-01-01

Malaria is a major cause of morbidity and mortality in Liberia. At the same time, insecticide-treated net (ITN) ownership and use remain low. Access is a key determinant of ITN use but it is not the only one; prior studies have identified factors that affect the use of ITNs in households with at least one ITN. These factors operate at the individual, household, and community levels. However, studies have generally not assessed the psychosocial or ideational determinants of ITN use. Using 2014 household survey data, this manuscript examines the socio-demographic, ideational, household, and community factors associated with household member use of ITNs in Liberia. Multilevel modeling was used to assess fixed effects at the individual, household, and community levels, and random effects at the household and cluster levels. The data showed significant residual clustering at the household level, indicating that there were unmeasured factors operating at this level that are associated with ITN use. The association of age with ITN use was moderated by sex such that men, older children, and teenagers were less likely to sleep under an ITN compared to women and children under five years old. Female caregivers' perceived severity of malaria, perceived self-efficacy to detect a complicated case of malaria, and exposure to the "Take Cover" communication campaign were positively associated with ITN use by members of her household. The association with household size was negative, while the relationship with the number of ITNs was positive. Programs should seek to achieve universal coverage (that is, one ITN for every two household members) and promote the notion that everyone needs to sleep under an ITN every night. Programs should also seek to strengthen perceived severity of malaria and educate intended audience groups on the signs of malaria complications. Given the significance of residual clustering at the household level, interventions that engage men as heads of

Household food insecurity, diabetes and hypertension among Mexican adults: results from Ensanut 2012.

PubMed

Pérez-Escamilla, Rafael; Villalpando, Salvador; Shamah-Levy, Teresa; Méndez-Gómez Humarán, Ignacio

2014-01-01

To examine the independent association of household food insecurity (HFI) with diabetes and hypertension in a nationally representative cross-sectional sample from Mexico. We assessed the association between HFI and self-reported doctor diagnosed diabetes and hypertension among 32 320 adult individuals using multiple logistic regression. HFI was measured using an adapted version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). HFI was a risk factor for diabetes among women but not men and for hypertension among both genders. Diabetes odds were higher by 31, 67 and 48%, among women living in mild, moderate, and severe food-insecure (vs. food-secure) households, respectively. Living in moderate to severe food-insecure (vs. food-secure) households was associated with hypertension odds that were 28 and 32% higher, respectively. Decreasing HFI may help improve public health and national development in Mexico.

National prevalence of posttraumatic stress disorder among sexually revictimized adolescent, college, and adult household-residing women.

PubMed

Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L; Saunders, Benjamin E; Kilpatrick, Dean G; Resnick, Heidi S

2012-09-01

Despite empirical links between sexual revictimization (ie, experiencing 2 or more sexual assaults) and posttraumatic stress disorder (PTSD), to our knowledge, no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. To estimate the prevalence of sexual revictimization and PTSD among 3 national female samples (adolescent, college, and adult household probability). Surveys were used to collect data from the National Women's Study-Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women's Study-Replication (2006; household probability). Households and college campuses across the United States. One thousand seven hundred sixty-three adolescent girls, 2000 college women, and 3001 household-residing adult women. Behaviorally specific questions assessed unwanted sexual acts occurring over the life span owing to the use of force, threat of force, or incapacitation via drug or alcohol use. Posttraumatic stress disorder was assessed with a module validated against the criterion standard Structured Clinical Interview for DSM-IV. About 53% of victimized adolescents, 50% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20% of revictimized adolescents, 40% of revictimized college women, and 27.2% of revictimized household-residing women. Compared with nonvictims, odds of meeting past 6-month PTSD were 4.3 to 8.2 times higher for revictimized respondents and 2.4 to 3.5 times higher for single victims. Population prevalence estimates suggest that 769 000 adolescent girls, 625 000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154 000 sexually revictimized adolescents, 250 000 sexually

Child-orientated environmental education influences adult knowledge and household behaviour

NASA Astrophysics Data System (ADS)

Damerell, P.; Howe, C.; Milner-Gulland, E. J.

2013-03-01

Environmental education is frequently undertaken as a conservation intervention designed to change the attitudes and behaviour of recipients. Much conservation education is aimed at children, with the rationale that children influence the attitudes of their parents, who will consequently change their behaviour. Empirical evidence to substantiate this suggestion is very limited, however. For the first time, we use a controlled trial to assess the influence of wetland-related environmental education on the knowledge of children and their parents and household behaviour. We demonstrate adults exhibiting greater knowledge of wetlands and improved reported household water management behaviour when their child has received wetland-based education at Seychelles wildlife clubs. We distinguish between ‘folk’ knowledge of wetland environments and knowledge obtained from formal education, with intergenerational transmission of each depending on different factors. Our study provides the first strong support for the suggestion that environmental education can be transferred between generations and indirectly induce targeted behavioural changes.

How family members manage risk around functional decline: the autonomy management process in households facing dementia.

PubMed

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-04-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of in-depth interviewing in 2012-2014, it investigates how family members in US households manage decline in an affected individual's natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual's deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual's ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual's autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder's functional ability and manage his or her activity involvements. Copyright © 2015 Elsevier Ltd. All rights reserved.

How family members manage risk around functional decline: The autonomy management process in households facing dementia

PubMed Central

Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

2015-01-01

Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of retrospective interviewing in 2012–2014, it investigates how family members in US households manage decline in an affected individual’s natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual’s deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual’s ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual’s autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder’s functional ability and manage his or her activity involvements. PMID:25697634

Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics

PubMed Central

RUKKE, BJØRN ARNE; BIRKEMOE, TONE; SOLENG, ARNULF; LINDSTEDT, HEIDI HEGGEN; OTTESEN, PREBEN

2011-01-01

SUMMARY Head lice prevalence varies greatly between and within countries, and more knowledge is needed to approach causes of this variation. In the present study, we investigated head lice prevalence among elementary school students and their households in relation to individual and household characteristics as well as spatial variables. The investigation included households from 5 geographically separated municipalities. Present infestations among household members as well as previous infestations in the household were reported in a questionnaire. In elementary school students prevalence was low (1·63%), but more than one-third of the households (36·43%) had previously experienced pediculosis. Prevalence was higher in elementary school students than in other household members, and highest in third-grade children. Prevalence was also influenced by the school attended, which suggested that interactions between children in the same school are important for head lice transmission. Previous occurrence of head lice in homes also increased the risk of present infestation. Prevalence of previous infestations was higher in households with more children and in more densely populated municipalities, indicating that the density of hosts or groups of hosts influences transmission rates. These results demonstrate that information of hosts’ spatial distribution as well as household and individual characteristics is needed to better understand head lice population dynamics. PMID:21767439

Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics.

PubMed

Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

2011-09-01

Head lice prevalence varies greatly between and within countries, and more knowledge is needed to approach causes of this variation. In the present study, we investigated head lice prevalence among elementary school students and their households in relation to individual and household characteristics as well as spatial variables. The investigation included households from 5 geographically separated municipalities. Present infestations among household members as well as previous infestations in the household were reported in a questionnaire. In elementary school students prevalence was low (1·63%), but more than one-third of the households (36·43%) had previously experienced pediculosis. Prevalence was higher in elementary school students than in other household members, and highest in third-grade children. Prevalence was also influenced by the school attended, which suggested that interactions between children in the same school are important for head lice transmission. Previous occurrence of head lice in homes also increased the risk of present infestation. Prevalence of previous infestations was higher in households with more children and in more densely populated municipalities, indicating that the density of hosts or groups of hosts influences transmission rates. These results demonstrate that information of hosts' spatial distribution as well as household and individual characteristics is needed to better understand head lice population dynamics.

Orphan care in Botswana's working households: growing responsibilities in the absence of adequate support.

PubMed

Miller, Candace M; Gruskin, Sofia; Subramanian, S V; Rajaraman, Divya; Heymann, S Jody

2006-08-01

Botswana has one of the world's highest HIV-prevalence rates and the world's highest percentages of orphaned children among its population. We assessed the ability of income-earning households in Botswana to adequately care for orphans. We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Thirty-seven percent of respondents provided orphan care, usually to extended family members. We applied logistic regression models to determine the factors associated with experiencing problems related to orphan caregiving. Nearly half of working households with orphan-care responsibilities reported experiencing financial and other difficulties because of orphan care. Issues of concern included caring for multiple orphans, caring for sick adults and orphans simultaneously, receiving no assistance, and low income. The orphan crisis is impoverishing even working households, where caregivers lack sufficient resources to provide basic needs. Neither the public sector nor communities provide adequate safety nets. International assistance is critical to build capacity within the social welfare infrastructure and to fund community-level activities that support households. Lessons from Botswana's orphan crisis can provide valuable insights to policymakers throughout sub-Saharan Africa.

Participation of family members and quality of patient care - the perspective of adult surgical patients.

PubMed

Leino-Kilpi, Helena; Gröndahl, Weronica; Katajisto, Jouko; Nurminen, Matti; Suhonen, Riitta

2016-08-01

The aim of this study is to describe the participation of family members in the care of Finnish adult surgical patients and the connection of the participation with the quality of patient care as perceived by surgical patients. The family members of adult surgical patients are important. Earlier studies vary concerning the nature of participation, its meaning and the connection of participation with patient-centred quality of care. In this study, we aim to produce new knowledge about adult surgical patients whose family members have participated in their care. This was a cross-sectional descriptive survey study. The data were collected among adult surgical patients (N = 481) before being discharged home from hospital with two instruments: the Good Nursing Care scale and the Received Knowledge of Hospital Patients. Based on the results, most adult surgical patients report that family members participate in their care. Participation was connected with received knowledge and preconditions of care, which are components of the quality of patient care. In future, testing of different solutions for improving the participation of surgical patients' family members in patient care should be implemented. Furthermore, the preconditions of family members' participation in care and the concept of participation should be analysed to emphasise the active role of family members. The results emphasised the importance of family members for the patients in surgical care. Family members' participation is connected with the quality of patient care. © 2016 John Wiley & Sons Ltd.

Association of household income and education with eating behaviors in Japanese adults: a cross-sectional study.

PubMed

Nakamura, Saki; Inayama, Takayo; Hata, Kikuko; Matsushita, Munehiro; Takahashi, Masaki; Harada, Kazuhiro; Arao, Takashi

2016-01-22

Socioeconomic inequalities as social determinants of health are important issues in public health and health promotion. However, the association between socioeconomic status and eating behaviors has been investigated poorly in Japanese adults. To fill this gap, the present study examines the association of eating behaviors with household income and education. The sample comprised 3,137 Japanese adults (1,580 men and 1,557 women) aged 30 to 59 years who responded to an Internet-based cross-sectional survey in 2014. Data on the following eating behaviors were collected via self-report: "taking care of one's diet for health," "eating vegetables," "frequency of eating breakfast," "frequency of family breakfasts," "frequency of family dinners," "using the information on nutrition labels," and "conversations with family or friends during meals." Self-reported data on socioeconomic status (household income and education) and demographic variables (gender, age, district of residence, marital status, residence status, and employment status) were also collected. The associations between eating behaviors and household income or education were tested using binomial logistic regression analysis with eating behaviors as dependent variables and household income and education as independent variables. A trend P -value was calculated for three categories of household income (less than 3,000,000 JPY, 3,000,000-7,000,000 JPY, and over 7,000,000 JPY) and education (junior high/high school, 2-year college, and 4-year college/graduate school). Higher household income and education were significantly associated with higher rates of eating vegetables, using the information on nutrition labels, and conversation with family or friends during meals in Japanese men and women. Higher household incomes were significantly associated with lower rates of frequency of family breakfasts in Japanese men and lower rates of frequency of family dinners in Japanese men and women. Higher socioeconomic

Break-up of New Orleans Households after Hurricane Katrina

PubMed Central

Rendall, Michael S.

2011-01-01

Theory and evidence on disaster-induced population displacement have focused on individual and population-subgroup characteristics. Less is known about impacts on households. I estimate excess incidence of household break-up due to Hurricane Katrina by comparing a probability sample of pre-Katrina New Orleans resident adult household heads and non–household heads (N = 242), traced just over a year later, with a matched sample from a nationally representative survey over an equivalent period. One in three among all adult non–household heads, and one in two among adult children of household heads, had separated from the household head 1 year post-Katrina. These rates were, respectively, 2.2 and 2.7 times higher than national rates. A 50% higher prevalence of adult children living with parents in pre-Katrina New Orleans than nationally increased the hurricane’s impact on household break-up. Attention to living arrangements as a dimension of social vulnerability in disaster recovery is suggested. PMID:21709733

Growing parental economic power in parent-adult child households: coresidence and financial dependency in the United States, 1960-2010.

PubMed

Kahn, Joan R; Goldscheider, Frances; García-Manglano, Javier

2013-08-01

Research on coresidence between parents and their adult children in the United States has challenged the myth that elders are the primary beneficiaries, instead showing that intergenerationally extended households generally benefit the younger generation more than their parents. Nevertheless, the economic fortunes of those at the older and younger ends of the adult life course have shifted in the second half of the twentieth century, with increasing financial well-being among older adults and greater financial strain among younger adults. This article uses U.S. census and American Community Survey (ACS) data to examine the extent to which changes in generational financial well-being over the late twentieth and early twenty-first centuries have been reflected in the likelihood of coresidence and financial dependency in parent-adult child U.S. households between 1960 and 2010. We find that younger adults have become more financially dependent on their parents and that while older adults have become more financially independent of their adult children, they nevertheless coreside with their needy adult children. We also find that the effect of economic considerations in decisions about coresidence became increasingly salient for younger adults, but decreasingly so for older adults.

Food Insecurity in Households with Children: Prevalence, Severity, and Household Characteristics. Economic Information Bulletin Number 56

ERIC Educational Resources Information Center

Nord, Mark

2009-01-01

Eighty-four percent of U.S. households with children were food secure throughout 2007, meaning that they had consistent access to adequate food for active, healthy lives for all household members. Nearly 16 percent of households with children were food insecure sometime during the year, including 8.3 percent in which children were food insecure…

Premature adult mortality in urban Zambia: a repeated population-based cross-sectional study

PubMed Central

Timæus, Ian M; Banda, Richard; Thankian, Kusanthan; Banda, Andrew; Lemba, Musonda; Stringer, Jeffrey S A; Chi, Benjamin H

2016-01-01

Objectives To measure the sex-specific and community-specific mortality rates for adults in Lusaka, Zambia, and to identify potential individual-level, household-level and community-level correlates of premature mortality. We conducted 12 survey rounds of a population-based cross-sectional study between 2004 and 2011, and collected data via a structured interview with a household head. Setting Households in Lusaka District, Zambia, 2004–2011. Participants 43 064 household heads (88% female) who enumerated 123 807 adult household members aged between 15 and 60 years. Primary outcome Premature adult mortality. Results The overall mortality rate was 16.2/1000 person-years for men and 12.3/1000 person-years for women. The conditional probability of dying between age 15 and 60 (45q15) was 0.626 for men and 0.537 for women. The top three causes of death for men and women were infectious in origin (ie, tuberculosis, HIV and malaria). We observed an over twofold variation of mortality rates between communities. The mortality rate was 1.98 times higher (95% CI 1.57 to 2.51) in households where a family member required nursing care, 1.44 times higher (95% CI 1.22 to 1.71) during the cool dry season, and 1.28 times higher (95% CI 1.06 to 1.54) in communities with low-cost housing. Conclusions To meet Zambia's development goals, further investigation is needed into the factors associated with adult mortality. Mortality can potentially be reduced through focus on high-need households and communities, and improved infectious disease prevention and treatment services. PMID:26940113

Out-of-Pocket Household Expenditures on Medical Injections in Cambodia.

PubMed

Ozawa, Sachiko; Yemeke, Tatenda T; Tawah, Alie F; Kulkarni, Vivek; Villar Uribe, Manuela

2018-02-09

Cambodia has one of the highest rates of overall medical injection usage worldwide. Therapeutic injections, which are often unnecessary, contribute to the spread of blood-borne diseases. This study describes injection practices and associated household expenditures in rural northwest Cambodia. We assessed care-seeking patterns of surveyed adult family members who sought healthcare in the previous 30 days, including location of care, medical injection use, and out-of-pocket household expenditures for treatment. A regression model was used to explore the impact of injection use on out-of-pocket household expenditures. Among 480 households sampled, 298 included members who had been sick within the previous 30 days; a total of 342 episodes of care had been sought. Private providers accounted for over 66% (n = 226) of all episodes of care, with public and informal providers accounting for 20% (n = 69) and 14% (n = 47), respectively. Injections were administered in over 120 (35%) episodes of care, with 81% of injections administered by private providers. Patients who received injections incurred total out-of-pocket household expenditures that were, on average, 126,590 Cambodian Riel (KHR) (US$31.65) higher than those who did not receive injections (p < 0.01), equivalent to nearly half of the country's total annual health expenditure per capita. Receiving injections and perceived severity of illness were significantly associated with higher out-of-pocket household expenditures. This study found high levels of medical injection use, particularly among private healthcare providers, which was significantly associated with high healthcare expenditures. Reducing the number of medical injections would not only reduce disease transmission risk but also contribute to reduced healthcare costs and greater financial protection.

Association between Race, Household Income and Grip Strength in Middle- and Older-Aged Adults.

PubMed

Thorpe, Roland J Jr; Simonsick, Eleanor; Zonderman, Alan; Evans, Michelle K

2016-10-20

Poor grip strength is an indicator of frailty and a precursor to functional limitations. Although poor grip strength is more prevalent in older disabled African American women, little is known about the association between race and poverty-related disparities and grip strength in middle-aged men and women. We examined the cross-sectional relationship between race, socioeconomic status as assessed by household income, and hand grip strength in men and women in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. General linear models examined grip strength (maximum of two trials on both sides) by race and household income adjusted for age, weight, height, hand pain, education, insurance status, family income, and two or more chronic conditions. Of 2,091 adults, 422(45.4%) were male, 509(54.8%) were African American, and 320 (34.5%) were living in households with incomes below 125% of the federal poverty level (low SES). In adjusted models, African American women had greater grip strength than White women independent of SES (low income household: 29.3 vs 26.9 kg and high income household: 30.5 vs. 28.3kg; P<.05 for both); whereas in men, only African Americans in the high income household group had better grip strength than Whites (46.3 vs. 43.2; P<.05). The relationship between grip strength, race and SES as assessed by household income varied in this cohort. Efforts to develop grip strength norms and cut points that indicate frailty and sarcopenia may need to be race- and income-specific.

Psychiatric Morbidity and Social Functioning among Adults with Borderline Intelligence Living in Private Households

ERIC Educational Resources Information Center

Hassiotis, A.; Strydom, A.; Hall, I.; Ali, A.; Lawrence-Smith, G.; Meltzer, H.; Head, J; Bebbington, P.

2008-01-01

Background: Approximately one-eighth of the population will have DSM-IV borderline intelligence. Various mental disorders and social disability are associated with it. Method: The paper uses data (secondary analysis) from a UK-wide cross-sectional survey of 8450 adults living in private households. Data were collected on psychiatric disorders,…

Examining risk factors for cardiovascular disease among food bank members in Vancouver.

PubMed

Fowokan, A O; Black, J L; Holmes, E; Seto, D; Lear, S A

2018-06-01

Food banks provide supplemental food to low-income households, yet little is known about the cardiovascular health of food banks members. This study therefore described cardiovascular disease (CVD) risk factors among food bank members and explored associations between food insecurity and CVD risk. Adults ≥18 years (n = 77) from three food bank sites in metro Vancouver, British Columbia completed surveys and physical assessments examining a range of socio-demographic variables and CVD risk factors. A composite measure of myocardial infarction (MI) risk called the INTERHEART score was assessed and household food insecurity was measured using the Household Food Security Survey Module. Regression models were used to explore associations between food insecurity and CVD risk measures, including the INTERHEART score. Ninety-seven percent of food bank members reported experiencing food insecurity, 65% were current smokers, 53% reported either chronic or several periods of stress in the past year, 55% reported low physical activity levels and 80% reported consuming fewer than five servings of fruit and vegetables daily. Prevalence of self-reported diabetes and hypertension were 13% and 29% respectively. Fifty-two percent of the sample were at high risk of non-fatal MI. No statistically significant associations were found between increased severity of food insecurity and CVD risk factors among this sample where both severe food insecurity and high CVD risks were prevalent. Food bank members were at elevated risk for CVD compared with the general population. Strategies are needed to reduce prevalence of food insecurity and CVD risk factors, both of which disproportionately affected food bank members.

American household structure in transition.

PubMed

Glick, P C

1984-01-01

The number of U.S. households rose by 58 percent between 1960 and 1983, with nontraditional household types accounting for most of the increase. Whereas the number of households containing married couples with children younger than 18 rose by only four percent over the period, one-parent households increased by 175 percent; one-person households, by 173 percent; and households composed of unmarried couples, by 331 percent. In 1983, households maintained by married couples constituted six in 10 U.S. households; the second most common household type--adults living alone--accounted for about one-quarter of all households. Lone parents living with their children represent nearly one in 10 households. Almost all of these parents are women--of whom two-thirds are separated or divorced, one-quarter have never been married, and fewer than one in 10 are widows. Among adults living alone, women aged 45 and older predominate; but the rate at which the practice has been adopted since 1960 has been greatest among those under age 45. Most of the growth in the number of one-person households occurred during the 1970s. The increase in cohabitation--most of it also in the 1970s--has similarly been concentrated in the younger age-groups. The living arrangements of children younger than 18 have changed accordingly over the two decades. Since 1960, the number of children living with two parents has declined by nearly one-fifth, and the number living with one parent--generally the mother--has more than doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

Illness, death, and macronutrients: adequacy of rural Mozambican household production of macronutrients in the face of HIV/AIDS.

PubMed

Donovan, Cynthia; Massingue, Jaquelino

2007-06-01

As the public sector and civil society develop intervention programs to deal with the HIV/ AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients. To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/ AIDS and other major illnesses over two time periods. Methods. This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps. Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent. Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market.

The household food insecurity and health outcomes of U.S.-Mexico border migrant and seasonal farmworkers.

PubMed

Weigel, M Margaret; Armijos, Rodrigo X; Hall, Yolanda Posada; Ramirez, Yolanda; Orozco, Rubi

2007-07-01

Emerging evidence suggests chronic household food insecurity has an adverse effect on health. This study examined the prevalence, predictors and health outcomes associated with food insecurity in 100 migrant and seasonal farmworker (MSFW) households living on the U.S.-Mexico border. Data were collected using the U.S. Food Security Scale, California Agricultural Worker's Health Survey, and objective anthropometric, clinical and biochemical indicators. Food insecurity affected 82% of households; 49% also had hunger. Household food insecurity was predicted by the presence of minor children in the home and low maternal education. Food insecure households were more likely to have at least one member affected by symptoms of depression (deprimido), nervios (an ethnospecific condition), learning disorders, and symptoms suggestive of gastrointestinal infection. Although not directly associated with food insecurity, adult obesity, central body adiposity, elevated blood pressure, and blood lipid and glucose disturbances were common. These findings highlight the significant food security and health challenges faced by border area MSFW families.

Is Knowledge Shared within Households? Policy Research Working Papers No. 2261.

ERIC Educational Resources Information Center

Basu, Kaushik; Narayan, Ambar; Ravallion, Martin

This paper examines whether an illiterate worker's earnings are affected by the literacy of other members of the household. Theory suggests that a member of a collective-action household may or may not share knowledge with others in the household. Shared income gains from shared knowledge may well be offset by a shift in the balance of power…

[Intra-household distribution of energy and macronutrients in Colombian households].

PubMed

Ardila, Víctor A; Prada, Gloria E; Herrán, Oscar F

2013-01-01

Knowing the intra-household distribution of dietary intake is useful to establish food policy. To estimate the intra-household distribution of energy and macronutrients by kinship in Colombian households. We applied two recalls of dietary intake for the last 24 hours (R24H) in 1,505 subjects living in 432 households. Usual intake was calculated for each subject, aggregated for each household and calculated the share (%) for each of its members. Participation data was adjusted in linear models for age, gender, body mass index, energy requirement, socioeconomic levels, education and household size. The head of the household participates on average in 27.4% (95% CI: 26.5 to 28.2) of the total energy, without sex differences or if they contribute to the household income or not. The participation of unrelated subjects was 30.3% (95% CI: 25.3 to 35.3), and 26.0% (95% CI: 22.7 to 29.3) of the siblings of the head of the household, which is equivalent to that of the head of the household. By adjusting participation, the grandson becomes important with 29.8% (95% CI: 27.4 to 30.9). Men participate more than women (p<0.05). Even in smaller households, participation is lower if the economic level is low and they are receiving food aids (p<0.05). In the context of the structures of power and authority, the need for a cultural intervention with nutritional purposes to modify the principles of contribution, necessity, equity and demand emerges. Inequality is evident in the distribution.

The association of household food insecurity with the risk of type 2 diabetes mellitus in adults: a systematic review and meta-analysis.

PubMed

Abdurahman, Ahmed A; Chaka, Eshetu E; Nedjat, S; Dorosty, Ahmed Reza; Majdzadeh, R

2018-05-02

The link between household food insecurity and risk of type 2 diabetes mellitus still remains controversial. Therefore, we performed a systematic review and meta-analysis to clarify the association between household food insecurity and type 2 diabetes mellitus. EMBASE, PubMed, ISI Web of Science and Scopus databases were searched up to March 2017. The selection of studies, data extraction and assessing the risk of bias in the included studies were carried out by two reviewers independently. Study-specific odds ratios (ORs) were pooled using a random effects model. A total of 18 articles including a total of 55,353,915 adult participants were included in the meta-analysis. The pooled ORs of the cross-sectional studies revealed that household food insecurity was significantly associated with the odds of T2DM (OR 1.27, 95% CI 1.11-1.42) with no evidence of publication bias (p = 0.63) but heterogeneity between studies (I 2  = 61.1%). Similarly, subgroup analyses showed that the country where the study conducted and household food insecurity assessment tool used to influence the effect of household food insecurity on the odds of T2DM. However, the pooled ORs for two case-control and one cohort studies were not significantly associated between household food insecurity and T2DM in adults. This study strengthens the hypothesis of the household food insecurity effect on the odds of T2DM among adults. Further longitudinal studies based on larger, and more representative samples are needed to identify the underlying relationships between food insecurity and type 2 diabetes mellitus.

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China.

PubMed

Guerchet, Maëlenn M; Guerra, Mariella; Huang, Yueqin; Lloyd-Sherlock, Peter; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Ezeah, Peter; Gallardo, Sara; Liu, Zhaorui; Mayston, Rosie; Montes de Oca, Veronica; Wang, Hong; Prince, Martin J

2018-01-01

While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China. Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as 'incident care', 'chronic care' or 'no care', and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care). Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78-1.00) and government transfers (pCR 0.80, 95% CI 0.69-0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77-0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26-1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64-2.22) in care households. While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people's needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age; incentivisation of informal care through compensation for direct and

Beliefs associated with intention to ban smoking in households with smokers.

PubMed

Hennessy, Michael; Bleakley, Amy; Mallya, Giridhar; Romer, Dan

2014-01-01

Smoking in homes exposes family members to secondhand smoke, an exposure that is harmful to children and adults. This study identifies barriers to instituting household smoking bans and beliefs that are positively and negatively related to smoking bans in households with smokers. A telephone survey of parents living in Philadelphia with at least 1 smoker and a child under the age of 13 years in the household was conducted in 2012. Using the reasoned action model, the survey assessed beliefs regarding attitudes, norms, and self-efficacy/control predictors of intention to ban household smoking. Forty-seven percent of households reported high intention to not allow smoking in the home. Regression analysis to identify the reasoned action predictors associated with intention to restrict smoking in the home showed that all 3 of the predictors of intention (attitude, normative pressure, and control) were significantly related to intention. Important underlying beliefs related to intention included beliefs about the health effects of secondhand smoke on children's health, norms regarding those restrictions, and barriers to enforcing such restrictions. Messages that increase concern about the health effects of secondhand smoke on children, that contrast the rights of smokers with negative health effects, and that suggest alternative locations to smoke are promising strategies to motivate smokers to implement indoor smoking bans.

Self-reported illness and household strategies for coping with health-care payments in Bangladesh

PubMed Central

Gilmour, Stuart; Saito, Eiko; Sultana, Papia; Shibuya, Kenji

2013-01-01

Abstract Objective To investigate self-reported illness and household strategies for coping with payments for health care in a city in Bangladesh. Methods A cluster-sampled probability survey of 1593 households in the city of Rajshahi, Bangladesh, was conducted in 2011. Multilevel logistic regression – with adjustment for any clustering within households – was used to examine the risk of self-reported illness in the previous 30 days. A multilevel Poisson regression model, with adjustment for clustering within households and individuals, was used to explore factors potentially associated with the risk of health-care-related “distress” financing (e.g. paying for health care by borrowing, selling, reducing food expenditure, removing children from school or performing additional paid work). Findings According to the interviewees, about 45% of the surveyed individuals had suffered at least one episode of illness in the previous 30 days. The most frequently reported illnesses among children younger than 5 years and adults were common tropical infections and noncommunicable diseases, respectively. The risks of self-reported illness in the previous 30 days were relatively high for adults older than 44 years, women and members of households in the poorest quintile. Distress financing, which had been implemented to cover health-care payments associated with 13% of the reported episodes, was significantly associated with heart and liver disease, asthma, typhoid, inpatient care, the use of public outpatient facilities, and poverty at the household level. Conclusion Despite the subsidization of public health services in Bangladesh, high prevalences of distress financing – and illness – were detected in the surveyed, urban households. PMID:24052682

Early-life mental disorders and adult household income in the World Mental Health Surveys

PubMed Central

Kawakami, Norito; Abdulghani, Emad Abdulrazaq; Alonso, Jordi; Bromet, Evelyn; Bruffaerts, Ronny; de Almeida, Jose Miguel Caldas; Chiu, Wai Tat; de Girolamo, Giovanni; de Graaf, Ron; Fayyad, John; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Lakoma, Matthew D.; LeBlanc, William; Lee, Sing; Levinson, Daphna; Malhotra, Savita; Matschinger, Herbert; Medina-Mora, Maria Elena; Nakamura, Yosikazu; Browne, Mark A. Oakley; Okoliyski, Michail; Posada-Villa, Jose; Sampson, Nancy A.; Viana, Maria Carmen; Kessler, Ronald C.

2012-01-01

Background Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy-makers to the value of expanding initiatives for early detection-treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Methods Data come from the WHO World Mental Health (WMH) Surveys in eleven high income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents ages 18-64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Results Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16-33% of median within-country household income, while population-level effect sizes are in the range 1.0-1.4% of Gross Household Income. Conclusions Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy-makers should take these associations into consideration in making healthcare research and treatment resource allocation decisions. PMID:22521149

Cohabiting family members share microbiota with one another and with their dogs.

PubMed

Song, Se Jin; Lauber, Christian; Costello, Elizabeth K; Lozupone, Catherine A; Humphrey, Gregory; Berg-Lyons, Donna; Caporaso, J Gregory; Knights, Dan; Clemente, Jose C; Nakielny, Sara; Gordon, Jeffrey I; Fierer, Noah; Knight, Rob

2013-04-16

Human-associated microbial communities vary across individuals: possible contributing factors include (genetic) relatedness, diet, and age. However, our surroundings, including individuals with whom we interact, also likely shape our microbial communities. To quantify this microbial exchange, we surveyed fecal, oral, and skin microbiota from 60 families (spousal units with children, dogs, both, or neither). Household members, particularly couples, shared more of their microbiota than individuals from different households, with stronger effects of co-habitation on skin than oral or fecal microbiota. Dog ownership significantly increased the shared skin microbiota in cohabiting adults, and dog-owning adults shared more 'skin' microbiota with their own dogs than with other dogs. Although the degree to which these shared microbes have a true niche on the human body, vs transient detection after direct contact, is unknown, these results suggest that direct and frequent contact with our cohabitants may significantly shape the composition of our microbial communities. DOI:http://dx.doi.org/10.7554/eLife.00458.001.

Cohabiting family members share microbiota with one another and with their dogs

PubMed Central

Song, Se Jin; Lauber, Christian; Costello, Elizabeth K; Lozupone, Catherine A; Humphrey, Gregory; Berg-Lyons, Donna; Caporaso, J Gregory; Knights, Dan; Clemente, Jose C; Nakielny, Sara; Gordon, Jeffrey I; Fierer, Noah; Knight, Rob

2013-01-01

Human-associated microbial communities vary across individuals: possible contributing factors include (genetic) relatedness, diet, and age. However, our surroundings, including individuals with whom we interact, also likely shape our microbial communities. To quantify this microbial exchange, we surveyed fecal, oral, and skin microbiota from 60 families (spousal units with children, dogs, both, or neither). Household members, particularly couples, shared more of their microbiota than individuals from different households, with stronger effects of co-habitation on skin than oral or fecal microbiota. Dog ownership significantly increased the shared skin microbiota in cohabiting adults, and dog-owning adults shared more ‘skin’ microbiota with their own dogs than with other dogs. Although the degree to which these shared microbes have a true niche on the human body, vs transient detection after direct contact, is unknown, these results suggest that direct and frequent contact with our cohabitants may significantly shape the composition of our microbial communities. DOI: http://dx.doi.org/10.7554/eLife.00458.001 PMID:23599893

The impact of childhood experiences and family members outside the household on residential environment choices.

PubMed

Blaauboer, Marjolein

2011-01-01

Choices of urban, suburban or rural residential environments have often been studied from a life-course perspective. In this paper, an examination is made of the influence of childhood experiences and of residential environment choices of family members outside the household. It is argued that socialisation, location-specific capital and the wish to maintain close family ties may result in living in a similar residential environment later in life and in similar environments to siblings and parents. Results of multinomial logistic regression analyses of data from the Netherlands Kinship Panel Study show that the residential environment during childhood is indeed strongly associated with the current residential environment. Moreover, individuals show a strong similarity to their parents and siblings in their residential environment, even after accounting for residential inertia and return migration.

Early-life mental disorders and adult household income in the World Mental Health Surveys.

PubMed

Kawakami, Norito; Abdulghani, Emad Abdulrazaq; Alonso, Jordi; Bromet, Evelyn J; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; Chiu, Wai Tat; de Girolamo, Giovanni; de Graaf, Ron; Fayyad, John; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Lakoma, Matthew D; Leblanc, William; Lee, Sing; Levinson, Daphna; Malhotra, Savita; Matschinger, Herbert; Medina-Mora, Maria Elena; Nakamura, Yosikazu; Oakley Browne, Mark A; Okoliyski, Michail; Posada-Villa, Jose; Sampson, Nancy A; Viana, Maria Carmen; Kessler, Ronald C

2012-08-01

Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy makers to the value of expanding initiatives for early detection and treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Data come from the World Health Organization (WHO) World Mental Health Surveys in 11 high-income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents aged 18 to 64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16% to 33% of median within-country household income, and population-level effect sizes are in the range 1.0% to 1.4% of gross household income. Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy makers should take these associations into consideration in making health care research and treatment resource allocation decisions. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA).

PubMed

Roy, Arunima; Hechtman, Lily; Arnold, L Eugene; Swanson, James M; Molina, Brooke S G; Sibley, Margaret H; Howard, Andrea L

2017-08-01

Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functional outcomes are not adequately understood. The objective of the present study was to determine the effects of childhood demographic, clinical, and family factors on adult functional outcomes in individuals with and without childhood ADHD from the MTA cohort. Regressions were used to determine associations of childhood factors (age range 7-10 years) of family income, IQ, comorbidity (internalizing, externalizing, and total number of non-ADHD diagnoses), parenting styles, parental education, number of household members, parental marital problems, parent-child relationships, and ADHD symptom severity with adult outcomes (mean age 25 years) of occupational functioning, educational attainment, emotional functioning, sexual behavior, and justice involvement in participants with (n = 579) and without (n = 258) ADHD. Predictors of adult functional outcomes in ADHD included clinical factors such as baseline ADHD severity, IQ, and comorbidity; demographic factors such as family income, number of household members and parental education; and family factors such as parental monitoring and parental marital problems. Predictors of adult outcomes were generally comparable for children with and without ADHD. Childhood ADHD symptoms, IQ, and household income levels are important predictors of adult functional outcomes. Management of these areas early on, through timely treatments for ADHD symptoms, and providing additional support to children with lower IQ and from households with low incomes, could assist in improving adult functioning. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

PubMed Central

Hogeling, Lette; Spruijt, Renate; Postma, Nathalie; de Vries, Hein

2017-01-01

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to) work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children’s activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group’s environment by educating social workers and ensuring healthier food bank packages. PMID:29036936

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China

PubMed Central

Guerchet, Maëlenn M.; Guerra, Mariella; Huang, Yueqin; Lloyd-Sherlock, Peter; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Ezeah, Peter; Gallardo, Sara; Liu, Zhaorui; Mayston, Rosie; Montes de Oca, Veronica; Wang, Hong

2018-01-01

Background While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China. Methods Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as ‘incident care’, ‘chronic care’ or ‘no care’, and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care). Results Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78–1.00) and government transfers (pCR 0.80, 95% CI 0.69–0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77–0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26–1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64–2.22) in care households. Conclusions While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people’s needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age

Household transmission of influenza virus

PubMed Central

Tsang, Tim K.; Lau, Lincoln L. H.; Cauchemez, Simon; Cowling, Benjamin J.

2015-01-01

Human influenza viruses cause regular epidemics and occasional pandemics with a substantial public health burden. Household transmission studies have provided valuable information on the dynamics of influenza transmission. We reviewed published studies and found that once one household member is infected with influenza, the risk of infection in a household contact can be up to 38%, and the delay between onset in index and secondary cases is around 3 days. Younger age was associated with higher susceptibility. In the future, household transmission studies will provide information on transmission dynamics including the correlation of virus shedding and symptoms with transmission, and the correlation of new measures of immunity with protection against infection. PMID:26612500

Application of adult attachment theory to group member transference and the group therapy process.

PubMed

Markin, Rayna D; Marmarosh, Cheri

2010-03-01

Although clinical researchers have applied attachment theory to client conceptualization and treatment in individual therapy, few researchers have applied this theory to group therapy. The purpose of this article is to begin to apply theory and research on adult dyadic and group attachment styles to our understanding of group dynamics and processes in adult therapy groups. In particular, we set forth theoretical propositions on how group members' attachment styles affect relationships within the group. Specifically, this article offers some predictions on how identifying group member dyadic and group attachment styles could help leaders predict member transference within the therapy group. Implications of group member attachment for the selection and composition of a group and the different group stages are discussed. Recommendations for group clinicians and researchers are offered. PsycINFO Database Record (c) 2010 APA, all rights reserved

Household perceptions towards a redistributive policy across health insurance funds in Tanzania.

PubMed

Chomi, Eunice N; Mujinja, Phares G M; Hansen, Kristian; Kiwara, Angwara D; Enemark, Ulrika

2015-03-15

The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is grounded on the level of solidarity within the country. The aim of this paper is to analyse the perceptions of CHF, NHIF and non-member households towards cross-subsidisation of the poor as an indication of the level of solidarity and acceptance of redistributive mechanisms. This study analyses data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used to identify factors associated with support for cross-subsidisation of the poor. Compared to CHF and NHIF households, non-member households expressed the highest support for subsidised CHF membership for the poor. The odds of expressing support for subsidised CHF membership are higher for NHIF households and non-member households, households that are wealthier, whose household heads have lower education levels, and have sick members. The majority of households support a partial rather than fully subsidised CHF membership for the poor and there were no significant differences by membership status. The odds of expressing willingness to contribute towards subsidised CHF membership are higher for households that are wealthier, with young household heads and have confidence in scheme management. The majority may support a redistributive policy, but there are indications that this support and willingness to contribute to its achievement are influenced by the perceived benefits, amount of subsidy considered, and trust in scheme management. These present important issues for consideration when designing

Severity of household food insecurity and lifetime racial discrimination among African-American households in South Carolina.

PubMed

Burke, Michael P; Jones, Sonya J; Frongillo, Edward A; Fram, Maryah S; Blake, Christine E; Freedman, Darcy A

2018-04-01

In 2014, 30% of African-American households with children had low or very low food security, a rate double that of white households with children. A household has low food security if its members experience food shortages and reductions in food quality attributable to a lack of household resources or access and very low food security if its members also experience reductions in food intake and disrupted eating patterns. Households that are either low or very low food secure are known collectively as food insecure. We examined the association between the severity of household food insecurity and reports of lifetime racial discrimination among a sample of food-insecure African-American households in South Carolina. Data were collected from 154 African-American respondents. Food insecurity was measured using the US Department of Agriculture's Household Food Security Survey Module. Lifetime racial discrimination was measured using the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). We used logistic regression to test the association between severity of food insecurity (low vs. very low food secure), PEDQ-CV score and PEDQ-CV subscales. All models were adjusted for demographic and socioeconomic variables. A one-unit increase in the frequency of lifetime racial discrimination was associated with a 5% increase in the odds of being very low food secure (odds ratio (OR) 1.05, P < .05). More reports of discrimination that were stigmatizing or devaluing (OR 1.16, P < .05), took place at a workplace or school (OR 1.15, P < .05) or were threatening or aggressive (OR 1.39, P < .05) increased the odds of being very low food secure. More reports of racial discrimination that were excluding or rejecting did not significantly increase the odds of being very low food secure (OR 1.07, P > .05). Severity of household food insecurity is associated with lifetime racial discrimination among African-American households in South Carolina.

The Differentiation of Multigenerational Households.

ERIC Educational Resources Information Center

Rosenthal, Carolyn J.

1986-01-01

This analysis employs the distinction of parent's home versus child's home and investigates multigenerational households in a random sample of adults in Hamilton, Ontario. In a qualitative analysis, the two types of multigenerational households are shown to be related to different family life course phases and to differ on a number of dimensions.…

Household products: a review.

PubMed

DiCarlo, Marc A

2003-10-01

Household products include detergents, cleaners and polishes, bleaches, disinfectants and sterilizers, dust removers, antistatics and deodorizers, office materials, removers, and products for clothing. Many of these contain chemicals that present a risk to those who come into contact with them. This contact may be through inhalation or dermal exposure for human adults, or by ingestion for children. Pets are exposed through ingestion, dermal contact, and inhalation. An emerging class of household products is the fabric refreshers, which may pose a hazard to humans and pets. This review explores the major chemicals expected in typical fabric refreshers, "and their potential hazards to household pets.

Maternal resources and household food security: evidence from Nicaragua.

PubMed

Schmeer, Kammi K; Piperata, Barbara A; Herrera Rodríguez, Andrés; Salazar Torres, Virgilio Mariano; Centeno Cárdenas, Francisco José

2015-11-01

Women (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children. Data from a population-based sample of households was collected in León, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0·05) of maternal resources with household, adult-specific and child-specific food insecurity. Municipality of León, Nicaragua. Households with children aged 3-11 years in rural and urban León. Only 25% of households with young children were food secure, with 50% mildly food insecure and 25% moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34% lower than when their spouse/partner was the main provider. The odds of food insecurity were 60% lower when mothers managed household money, 48% lower when mothers had a secondary (v. primary) education, 65% higher among single mothers and 16% lower with each indicator of social support. Results were similar for adult- and child-specific food insecurity. This research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women's social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.

The Effects of Alaska's Economic Recession on Anchorage Households.

ERIC Educational Resources Information Center

Foster, Karen Pyle; And Others

1988-01-01

This publication is based on two surveys of the same Anchorage, Alaska households taken in June and November 1987 to study the effects of a strong recession of the previous two years. Different kinds of households were queried about household incomes, housing status, members' occupations, moving plans, and expectations about the financial future.…

Household Transmission of Vibrio cholerae in Bangladesh

PubMed Central

Sugimoto, Jonathan D.; Koepke, Amanda A.; Kenah, Eben E.; Halloran, M. Elizabeth; Chowdhury, Fahima; Khan, Ashraful I.; LaRocque, Regina C.; Yang, Yang; Ryan, Edward T.; Qadri, Firdausi; Calderwood, Stephen B.; Harris, Jason B.; Longini, Ira M.

2014-01-01

Background Vibrio cholerae infections cluster in households. This study's objective was to quantify the relative contribution of direct, within-household exposure (for example, via contamination of household food, water, or surfaces) to endemic cholera transmission. Quantifying the relative contribution of direct exposure is important for planning effective prevention and control measures. Methodology/Principal Findings Symptom histories and multiple blood and fecal specimens were prospectively collected from household members of hospital-ascertained cholera cases in Bangladesh from 2001–2006. We estimated the probabilities of cholera transmission through 1) direct exposure within the household and 2) contact with community-based sources of infection. The natural history of cholera infection and covariate effects on transmission were considered. Significant direct transmission (p-value<0.0001) occurred among 1414 members of 364 households. Fecal shedding of O1 El Tor Ogawa was associated with a 4.9% (95% confidence interval: 0.9%–22.8%) risk of infection among household contacts through direct exposure during an 11-day infectious period (mean length). The estimated 11-day risk of O1 El Tor Ogawa infection through exposure to community-based sources was 2.5% (0.8%–8.0%). The corresponding estimated risks for O1 El Tor Inaba and O139 infection were 3.7% (0.7%–16.6%) and 8.2% (2.1%–27.1%) through direct exposure, and 3.4% (1.7%–6.7%) and 2.0% (0.5%–7.3%) through community-based exposure. Children under 5 years-old were at elevated risk of infection. Limitations of the study may have led to an underestimation of the true risk of cholera infection. For instance, available covariate data may have incompletely characterized levels of pre-existing immunity to cholera infection. Transmission via direct exposure occurring outside of the household was not considered. Conclusions Direct exposure contributes substantially to endemic transmission of symptomatic

Breakup of New Orleans Households after Hurricane Katrina

ERIC Educational Resources Information Center

Rendall, Michael S.

2011-01-01

Theory and evidence on disaster-induced population displacement have focused on individual and population-subgroup characteristics. Less is known about impacts on households. I estimate excess incidence of household breakup resulting from Hurricane Katrina by comparing a probability sample of pre-Katrina New Orleans resident adult household heads…

Impact of non-pharmaceutical interventions on URIs and influenza in crowded, urban households.

PubMed

Larson, Elaine L; Ferng, Yu-hui; Wong-McLoughlin, Jennifer; Wang, Shuang; Haber, Michael; Morse, Stephen S

2010-01-01

We compared the impact of three household interventions-education, education with alcohol-based hand sanitizer, and education with hand sanitizer and face masks-on incidence and secondary transmission of upper respiratory infections (URIs) and influenza, knowledge of transmission of URIs, and vaccination rates. A total of 509 primarily Hispanic households participated. Participants reported symptoms twice weekly, and nasal swabs were collected from those with an influenza-like illness (ILI). Households were followed for up to 19 months and home visits were made at least every two months. We recorded 5034 URIs, of which 669 cases reported ILIs and 78 were laboratory-confirmed cases of influenza. Demographic factors significantly associated with infection rates included age, gender, birth location, education, and employment. The Hand Sanitizer group was significantly more likely to report that no household member had symptoms (p < 0.01), but there were no significant differences in rates of infection by intervention group in multivariate analyses. Knowledge improved significantly more in the Hand Sanitizer group (p < 0.0001). The proportion of households that reported > or = 50% of members receiving influenza vaccine increased during the study (p < 0.001). Despite the fact that compliance with mask wearing was poor, mask wearing as well as increased crowding, lower education levels of caretakers, and index cases 0-5 years of age (compared with adults) were associated with significantly lower secondary transmission rates (all p < 0.02). In this population, there was no detectable additional benefit of hand sanitizer or face masks over targeted education on overall rates of URIs, but mask wearing was associated with reduced secondary transmission and should be encouraged during outbreak situations. During the study period, community concern about methicillin-resistant Staphylococcus aureus was occurring, perhaps contributing to the use of hand sanitizer in the

Household cereal crop harvest and children's nutritional status in rural Burkina Faso.

PubMed

Belesova, Kristine; Gasparrini, Antonio; Sié, Ali; Sauerborn, Rainer; Wilkinson, Paul

2017-06-20

Reduction of child undernutrition is one of the Sustainable Development Goals for 2030. Achievement of this goal may be made more difficult in some settings by climate change through adverse impact on agricultural productivity. However, there is only limited quantitative evidence on the link between household crop harvests and child nutrition. We examined this link in a largely subsistence farming population in rural Burkina Faso. Data on the middle-upper arm circumference (MUAC) of 975 children ≤5 years of age, household crop yields, and other parameters were obtained from the Nouna Health and Demographic Surveillance System. Multilevel modelling was used to assess the relationship between MUAC and the household crop harvest in the year 2009 estimated in terms of kilocalories per adult equivalent per day (kcal/ae/d). Fourteen percent of children had a MUAC <125 mm (a value indicative of acute undernutrition). The relationship between MUAC and annual household food energy production adjusted for age, sex, month of MUAC measurement, household wealth, whether a household member had a non-agricultural occupation, garden produce, village infrastructure and market presence, suggested a decline in MUAC below around 3000 kcal/ae/d. The mean MUAC was 2.49 (95% CI 0.45, 4.52) mm less at 1000 than at 3000 kcal/ae/d. Low per capita household crop production is associated with poorer nutritional status of children in a rural farming population in Burkina Faso. This and similar populations may thus be vulnerable to the adverse effects of weather on agricultural harvest, especially in the context of climate change.

Socioeconomic disparities in osteoporosis prevalence: different results in the overall Korean adult population and single-person households.

PubMed

Kim, Jungmee; Lee, Joongyub; Shin, Ju-Young; Park, Byung-Joo

2015-03-01

The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ≥ 50 years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. There were 8221 osteoporosis patients aged ≥ 50 years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p = 0.01, p < 0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

Household and area income levels are associated with smoking status in the Korean adult population.

PubMed

Yun, Woo-Jun; Rhee, Jung-Ae; Kim, Sun A; Kweon, Sun-Seog; Lee, Young-Hoon; Ryu, So-Yeon; Park, Soon-Woo; Kim, Dong Hyun; Shin, Min-Ho

2015-01-31

Some previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults. This study was based on the Korean Community Health Survey (KCHS) performed in South Korea, between September and November 2009. In total, 222,242 subjects (103,124 men and 119,118 women) were included in the analysis. Information on smoking status was collected using a standardized questionnaire. Income status was determined by monthly household income. Household income was categorized as: <1 million won; <2 million won; <3 million won; and ≥3 million won. Area-level income categorized as quartiles. Data were analyzed using multilevel regression models. The analysis was conducted separately urban and rural, by sex. The lowest household income group had a higher risk of smoking than the highest household income group in both urban and rural areas for both men and women after adjusting for individual characteristics (urban men: odds ration [OR], 1.44; 95% confidence interval [CI], 1.36-1.53; rural men: OR, 1.33; 95% CI, 1.25-1.42; urban women: OR, 2.38; 95% CI, 2.06-2.76; rural women: OR, 1.51; 95% CI, 1.25-1.83). In men, the lowest area-level income group had a higher risk for smoking than the highest area-level income group in urban areas after adjusting for individual characteristics and household income (OR, 1.17; 95% CI, 1.02-1.33). In women, the lowest area-level income group had a lower risk for smoking than the highest area-level income group in rural areas after adjusting for individual characteristics and household income (OR, 0.52; 95% CI, 0.39-0.70). However, no association was observed between area-level income and smoking in rural areas for men or in urban areas for women. The results showed that smoking is strongly associated with household income status in both men and women, and area-level income is partly associated with smoking

Assessing disaster preparedness and mental health of community members in Aceh, Indonesia: a community-based, descriptive household survey of a national program.

PubMed

Ismail, Nizam; Suwannapong, Nawarat; Howteerakul, Nopporn; Tipayamongkholgul, Mathuros; Apinuntavech, Suporn

2016-01-01

Disaster preparedness of the community is an essential disaster-mitigation strategy to protect human life and to prevent injuries and property damage. This study aimed to assess the knowledge of disaster, and the disaster preparedness of community members in Aceh, Indonesia. A community-based descriptive household survey was conducted in 40 villages of three tsunami-affected districts in Aceh State, Indonesia. In total, 827 randomly selected community members were interviewed with structured questionnaires during the period September-October 2014. About 57.6% of community members had good knowledge of disaster, while 26.0% had good community disaster preparedness. Neither knowledge of disaster nor disaster preparedness of community members achieved the target of the Community Mental Health Nurse Program outcome indicators (<70.0%). The proportions of people with good knowledge of disaster and disaster preparedness were quite low. The government of Aceh State should revitalize the program to improve the effectiveness of community mental health nurses in transferring the knowledge of disasters and disaster preparedness to the community's members, then expand it to other provinces of Indonesia, using standard approaches and the lessons learned from Aceh.

Household roles and care-seeking behaviours in response to severe childhood illness in Mali.

PubMed

Ellis, Amy A; Doumbia, Seydou; Traoré, Sidy; Dalglish, Sarah L; Winch, Peter J

2013-11-01

Malaria is a major cause of under-five mortality in Mali and many other developing countries. Malaria control programmes rely on households to identify sick children and either care for them in the home or seek treatment at a health facility in the case of severe illness. This study examines the involvement of mothers and other household members in identifying and treating severely ill children through case studies of 25 rural Malian households. A wide range of intra-household responses to severe illness were observed among household members, both exemplifying and contravening stated social norms about household roles. Given their close contact with children, mothers were frequently the first to identify illness symptoms. However, decisions about care-seeking were often taken by fathers and senior members of the household. As stewards of the family resources, fathers usually paid for care and thus significantly determined when and where treatment was sought. Grandparents were frequently involved in diagnosing illnesses and directing care towards traditional healers or health facilities. Relationships between household members during the illness episode were found to vary from highly collaborative to highly conflictive, with critical effects on how quickly and from where treatment for sick children was sought. These findings have implications for the design and targeting of malaria and child survival programming in the greater West African region.

The Kaiser Permanente Northern California Adult Member Health Survey.

PubMed

Gordon, Nancy; Lin, Teresa

2016-01-01

The Kaiser Permanente Northern California (KPNC) Member Health Survey (MHS) is used to describe sociodemographic and health-related characteristics of the adult membership of this large, integrated health care delivery system to monitor trends over time, identify health disparities, and conduct research. To provide an overview of the KPNC MHS and share findings that illustrate how survey statistics and data have been and can be used for research and programmatic purposes. The MHS is a large-scale, institutional review board-approved survey of English-speaking KPNC adult members. The confidential survey has been conducted by mail triennially starting in 1993 with independent age-sex and geographically stratified random samples, with an option for online completion starting in 2005. The full survey sample and survey data are linkable at the individual level to Health Plan and geocoded data. Respondents are assigned weighting factors for their survey year and additional weighting factors for analysis of pooled survey data. Statistics from the 1999, 2002, 2005, 2008, and 2011 surveys show trends in sociodemographic and health-related characteristics and access to the Internet and e-mail for the adult membership aged 25 to 79 years and for 6 age-sex subgroups. Pooled data from the 2008 and 2011 surveys show many significant differences in these characteristics across the 5 largest race/ethnic groups in KPNC (non-Hispanic whites, blacks, Latinos, Filipinos, and Chinese). The KPNC MHS has yielded unique insights and provides an opportunity for researchers and public health organizations outside of KPNC to leverage our survey-generated statistics and collaborate on epidemiologic and health services research studies.

Transmission of human herpesvirus 7 through multigenerational families in the same household.

PubMed

Takahashi, Y; Yamada, M; Nakamura, J; Tsukazaki, T; Padilla, J; Kitamura, T; Yoshida, M; Nii, S

1997-10-01

Human herpesvirus 7 (HHV-7) closely resembles HHV-6 and to a lesser degree cytomegalovirus. HHV-7 infection is usually acquired during early childhood. Primary infection can cause a roseola-like illness but in most cases it is only mildly symptomatic. The majority of adults are seropositive and in contrast to HHV-6 and cytomegalovirus infection, they continue to secrete the virus in their saliva for many years. The mode of intrafamilial transmission of this virus is not well-understood. Saliva samples for virus isolation and DNA restriction analysis were obtained from all 47 members of 6 Japanese families, including 4 families with 3 generations living in the same household. HHV-7 was isolated from 43 of 47 saliva samples collected from children and adult members of the 6 families (91.5%). In one family the restriction patterns of the maternal grandmother, the mother and the children were similar, and the patterns of the paternal grandmother and the father were similar. In another family the patterns of the father and 5 of 6 children were similar, and those of the mother and the other child were similar. Altogether similar HHV-7 restriction profiles with his or her mother were found in 48% of offspring, and similar profiles with his or her father were found in 28% of offspring. The results strongly suggested horizontal transmission of HHV-7 from grandparents to parents to children through close contact within a household. Either parent could transmit HHV-7 to the children.

Household characteristics and influenza vaccination uptake in the community-dwelling elderly: a cross-sectional study

PubMed Central

Chan, Denise P.C.; Wong, Ngai Sze; Wong, Eliza L.Y.; Cheung, Annie W.L.; Lee, Shui Shan

2015-01-01

Elderly people are at higher risk of influenza diseases. The morbidity benefit of vaccination is often offset by its low and variable coverage in elderly people in the community. To assess household and individual factors associated with influenza vaccination uptake in the community-dwelling elderly of age ≥ 65, data from a cross-sectional Thematic Household Survey conducted in 2011/12 in Hong Kong were analysed, using vaccination in the past 12 months as the outcome variable. Households comprising an elderly person living with non-elderly member(s) of age ≤ 64 were also evaluated. Data fields included socio-demographics, household structures, health status, eligibility to financial subsidy, and subscription to health insurance. The influenza vaccination rate was 27% in 4204 elderly persons from 3224 households. Being male, being economically active, attaining primary education, having smoking behaviours were negatively associated with vaccination, while chronic illness and age ≥ 70 were positively associated factors. Elderly people living alone gave a variable rate of vaccination ranging from 16.4% in males of age 65–69 to 36.3% in females ≥ 70. Household size per se was not associated with vaccination, but a positive correlation could be seen if the household was composed of vaccinated non-elderly member(s). Influenza vaccination uptake in the community-dwelling elderly is dependent on both individual and household characteristics, the latter including the influence of vaccinated non-elderly member(s). The low vaccination coverage of “younger” (age 65–69) elderly men living alone is particularly worrisome. Interventions focusing on vulnerable elderly people and their social networks would be desirable. PMID:26844153

The process of death imminence awareness by family members of patients in adult critical care.

PubMed

Baumhover, Nancy C

2015-01-01

A focus on cost-effective quality end-of-life care remains a high priority in adult critical care given an aging population, high prevalence of death, and aggressive technologies used to extend or sustain life in this setting. A Glaserian grounded theory design was used to conduct this retrospective study to yield a substantive middle-range theory. The data source was semistructured interviews with 14 family members of decedents who died 6 to 60 months prior to the study. The purpose of this study was to generate a theory on how family members of patients in adult critical care come to realize that their loved one is dying. The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care middle-range theory contained 6 phases: (1) patient's near-death awareness, (2) dying right in front of me, (3) turning points in the patient's condition, (4) no longer the person I once knew, (5) doing right by them, and (6) time to let go. Patient's near-death awareness preceded all other phases, if communicated by the decedent with their family. Then, family members iteratively moved through all the other key phases in the process until a time to let go became evident. This substantive middle-range theory will guide nursing education, practice, and research aimed at providing quality and cost-effective end-of-life care in adult critical care.

Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey.

PubMed

Brinda, Ethel Mary; Andrés, Antonio Rodríguez; Andrés, Rodriguez Antonio; Enemark, Ulrika

2014-03-05

Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Increasing age, female gender, obesity and functional disability increased the adults' out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head's occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer's visits were significantly associated with high catastrophic health expenditures. We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health expenditures. We propose that investment in social welfare

Socioeconomic Disparities in Osteoporosis Prevalence: Different Results in the Overall Korean Adult Population and Single-person Households

PubMed Central

Kim, Jungmee; Lee, Joongyub; Shin, Ju-Young; Park, Byung-Joo

2015-01-01

Objectives: The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. Methods: A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ≥ 50 years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. Results: There were 8221 osteoporosis patients aged ≥ 50 years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p=0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). Conclusions: The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households. PMID:25857646

Dynamics of Adult Participation in Part-Time Education and Training: Results from the British Household Panel Survey

ERIC Educational Resources Information Center

Macleod, Flora; Lambe, Paul

2008-01-01

In this paper we analyse the dynamics of adult participation in part-time education and training throughout the 90s and into the 2000s using data from 14 waves (1992-2005) of the British Household Panel Survey (BHPS). We study the volume (stocks) of participation and non-participation and the gross flows between states. This analysis provides a…

Critical control points for foods prepared in households whose members had either alleged typhoid fever or diarrhea.

PubMed

Michanie, S; Bryan, F L; Alvarez, P; Olivo, A B; Paniagua, A

1988-10-01

Hazard analysis of food preparation practices were conducted in four households and eleven others were visited to survey both food preparation practices and environmental conditions. Households selected had members who were suffering from either diarrhea of unknown etiology or alleged typhoid fever. Hazard analyses and sanitary surveys included gathering data on time-temperature exposures of foods, collecting samples of food and drinking water, sampling sewage or drains, and obtaining stool specimens from persons with diarrhea and from family controls. Food samples were tested for aerobic mesophilic colony counts and common foodborne pathogens; specimens were tested for Salmonella, Shigella, Campylobacter and Yersinia. Campylobacter was isolated from two persons purported to have diarrhea, but neither Salmonella, Shigella nor Yersinia were recovered from alleged cases or controls. Salmonella agona was recovered from a latrine. Most foods were cooked to internal temperatures to or near to boiling. Those not promptly eaten were held at ambient room or outside temperatures until a subsequent meal, until a family member returned home, or until lunch time when taken to the fields. During these intervals, microorganisms multiplied and mesophilic aerobic organisms increased often reaching 10(8)/g or greater before consumption. None of these foods were reheated before eating. Bacillus cereus was isolated from 4 of 10 samples; one sample of 'moro' (beans and rice) exceeded 10(6)/g, two other samples exceeded 10(3)/g. Staphylococcus aureus was isolated from 7 of 14 samples, one exceeded 10(5)/g. Fecal coliforms were isolated from 8 of 14 food samples, five exceeded 10(5)/g. Neither Salmonella nor Shigella were isolated from any food, the community water supplies or from vessels of water within houses. Fecal coliform counts of water were less than 3/ml, except one sample from a clay vessel (9/ml). Risks associated with cooked foods which were not promptly eaten appeared to be

Living with an adult family member using advanced medical technology at home.

PubMed

Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

2011-12-01

Living with an adult family member using advanced medical technology at home An increased number of chronically ill adults perform self-care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults performing self-care at home, either using long-term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent-care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent-care and transition, which may have an influence on the self-care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context. © 2011 Blackwell Publishing Ltd.

Household Diversion of Prescription Stimulants: Medication Misuse by Parents of Children with Attention-Deficit/Hyperactivity Disorder.

PubMed

Pham, Tammy; Milanaik, Ruth; Kaplan, Alyson; Papaioannou, Helen; Adesman, Andrew

2017-10-01

The primary objective of this study is to investigate household diversion of stimulant medication. Secondary objectives are to examine clinical/demographic predictors of diversion, types of formulations diverted, exposure to household diversion in the media, and storage of prescription stimulants within households. Questionnaires were completed by 180 parents of youth who were currently taking stimulant medication for treatment of attention-deficit/hyperactivity disorder (ADHD). Parents were asked whether they or another adult in the home had ever taken their child's stimulant medication or given one child's stimulant medication to another child in the home. Additionally, data regarding demographics, parental ADHD (diagnosed or suspected), past suspicions of missing medication, and medication storage were also collected. Responses were compared using Pearson's chi-squared test with Yates' continuity correction. Sixteen percent of parents reported diversion of stimulant medication to another household member, with the majority admitting to taking the medication themselves. Another 13% had been tempted to illicitly self-administer their child's medication. Parents with suspected or diagnosed ADHD showed greater risk of self-administration or temptation to do so, compared to parents without (33% vs. 17%, p = 0.01). The majority of parents (71%) stored prescription stimulants "in plain sight," or "out of sight but available to all." Although previous research has focused on peer diversion among adolescents and young adults, clinicians must be vigilant for the possibility of diversion by parents of children treated with stimulant medication.

Emergency Food Supplies in Food Secure Households.

PubMed

Golem, Devon L; Byrd-Bredbenner, Carol

2015-08-01

Introduction Limited food supply paired with reduced access to food during emergency disasters can lead to malnutrition. To date, research evaluating the adequacy of household emergency food supplies relies on self-reported data from surveys and has not been measured objectively in households in the United States. The main objective of this study was to describe household calorie availability and nutrient density in a normal situation and to project changes that could occur when emergencies (eg, natural disasters) restrict replenishment of food supplies and disrupt water and/or energy needed for food preparation and storage. Hypothesis The calorie availability of the food supply within households in New Jersey (USA) is anticipated to be well above the recommended 3-day period. However, it is anticipated that the nutritional density of the food supply within these households will be negative. Additionally, the disaster-related factors that diminish the ability to consume stored food (eg, lack of water, power for cooking, and/or proper storage) will further reduce the caloric and nutritional adequacy of the household food supply. The household food supplies of 100 food secure families in New Jersey were inventoried at a non-emergency point in time. The number of days that the inventoried food supply would provide all household members 100% of the daily value (DV) for calories and other nutrients was determined. Additionally, the effects of water and power shortages on nutritional availability of household food supply were estimated. The households had an average of 33.16 days (SD=21.97; range=8.14-125.17 days) of calories at 100% DV for all household members. Lack of water, energy for cooking, or both would render a decrease in the total household calories by 28%, 35%, or 38%, respectively. Loss of power for greater than five days would reduce availability of household calories by 27%. A positive nutrient density was observed with and without the food

The Use of Household Cleaning Sprays and Adult Asthma

PubMed Central

Zock, Jan-Paul; Plana, Estel; Jarvis, Deborah; Antó, Josep M.; Kromhout, Hans; Kennedy, Susan M.; Künzli, Nino; Villani, Simona; Olivieri, Mario; Torén, Kjell; Radon, Katja; Sunyer, Jordi; Dahlman-Hoglund, Anna; Norbäck, Dan; Kogevinas, Manolis

2007-01-01

Rationale: Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied. Objectives: To investigate the risk of new-onset asthma in relation to the use of common household cleaners. Methods: Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis. Measurements and Main Results: The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [CI], 1.12−1.99) and wheeze (RR, 1.39; 95% CI, 1.06−1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% CI, 1.15−3.89). These associations were consistent for subgroups and not modified by atopy. Dose–response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma. Conclusions: Frequent use of common household cleaning sprays may be an important risk factor for adult asthma. PMID:17585104

Adolescent mothers leaving multigenerational households.

PubMed

Oberlander, Sarah E; Shebl, Fatma M; Magder, Laurence S; Black, Maureen M

2009-01-01

This study examined how the developmental processes of autonomy and relatedness are related to changes in the residential status of 181 first-time, adolescent, urban, low-income, African American mothers over the first 24 months postpartum. Although adolescent mothers were eager to live independently, few made a clear transition out of the multigenerational household; 56% lived in the household of origin continuously (IN), 21% left and never returned (OUT), and 23% had multiple moves in and out of the household (IN/OUT). Older adolescent maternal age, less supportive adolescent mother-grandmother relations, and high household density were associated with leaving the household of origin. The IN/OUT group had difficulty adopting the roles of adult and parent. Helping adolescent mothers and grandmothers negotiate roles to reduce conflict may promote autonomy and relatedness, allowing mothers to learn parenting skills, qualify for public assistance, and continue their education.

Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission.

PubMed

Waldram, Alison; Vivancos, Roberto; Hartley, Catherine; Lamden, Kenneth

2017-07-11

Giardia is a leading but neglected cause of infectious gastroenteritis worldwide and is treatable. There is a substantial burden of undetected Giardia in the UK and for every one case of Giardia reported to national surveillance there are 14 cases in the community. We aimed to ascertain the prevalence of, and risk factors associated with secondary household Giardia infections to assess the burden of infection and inform control measures. We identified all giardiasis cases notified in nine local authorities in Lancashire between June 2014 and June 2015, and invited their household contacts to submit faecal specimens for Giardia testing and complete a risk factor questionnaire. We estimated the proportion of households with additional Giardia infection. We compared household risk factors between households with and without additional Giardia using Fisher's exact test. We used multivariable logistic regression to identify independent risk factors for additional Giardia infections. We identified additional Giardia infections in 30% (27/91) of included households. A total of 41 infections were found from 212 household members, of which 37 were asymptomatic. The majority of infections were assemblage B (57%) but there were also a high number of mixed infections (20%). Risk factors significantly associated with additional household infections were; having children under 5 years in the household (odds ratio 42; 95% confidence intervals 10-178) and the presence of gastrointestinal illness in the household before the onset of the index case (odds ratio 9; 95% confidence intervals 1.5-48). Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing secondary cases and household clusters. We recommend the communication of this risk in household contacts of Giardia and reinforcement of

The determinant of household tourism expenditure in Central Java Province, Indonesia

NASA Astrophysics Data System (ADS)

Subanti, S.; Respatiwulan; Hakim, A. R.; Handajani, S. S.; Hakim, I. M.

2018-03-01

The purpose of our paper want to determine the factors of household tourism expenditure in Central Java Province, Indonesia. This paper used ordinary least squares regression. The findings from this paper, (1) the significant factors that affecting household tourism expenditure are marital status, sex, household income per capita, education for head of household, education for member of household, number of household, urbanrural, and industrial origin for head of household; (2) For variables which have positive relationship with household tourism expenditure, the variable of marital status has a biggest value from others; and (3) For variables which have negative relationship with household tourism expenditure, the variable of industrial origin for head household has a biggest value from others.

Narratives of family members on the suicide of older adults in an Amazonian metropolis.

PubMed

Costa, André Luis Sales da; Souza, Maximiliano Loiola Ponte de

2017-12-11

To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in Manaus, State of Amazonas, Brazil, where there is a low availability

Narratives of family members on the suicide of older adults in an Amazonian metropolis

PubMed Central

da Costa, André Luis Sales; de Souza, Maximiliano Loiola Ponte

2017-01-01

ABSTRACT OBJECTIVE To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. METHODS This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. RESULTS The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. CONCLUSIONS Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in Manaus, State of

Staphylococcus aureus infections: transmission within households and the community

PubMed Central

Knox, Justin; Uhlemann, Anne-Catrin; Lowy, Franklin D.

2015-01-01

Staphylococcus aureus , both methicillin susceptible and resistant, are now major community-based pathogens worldwide. The basis for this is multifactorial and includes the emergence of epidemic clones with enhanced virulence, antibiotic resistance, colonization potential, or transmissibility. Household reservoirs of these unique strains are crucial to their success as community-based pathogens. Staphylococci become resident in households, either as colonizers or environmental contaminants, increasing the risk for recurrent infections. Interactions of household members with others in different households or at community sites including schools and daycare facilities play a critical role in the ability of these strains to become endemic. Colonization density at these sites appears to play an important role in facilitating transmission. The integration of research tools including whole genome sequencing, mathematical modeling and social network analysis have provided additional insight into the transmission dynamics of these strains. Thus far, interventions designed to reduce recurrent infections among household members have had limited success, likely due to the multiplicity of potential sources for recolonization. The development of better strategies to reduce the number of household-based infections will depend on greater insight into the different factors that contribute to the success of these uniquely successful epidemic clones of S. aureus. PMID:25864883

Household Food Insecurity Is a Stronger Marker of Adequacy of Nutrient Intakes among Canadian Compared to American Youth and Adults.

PubMed

Kirkpatrick, Sharon I; Dodd, Kevin W; Parsons, Ruth; Ng, Carmina; Garriguet, Didier; Tarasuk, Valerie

2015-07-01

The most recent statistics indicate that the prevalence of food insecurity in the United States is double that in Canada, but the extent to which the nutrition implications of this problem differ between the countries is not known. This study was undertaken to compare adequacy of nutrient intakes in relation to household food insecurity among youth and adults in Canada and the United States. Data from comparable nationally representative surveys, the 2004 Canadian Community Health Survey and the 2003-2006 NHANES, were used to estimate prevalences of inadequate intakes of vitamins A and C, folate, calcium, magnesium, and zinc among youth and adults in food-secure and food-insecure households. Potential differences in the composition of the populations between the 2 countries were addressed by using standardization, and analyses also accounted for participation in food and nutrition assistance programs in the United States. Larger gaps in the prevalences of inadequate intakes between those in food-secure and food-insecure households were observed in Canada than in the United States for calcium and magnesium. For calcium, the prevalences of inadequate intakes among those in food-secure and food-insecure households in Canada were 50% and 66%, respectively, compared with 50% and 51%, respectively, in the United States. For magnesium, the prevalences of inadequate intakes in Canada were 39% and 60% among those in food-secure and food-insecure households, respectively, compared with 60% and 61%, respectively, in the United States. These findings were largely unchanged after we accounted for participation in food and nutrition assistance programs in the United States. This study suggests that household food insecurity is a stronger marker of nutritional vulnerability in Canada than in the United States. The results highlight the need for research to elucidate the effects of domestic policies affecting factors such as food prices and fortification on the nutritional

Determining Equity in Household's Health Care Payments in Hamedan Province, Iran.

PubMed

Rezapour, Aziz; Arabloo, Jalal; Tofighi, Shahram; Alipour, Vahid; Sepandy, Mojtaba; Mokhtari, Payam; Ghanbary, Abbas

2016-07-01

Financial protection of household against the consequences of the health care expenditures is one of the most important functions of health care systems. The objective of this study was to determine the equity in health care payments and determining factors among households in Hamedan, a province in Iran. In this cross-sectional study, 772 families of patients, who were being discharged from hospitals in Hamedan, were selected for study by using a stratified random sampling method. Required data regarding households' health and non-health expenditures were collected through World Health Organization standard questionnaire by interviews and observation method. According to the findings, 20.7% of households experienced catastrophic health expenditure. The incidence of impoverishment due to out-of-pocket payments for health care was 2.8% among studied households. The highest incidence rate of out-of-pocket health payment indices occurred in the first quintile (poorest or Q1). Variables such as having members under 6 years or over 60 years in household, household size, employment of household head, households' income quintile, existence of the disabled member in households and the education level of the household's head are the most important factors that affect the incidence of out-of-pocket health payment indices. There is considerable inequity in health care financing as well as households' health payments. This requires designing and implementing the operative and protective programs for understanding the important factors that affect equity in health financing, especially for poor households, against the unexpected health expenditures through the health care system.

Risk Factors for Self-Reported Cholera Within HIV-Affected Households in Rural Haiti

PubMed Central

Cheung, Hoi Ching; Meiselbach, Mark K; Jerome, Gregory; Ternier, Ralph; Ivers, Louise C

2018-01-01

Abstract Background Cholera continues to be a major cause of morbidity and mortality worldwide and is now endemic in Haiti since first being introduced in 2010. Cholera and HIV have significant geographic overlap globally, but little is known about the clinical features and risk of cholera among HIV-infected people and their households. Methods We assessed HIV-affected households originally recruited for a randomized controlled trial of food supplements. We assessed for correlation between household and individual factors and reported history of cholera since 2010 using univariable and multivariable analyses. Results There were 352 HIV-infected household members, 32 with reported history of medically attended cholera, and 1968 other household members, 55 with reported history of medically attended cholera. Among HIV-infected individuals in this study, no variables correlated with reported history of cholera in univariable analyses. Among all household members, known HIV infection (adjusted odds ratio [AOR], 3.75; 95% CI, 2.43–5.79; P < .0001), source of income in the household (AOR, 1.82; 95% CI, 1.05–3.15; P = .034), time required to fetch water (AOR, 1.07 per 5-minute increase; 95% CI, 1.01–1.12; P = .015), and severe household food insecurity (AOR, 3.23; 95% CI, 1.25–8.34; P = .016) were correlated with reported history of cholera in a multivariable analysis. Conclusions Known HIV infection, source of household income, time required to fetch water, and severe household food insecurity were independently associated with reported history of medically attended cholera in HIV-affected households in rural Haiti. Further research is required to better understand the interactions between HIV and cholera. PMID:29942825

Community awareness and predictors of uptake of pertussis booster vaccine in South Australian adults.

PubMed

Clarke, Michelle; Thomas, Natalie; Giles, Lynne; Marshall, Helen

2015-12-16

Pertussis is a highly virulent vaccine preventable disease that remains a global challenge. This study aimed to assess community knowledge of pertussis infection as well as awareness and uptake of adult pertussis booster vaccine. A cross-sectional survey was conducted of randomly selected households in South Australia by Computer Assisted Telephone Interviews in 2011. Survey data were weighted to the age, gender and geographical area profile of the population. From 3124 randomly sampled contactable households, 1967 interviews were conducted (participation rate 63%) with individuals aged 18-93 years, including 608 parents of children aged <18 years. The majority of respondents (97%) had heard of pertussis (whooping cough) and 18% reported that a household member had previously contracted whooping cough infection. Most respondents considered whooping cough to be highly contagious (73%) and severe for infants (89%). Over half (51%) of those surveyed were aware that family members commonly transmit pertussis to infants. Despite high knowledge, pertussis vaccine uptake was low, with only 10% of respondents reporting pertussis vaccination in the previous five years. Whilst 61% of respondents were aware of the availability of an adult pertussis booster vaccine, only 8% (n=154) reported their Family Physician had discussed it with them. If provided free, 77% agreed that they would be more likely to accept a booster pertussis vaccination. Independent predictors of recent pertussis vaccination included higher education, larger household size, perception of greater disease severity for infants and discussion with a Family Physician about pertussis vaccination. Whilst knowledge regarding transmission and severity of Bordetella pertussis was high, uptake of pertussis vaccination for adults is remarkably low amongst the South Australian community. Improved awareness regarding the availability of a booster pertussis vaccine through Family Physicians and/or provision of funded

Adult fat intake associated with the presence of children in households: findings from NHANES III.

PubMed

Laroche, Helena H; Hofer, Timothy P; Davis, Matthew M

2007-01-01

Increasing prevalence of obesity and lifestyle related chronic disease is fundamentally tied to Americans' poor eating habits. Family environment, including the presence of children, may affect adults' diet behavior. To compare dietary fat intake between adults with and without minor children in the home. Secondary analysis of cross-sectional survey data from the National Health and Nutrition Examination Survey III (NHANES III) public use dataset. Adults aged 17 to 65 years with and without children younger than 17 years old in the home. Intake of total fat, saturated fat, and kilocalories based on a 24-hour dietary recall and a selection of high-fat foods from a food frequency questionnaire. Linear and logistic regression, accounting for the sample weights and complex survey design. The presence of children in the household was associated with significantly higher adjusted total fat consumption for adults (4.9 g/24 hours [95% CI: 0.8, 9.1]) and significantly higher adjusted saturated fat consumption (1.7 g/24 hours [0.3, 3.3]). Adults with children ate many high-fat foods more frequently than adults without children, including salty snacks, pizza, cheese, beef, ice cream, cakes/cookies, bacon/sausage/processed meats, and peanuts. The presence of children in the home may affect adults' diets. Providers should emphasize dietary discretion for the entire family.

Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey

PubMed Central

Doubova, Svetlana V; Pérez-Cuevas, Ricardo; Canning, David; Reich, Michael R

2015-01-01

Objectives While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Setting Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). Participants The study population comprised 18 847 older adults and 13 180 households that have an elderly member. Outcome measures The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Results Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (−8.1%, t-stat −2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET −11.3%, t-stat −3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET −1.9%, t-stat −2.178). Conclusions Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant

Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey.

PubMed

Doubova, Svetlana V; Pérez-Cuevas, Ricardo; Canning, David; Reich, Michael R

2015-07-21

While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). The study population comprised 18,847 older adults and 13,180 households that have an elderly member. The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (-8.1%, t-stat -2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET -11.3%, t-stat -3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET -1.9%, t-stat -2.178). Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant protective effect against lack of access and catastrophic expenditures compared with

Improved employment and education outcomes in households of HIV-infected adults with high CD4 cell counts: evidence from a community health campaign in Uganda.

PubMed

Thirumurthy, Harsha; Chamie, Gabriel; Jain, Vivek; Kabami, Jane; Kwarisiima, Dalsone; Clark, Tamara D; Geng, Elvin; Petersen, Maya L; Charlebois, Edwin D; Kamya, Moses R; Havlir, Diane V

2013-02-20

There is limited evidence on the association between socioeconomic outcomes and CD4 counts in populations that include HIV-infected adults who have high CD4 counts or have not been diagnosed. We examined this association among adults in a rural Ugandan parish. A community health campaign offering diagnostic and treatment services for HIV and other diseases was conducted with Ministry of Health support. Data on campaign participants' education and employment were collected and a detailed household socioeconomic survey was conducted among a subset of participants. Regression analyses were used to assess relationships between CD4 count and employment and education outcomes. A total of 2323 adults (74% of the community) participated in the campaign; 179 of 2282 (7.8%) tested HIV-positive and 46% were newly diagnosed. Among HIV-infected adults not on antiretroviral therapy (ART), those with CD4 at least 500 worked 6.9 more days/month (P < 0.01; 39% more) and 2.5 more h per day (P < 0.05, 44% more) than those with CD4 less than 200. These effects were not significantly different from the effects for those with CD4 350-499. Children aged 6-11 years in households of adults with CD4 at least 350 did not have significantly different school enrollment rates than children in households of adults with CD4 less than 350, but differences were larger among children aged 12-18 years. Outcomes of HIV-infected adults with CD4 at least 350 were better than those of adults with CD4 less than 200 and resembled those of HIV-uninfected adults. The results suggest that early ART initiation may generate economic benefits by preventing a decline in socioeconomic status, but further research is needed to determine the CD4 threshold at which these benefits would be largest.

Spouse "Together Time": Quality Time within the Household

ERIC Educational Resources Information Center

Glorieux, Ignace; Minnen, Joeri; van Tienoven, Theun Pieter

2011-01-01

During the last decade more and more time-use data were gathered on a household level in stead of on an individual level. The time-use information of all members of the household provides much more insight in research fields that until now largely used data gathered at the individual level. One of these research fields is the study of quality of…

Preferences mapping of household biodigester in Bandung

NASA Astrophysics Data System (ADS)

Humaira, S.; Rianawati, E.; Sagala, S.; Sasongko, M. A.

2018-05-01

Bandung city government implemented household biodigester grants in 2015 and 2016. Unfortunately, there are some household biodigesters that still functioning well but not in use. Therefore, this study is an effort to improve the acceptance and usage rate of household biodigesters in Bandung. The purpose of this study is to know citizen’s preference when it comes to household biodigester. To get the picture, we conducted survey through online questionnaire based on eight dimension of quality defined by Garvin (1987) as basis to construct factors that might be favoured by current and potential users of household biodigesters. Based on result of cluster analysis, three clusters with different preferences were interpreted and profiled through Welch’s ANOVA and Games-Howell Test. This study reveals that the cluster with the largest number of members shows reliability and features as the key to determining current and potential user’s preference. This study suggests the developer of household biodigester to choose cluster 1 and prioritize the aspect of reliability and feature within the development of the next household biodigester product to get higher level of public acceptance.

Women's education level amplifies the effects of a livelihoods-based intervention on household wealth, child diet, and child growth in rural Nepal.

PubMed

Miller, Laurie C; Joshi, Neena; Lohani, Mahendra; Rogers, Beatrice; Mahato, Shubh; Ghosh, Shibani; Webb, Patrick

2017-10-18

diversity (p = .04), but not HAZ; higher education of any household member was associated only with household wealth (p < .0001). Moreover, households where the mother's education was better than the best-educated man also were significantly more likely to have children with better HAZ and dietary diversity (p = .03, p < .0001). Thus, the educational level of women and mothers had the broadest impact on child outcome variables. Household characteristics vary among participants in most community development projects. Of these, adult education likely mediates response to the inputs provided by the intervention. Particularly in interventions directed towards women, better education may enhance the ability of households to put interventions into practice, thus improving wealth, hygiene, and child diet and growth indices.

Clustering of physical inactivity in leisure, work, commuting and household domains among Brazilian adults.

PubMed

Del Duca, G F; Nahas, M V; de Sousa, T F; Mota, J; Hallal, P C; Peres, K G

2013-06-01

To identify the clustering of physical inactivity in leisure, work, commuting and household contexts, and the sociodemographic factors associated with the clustering of inactive behaviour in different domains among Brazilian adults. Cross-sectional population-based study. The study was performed in Florianopolis, capital of Santa Catarina, one of the southern states of Brazil, from September 2009 to January 2010. Adults aged 20-59 years were interviewed. Physical inactivity in each domain was defined as non-participation in specific physical activities, using a validated Brazilian questionnaire. Clustering of physical inactivity was identified by the ratio between observed prevalence and expected prevalence of 16 different combinations. Multinomial logistic regression was used in the analysis of sociodemographic factors associated with clustering of physical inactivity. Of the 1720 interviewees, the greatest differences between the observed and expected proportions were observed in simultaneous physical inactivity in the leisure and household domains for men, and physical inactivity in the leisure domain alone for women (59% and 88%, respectively); these differences were higher than expected if the behaviours were independent. Physical inactivity in two or more domains was observed more frequently in men and in individuals with a higher per-capita family income. Ageing was associated with physical inactivity in three or four domains. Physical inactivity was observed in different domains according to gender. Men and older individuals with a higher per-capita family income were more likely to exhibit physical inactivity when all domains were considered together. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Risk Factors for Anthroponotic Cutaneous Leishmaniasis at the Household Level in Kabul, Afghanistan

PubMed Central

Reithinger, Richard; Mohsen, Mohammad; Leslie, Toby

2010-01-01

Background Kabul, Afghanistan, is the largest focus of anthroponotic cutaneous leishmaniasis (ACL) in the world. ACL is a protozoan disease transmitted to humans by the bite of phlebotomine sand flies. Although not fatal, ACL can lead to considerable stigmatization of affected populations. Methods Using data from a standardized survey of 872 households in 4 wards of Kabul, Afghanistan, univariate and multivariate logistic regression analyses tested associations between presence of active ACL and ACL scars with 15 household-level variables. Findings Univariate analyses showed that active ACL was positively associated with household member's age, ACL prevalence, and brick wall type, but negatively associated with household number of rooms, bednet use, and proportion of windows with screens. Multivariate analysis showed a positive association between active ACL and household member's age, ACL prevalence, and brick wall type, and a negative association with household proportion of windows with screens. Conclusion Household-level charateristics were shown to be risk factors for ACL. Monitoring a selected number of household characteristics could assist in rapid assessments of household-level variation in risk of ACL. ACL prevention and control programs should consider improving house construction, including smoothing of walls and screening of windows. PMID:20351787

7 CFR 273.11 - Action on households with special circumstances.

Code of Federal Regulations, 2012 CFR

2012-01-01

... resources with the resource eligibility limits. (3) Ineligible alien. The State agency must determine the eligibility and benefit level of any remaining household members of a household containing an ineligible alien... pro rata share, of the ineligible alien's income and deductible expenses and all of the ineligible...

7 CFR 273.11 - Action on households with special circumstances.

Code of Federal Regulations, 2013 CFR

2013-01-01

... resources with the resource eligibility limits. (3) Ineligible alien. The State agency must determine the eligibility and benefit level of any remaining household members of a household containing an ineligible alien... pro rata share, of the ineligible alien's income and deductible expenses and all of the ineligible...

Perspectives of Mothers in Farmworker Households on Reducing the Take-Home Pathway of Pesticide Exposure

ERIC Educational Resources Information Center

Strong, Larkin L.; Starks, Helene E.; Meischke, Hendrika; Thompson, Beti

2009-01-01

Farmworkers carry pesticide residue home on their clothing, boots, and skin, placing other household members at risk, particularly children. Specific precautions are recommended to reduce this take-home pathway, yet few studies have examined the perspectives of farmworkers and other household members regarding these behaviors and the reasons for…

Sources affecting knowledge and behavior responses to the Zika virus in US households with current pregnancy, intended pregnancy and a high probability of unintended pregnancy.

PubMed

Chan, Man-Pui Sally; Farhadloo, Mohsen; Winneg, Kenneth; Jamieson, Kathleen Hall; Albarracin, Dolores

2018-06-01

This study examined the influences of information sources on Zika-relevant knowledge and behaviors in US households containing members who are pregnant, intend to become pregnant, or have a higher probability of unintended pregnancy in Zika-affected regions (i.e. respondents who are younger, are black, have less education, are unmarried, and reside in the southern USA). Over 22 000 US adults completed a survey measuring Zika-relevant knowledge and behaviors along with information sources (e.g. discussing Zika with practitioners), general media usage (e.g. TV) and demographic information over 30 weeks. Respondents in the group with (versus without) either pregnancy or intended pregnancy were more likely to use all information sources, which in turn created differences in knowledge and behavior responses. To gauge information sources in US-South respondents with a high probability of having a household member with unintended pregnancy based on demographics, younger, less-educated, unmarried, black respondents had fewer Zika discussion with practitioners than another group. Efforts to increase Zika-related knowledge and protective behaviors should target households with members who are pregnant or intending to become pregnant via practitioners, family and friends. Additional efforts should target information channels to reach younger, less educated, unmarried, black respondents, which are at risk for unintended pregnancy.

Variability in Intrahousehold Transmission of Ebola Virus, and Estimation of the Household Secondary Attack Rate.

PubMed

Glynn, Judith R; Bower, Hilary; Johnson, Sembia; Turay, Cecilia; Sesay, Daniel; Mansaray, Saidu H; Kamara, Osman; Kamara, Alie Joshua; Bangura, Mohammed S; Checchi, Francesco

2018-01-04

Transmission between family members accounts for most Ebola virus transmission, but little is known about determinants of intrahousehold spread. From detailed exposure histories, intrahousehold transmission chains were created for 94 households of Ebola survivors in Sierra Leone: 109 (co-)primary cases gave rise to 317 subsequent cases (0-100% of those exposed). Larger households were more likely to have subsequent cases, and the proportion of household members affected depended on individual and household-level factors. More transmissions occurred from older than from younger cases, and from those with more severe disease. The estimated household secondary attack rate was 18%. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease - Margibi County, Liberia: February-March 2015.

PubMed

Wilken, Jason A; Pordell, Paran; Goode, Brant; Jarteh, Rachel; Miller, Zayzay; Saygar, Benjamin G; Maximore, Leroy; Borbor, Watta M; Carmue, Moses; Walker, Gregory W; Yeiah, Adolphus

2017-12-01

. Nine of 16 (56%) reported that a household member had illnesses or injuries during quarantine; of these, all (100%) obtained care from a clinic, hospital, or Ebola treatment unit (ETU). Residents' knowledge of EVD transmission routes and incubation period were suboptimal. Public health authorities should consider assessing residents' understanding of Ebola transmission routes and effectively educate them to ensure correct understanding. Quarantined residents should be provided with sufficient food, water, and access to medical care. Wilken JA , Pordell P , Goode B , Jarteh R , Miller Z , Saygar BG Sr. , Maximore L , Borbor WM , Carmue M , Walker GW , Yeiah A . Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola Virus Disease - Margibi County, Liberia: February-March 2015. Prehosp Disaster Med. 2017;32(6):673-678.

Adherence to and outcome of isoniazid chemoprophylaxis among household contact children of adults having pulmonary tuberculosis in Alexandria, Egypt.

PubMed

Mohamed, Aida M

2012-08-01

Current international guidelines recommend 6-9 months of isoniazid (INH) preventive chemotherapy to prevent the development of active tuberculosis (TB) in susceptible children exposed to Mycobacterium tuberculosis. However, this is dependent on good adherence, as shown by previous studies. This study was conducted to describe the outcome of screening of contact children aged 5 years or less with household exposure to an adult pulmonary TB index case to determine the prevalence and possible risk factors of infection among contact children and to determine the extent and outcome of adherence of contact children to unsupervised INH chemoprophylaxis for 6 months. A descriptive facility-based cross-sectional study was conducted from March 2009 to August 2010. Research settings were three of the National TB control program chest dispensaries (primary care facilities) in Alexandria, Egypt. Facility-based TB treatment registers of the previous 3 months were used to identify all new adult pulmonary TB cases. All children aged 5 years or less living in the same house as the index cases were identified and screened for TB. The contact children were given unsupervised INH preventive chemotherapy once active TB was excluded. Adherence to and outcome of preventive chemotherapy were followed up. Preventive chemotherapy consisted of unsupervised INH monotherapy for 6 months with monthly collection of tablets from the clinic. Adherence was documented after completion of the 6-month preventive treatment period. Adherence was considered reasonable if tablets were collected for more than 4 months, poor if collected for 2-4 months, and very poor if collected for less than 2 months. (a) Prevalence of infection and disease and the possible risk factors among contacts. (b) The extent and outcome of adherence to unsupervised INH chemoprophylaxis among contact children. (c) Factors behind poor adherence. In total, 197 adult TB index cases from 187 households were identified. In all, 297

Family meals and body weight in US adults.

PubMed

Sobal, Jeffery; Hanson, Karla

2011-09-01

Family meals are an important ritual in contemporary societies and many studies have reported associations of family meals with several biopsychosocial outcomes among children and adolescents. However, few representative analyses of family meals have been conducted in samples of adults, and adults may differ from young people in predictors and outcomes of family meal consumption. We examined the prevalence and predictors of adult family meals and body weight outcomes. The cross-sectional 2009 Cornell National Social Survey (CNSS) included questions about the frequency of family meals, body weight as BMI and sociodemographic characteristics. The CNSS telephone survey used random digit dialling to sample individuals. We analysed data from 882 adults living with family members in a nationally representative US sample. Prevalence of family meals among these adults revealed that 53 % reported eating family meals seven or more times per week. Predictive results revealed that adults who more frequently ate family meals were more likely to be married and less likely to be employed full-time, year-round. Outcome results revealed that the overall frequency of family meals among adults was not significantly associated with any measure of body weight. However, interaction term analysis suggested an inverse association between frequency of family meals and BMI for adults with children in the household, and no association among adults without children. These findings suggest that family meals among adults are commonplace, associated with marital and work roles, and marginally associated with body weight only in households with children.

Men Want Equality, but Women Don't Expect It: Young Adults' Expectations for Participation in Household and Child Care Chores

ERIC Educational Resources Information Center

Askari, Sabrina F.; Liss, Miriam; Erchull, Mindy J.; Staebell, Samantha E.; Axelson, Sarah J.

2010-01-01

This study explored whether there was a discrepancy between young adults' ideal and expected participation in household and child care chores as well as what variables predicted expectations for future chore division. Three-hundred fifty-eight unmarried, heterosexual participants with no children completed an online questionnaire assessing the…

Household Transmission of Clostridium difficile to Family Members and Domestic Pets.

PubMed

Loo, Vivian G; Brassard, Paul; Miller, Mark A

2016-11-01

OBJECTIVE To determine the risk of Clostridium difficile transmission from index cases with C. difficile infection (CDI) to their household contacts and domestic pets. DESIGN A prospective study from April 2011 to June 2013. SETTING Patients with CDI from Canadian tertiary care centers. PARTICIPANTS Patients with CDI, their household human contacts, and pets. METHODS Epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. Pulsed-field gel electrophoresis (PFGE) was performed on C. difficile isolates. Probable transmission was defined as the conversion of a C. difficile culture-negative contact to C. difficile culture-positive contact with a PFGE pattern indistinguishable or closely related to the index case. Possible transmission was defined as a contact with a positive C. difficile culture at baseline with a strain indistinguishable or closely related to the index case. RESULTS A total of 51 patients with CDI participated in this study; 67 human contacts and 15 pet contacts were included. Overall, 9 human contacts (13.4%) were C. difficile culture positive; 1 contact (1.5%) developed CDI; and 8 contacts were asymptomatic. Of 67 human contacts, probable transmission occurred in 1 human contact (1.5%) and possible transmission occurred in 5 human contacts (7.5%). Of 15 pet contacts, probable transmission occurred in 3 (20%) and possible transmission occurred in 1 (6.7%). CONCLUSIONS There was a high proportion of C. difficile culture positivity at 13.4% among human contacts and asymptomatic carriage of domestic pets reached 26.7%. These results suggest that household transmission of C. difficile may be a source of community-associated cases. Infect Control Hosp Epidemiol 2016;1-7.

Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey.

PubMed

Hughes, Karen; Lowey, Helen; Quigg, Zara; Bellis, Mark A

2016-03-03

Individuals' childhood experiences can strongly influence their future health and well-being. Adverse childhood experiences (ACEs) such as abuse and dysfunctional home environments show strong cumulative relationships with physical and mental illness yet less is known about their effects on mental well-being in the general population. A nationally representative household survey of English adults (n = 3,885) measuring current mental well-being (Short Edinburgh-Warwick Mental Well-being Scale SWEMWBS) and life satisfaction and retrospective exposure to nine ACEs. Almost half of participants (46.4 %) had suffered at least one ACE and 8.3 % had suffered four or more. Adjusted odds ratios (AORs) for low life satisfaction and low mental well-being increased with the number of ACEs. AORs for low ratings of all individual SWEMWBS components also increased with ACE count, particularly never or rarely feeling close to others. Of individual ACEs, growing up in a household affected by mental illness and suffering sexual abuse had the most relationships with markers of mental well-being. Childhood adversity has a strong cumulative relationship with adult mental well-being. Comprehensive mental health strategies should incorporate interventions to prevent ACEs and moderate their impacts from the very earliest stages of life.

Tuberculosis attributed to household contacts in the Philippines.

PubMed

Sia, I G; Orillaza, R B; St Sauver, J L; Quelapio, I D; Lahr, B D; Alcañeses, R S; Wilson, W R; Cockerill, F R; Balane, G I; Mangubat, N V; Wengenack, N L; Tupasi, T E

2010-01-01

Data on the burden of disease from tuberculosis (TB) in Filipino households are limited. To determine the magnitude of undiagnosed TB in TB households, and the demographic and socio-economic factors associated with TB in the Philippines, household contacts of adult smear-positive TB patients seen from July 2001 to June 2003 were assessed based on interview, chest X-ray, tuberculin skin test and sputum examination. History of TB and older age were independently associated with TB disease, and age and duration of cohabitation with TB infection. TB and TB infection are highly prevalent in TB households in the Philippines.

The impact of rheumatoid arthritis on the household work performance of women.

PubMed

Allaire, S H; Meenan, R F; Anderson, J J

1991-06-01

We conducted a study to assess whether and to what degree household work disability exists in women with rheumatoid arthritis (RA) and to examine the role of health versus family and personal factors as predictors of household work disability. In addition, the participation of other family members and paid employees in household work was evaluated. One hundred forty-two women with RA and 58 female friends/neighbors completed questionnaires which assessed household work performance and health, family, and personal variables. Performance was measured in 4 ways: the current amount of time spent on household work, the proportion of the household work done, and the changes in time and proportion since just before the onset of RA. Functional status was measured via the Health Assessment Questionnaire. Pain, anxiety and depression, and general health perception were measured via the Arthritis Impact Measurement Scales. The results indicate that household work disability exists in women with RA, but is substantial only in women with moderate-to-severe disease. In families in which the wife/mother has moderate-to-severe RA, the other family members spend 7 hours more per week on household work than in control families, but there was no increase in the use of paid household employees. Health factors were the strongest predictors of household work disability, but family and personal factors also had significant effects. Household work disability in women with moderate or severe RA merits more attention because of the importance of household work to family functioning and the negative effects that changes in this area can produce.

Exposure reductions associated with introduction of solar lamps to kerosene lamp-using households in Busia County, Kenya.

PubMed

Lam, N L; Muhwezi, G; Isabirye, F; Harrison, K; Ruiz-Mercado, I; Amukoye, E; Mokaya, T; Wambua, M; Bates, M N

2018-03-01

Solar lamps are a clean and potentially cost-effective alternative to polluting kerosene lamps used by millions of families in developing countries. By how much solar lamps actually reduce exposure to pollutants, however, has not been examined. Twenty households using mainly kerosene for lighting were enrolled through a secondary school in Busia County, Kenya. Personal PM 2.5 and CO concentrations were measured on a school pupil and an adult in each household, before and after provision of 3 solar lamps. PM 2.5 concentrations were measured in main living areas, pupils' bedrooms, and kitchens. Usage sensors measured use of kerosene and solar lighting devices. Ninety percent of baseline kerosene lamp use was displaced at 1-month follow-up, corresponding to average PM 2.5 reductions of 61% and 79% in main living areas and pupils' bedrooms, respectively. Average 48-h exposure to PM 2.5 fell from 210 to 104 μg/m 3 (-50%) among adults, and from 132 to 35 μg/m 3 (-73%) among pupils. Solar lamps displaced most kerosene lamp use in at least the short term. If sustained, this could mitigate health impacts of household air pollution in some contexts. Achieving safe levels of exposure for all family members would likely require also addressing use of solid-fuel stoves. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Health, Enterprise, and Labor Complementarity in the Household*

PubMed Central

Adhvaryu, Achyuta; Nyshadham, Anant

2017-01-01

We study the role of household enterprise as a coping mechanism after health shocks. Using variation in the cost of traveling to formal sector health facilities to predict recovery from acute illness in Tanzania, we show that individuals with prolonged illness switch from farm labor to enterprise activity. This response occurs along both the extensive (entry) and intensive (capital stock and labor supply) margins. Family members who are not ill exhibit exactly the same pattern of responses. Deriving a simple extension to the canonical agricultural household model, we show that our results suggest complementarities in household labor. PMID:28943705

"Grandma, You Should Do It--It's Cool" Older Adults and the Role of Family Members in Their Acceptance of Technology.

PubMed

Luijkx, Katrien; Peek, Sebastiaan; Wouters, Eveline

2015-12-05

Despite its potential, the acceptance of technology to support the ability to live independently in one's own home, also called aging in place, is not optimal. Family members may play a key role in technology acceptance by older adults; however, it is not well understood why and how they exert influence. Based on open interviews with 53 community-dwelling older adults, this paper describes the influence of family members, including spouses, on the use of various types of consumer electronics by older adults as was reported by themselves. Such a broad focus enables understanding the use of technology as was reported by older adults, instead of its intended use. Our study reveals that the influence of each family member has its own characteristics. The influence of technology acceptance is a natural and coincidental part of the interaction with spouses and grandchildren in which entertainment and pleasure are prominent. This is also partly true for the influence of children, but their influence also is intentional and driven by concerns. Our study indicates the importance of including all family members when implementing technology in the lives of older adults. Besides information for children about the use(fullness) of devices, it is worthwhile to give grandchildren an important role, because older adults easily adopt their enthusiasm and it might eventually lighten the burden on children.

The Economic Burden of Road Traffic Injuries on Households in South Asia

PubMed Central

Alam, Khurshid; Mahal, Ajay

2016-01-01

Globally, road traffic injuries accounted for about 1.36 million deaths in 2015 and are projected to become the fourth leading cause of disability-adjusted life years (DALYs) lost by 2030. One-fifth of these deaths occurred in South Asia where road traffic injuries are projected to increase by 144% by 2020. Despite this rapidly increasing disease burden there is limited evidence on the economic burden of road traffic injuries on households in South Asia. We applied a novel coarsened exact matching method to assess the household economic burden of road traffic injuries using nationally representative World Health Survey data from five South Asian countries- Bangladesh, India, Nepal, Pakistan and Sri Lanka collected during 2002–2003. We examined the impact of road traffic injuries on household out-of-pocket (OOP) health spending, household non-medical consumption expenditure and the employment status of the traffic injury-affected respondent. We exactly matched a household (after ‘coarsening’) where a respondent reported being involved in a road traffic injury to households where the respondent did not report a road traffic injury on each of multiple observed household characteristics. Our analysis found that road traffic injury-affected households had significantly higher levels of OOP health spending per member (I$0.75, p<0.01), higher OOP spending on drugs per member (I$0.30, p = 0.03), and higher OOP hospital spending per member (I$0.29, p<0.01) in the four weeks preceding the survey. Indicators of “catastrophic spending” were also significantly higher in road traffic injury-affected households: 6.45% (p<0.01) for a threshold of OOP health spending to total household spending ratio of 20%, and 7.40% (p<0.01) for a threshold of OOP health spending to household ‘capacity to pay’ ratio of 40%. However, no statistically significant effects were observed for household non-medical consumption expenditure, and employment status of the road traffic injury

Helping older adults to help themselves: the role of mental health literacy in family members.

PubMed

White, Margaret; Casey, Leanne

2017-11-01

Family members may play an important role in the health and well-being of older adults. However, little is known about the factors that influence the likelihood of family members supporting older relatives to seek help from mental health professionals for mental health concerns. Mental health literacy is associated with people's help-seeking intentions regarding their own mental health concerns, and some studies have suggested it may play a role in help-seeking on behalf of others. The purpose of this study was to investigate whether mental health literacy is associated with adults' likelihood of supporting an older relative to seek professional help for mental health concerns. Two hundred and sixty-three participants completed a measure of mental health literacy and responded to a hypothetical scenario by indicating their likelihood of supporting an older relative experiencing mental health problems to seek help from various sources. Mental health literacy was positively associated with intentions to support older relative's help-seeking. Interventions to increase the mental health literacy of the relatives of older adults may lead to additional support for older adults' help-seeking for mental health concerns.

Economic costs of fever to households in the middle belt of Ghana.

PubMed

Tawiah, Theresa; Asante, Kwaku Poku; Dwommoh, Rebecca Akua; Kwarteng, Anthony; Gyaase, Stephaney; Mahama, Emmanuel; Abokyi, Livesy; Amenga-Etego, Seeba; Hansen, Kristian; Akweongo, Patricia; Owusu-Agyei, Seth

2016-02-06

Malaria is one of the main health problems in the sub-Saharan Africa accounting for approximately 198 million morbidity and close to 600,000 mortality cases. Households incur out-of-pocket expenditure for treatment and lose income as a result of not being able to work or care for family members. The main objective of this survey was to assess the economic cost of treating malaria and/or fever with the new ACT to households in the Kintampo districts of Ghana where a health and demographic surveillance systems (KHDSS) are set up to document population dynamics. The study was a cross-sectional survey conducted from October 2009 to July 2011 using community members' accessed using KHDSS population in the Kintampo area. An estimated sample size of 4226 was randomly selected from the active members of the KHDSS. A structured questionnaire was administered to the selected populates who reported of fever within the last 2 weeks prior to the visit. Data was collected on treatment-seeking behaviour, direct and indirect costs of malaria from the patient perspective. Of the 4226 households selected, 947 households with 1222 household members had fever out of which 92 % sought treatment outside home; 55 % of these were females. 31.6 % of these patients sought care from chemical shops. A mean amount of GHS 4.2 (US$2.76) and GHS 18.0 (US$11.84) were incurred by households as direct and indirect cost respectively. On average a household incurred a total cost of GHS 22.2 (US$14.61) per patient per episode. Total economic cost was lowest for those in the highest quintile and highest for those in the middle quintile. The total cost of treating fever/malaria episode is relatively high in the study area considering the poverty levels in Ghana. The NHIS has positively influenced health-seeking behaviours and reduced the financial burden of seeking care for those that are insured.

Demand for and utilization of dental services according to household income in the adult population in Norway.

PubMed

Grytten, Jostein; Holst, Dorthe; Skau, Irene

2012-08-01

The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population. The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents' household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year. Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment. Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater. © 2012 John Wiley & Sons A/S.

Household context and child mortality in rural South Africa: the effects of birth spacing, shared mortality, household composition and socio-economic status

PubMed Central

Houle, Brian; Stein, Alan; Kahn, Kathleen; Madhavan, Sangeetha; Collinson, Mark; Tollman, Stephen M; Clark, Samuel J

2013-01-01

Background Household characteristics are important influences on the risk of child death. However, little is known about this influence in HIV-endemic areas. We describe the effects of household characteristics on children’s risk of dying in rural South Africa. Methods We use data describing the mortality of children younger than 5 years living in the Agincourt health and socio-demographic surveillance system study population in rural northeast South Africa during the period 1994–2008. Using discrete time event history analysis we estimate children’s probability of dying by child characteristics and household composition (other children and adults other than parents) (N = 924 818 child-months), and household socio-economic status (N = 501 732 child-months). Results Children under 24 months of age whose subsequent sibling was born within 11 months experience increased odds of dying (OR 2.5; 95% CI 1.1–5.7). Children also experience increased odds of dying in the period 6 months (OR 2.1; 95% CI 1.2–3.6), 3–5 months (OR 3.0; 95% CI 1.5–5.9), and 2 months (OR 11.8; 95% CI 7.6–18.3) before another household child dies. The odds of dying remain high at the time of another child’s death (OR 11.7; 95% CI 6.3–21.7) and for the 2 months following (OR 4.0; 95% CI 1.9–8.6). Having a related but non-parent adult aged 20–59 years in the household reduces the odds (OR 0.6; 95% CI 0.5–0.8). There is an inverse relationship between a child’s odds of dying and household socio-economic status. Conclusions This detailed household profile from a poor rural setting where HIV infection is endemic indicates that children are at high risk of dying when another child is very ill or has recently died. Short birth intervals and additional children in the household are further risk factors. Presence of a related adult is protective, as is higher socio-economic status. Such evidence can inform primary health care practice and facilitate targeting of community health

Household context and child mortality in rural South Africa: the effects of birth spacing, shared mortality, household composition and socio-economic status.

PubMed

Houle, Brian; Stein, Alan; Kahn, Kathleen; Madhavan, Sangeetha; Collinson, Mark; Tollman, Stephen M; Clark, Samuel J

2013-10-01

Household characteristics are important influences on the risk of child death. However, little is known about this influence in HIV-endemic areas. We describe the effects of household characteristics on children's risk of dying in rural South Africa. We use data describing the mortality of children younger than 5 years living in the Agincourt health and socio-demographic surveillance system study population in rural northeast South Africa during the period 1994-2008. Using discrete time event history analysis we estimate children's probability of dying by child characteristics and household composition (other children and adults other than parents) (N=924,818 child-months), and household socio-economic status (N=501,732 child-months). Children under 24 months of age whose subsequent sibling was born within 11 months experience increased odds of dying (OR 2.5; 95% CI 1.1-5.7). Children also experience increased odds of dying in the period 6 months (OR 2.1; 95% CI 1.2-3.6), 3-5 months (OR 3.0; 95% CI 1.5-5.9), and 2 months (OR 11.8; 95% CI 7.6-18.3) before another household child dies. The odds of dying remain high at the time of another child's death (OR 11.7; 95% CI 6.3-21.7) and for the 2 months following (OR 4.0; 95% CI 1.9-8.6). Having a related but non-parent adult aged 20-59 years in the household reduces the odds (OR 0.6; 95% CI 0.5-0.8). There is an inverse relationship between a child's odds of dying and household socio-economic status. This detailed household profile from a poor rural setting where HIV infection is endemic indicates that children are at high risk of dying when another child is very ill or has recently died. Short birth intervals and additional children in the household are further risk factors. Presence of a related adult is protective, as is higher socio-economic status. Such evidence can inform primary health care practice and facilitate targeting of community health worker efforts, especially when covering defined catchment areas.

Precursors to overnutrition: the effects of household market food expenditures on measures of body composition among Tsimane' adults in lowland Bolivia.

PubMed

Rosinger, Asher; Tanner, Susan; Leonard, William R

2013-09-01

Nutrition transitions are characterized by shifts in diet and activity levels that lead to changes in weight and body fatness over a relatively short time. Research has linked these nutritional shifts to socio-economic factors, including wealth and income. However, few studies have examined household spending patterns on market foods among subsistence populations, which may reveal food access, choice, and indicate household nutritional environment. This paper examines the relation between household monetary expenditures on "market" foods and measures of body composition among Tsimane', a forager-horticulturalist indigenous group in the Bolivian Amazon. Economic and anthropometric surveys were conducted for adults (n = 1199) 16 years or older in 563 households in 40 Tsimane' villages in 2008. Results indicate that overweight status (19% of men and 24% of women) is more common than obesity (1% of men and 4% of women). Sixty-one percent (61%) of households reported purchasing market foods during the previous week. Multiple linear and logistic regressions suggest that men living in households in the top third of monetary expenditures on market foods had significantly higher BMI (0.69 kg/m(2); p = 0.027), weight (1.80 kg; p = 0.048), percent body fat (1.06%; p = 0.025), and probability of being overweight/obese (Odds ratio = 1.83; p = 0.042) than men in households that reported not spending money on market foods in the previous week. We discuss the possibility that the division of labor may help explain the differences between men and women in this sample. This research suggests household expenditures on market foods may mediate the relation between wealth and body composition. Copyright © 2013 Elsevier Ltd. All rights reserved.

Estimating household and community transmission of ocular Chlamydia trachomatis.

PubMed

Blake, Isobel M; Burton, Matthew J; Bailey, Robin L; Solomon, Anthony W; West, Sheila; Muñoz, Beatriz; Holland, Martin J; Mabey, David C W; Gambhir, Manoj; Basáñez, María-Gloria; Grassly, Nicholas C

2009-01-01

Community-wide administration of antibiotics is one arm of a four-pronged strategy in the global initiative to eliminate blindness due to trachoma. The potential impact of more efficient, targeted treatment of infected households depends on the relative contribution of community and household transmission of infection, which have not previously been estimated. A mathematical model of the household transmission of ocular Chlamydia trachomatis was fit to detailed demographic and prevalence data from four endemic populations in The Gambia and Tanzania. Maximum likelihood estimates of the household and community transmission coefficients were obtained. The estimated household transmission coefficient exceeded both the community transmission coefficient and the rate of clearance of infection by individuals in three of the four populations, allowing persistent transmission of infection within households. In all populations, individuals in larger households contributed more to the incidence of infection than those in smaller households. Transmission of ocular C. trachomatis infection within households is typically very efficient. Failure to treat all infected members of a household during mass administration of antibiotics is likely to result in rapid re-infection of that household, followed by more gradual spread across the community. The feasibility and effectiveness of household targeted strategies should be explored.

Household costs of hospitalized dengue illness in semi-rural Thailand

PubMed Central

Ratanawong, Pitcha; Sewe, Maquines Odhiambo; Wilder-Smith, Annelies; Kittayapong, Pattamaporn

2017-01-01

Background Dengue-related illness is a leading cause of hospitalization and death in Thailand and other Southeast Asian countries, imposing a major economic burden on households, health systems, and governments. This study aims to assess the economic impact of hospitalized dengue cases on households in Chachoengsao province in eastern Thailand. Methods We conducted a prospective cost-of-illness study of hospitalized pediatric and adult dengue patients at three public hospitals. We examined all hospitalized dengue cases regardless of disease severity. Patients or their legal guardians were interviewed using a standard questionnaire to determine household-level medical and non-medical expenditures and income losses during the illness episode. Results Between March and September 2015, we recruited a total of 224 hospitalized patients (<5 years, 4%; 5–14 years, 20%, 15–24 years, 36%, 25–34 years, 15%; 35–44 years, 10%; 45+ years, 12%), who were clinically diagnosed with dengue. The total cost of a hospitalized dengue case was higher for adult patients than pediatric patients, and was US$153.6 and US$166.3 for pediatric DF and DHF patients, respectively, and US$171.2 and US$226.1 for adult DF and DHF patients, respectively. The financial burden on households increased with the severity of dengue illness. Conclusions Although 74% of the households reported that the patient received free medical care, hospitalized dengue illness cost approximately 19–23% of the monthly household income. These results indicated that dengue imposed a substantial financial burden on households in Thailand where a great majority of the population was covered by the Universal Coverage Scheme for health care. PMID:28937986

Sources of household air pollution: The association with lung function and respiratory symptoms in middle-aged adult.

PubMed

Devien, Laurent; Giovannelli, Jonathan; Cuny, Damien; Matran, Régis; Amouyel, Philippe; Hulo, Sébastien; Edmé, Jean Louis; Dauchet, Luc

2018-07-01

The objective of the present study was to investigate the relationship between sources of household air pollution, respiratory symptoms and lung function. 3039 adults aged from 40 to 65 participated in the 2011-2013 ELISABET cross-sectional survey in northern France. Lung function was measured using spirometry. During a structured interview, respiratory symptoms, household fuels, exposure to moulds, and use of ventilation were recorded on a questionnaire. The self-reported presence of mould in at least two rooms (not including the bathroom and the kitchen) was associated with a 2.5% lower predicted forced expiratory volume in 1 s (95% confidence interval, -4.7 to -0.29; p-trend <0.05) and a higher risk of wheezing (p-trend < 0.001). Visible condensation was associated with wheezing (p < .05) and chronic cough (p < .05). There were no significant associations with the type of household fuel or inadequate ventilation/aeration. Similar results were found when the analyses were restricted to participants without known respiratory disease. Our results suggest that the presence of mould (known to be associated with more severe asthma symptoms) could also have an impact on respiratory symptoms and lung function in the general population and in populations without known respiratory disease. Copyright © 2018 Elsevier Inc. All rights reserved.

A Family-Based Diabetes Intervention for Hispanic Adults and Their Family Members

PubMed Central

Wallace, Debra; McCoy, Thomas; Amirehsani, Karen

2014-01-01

Aims The purpose of this quasi-experimental one group longitudinal study is to examine the effects of a family-based intervention program on diabetes self-management behaviors, HbA1c, other biomarkers, psychosocial factors and health-related quality of life in Hispanics with diabetes. Methods Adult patients with diabetes (n = 36) and family members (n = 37) were recruited from a community clinic in rural central North Carolina. Patients and family members attended an 8-week culturally tailored diabetes educational program taught in Spanish. Data was collected pre and post intervention for both patients and family members, with an additional data collection for patients 1 month post intervention. Results Most patients and family members were female and almost all were immigrants. HbA1c dropped by 0.41% on average among patients from pre-intervention to 1 month post intervention. Patients showed significant improvements in systolic blood pressure, diabetes self-efficacy diabetes knowledge, and physical and mental components of health-related quality of life. Higher levels of intake of healthy foods and performance of blood sugar tests and foot inspections were reported. Family members significantly lowered BMI and improved diabetes knowledge from pre- to immediate post-intervention. No significant changes in levels of physical activity were found among patients with diabetes or family members. Conclusions Findings suggest that including family members in educational interventions may provide emotional and psychological support to patients with diabetes, help to develop healthy family behaviors, and promote diabetes self-management. PMID:24248832

Family ties: the multilevel effects of households and kinship on the networks of individuals.

PubMed

Koster, Jeremy

2018-04-01

Among social mammals, humans uniquely organize themselves into communities of households that are centred around enduring, predominantly monogamous unions of men and women. As a consequence of this social organization, individuals maintain social relationships both within and across households, and potentially there is conflict among household members about which social ties to prioritize or de-emphasize. Extending the logic of structural balance theory, I predict that there will be considerable overlap in the social networks of individual household members, resulting in a pattern of group-level reciprocity. To test this prediction, I advance the Group-Structured Social Relations Model, a generalized linear mixed model that tests for group-level effects in the inter-household social networks of individuals. The empirical data stem from social support interviews conducted in a community of indigenous Nicaraguan horticulturalists, and model results show high group-level reciprocity among households. Although support networks are organized around kinship, covariates that test predictions of kin selection models do not receive strong support, potentially because most kin-directed altruism occurs within households, not between households. In addition, the models show that households with high genetic relatedness in part from children born to adulterous relationships are less likely to assist each other.

Household composition and psychological health: Results of the Second Diabetes Attitudes, Wishes and Needs (DAWN2) study.

PubMed

Joensen, Lene E; Willaing, Ingrid; Holt, Richard I G; Wens, Johan; Skovlund, Søren; Peyrot, Mark

2017-02-01

1) To explore the effect of household composition on the psychological health of adults with diabetes by comparing those living with other adult(s) including a partner with those living with neither partner nor other adult(s); 2) to examine potential mediation of social support in the association between household composition and psychological health. The study is part of the DAWN2 study conducted in 17 countries. The population comprised 8596 people with diabetes (PWD). Multiple regression models (linear and binary) were applied. People living with 'other adult(s) but no partner' experienced significantly lower well-being, higher diabetes distress and worried more frequently about hypoglycaemic events than those with a partner or those not co-habiting with another adult. However, participants living with 'other adult(s) but no partner' were more empowered compared to the other household composition groups. The association between household composition and psychological health was not mediated by diabetes-specific social support. The study indicates the psychological vulnerability of respondents living without a partner but with other adult(s). Appropriate support interventions must be developed and tested in order to enhance psychological health in people with diabetes living with other adults such as adult children, but with no partner. Copyright © 2017 Elsevier Inc. All rights reserved.

Food security and metabolic syndrome in U.S. adults and adolescents: findings from the National Health and Nutrition Examination Survey, 1999-2006.

PubMed

Parker, Emily D; Widome, Rachel; Nettleton, Jennifer A; Pereira, Mark A

2010-05-01

We sought to examine the association of food security and metabolic syndrome in a representative sample of U.S. adults and adolescents. We hypothesized that compared with those in food-secure households, adolescents and adults living in food-insecure households would have increased odds of (MetS). Data from the National Health and Nutrition Examination Surveys from 1999 to 2006 were combined and analyzed cross-sectionally. Logistic regression was used to compute odds ratios and 95% confidence intervals (95% CI) in the association of household food security (fully food secure, marginal, low, and very low food security) and MetS. Compared with those who were food secure, adults in households with marginal food security had 1.80-fold increased odds of MetS (95% CI, 1.30-2.49), and those with very low food security had a 1.65-fold increased odds of MetS (95% CI 1.12-2.42). There was no association with low food security. The association of marginal household food security and MetS was not significant in adolescents. In adults and adolescents, very low was food security not associated with increased odds of MetS compared with those who were food secure. Members of households with marginal and very low food security are at increased risk of MetS. A mechanism may be that foods that are inexpensive and easily accessible tend to be energy dense and nutrient poor. 2010 Elsevier Inc. All rights reserved.

Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China.

PubMed

Wang, Zhonghua; Li, Xiangjun; Chen, Mingsheng

2015-01-20

Although numerous studies examine catastrophic health expenditures (CHE) worldwide, most focus on whole populations rather than specific vulnerable groups. This study analyzes the extent, associated factors and inequality of CHE in elderly household with chronic disease patients in China. Data were obtained from a nationally representative elderly household survey-the China Health and Retirement Longitudinal Study-that was conducted by the National School of Development of Peking University in 2011. An elderly household with chronic disease patients is defined by ≥ 1 chronic disease patient who is ≥ 45 years of age. CHE was measured according to the proportion of out-of-pocket health payments to non-food household expenditures. The associated factors of CHE were estimated using ordinary least square and logistic regression modeling. CHE inequality was measured according to the concentration index (CI) and its decomposition. CHE incidence and intensity were relatively high among elderly households with chronic disease patients. The main associated factors of CHE include household size, having members > 65 years, having members with ≥ 2 chronic diseases, per capita income, and elderly household members demonstrating healthcare-seeking behaviors. Healthcare insurance did not significantly affect CHE risk. Disproportionate concentration of CHE was noted among elderly households, and poor elderly households demonstrated a higher probability of experiencing CHE. Factors such as household size, per capita income, having members > 65 years, and having members with ≥ 2 chronic diseases are major and positive contributors to CHE inequality. Some inpatient and outpatient services are negatively contributed to CHE inequality,suggesting that the unequal usage of such services reduces CHE inequality among elderly households with chronic disease patients. Policy efforts should focus on improving financial protection and relieving the economic

Innate and Adaptive Immune Responses during Acute M. tuberculosis Infection in Adult Household Contacts in Kampala, Uganda

PubMed Central

Mahan, C. Scott; Zalwango, Sarah; Thiel, Bonnie A.; Malone, LaShaunda L.; Chervenak, Keith A.; Baseke, Joy; Dobbs, Dennis; Stein, Catherine M.; Mayanja, Harriet; Joloba, Moses; Whalen, Christopher C.; Boom, W. Henry

2012-01-01

Contacts of active pulmonary tuberculosis (TB) patients are at risk for Mycobacterium tuberculosis (MTB) infection. Because most infections are controlled, studies during MTB infection provide insight into protective immunity. We compared immune responses of adult household contacts that did and did not convert the tuberculin skin test (TST). Innate and adaptive immune responses were measured by whole blood assay. Responses of TST converters (TSTC) were compared with persistently TST negative contacts (PTST–) and contacts who were TST+ at baseline (TST+). TLR-2, TLR-4, and IFN-γR responses to IFN-γ did not differ between the groups, nor did γδ T cell responses. T cell responses to MTB antigens differed markedly among TSTC, PTST–, and TST+ contacts. Thus, no differences in innate responses were found among the three household contact groups. However, adaptive T cell responses to MTB antigens did differ before and during MTB infection among PTST–, TSTC, and TST+ contacts. PMID:22492155

5 CFR 3201.106 - Employment of family members outside the Corporation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... matter if the employer of the employee's spouse, child, parent, brother, sister, or a member of the... employment of the employee's spouse, child, parent, brother, sister, or a member of the employee's household...

5 CFR 3201.106 - Employment of family members outside the Corporation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... matter if the employer of the employee's spouse, child, parent, brother, sister, or a member of the... employment of the employee's spouse, child, parent, brother, sister, or a member of the employee's household...

5 CFR 3201.106 - Employment of family members outside the Corporation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... matter if the employer of the employee's spouse, child, parent, brother, sister, or a member of the... employment of the employee's spouse, child, parent, brother, sister, or a member of the employee's household...

5 CFR 3201.106 - Employment of family members outside the Corporation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... matter if the employer of the employee's spouse, child, parent, brother, sister, or a member of the... employment of the employee's spouse, child, parent, brother, sister, or a member of the employee's household...

Extended Household Transitions, Race/Ethnicity, and Early Childhood Cognitive Outcomes*

PubMed Central

Mollborn, Stefanie; Fomby, Paula; Dennis, Jeff A.

2012-01-01

Beyond mothers’ union status transitions, other adults’ transitions into and out of the household contribute to family instability, particularly in early childhood. Using the Early Childhood Longitudinal Study-Birth Cohort (N≅8,550), this study examines associations between extended household transitions and age 2 cognitive development. A substantial minority of toddlers experiences these transitions, and their consequences vary by household member type, entry versus exit, and race/ethnicity. Extended household transitions predict lower cognitive scores for white children, but the selection of low-socioeconomic status families into extended households explains these disparities. Grandparent transitions predict significantly higher cognitive scores for African American and Latino children than whites, and some “other adult” transitions predict higher scores for Latinos than African Americans and whites. Extended household transitions’ consequences are independent of co-occurring residential moves and partner transitions. Findings suggest that studying extended household transitions is useful for understanding children’s early development, and their consequences vary by race/ethnicity. PMID:23017924

Recent trend in family households in Beijing.

PubMed

Guo, Z; Guo, L

1997-01-01

This study examined trends in household size and age structure in Beijing, China, in 1995. Data were reliably obtained from the 1% sample survey of China. Findings indicate that the average size of a family household was 3.15 persons, that is, 0.050 persons fewer than the 3.20 from the 1990 Census. Children aged 0-14 years in each household averaged 0.04 fewer children during 1990-95. 80% of the decline in household size was due to decreases in the number of children. The percentage of single-family and single-person households declined. Three-person households were the only size group that increased (23.2-40.7%). The household headship (HH) rate for males increased dramatically between the ages of 20 and 30 years and stabilized after 35 years. The HH rate for women grew slowly and continuously until age 50 years and then stabilized. The gender gap in HH appeared at an early age and remained thereafter. The HH rate declined at older ages. The HH rate in Beijing, compared to the national rate, suggests relative gender equity in Beijing. As a child ages, the percentage of three-generation households declines and the percentage of two-generation households rises. As a child becomes an adult, the percentages of single-person households and single-couple households increase. Single-couple households decreased among the middle-aged. 67.4% of the elderly lived in two- or three-generation households. 31.4% of elderly lived in single-person/couple households. The percentage of elderly living with their children declined by 2 points during 1990-95.

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

PubMed

Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

2015-01-01

To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.

Age- and Sex-Specific Relationships between Household Income, Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010

PubMed Central

Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

2015-01-01

Background To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Methods Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. Results The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. Conclusions We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations. PMID:25622031

45 CFR 286.90 - How many hours per week must an adult or minor head-of-household participate in work-related...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false How many hours per week must an adult or minor head-of-household participate in work-related activities to count in the numerator of the work... SERVICES TRIBAL TANF PROVISIONS Tribal TANF Plan Content and Processing § 286.90 How many hours per week...

Seroprevalence of SARS coronavirus antibody in household contacts.

PubMed Central

Lee, C-C; Chen, S-Y; Chang, I-J; Tsai, P-C; Lu, T-C; Wu, P-L; Chen, W-J; Huang, L-M; Chang, S-C

2005-01-01

Between March and July 2003, 671 cases of severe acute respiratory syndrome (SARS) were diagnosed in Taiwan with a total of 84 fatalities. After the epidemic, a serological survey was conducted involving the asymptomatic household contacts. Household contacts of 13 index patients were enrolled in the study. Contact history and clinical symptoms of the household contacts were recorded by standardized questionnaires. Blood samples of patients and household contacts were collected at least 28 days after symptom onset in the index patients or household exposure in the contacts for SARS-associated coronavirus (SARS-CoV) IgG testing. On the basis of this investigation, 29 persons (25 adults and 4 children) were identified as having had unprotected exposure to the index cases before infection-control practices were implemented. Laboratory evaluation of clinical specimens showed no evidence of transmission of SARS-CoV infection to any contacts. This investigation demonstrated that subclinical transmission among household contacts was low in the described setting. PMID:16274510

Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

PubMed Central

2014-01-01

Background Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. Methods We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Results Increasing age, female gender, obesity and functional disability increased the adults’ out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head’s occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer’s visits were significantly associated with high catastrophic health expenditures. Conclusion We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health

Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study

PubMed Central

Heinsbroek, Ellen; Tafatatha, Terence; Chisambo, Christina; Phiri, Amos; Mwiba, Oddie; Ngwira, Bagrey; Crampin, Amelia C.; Read, Jonathan M.; French, Neil

2016-01-01

The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than in adults who are not. We hypothesized that infants exposed to HIV become carriers of nasopharyngeal pneumococcus earlier and more frequently than infants who are not exposed to HIV. We compared infant pneumococcal acquisition by maternal HIV status and household exposure in Karonga District, Malawi, in 2009–2011, before the introduction of pneumococcal conjugate vaccine. Nasopharyngeal swabs were collected every 4–6 weeks in the first year of life from infants with known HIV-exposure status, their mothers, and other household members. We studied infant pneumococcal acquisition by maternal HIV status, serotype-specific household exposure, and other risk factors, including seasonality. We recruited 54 infants who were exposed to HIV and 131 infants who were not. There was no significant difference in pneumococcal acquisition by maternal HIV status (adjusted rate ratio (aRR) = 1.00, 95% confidence interval (CI): 0.87, 1.15). Carriage by the mother was associated with greater acquisition of the same serotype (aRR = 3.09, 95% CI: 1.47, 6.50), but the adjusted population attributable fraction was negligible (1.9%, 95% CI: 0.0, 4.3). Serotype-specific exposure to children under 5 years of age was associated with higher acquisition (aRR = 4.30, 95% CI: 2.80, 6.60; adjusted population attributable fraction = 8.8%, 95% CI: 4.0, 13.4). We found no evidence to suggest that maternal HIV infection would affect the impact of pneumococcal vaccination on colonization in this population. PMID:26628514

Zika virus infection in Nicaraguan households.

PubMed

Burger-Calderon, Raquel; Gonzalez, Karla; Ojeda, Sergio; Zambrana, José Victor; Sanchez, Nery; Cerpas Cruz, Cristhiam; Suazo Laguna, Harold; Bustos, Fausto; Plazaola, Miguel; Lopez Mercado, Brenda; Elizondo, Douglas; Arguello, Sonia; Carey Monterrey, Jairo; Nuñez, Andrea; Coloma, Josefina; Waggoner, Jesse J; Gordon, Aubree; Kuan, Guillermina; Balmaseda, Angel; Harris, Eva

2018-05-01

Zika virus (ZIKV) infection recently caused major epidemics in the Americas and is linked to congenital birth defects and Guillain-Barré Syndrome. A pilot study of ZIKV infection in Nicaraguan households was conducted from August 31 to October 21, 2016, in Managua, Nicaragua. We enrolled 33 laboratory-confirmed Zika index cases and their household members (109 contacts) and followed them on days 3-4, 6-7, 9-10, and 21, collecting serum/plasma, urine, and saliva specimens along with clinical, demographic, and socio-economic status information. Collected samples were processed by rRT-PCR to determine viral load (VL) and duration of detectable ZIKV RNA in human bodily fluids. At enrollment, 11 (10%) contacts were ZIKV rRT-PCR-positive and 23 (21%) were positive by IgM antibodies; 3 incident cases were detected during the study period. Twenty of 33 (61%) index households had contacts with ZIKV infection, with an average of 1.9 (range 1-6) positive contacts per household, and in 60% of these households, ≥50% of the members were positive for ZIKV infection. Analysis of clinical information allowed us to estimate the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts, finding 62% of the infections to be asymptomatic. The maximum number of days during which ZIKV RNA was detected was 7 days post-symptom onset in saliva and serum/plasma and 22 days in urine. Overall, VL levels in serum/plasma, saliva, and urine specimens were comparable, with means of 5.6, 5.3 and 4.5 log10 copies/ml respectively, with serum attaining the highest VL peak at 8.1 log10 copies/ml. Detecting ZIKV RNA in saliva over a similar time-period and level as in serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Finding the majority of infections to be asymptomatic emphasizes the importance of silent ZIKV transmission and helps inform public health interventions in the region and globally.

“Grandma, You Should Do It—It’s Cool” Older Adults and the Role of Family Members in Their Acceptance of Technology

PubMed Central

Luijkx, Katrien; Peek, Sebastiaan; Wouters, Eveline

2015-01-01

Despite its potential, the acceptance of technology to support the ability to live independently in one’s own home, also called aging in place, is not optimal. Family members may play a key role in technology acceptance by older adults; however, it is not well understood why and how they exert influence. Based on open interviews with 53 community-dwelling older adults, this paper describes the influence of family members, including spouses, on the use of various types of consumer electronics by older adults as was reported by themselves. Such a broad focus enables understanding the use of technology as was reported by older adults, instead of its intended use. Our study reveals that the influence of each family member has its own characteristics. The influence of technology acceptance is a natural and coincidental part of the interaction with spouses and grandchildren in which entertainment and pleasure are prominent. This is also partly true for the influence of children, but their influence also is intentional and driven by concerns. Our study indicates the importance of including all family members when implementing technology in the lives of older adults. Besides information for children about the use(fullness) of devices, it is worthwhile to give grandchildren an important role, because older adults easily adopt their enthusiasm and it might eventually lighten the burden on children. PMID:26690188

Chlorination of Household Drinking Water Among Cholera Patients' Households to Prevent Transmission of Toxigenic Vibrio cholerae in Dhaka, Bangladesh: CHoBI7 Trial.

PubMed

Rashid, Mahamud-Ur; George, Christine Marie; Monira, Shirajum; Mahmud, Toslim; Rahman, Zillur; Mustafiz, Munshi; Saif-Ur-Rahman, K M; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Biswas, Shwapon Kumar; Akhter, Shamima; Zhang, Xiaotong; Sack, David; Sack, R Bradley; Alam, Munirul

2016-12-07

Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka, Bangladesh. In laboratory experiments, we found that the concentrations of free chlorine required to inactivate 10 5 colony-forming units (CFU)/mL of V. cholerae serogroups O1 and O139 were 0.1 mg/L and 0.2 mg/L, respectively. The concentration of free chlorine generated by a single chlorine tablet (sodium dichloroisocyanurate [33 mg]) after a 30-minute reaction time in a 10-L sealed vessel containing Dhaka city municipal supply water was 1.8 mg/L; and the concentration declined to 0.26 mg/L after 24 hours. In field measurements, water collected from 165 households enrolled in a randomized controlled trial (RCT) of a chlorine and handwashing with soap intervention (Cholera-Hospital-Based-Intervention-for-7-Days [CHoBI7]), we observed significantly higher free chlorine concentrations in the 82 intervention arm households (mean = 1.12 mg/L, standard deviation [SD] = 0.52, range = 0.07-2.6 mg/L) compared with the 83 control households (0.017 mg/L, SD = 0.01, range = 0-0.06 mg/L) (P < 0.001) during spot check visits. These findings suggest that point-of-use chlorine tablets present an effective approach to inactivate V. cholerae from drinking water in households of cholera patients in Dhaka city. This result is consistent with the findings from the RCT of CHoBI7 which found that this intervention led to a significant reduction in symptomatic cholera infections among household members of cholera patients and no stored drinking water samples with detectable V. cholerae. © The American Society of Tropical Medicine and Hygiene.

Chlorination of Household Drinking Water among Cholera Patients' Households to Prevent Transmission of Toxigenic Vibrio cholerae in Dhaka, Bangladesh: CHoBI7 Trial

PubMed Central

Rashid, Mahamud-ur; George, Christine Marie; Monira, Shirajum; Mahmud, Toslim; Rahman, Zillur; Mustafiz, Munshi; Saif-Ur-Rahman, K. M.; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Biswas, Shwapon Kumar; Akhter, Shamima; Zhang, Xiaotong; Sack, David; Sack, R. Bradley; Alam, Munirul

2016-01-01

Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka, Bangladesh. In laboratory experiments, we found that the concentrations of free chlorine required to inactivate 105 colony-forming units (CFU)/mL of V. cholerae serogroups O1 and O139 were 0.1 mg/L and 0.2 mg/L, respectively. The concentration of free chlorine generated by a single chlorine tablet (sodium dichloroisocyanurate [33 mg]) after a 30-minute reaction time in a 10-L sealed vessel containing Dhaka city municipal supply water was 1.8 mg/L; and the concentration declined to 0.26 mg/L after 24 hours. In field measurements, water collected from 165 households enrolled in a randomized controlled trial (RCT) of a chlorine and handwashing with soap intervention (Cholera-Hospital-Based-Intervention-for-7-Days[CHoBI7]), we observed significantly higher free chlorine concentrations in the 82 intervention arm households (mean = 1.12 mg/L, standard deviation [SD] = 0.52, range = 0.07–2.6 mg/L) compared with the 83 control households (0.017 mg/L, SD = 0.01, range = 0–0.06 mg/L) (P < 0.001) during spot check visits. These findings suggest that point-of-use chlorine tablets present an effective approach to inactivate V. cholerae from drinking water in households of cholera patients in Dhaka city. This result is consistent with the findings from the RCT of CHoBI7 which found that this intervention led to a significant reduction in symptomatic cholera infections among household members of cholera patients and no stored drinking water samples with detectable V. cholerae. PMID:27698273

Intra-Household Allocation of Nutrients in an Opening China.

PubMed

Zhou, Li; Chen, Xiaohong; Lei, Lei

2018-04-09

This paper uses China Health and Nutrition Survey (CHNS) data to analyze the effect of foreign direct investment (FDI) on nutrient intakes across various family roles to identify the different family roles' heterogeneous nutrition intake responses to economic openness. The empirical evidence shows that FDI enhances labor forces' calorie intake significantly, especially for rural households. The government should continue facilitating more FDI inflows, especially FDI in secondary industries for rural populations. However, the larger the family, the smaller the effect of FDI on nutrient intake for some family roles. The elderly and children may be weaker responders on nutrient intake than other family members in an open economy. This implies the existence of intra-household redistribution and that the level of effectiveness will decrease with family size. The results suggest that family members in rural areas can benefit more in terms of nutrient intake. Our empirical evidence also indicates that female family members' calorie intake from the FDI effect is higher than that of male family members (except for the granddaughter/grandson). Preferential policies should be provided for the FDI, flowing to rural areas and female dominant industries.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias.

PubMed

Sharkey, Joseph R; Dean, Wesley R; Nalty, Courtney C; Xu, Jin

2013-01-17

Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability. Although household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults.

A Household-Based Study of Contact Networks Relevant for the Spread of Infectious Diseases in the Highlands of Peru

PubMed Central

Grijalva, Carlos G.; Goeyvaerts, Nele; Verastegui, Hector; Edwards, Kathryn M.; Gil, Ana I.; Lanata, Claudio F.; Hens, Niel

2015-01-01

Background Few studies have quantified social mixing in remote rural areas of developing countries, where the burden of infectious diseases is usually the highest. Understanding social mixing patterns in those settings is crucial to inform the implementation of strategies for disease prevention and control. We characterized contact and social mixing patterns in rural communities of the Peruvian highlands. Methods and Findings This cross-sectional study was nested in a large prospective household-based study of respiratory infections conducted in the province of San Marcos, Cajamarca-Peru. Members of study households were interviewed using a structured questionnaire of social contacts (conversation or physical interaction) experienced during the last 24 hours. We identified 9015 reported contacts from 588 study household members. The median age of respondents was 17 years (interquartile range [IQR] 4–34 years). The median number of reported contacts was 12 (IQR 8–20) whereas the median number of physical (i.e. skin-to-skin) contacts was 8.5 (IQR 5–14). Study participants had contacts mostly with people of similar age, and with their offspring or parents. The number of reported contacts was mainly determined by the participants’ age, household size and occupation. School-aged children had more contacts than other age groups. Within-household reciprocity of contacts reporting declined with household size (range 70%-100%). Ninety percent of household contact networks were complete, and furthermore, household members' contacts with non-household members showed significant overlap (range 33%-86%), indicating a high degree of contact clustering. A two-level mixing epidemic model was simulated to compare within-household mixing based on observed contact networks and within-household random mixing. No differences in the size or duration of the simulated epidemics were revealed. Conclusion This study of rural low-density communities in the highlands of Peru suggests

Adults and Children in Low-Income Households that Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption.

PubMed

Hanson, Karla L; Kolodinsky, Jane; Wang, Weiwei; Morgan, Emily H; Pitts, Stephanie B Jilcott; Ammerman, Alice S; Sitaker, Marilyn; Seguin, Rebecca A

2017-07-08

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 ( n = 41) and February 2016 ( n = 23). FVI was measured by the National Cancer Institute's (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t -tests ( p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes.

Adults and Children in Low-Income Households That Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption

PubMed Central

Hanson, Karla L.; Kolodinsky, Jane; Wang, Weiwei; Morgan, Emily H.; Jilcott Pitts, Stephanie B.; Ammerman, Alice S.; Sitaker, Marilyn; Seguin, Rebecca A.

2017-01-01

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2–12 y in a summer CO-CSA were surveyed online twice: August 2015 (n = 41) and February 2016 (n = 23). FVI was measured by the National Cancer Institute’s (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t-tests (p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes. PMID:28698460

Transmission of respiratory and gastrointestinal infections in German households with children attending child care.

PubMed

Schlinkmann, K M; Bakuli, A; Karch, A; Meyer, F; Dreesman, J; Monazahian, M; Mikolajczyk, R

2018-04-01

Transmission of acute respiratory infections (ARI) and acute gastroenteritis (AGE) often occurs in households. The aim of this study was to assess which proportion of ARI and AGE is introduced and transmitted by children in German households with children attending child care. We recruited families with children aged 0-6 years in Braunschweig (Germany), for a 4 months prospective cohort study in the winter period 2014/2015. Every household member was included in a health diary and used nasal swabs for pathogen identification in case of ARI. We defined a transmission if two persons had overlapping periods with symptoms and used additional definitions for sensitivity analyses. In total, 77 households participated with 282 persons. We observed 277 transmission events for ARI and 23 for AGE. In most cases, the first infected person in a household was a child (ARI: 63%, AGE: 53%), and the risk of within-household transmission was two times higher when the index case was a child. In 26 ARI-transmission events, pathogens were detected for both cases; hereof in 35% (95% confidence interval (17-56%)) the pathogens were different. Thus, symptomatic infections in household members, apparently linked in time, were in 2/3 associated with the same pathogens.

Household Task Participation of Children with and without Attentional Problems

ERIC Educational Resources Information Center

Dunn, Louise; Coster, Wendy J.; Orsmond, Gael I.; Cohn, Ellen S.

2009-01-01

Children with attention deficit/hyperactivity disorder (ADHD) often demonstrate problems in their participation in family occupations, such as household tasks, due to their needs for assistance and their behavior. Because participation in household tasks is part of family life and may be one way that families prepare children for adult roles, it…

Road traffic injuries in Baghdad from 2003 to 2014: results of a randomised household cluster survey.

PubMed

Stewart, Barclay T; Lafta, Riyadh; Cherewick, Megan; Esa Al Shatari, Sahar A; Flaxman, Abraham D; Hagopian, Amy; Galway, Lindsay P; Takaro, Tim K; Burnham, Gilbert; Kushner, Adam L; Mock, Charles

2016-10-01

Around 50 million people are killed or left disabled on the world's roads each year; most are in middle-income cities. In addition to this background risk, Baghdad has been plagued by decades of insecurity that undermine injury prevention strategies. This study aimed to determine death and disability and household consequences of road traffic injuries (RTIs) in postinvasion Baghdad. A two-stage, cluster-randomised, community-based household survey was performed in May 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding crash specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Nine hundred households, totalling 5148 individuals, were interviewed. There were 86 RTIs (16% of all reported injuries) that resulted in 8 deaths (9% of RTIs). Serious RTIs increased in the decade postinvasion and were estimated to be 26 341 in 2013 (350 per 100 000 persons). 53% of RTIs involved pedestrians, motorcyclists or bicyclists. 51% of families directly affected by a RTI reported a significant decline in household income or suffered food insecurity. RTIs were extremely common and have increased in Baghdad. Young adults, pedestrians, motorcyclists and bicyclists were the most frequently injured or killed by RTCs. There is a large burden of road injury, and the families of road injury victims suffered considerably from lost wages, often resulting in household food insecurity. Ongoing conflict may worsen RTI risk and undermine efforts to reduce road traffic death and disability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Experiences of adults with high-care needs and their family members with housing and support pathways in Australia.

PubMed

McIntyre, Deborah; Fleming, Jennifer; Foster, Michele; Tweedy, Sean

2017-09-01

Many adults aged less than 65 years with high-care needs resulting from acquired disabilities are unable to access age-appropriate housing and support, and reside in residential aged care or live with family members who may struggle to navigate the disability support system. This qualitative study aimed to investigate the experiences of adults with high-care needs and their family members regarding pathways related to housing and support. Two in-depth semi-structured interviews were conducted six months apart with 21 people aged 18 to 65 with high-care needs of varying etiology and living in different housing settings. Nineteen family members involved in decision-making about housing and supports were also interviewed. Thematic data analysis yielded five themes: (1) Traveling in different directions; (2) "the fight, the battle and the war"; (3) willing but wanting; (4) uncertainty and vulnerability; and (5) redefining social roles and relationships. Current disability policy is not satisfying the housing and support requirements of adults with high-care needs and their families. The findings provide rigorous, empirical evidence which indicate the urgent need to improve access to affordable, individualized housing and support packages, including financial, practical and informational support for family members involved in caring roles. Implications for Rehabilitation Individual preferences are an important consideration in housing and support arrangements for younger people with high-care needs alongside needs-based solutions. Individualized funding approaches may provide flexibility of care and choice in housing and support for people with disability. Family members willingly provide substantial informal care, support and advocacy for younger people with high needs but perceive their role as a constant "battle". Payment of family members in recognition of caring work was perceived as a solution to relieve family hardship and ensure optimal care.

Consumption and sources of dietary salt in family members in Beijing.

PubMed

Zhao, Fang; Zhang, Puhong; Zhang, Lu; Niu, Wenyi; Gao, Jianmei; Lu, Lixin; Liu, Caixia; Gao, Xian

2015-04-10

In China, few people are aware of the amount and source of their salt intake. We conducted a survey to investigate the consumption and sources of dietary salt using the "one-week salt estimation method" by weighing cooking salt and major salt-containing food, and estimating salt intake during dining out based on established evidence. Nine hundred and three families (1981 adults and 971 children) with students in eight primary or junior high schools in urban and suburban Beijing were recruited. On average, the daily dietary salt intake of family members in Beijing was 11.0 (standard deviation: 6.2) g for children and adolescents (under 18 years old), 15.2 (9.1) g for adults (18 to 59 years old), and 10.2 (4.8) g for senior citizens (60 years old and over), respectively. Overall, 60.5% of dietary salt was consumed at home, and 39.5% consumed outside the home. Approximately 90% of the salt intake came from cooking (household cooking and cafeteria or restaurant cooking), while less than 10% came from processed food. In conclusion, the dietary salt intake in Beijing families far surpassed the recommended amounts by World Health Organization, with both household cooking and dining-out as main sources of salt consumption. More targeted interventions, especially education about major sources of salt and corresponding methods for salt reduction should be taken to reduce the risks associated with a high salt diet.

Violence toward a family member, angry adult conflict, and child adjustment difficulties: relations in families with 1- to 3-year-old children.

PubMed

McDonald, Renee; Jouriles, Ernest N; Briggs-Gowan, Margaret J; Rosenfield, David; Carter, Alice S

2007-06-01

In this study, the authors examined whether witnessing violence toward a family member increases the risk for adjustment difficulties among children in the 1- to 3-year age range, beyond the risk attributable to witnessing nonviolent, angry adult conflict. Participants were 1,152 caregivers of 1- to 3-year-old children, randomly selected from birth records and recruited from the community. Caregivers indicated whether their children had witnessed violence toward a family member and/or angry adult conflict. They also completed a comprehensive measure of child adjustment difficulties. Exposure to violence toward a family member and exposure to angry adult conflict were each uniquely associated with increased risk for adjustment problems. These results emerged after accounting for pertinent demographic variables and for caregiver distress variables.

Age and gender differences in correlations of leisure-time, household, and work-related physical activity with physical performance in older Japanese adults.

PubMed

Tsunoda, Kenji; Soma, Yuki; Kitano, Naruki; Tsuji, Taishi; Mitsuishi, Yasuhiro; Yoon, Ji-Yeong; Okura, Tomohiro

2013-10-01

This study aimed to compare relationships of leisure-time, household, and work-related physical activity (PA) with physical performance by age and gender in older Japanese adults. This cross-sectional study included 525 community-dwelling older adults (73.3 ± 5.2 years) recruited in 2009-2011 in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess PA variables. Physical performance was evaluated by 11 performance tests: grip strength, single-leg balance, functional reach, sit-and-reach, standing time from long sitting position, sit-to-stand, timed up and go, habitual walk, hand working, and simple and choice reaction times. After adjusting for potential confounders, leisure-time PA in young-old (≤ 74 years) men correlated significantly with eight performance tests (absolute value of Spearman's partial rank correlation coefficient: r = 0.18-0.39), whereas in old-old (≥ 75 years) men it correlated with three performance tests (r = 0.20-0.23). Although leisure-time PA correlated with six performance tests (r = 0.19-0.22) in young-old women, there were no significant correlations between leisure-time PA and performance tests in old-old women. Household PA of young-old men (r = 0.20-0.23) and old-old women (r = 0.26-0.34) correlated with four performance tests. In old-old men and young-old women, no significant correlation was found between household PA and performance tests. Work-related PA did not relate significantly to any performance tests in any groups. This study showed that leisure-time PA is related to physical performance, especially in young-old men and women, and household PA is especially related in young-old men and old-old women. Our findings suggest that supporting strategies for maintaining physical functions would differ by gender and age. © 2013 Japan Geriatrics Society.

FOOD ACQUISITION AND INTRA-HOUSEHOLD CONSUMPTION PATTERNS: A STUDY OF LOW AND MIDDLE INCOME URBAN HOUSEHOLDS IN DELHI, INDIA.

PubMed

Pradhan, Mr; Taylor, Fc; Agrawal, S; Prabhakaran, D; Ebrahim, S

2013-12-01

Food habits and choices in India are shifting due to many factors: changing food markets, fast urbanization, food price inflation, uncertain food production and unequal distribution during the past decade. This study aims to explore food acquisition and intra-household consumption patterns in urban low and middle income (LMI) households in Delhi. Twenty households were randomly selected from the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) surveillance study. Data were derived from 20 questionnaires administered to women responsible for food preparation, four key-informant-interviews, and 20 in-depth interviews with household heads during September-November 2011. STATA and ATLAS.ti software were used for data analysis. Half of the households spent at least two-thirds of their income on food. The major expenditures were on vegetables (22% of total food expenditure), milk and milk products (16%), and cereal and related products (15%). Income, food prices, food preferences, and seasonal variation influenced food expenditure. Adults usually ate two to three times a day while children ate more frequently. Eating sequence was based on the work pattern within the household and cultural beliefs. Contrary to previous evidence, there was no gender bias in intra-household food distribution. Women considered food acquisition, preparation and distribution part of their self-worth and played a major role in food related issues in the household. Women's key roles in food acquisition, preparation and intra household food consumption should be considered in formulating food policies and programs.

Impact of the HIV epidemic on population and household structure: the dynamics and evidence to date.

PubMed

Heuveline, Patrick

2004-06-01

HIV is contracted most frequently at birth and during early adulthood. The epidemic may thus impact the demographic structure and the household structure of affected populations. This paper reviews earlier evidence of such an impact, uses demographic theory to anticipate its changes over time, and reviews the most recent evidence for indications of these changes. Modest increases in the male : female ratio are beginning to show within certain age groups only (approximately 15% among 25-34 year olds). Similarly sized increases in the proportion of 15-29 year olds relative to 30-54 year olds are observed in some age pyramids. These 'youth bulges' are expected to fade out, whereas an aging effect phases in with the fertility impact of the epidemic. In the longer run, the size of all age groups will be reduced, but relatively less so for middle-aged adults. Proportions of orphans and widows have increased in the most affected countries. Fewer remarriage probabilities for widows were observed. Resulting increases in the proportion of female-headed households should only be temporary, as female mortality is catching up with male mortality. The number of double orphans is beginning to increase, but overall, orphans continue to live predominantly with a family member, most often the grandparents if not with the surviving parent. To date, the epidemic's impact on the population and household structure has been limited by demographic (aging) and social (adaptive movements of kin across households) processes that contribute to diffuse the epidemic throughout the entire population and all households.

Household catastrophic medical expenses in eastern China: determinants and policy implications

PubMed Central

2013-01-01

Background Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China. Methods Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants. Results The incidence of household catastrophic medical expenses in eastern China ranged from 9.24% to 24.79%. Incidence of household catastrophic medical expenses was lower if the head of household had a higher level of education, labor insurance coverage, while the incidence was higher if they lived in rural areas, had a family member with chronic diseases, had a child younger than 5 years old, had a person at home who was at least 65 years old, and had a household member who was hospitalized. Moreover, the impact of the economic level on catastrophic medical expenses was non-linear. The poorest group had a lower incidence than that of the second lowest income group and the group with the highest income had a higher incidence than that of the second highest income group. In addition, region was a significant determinant. Conclusions Reducing the incidence of household catastrophic medical expenses should be one of the priorities of health policy. It can be achieved by improving residents’ health status to reduce avoidable health services such as hospitalization. It is also important to design more targeted health insurance in order to increase financial support for such vulnerable groups as the poor, chronically ill, children, and senior populations. PMID:24308317

Brief Report: What Happens When I Can No Longer Support My Autistic Relative? Worries about the Future for Family Members of Autistic Adults

ERIC Educational Resources Information Center

Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

2017-01-01

Very little is known about autism and adulthood. Family members are often the primary support for autistic adults and frequently express concerns about what the future will hold and what support will be available for their relative. 120 family members of autistic adults completed an online survey exploring concerns about the future for their…

Household knowledge, attitudes and practices related to pet contact and associated zoonoses in Ontario, Canada

PubMed Central

2012-01-01

Background Many human infections are transmitted through contact with animals (zoonoses), including household pets. Although pet ownership is common in most countries and non-pet owners may have frequent contact with pets, there is limited knowledge of the public’s pet contact practices and awareness of zoonotic disease risks from pets. The objective of this study was to characterize the general public’s knowledge, attitudes and risks related to pet ownership and animal contact in southern Ontario, Canada. Methods A self-administered questionnaire was distributed to individuals at two multi-physician clinics in Waterloo, Ontario, Canada during 2010. A single adult from each household was invited to participate in the study. Results Seventy five percent (641/853) of individuals approached completed the questionnaire. Pet ownership and contact were common; 64% of participants had a pet in their household and 37% of non-pet owning households had a member with at least weekly animal contact outside the home. Pet ownership was high (55%) for households with individuals at higher risk for infections (i.e., < 5 yrs, ≥ 65 yrs, immunocompromised). Most respondents (64%) indicated that they had never received information regarding pet-associated disease risks. When given a list of 11 infectious pathogens, respondents were only able to correctly classify just over half on their potential to be transmitted from pets to people (mean 6.4); independently, pet owners and those who recalled receiving information in the past about this topic were able to make significantly more correct identifications. Pet (36%) and non-pet owning households (10%) reported dog or cat bites or scratches during the preceding year. Households with individuals at higher risk for an infection did not differ from the remaining households regarding their perceived disease risk of pets, zoonotic disease knowledge, recall of being asked by their medical provider if they owned any pets, or recall of

The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults.

PubMed

Jessiman-Perreault, Geneviève; McIntyre, Lynn

2017-12-01

Household food insecurity is related to poor mental health. This study examines whether the level of household food insecurity is associated with a gradient in the risk of reporting six adverse mental health outcomes. This study further quantifies the mental health impact if severe food insecurity, the extreme of the risk continuum, were eliminated in Canada. Using a pooled sample of the Canadian Community Health Survey (N = 302,683), we examined the relationship between level of food insecurity, in adults 18-64 years, and reporting six adverse mental health outcomes. We conducted a probit analysis adjusted for multi-variable models, to calculate the reduction in the odds of reporting mental health outcomes that might accrue from the elimination of severe food insecurity. Controlling for various demographic and socioeconomic covariates, a food insecurity gradient was found in six mental health outcomes. We calculated that a decrease between 8.1% and 16.0% in the reporting of these mental health outcomes would accrue if those who are currently severely food insecure became food secure, after controlling for covariates. Household food insecurity has a pervasive graded negative effect on a variety of mental health outcomes, in which significantly higher levels of food insecurity are associated with a higher risk of adverse mental health outcomes. Reduction of food insecurity, particularly at the severe level, is a public health concern and a modifiable structural determinant of health worthy of macro-level policy intervention.

Older people as resources in South Africa: Mpumalanga households.

PubMed

Kimuna, Sitawa R; Makiwane, Monde

2007-01-01

The extended family used to be relied upon to provide subsistence and care for older people in sub-Saharan Africa. However, recently South Africa has seen a reversal of roles, where older people now provide subsistence and care to younger generations; this role reversal is being accelerated by HIV/AIDS deaths among young adults. In most rural households, the non-contributory old age pension (OAP) that is means-tested is an important factor in making older people breadwinners. Using data from the 2004 Mpumalanga Older People's Survey, we examined the changing role of older people, which has been influenced mainly by changes in household structure and old age pension. Findings show that in 63% of matrifocal, multigenerational households, 76% of older people are the sole providers of household necessities, caring for the sick and grandchildren in increasingly skip-generation households.

The global household: toward a feminist postcapitalist international political economy.

PubMed

Safri, Maliha; Graham, Julie

2010-01-01

The goal of this article is to introduce a new category into international political economy-the global household-and to begin to widen the focus of international political economy to include nonmarket transactions and noncapitalist production. As an economic institution composed of transnational extended families and codwellers (including international migrants and family members left behind in countries of origin), the global household is engaged in coordinating international migration, sending and receiving billions of dollars in remittances, and organizing and conducting market- and non-market-oriented production on an international scale. We first trace the discursive antecedents of the global household concept to theories of the household as a site of noncapitalist production and to feminist ethnographies of transnational families. In order to demonstrate the potential significance and effect of this newly recognized institution, we estimate the aggregate population of global households, the size and distribution of remittances, and the magnitude and sectoral scope of global household production. We then examine the implications of the global household concept for three areas of inquiry: globalization, economic development, and the household politics of economic transformation. Finally, we briefly explore the possibilities for research and activism opened up by a feminist, postcapitalist international political economy centered on the global household.

Social capital, social participation and life satisfaction among Chilean older adults.

PubMed

Ponce, María Soledad Herrera; Rosas, Raúl Pedro Elgueta; Lorca, María Beatriz Fernández

2014-10-01

To examine factors associated with social participation and their relationship with self-perceived well-being in older adults. This study was based on data obtained from the National Socioeconomic Characterization (CASEN) Survey conducted in Chile, in 2011, on a probability sample of households. We examined information of 31,428 older adults living in these households. Descriptive and explanatory analyses were performed using linear and multivariate logistic regression models. We assessed the respondents' participation in different types of associations: egotropic, sociotropic, and religious. Social participation increased with advancing age and then declined after the age of 80. The main finding of this study was that family social capital is a major determinant of social participation of older adults. Their involvement was associated with high levels of self-perceived subjective well-being. We identified four settings as sources of social participation: home-based; rural community-based; social policy programs; and religious. Older adults were significantly more likely to participate when other members of the household were also involved in social activities evidencing an intergenerational transmission of social participation. Rural communities, especially territorial associations, were the most favorable setting for participation. There has been a steady increase in the rates of involvement of older adults in social groups in Chile, especially after retirement. Religiosity remains a major determinant of associativism. The proportion of participation was higher among older women than men but these proportions equaled after the age of 80. Self-perceived subjective well-being is not only dependent upon objective factors such as health and income, but is also dependent upon active participation in social life, measured as participation in associations, though its effects are moderate.

Health care expenditure of households in magway, myanmar.

PubMed

Khaing, Inn Kynn; Malik, Amonov; Oo, Myo; Hamajima, Nobuyuki

2015-02-01

Myanmar has a high proportion of out-of-pocket (OOP) health care expenditures with limited cost-sharing mechanisms. In Myanmar, there were limited data on the frequency of catastrophic health expenditure (CHE) due to OOP payments, as well as on the factors associated with CHE. This study aimed to investigate health care expenditure, the frequency of CHE, and the factors influencing CHE among households in Magway, Myanmar. A cross-sectional household survey was conducted in 2012 for 700 households (350 in urban areas and 350 in rural areas) in Magway. CHE was defined as a condition wherein the total amount of household health care expenditure was 40% or more of non-food expenditure in the past year. Multiple logistic regression analysis was applied to estimate odds ratios (ORs) and 95% confident intervals (CIs) of CHE. In the previous year, 28.3% of 350 urban households and 51.4% of 350 rural households utilized outpatient services. Households with at least one member admitted to a medical facility were 10.0% and 12.9%, respectively. Those with CHE were 25.2% in the urban areas and 22.7% in the rural areas. The adjusted OR of CHE was 7.79 (95% CI 3.73-16.26) for hospitalization and 1.08 (95% CI 0.36-3.23) for outpatient care, relative to no services used. These findings indicated that nearly one fourth of households in Magway faced CHE due to inpatient care. A safety-net mechanism to protect households from CHE in Myanmar seems essential.

HEALTH CARE EXPENDITURE OF HOUSEHOLDS IN MAGWAY, MYANMAR

PubMed Central

KHAING, INN KYNN; MALIK, AMONOV; OO, MYO; HAMAJIMA, NOBUYUKI

2015-01-01

ABSTRACT Myanmar has a high proportion of out-of-pocket (OOP) health care expenditures with limited cost-sharing mechanisms. In Myanmar, there were limited data on the frequency of catastrophic health expenditure (CHE) due to OOP payments, as well as on the factors associated with CHE. This study aimed to investigate health care expenditure, the frequency of CHE, and the factors influencing CHE among households in Magway, Myanmar. A cross-sectional household survey was conducted in 2012 for 700 households (350 in urban areas and 350 in rural areas) in Magway. CHE was defined as a condition wherein the total amount of household health care expenditure was 40% or more of non-food expenditure in the past year. Multiple logistic regression analysis was applied to estimate odds ratios (ORs) and 95% confident intervals (CIs) of CHE. In the previous year, 28.3% of 350 urban households and 51.4% of 350 rural households utilized outpatient services. Households with at least one member admitted to a medical facility were 10.0% and 12.9%, respectively. Those with CHE were 25.2% in the urban areas and 22.7% in the rural areas. The adjusted OR of CHE was 7.79 (95% CI 3.73–16.26) for hospitalization and 1.08 (95% CI 0.36–3.23) for outpatient care, relative to no services used. These findings indicated that nearly one fourth of households in Magway faced CHE due to inpatient care. A safety-net mechanism to protect households from CHE in Myanmar seems essential. PMID:25797985

7 CFR 253.6 - Eligibility of households.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF... special diets, incurred by any household member who is elderly or disabled as defined in § 253.2 of this... allowable medical costs are those permitted at 7 CFR 273.9(d)(3) for the Supplemental Nutrition Assistance...

Household food insecurity and dietary patterns in rural and urban American Indian families with young children.

PubMed

Tomayko, Emily J; Mosso, Kathryn L; Cronin, Kate A; Carmichael, Lakeesha; Kim, KyungMann; Parker, Tassy; Yaroch, Amy L; Adams, Alexandra K

2017-06-30

High food insecurity has been demonstrated in rural American Indian households, but little is known about American Indian families in urban settings or the association of food insecurity with diet for these families. The purpose of this study was to examine the prevalence of food insecurity in American Indian households by urban-rural status, correlates of food insecurity in these households, and the relationship between food insecurity and diet in these households. Dyads consisting of an adult caregiver and a child (2-5 years old) from the same household in five urban and rural American Indian communities were included. Demographic information was collected, and food insecurity was assessed using two validated items from the USDA Household Food Security Survey. Factors associated with food insecurity were examined using logistic regression. Child and adult diets were assessed using food screeners. Coping strategies were assessed through focus group discussions. These cross-sectional baseline data were collected from 2/2013 through 4/2015 for the Healthy Children, Strong Families 2 randomized controlled trial of a healthy lifestyles intervention for American Indian families. A high prevalence of food insecurity was determined (61%) and was associated with American Indian ethnicity, lower educational level, single adult households, WIC participation, and urban settings (p = 0.05). Food insecure adults had significantly lower intake of vegetables (p < 0.05) and higher intakes of fruit juice (<0.001), other sugar-sweetened beverages (p < 0.05), and fried potatoes (p < 0.001) than food secure adults. Food insecure children had significantly higher intakes of fried potatoes (p < 0.05), soda (p = 0.01), and sports drinks (p < 0.05). Focus group participants indicated different strategies were used by urban and rural households to address food insecurity. The prevalence of food insecurity in American Indian households in our sample is extremely high, and

[Food availability according to food security-insecurity among Mexican households].

PubMed

Valencia-Valero, Reyna Guadalupe; Ortiz-Hernández, Luis

2014-04-01

To know the differences in food availability according to food insecurity level among the Mexican households. We analyzed the database of the National Survey of Household's Incomes and Expenditures (n=27 445 households). Households were classified according to the Latin American and Caribbean Inventory of Food Security. The availability of each food group was estimated as grams per day per equivalent adult. 50.0% of Mexican households experienced some degree of food insecurity. Among households with food insecurity there was high availability of corn, wheat, egg, and sugars; but there was low availability of fresh fruits and vegetables, lean meat, poultry, seafood, milk, cheeses, and sweetened beverages. Although in households with food insecurity there is lower availability of most food groups (both with high nutrient density and with high energy density); they have higher availability of cheap foods, which in some cases are only source of energy but do not provide nutrients.

FOOD ACQUISITION AND INTRA-HOUSEHOLD CONSUMPTION PATTERNS: A STUDY OF LOW AND MIDDLE INCOME URBAN HOUSEHOLDS IN DELHI, INDIA

PubMed Central

Pradhan, MR; Taylor, FC; Agrawal, S; Prabhakaran, D; Ebrahim, S

2014-01-01

Background Food habits and choices in India are shifting due to many factors: changing food markets, fast urbanization, food price inflation, uncertain food production and unequal distribution during the past decade. This study aims to explore food acquisition and intra-household consumption patterns in urban low and middle income (LMI) households in Delhi. Methods Twenty households were randomly selected from the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) surveillance study. Data were derived from 20 questionnaires administered to women responsible for food preparation, four key-informant-interviews, and 20 in-depth interviews with household heads during September-November 2011. STATA and ATLAS.ti software were used for data analysis. Results Half of the households spent at least two-thirds of their income on food. The major expenditures were on vegetables (22% of total food expenditure), milk and milk products (16%), and cereal and related products (15%). Income, food prices, food preferences, and seasonal variation influenced food expenditure. Adults usually ate two to three times a day while children ate more frequently. Eating sequence was based on the work pattern within the household and cultural beliefs. Contrary to previous evidence, there was no gender bias in intra-household food distribution. Women considered food acquisition, preparation and distribution part of their self-worth and played a major role in food related issues in the household. Conclusion Women’s key roles in food acquisition, preparation and intra household food consumption should be considered in formulating food policies and programs. PMID:25473147

Household fear of deportation in Mexican-origin families: Relation to body mass index percentiles and salivary uric acid.

PubMed

Martínez, Airín D; Ruelas, Lillian; Granger, Douglas A

2017-11-01

Fear of deportation (FOD) is a prevalent concern among mixed-status families. Yet, our understanding of how FOD shapes human health and development is in its infancy. To begin to address this knowledge gap, we examined the relationship between household FOD, body mass index (BMI) percentiles and salivary uric acid (sUA), a biomarker related to oxidative stress/hypertension/metabolic syndrome, among 111 individuals living in Mexican-origin families. Participants were 65 children (2 months-17 years, 49% female) and 46 adults (20-58 years, 71% female) living in 30 Mexican-origin families with at least one immigrant parent in Phoenix, AZ. We recruited families using cluster probability sampling of 30 randomly selected census tracts with a high proportion of Hispanic/Latino immigrants. The head of household completed a survey containing demographic, FOD, and psychosocial measures. All family members provided saliva (later assayed for sUA) and anthropometric measures. Relationships between household FOD, BMI percentile, and sUA levels were estimated using multilevel models. Higher levels of household FOD were associated with lower BMI percentiles and lower sUA levels between families, after controlling for social support and socioeconomic proxies. Key features of the social ecology in which mixed-status families are embedded are associated with individual differences in biological processes linked to increased risk for chronic disease. © 2017 Wiley Periodicals, Inc.

Effect of household size on mental problems in children: results from the Norwegian Mother and Child Cohort study.

PubMed

Grinde, Bjørn; Tambs, Kristian

2016-06-02

Most people in industrialized societies grow up in core (parents only) families with few if any siblings. Based on an evolutionary perspective, it may be argued that this environment reflects a mismatch, in that the tribal setting offered a larger number of close affiliates. The present project examined whether this mismatch may have a negative impact on mental health. We used data from the Norwegian Mother and Child Cohort Study (MoBa), which includes 114 500 children. The mothers were recruited during pregnancy and followed up with questionnaires as the infants grew older. Correlates between number and type of people living in the household and questions probing mental health were corrected for likely confounders. The number of household members correlated with scores on good mental health at all ages tested (3, 5 and 8 years). The effects were distinct, highly significant, and present regardless of how mental issues were scored. The outcome could be attributed to having older siblings, rather than adults beyond parents. The more siblings, and the closer in age, the more pronounced was the effect. Living with a single mother did not make any difference compared to two parents. Girls were slightly more responsive to the presence of siblings than boys. Household pets did not have any appreciable impact. A large household is associated with fewer mental problems in children.

The Structure of Adult ADHD

PubMed Central

Adler, Lenard A.; Faraone, Stephen V.; Spencer, Thomas J.; Berglund, Patricia; Alperin, Samuel; Kessler, Ronald C.

2017-01-01

Although DSM-5 stipulates that symptoms of attention-deficit/hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functioning and emotional control. Previous psychometric analyses to evaluate these observations have been limited in ways addressed in the current study, which analyzes the structure of an expanded set of adult ADHD symptoms in 3 pooled U.S. samples: a national household sample, a sample of health plan members, and a sample of adults referred for evaluation at an adult ADHD clinic. Exploratory factor analysis found 4 factors representing executive dysfunction/inattention (including, but not limited to, all the DSM-5 inattentive symptoms, with non-DSM symptoms having factor loadings comparable to those of DSM symptoms), hyperactivity, impulsivity, and emotional dyscontrol. Empirically-derived multivariate symptom profiles were broadly consistent with the DSM-5 inattentive-only, hyperactive/impulsive-only, and combined presentations, but with inattention including executive dysfunction/inattention and hyperactivity-only limited to hyperactivity without high symptoms of impulsivity. These results show that executive dysfunction is as central as DSM-5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but prominent resent in the combined presentation of adult ADHD. PMID:28211596

Screening of a healthy newborn identifies three adult family members with symptomatic glutaric aciduria type I.

PubMed

McH, Janssen; Laj, Kluijtmans; S B, Wortmann

2014-06-01

We report three adult sibs (one female, two males) with symptomatic glutaric acidura type I, who were diagnosed after a low carnitine level was found by newborn screening in a healthy newborn of the women. All three adults had low plasma carnitine, elevated glutaric acid levels and pronounced 3-hydroxyglutaric aciduria. The diagnosis was confirmed by undetectable glutaryl-CoA dehydrogenase activity in lymphocytes and two pathogenic heterozygous mutations in the GCDH gene (c.1060A > G, c.1154C > T). These results reinforce the notion that abnormal metabolite levels in newborns may lead to the diagnosis of adult metabolic disease in the mother and potentially other family members.

“Taking care of my own blood”: Older women's relationships to their households in rural South Africa1

PubMed Central

SCHATZ, ENID J.

2010-01-01

Aim: This paper examines financial, emotional, and physical responsibilities elderly women are being asked to take on due to the incapacity of their adult children to care for the next generation; such incapacity is likely to increase as the HIV/AIDS epidemic worsens. Methods: This paper combines quantitative and qualitative data. Census data from the Agincourt health and demographic surveillance system (AHDSS) describe the presence of the elderly (specifically women over the age of 60 and men over the age of 65) in households in the Agincourt study site. Semi-structured interviews with 30 female residents aged 60–75 complement the census data by exploring the roles that older women, in particular, are playing in their households. Results: An elderly man and/or woman lives in 27.6% of households; 86% of elders live with non-elders. Households with a woman over the age of 60 resident (as opposed to those without) are twice as likely to have a fostered child living in the household and three times as likely to have an orphaned child in the household. Elderly women face financial, physical, and emotional burdens related to the morbidity and mortality of their adult children, and to caring for grandchildren left behind due to adult children's mortality, migration, (re)marriage, and unemployment. Conclusions: Older women provide crucial financial, physical, and emotional support for ill adult children and fostered and orphaned grandchildren in their households. As more prime-aged adults suffer from HIV/AIDS-related morbidity and mortality, these obligations are likely to increase. PMID:17676516

Perceived Family Resources Based on Number of Members with ADHD

ERIC Educational Resources Information Center

Corwin, Melinda; Mulsow, Miriam; Feng, Du

2012-01-01

Objective: This study examines how the number of family members with ADHD affects other family members' perceived resources. Method: A total of 40 adolescents diagnosed with ADHD and their mothers, fathers, and adolescent siblings living in the household participated. Hierarchical linear modeling was used to analyze family-level data from a total…

Impact of Osteoarthritis on Household Catastrophic Health Expenditures in Korea.

PubMed

Kim, Hyoungyoung; Cho, Soo-Kyung; Kim, Daehyun; Kim, Dalho; Jung, Sun-Young; Jang, Eun Jin; Sung, Yoon-Kyoung

2018-05-21

Osteoarthritis (OA) is a disease of old age whose prevalence is increasing. This study explored the impact of OA on household catastrophic health expenditure (CHE) in Korea. We used data on 5,200 households from the Korea Health Panel Survey in 2013 and estimated annual living expenses and out-of-pocket (OOP) payments. Household CHE was defined when a household's total OOP health payments exceeded 10%, 20%, 30%, or 40% of the household's capacity to pay. To compare the OOP payments of households with OA individuals and those without OA, OA households were matched 1:1 with households containing a member with other chronic disease such as neoplasm, hypertension, heart disease, cerebrovascular disease, diabetes, or osteoporosis. The impact of OA on CHE was determined by multivariable logistic analysis. A total of 1,289 households were included, and households with and without OA patients paid mean annual OOP payments of $2,789 and $2,607, respectively. The prevalence of household CHE at thresholds of 10%, 20%, 30%, and 40% were higher in households with OA patients than in those without OA patients ( P < 0.001). The presence of OA patients in each household contributed significantly to CHE at thresholds of 10% (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.16-1.87), 20% (OR, 1.29; 95% CI, 1.01-1.66), and 30% (OR, 1.37; 95% CI, 1.05-1.78), but not of 40% (OR, 1.17; 95% CI, 0.87-1.57). The presence of OA patients in Korean households is significantly related to CHE. Policy makers should try to reduce OOP payments in households with OA patients.

Resilient family processes, personal reintegration, and subjective well-being outcomes for military personnel and their family members.

PubMed

Clark, Malissa A; O'Neal, Catherine W; Conley, Kate M; Mancini, Jay A

2018-01-01

Deployment affects not just the service members, but also their family members back home. Accordingly, this study examined how resilient family processes during a deployment (i.e., frequency of communication and household management) were related to the personal reintegration of each family member (i.e., how well each family member begins to "feel like oneself again" after a deployment), as well as several indicators of subjective well-being. Drawing from the family attachment network model (Riggs & Riggs, 2011), the present study collected survey data from 273 service members, their partners, and their adolescent children. Resilient family processes during the deployment itself (i.e., frequency of communication, household management), postdeployment positive and negative personal reintegration, and several indicators of well-being were assessed. Frequency of communication was related to personal reintegration for service members, while household management was related to personal reintegration for nondeployed partners; both factors were related to personal reintegration for adolescents. Negative and positive personal reintegration related to a variety of subjective well-being outcomes for each individual family member. Interindividual (i.e., crossover) effects were also found, particularly between adolescents and nondeployed partners. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion.

PubMed

Saibul, Nurfaizah; Shariff, Zalilah Mohd; Lin, Khor Geok; Kandiah, Mirnalini; Ghani, Nawalyah Abdul; Rahman, Hejar Abdul

2009-01-01

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.

On-Farm Crop Species Richness Is Associated with Household Diet Diversity and Quality in Subsistence- and Market-Oriented Farming Households in Malawi.

PubMed

Jones, Andrew D

2017-01-01

On-farm crop species richness (CSR) may be important for maintaining the diversity and quality of diets of smallholder farming households. The objectives of this study were to 1) determine the association of CSR with the diversity and quality of household diets in Malawi and 2) assess hypothesized mechanisms for this association via both subsistence- and market-oriented pathways. Longitudinal data were assessed from nationally representative household surveys in Malawi between 2010 and 2013 (n = 3000 households). A household diet diversity score (DDS) and daily intake per adult equivalent of energy, protein, iron, vitamin A, and zinc were calculated from 7-d household consumption data. CSR was calculated from plot-level data on all crops cultivated during the 2009-2010 and 2012-2013 agricultural seasons in Malawi. Adjusted generalized estimating equations were used to assess the longitudinal relation of CSR with household diet quality and diversity. CSR was positively associated with DDS (β: 0.08; 95% CI: 0.06, 0.12; P < 0.001), as well as daily intake per adult equivalent of energy (kilocalories) (β: 41.6; 95% CI: 20.9, 62.2; P < 0.001), protein (grams) (β: 1.78; 95% CI: 0.80, 2.75; P < 0.001), iron (milligrams) (β: 0.30; 95% CI: 0.16, 0.44; P < 0.001), vitamin A (micrograms of retinol activity equivalent) (β: 25.8; 95% CI: 12.7, 38.9; P < 0.001), and zinc (milligrams) (β: 0.26; 95% CI: 0.13, 0.38; P < 0.001). Neither proportion of harvest sold nor distance to nearest population center modified the relation between CSR and household diet diversity or quality (P ≥ 0.05). Households with greater CSR were more commercially oriented (least-squares mean proportion of harvest sold ± SE, highest tertile of CSR: 17.1 ± 0.52; lowest tertile of CSR: 8.92 ± 1.09) (P < 0.05). Promoting on-farm CSR may be a beneficial strategy for simultaneously supporting enhanced diet quality and diversity while also creating opportunities for smallholder farmers to engage with

Life Course Changes and Parent-Adult Child Contact

PubMed Central

Ward, Russell; Deane, Glenn; Spitze, Glenna

2015-01-01

Despite increased interest in parent-adult child relations, there has been little attention to how these are influenced by changes in their lives, reflecting transitions and linked lives within a life course perspective. Hybrid multi-level models are used to analyze change in parent-adult child contact over two waves of the National Survey of Families and Households. Changes in parent-child proximity, parent and child marital status, and child parental status are associated with change in contact; continued coresidence with another adult child is related to contact with noncoresidential children; but change in parent health does not affect contact. Some patterns are stronger for daughters and biological children, who tend to have stronger relationships with parents. These analyses demonstrate how life course transitions of parents and adult children can be examined in family context to understand how changes in the life of one family member may influence relations with another. PMID:25651511

Religious Coping Among Adults Caring for Family Members with Serious Mental Illness.

PubMed

Pearce, Michelle J; Medoff, Deborah; Lawrence, Ryan E; Dixon, Lisa

2016-02-01

This cross-sectional study investigated the use of religious coping strategies among family members of adults with serious mental illness. A sample of 436 individuals caring for a family member with serious mental illness were recruited into a randomized clinical trial for the National Alliance on Mental Illness Family to Family Education Program. Relationships are reported between religious coping and caregiving, care recipient, and mental health services outcomes. Religious coping was associated with more objective caregiving burden, greater care recipient need, less mental health knowledge, and less receipt of mental health services after adjusting for non-religious types of coping. At the same time, religious coping was associated with a positive caregiving experience and greater religious support. Religious coping plays an important role for many caregivers of persons with serious mental illness. Caregivers who use more religious coping may have an especially high need for mental health education and mental health services.

Using Household Consumption and Expenditures Survey (HCES) data to assess dietary intake in relation to the nutrition transition: a case study from Cape Verde.

PubMed

Dop, Marie Claude; Pereira, Clodomir; Mistura, Lorenza; Martinez, Claudio; Cardoso, Edith

2012-09-01

Few surveys of food and nutrient intakes are conducted at the individual level in low- and middle-income countries, whereas Household Consumption and Expenditures Surveys (HCES) are regularly carried out to monitor economic conditions. Because of the paucity of individual-level data, there is interest in using HCES to aid in the design of food and nutrition policies. Data from the 2001/02 HCES from Cape Verde were used to assess household dietary intakes in the context of the country's nutrition transition. The survey included weighed measurements of household food intake and measurements of the weight and height of all household members. Households were classified as "underweight" if they had at least one underweight member, "overweight" if they had at least one overweight member, and "dual burden" if they had at least one underweight and one overweight member. The proportion of households classified as underweight, overweight, and dual burden was 18%, 41%, and 14%, respectively. Household food and nutrient intakes were higher in the overweight households (particularly protein, vitamin A, and calcium) and lower in the underweight households, while there was no clear pattern of intakes in the dual burden group. Overweight households consumed more animal food groups than other households. Intakes of fruits and vegetables were low in all groups. The HCES data for Cape Verde were useful for assessing the extent of the nutrition transition and characterizing dietary intakes by anthropometric classification. Analysis of nutrient and food intakes showed that ensuring sufficient energy availability is no longer the most important issue for Cape Verde, but that ensuring dietary quality is equally crucial, in particular increasing access to fruits and vegetables.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias

PubMed Central

2013-01-01

the National School Lunch Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability. Conclusions Although household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults. PMID:23327426

Serum vitamin d level and susceptibility to multidrug-resistant tuberculosis among household contacts

NASA Astrophysics Data System (ADS)

Herlina, N.; Sinaga, B. Y. M.; Siagian, P.; Mutiara, E.

2018-03-01

Low levels of vitamin D is a predisposing factor for Multidrug-resistant tuberculosis. Family members in contact with the patient are also at risk of infection. Currently, there is no study that compares vitamin D levels between MDR-TB patients and household contact. This study aims to identify the association between level vitamin D within MDR-TB occurrence. This was a case-control study, with the number of samples in each group (MDR-TB) patients and household contactswere40 people. Each member of each group was checked for vitamin D levels using enzyme-linked immunosorbent assay (ELISA) technique. Statistical analysis was by using Chi-Square analysis using SPSS. Mean levels of vitamin D in MDR-TB patients were 32.21, household contact 31.7. There was anosignificant association between vitamin D levels and MDR-TB occurrence (p=1.0).No significant associationbetween vitamin D level with theMDR-TB occurrence.

Household Disorder, Network Ties, and Social Support in Later Life

PubMed Central

Cornwell, Erin York

2016-01-01

Family relationships, social interactions, and exchanges of support often revolve around the household context, but scholars rarely consider the social relevance of this physical space. In this article the author considers social causes and consequences of household disorder in the dwellings of older adults. Drawing from research on neighborhood disorder and social connectedness in later life, she describes how network characteristics may contribute to household disorder and how household disorder may weaken relationships and reduce access to support. This is explored empirically by estimating cross-lagged panel models with data from 2 waves of the National Social Life, Health, and Aging Project. The results reveal that household disorder reflects a lack of social support, and it leads to more kin-centered networks and more strain within family relationships. The author concludes by urging greater attention to how the household context shapes—and is shaped by—the social interactions and processes that occur within it. PMID:27524834

Older Caregiving Parents: Division of Household Labor, Marital Satisfaction, and Caregiver Burden

ERIC Educational Resources Information Center

Essex, Elizabeth Lehr; Hong, Jinkuk

2005-01-01

Based on a sample of 126 families, this study investigated how division of household labor is related to marital satisfaction and caregiving burden among older married parents caring for adult children with intellectual disabilities. For mothers, greater spousal participation in household work and satisfaction with the division of labor were…

Very Low Food Security in US Households Is Predicted by Complex Patterns of Health, Economics, and Service Participation.

PubMed

Choi, Seul Ki; Fram, Maryah S; Frongillo, Edward A

2017-10-01

Background: Very low food security (VLFS) happens at the intersection of nuanced and complex patterns of risk characteristics across multiple domains. Little is known about the idiosyncratic situations that lead households to experience VLFS. Objective: We used classification and regression tree (CART) analysis, which can handle complex combinations of predictors, to identify patterns of characteristics that distinguish VLFS households in the United States from other households. Methods: Data came from 3 surveys, the 2011-2014 National Health Interview Survey (NHIS), the 2005-2012 NHANES, and the 2002-2012 Current Population Survey (CPS), with sample participants aged ≥18 y and households with income <300% of the federal poverty line. Survey participants were stratified into households with children, adult-only households, and older-adult households (NHIS, CPS) or individuals aged 18-64 y and individuals aged ≥65 y (NHANES). Household food security was measured with the use of the 10-item US Adult Food Security Scale. Variables from multiple domains, including sociodemographic characteristics, health, health care, and participation in social welfare and food assistance programs, were considered as predictors. The 3 data sources were analyzed separately with the use of CART analysis. Results: Household experiences of VLFS were associated with different predictors for different types of households and often occurred at the intersection of multiple characteristics spanning unmet medical needs, poor health, disability, limitation, depressive symptoms, low income, and food assistance program participation. These predictors built complex trees with various combinations in different types of households. Conclusions: This study showed that multiple characteristics across multiple domains distinguished VLFS households. Flexible and nonlinear methods focusing on a wide range of risk characteristics should be used to identify VLFS households and to inform policies and

Intra-Household Allocation of Nutrients in an Opening China

PubMed Central

Zhou, Li; Chen, Xiaohong; Lei, Lei

2018-01-01

This paper uses China Health and Nutrition Survey (CHNS) data to analyze the effect of foreign direct investment (FDI) on nutrient intakes across various family roles to identify the different family roles’ heterogeneous nutrition intake responses to economic openness. The empirical evidence shows that FDI enhances labor forces’ calorie intake significantly, especially for rural households. The government should continue facilitating more FDI inflows, especially FDI in secondary industries for rural populations. However, the larger the family, the smaller the effect of FDI on nutrient intake for some family roles. The elderly and children may be weaker responders on nutrient intake than other family members in an open economy. This implies the existence of intra-household redistribution and that the level of effectiveness will decrease with family size. The results suggest that family members in rural areas can benefit more in terms of nutrient intake. Our empirical evidence also indicates that female family members’ calorie intake from the FDI effect is higher than that of male family members (except for the granddaughter/grandson). Preferential policies should be provided for the FDI, flowing to rural areas and female dominant industries. PMID:29642513

Social capital, social participation and life satisfaction among Chilean older adults

PubMed Central

Ponce, María Soledad Herrera; Rosas, Raúl Pedro Elgueta; Lorca, María Beatriz Fernández

2014-01-01

OBJECTIVE To examine factors associated with social participation and their relationship with self-perceived well-being in older adults. METHODS This study was based on data obtained from the National Socioeconomic Characterization (CASEN) Survey conducted in Chile, in 2011, on a probability sample of households. We examined information of 31,428 older adults living in these households. Descriptive and explanatory analyses were performed using linear and multivariate logistic regression models. We assessed the respondents’ participation in different types of associations: egotropic, sociotropic, and religious. RESULTS Social participation increased with advancing age and then declined after the age of 80. The main finding of this study was that family social capital is a major determinant of social participation of older adults. Their involvement was associated with high levels of self-perceived subjective well-being. We identified four settings as sources of social participation: home-based; rural community-based; social policy programs; and religious. Older adults were significantly more likely to participate when other members of the household were also involved in social activities evidencing an intergenerational transmission of social participation. Rural communities, especially territorial associations, were the most favorable setting for participation. There has been a steady increase in the rates of involvement of older adults in social groups in Chile, especially after retirement. Religiosity remains a major determinant of associativism. The proportion of participation was higher among older women than men but these proportions equaled after the age of 80. CONCLUSIONS Self-perceived subjective well-being is not only dependent upon objective factors such as health and income, but is also dependent upon active participation in social life, measured as participation in associations, though its effects are moderate. PMID:25372164

Household response to environmental incentives for rain garden adoption

NASA Astrophysics Data System (ADS)

Newburn, David A.; Alberini, Anna

2016-02-01

A decentralized approach to encourage the voluntary adoption of household stormwater management practices is increasingly needed to mitigate urban runoff and to comply with more stringent water quality regulations. We analyze the household response to a hypothetical rebate program to incentivize rain garden adoption using household survey data from the Baltimore-Washington corridor. We asked respondents whether the household would adopt a rain garden without a rebate or when offered a randomly assigned rebate. An interval-data model is used to estimate household demand on the willingness to pay (WTP) for a rain garden as a function of demographic factors, gardening activities, environmental attitudes, and other household characteristics. Estimation results indicate that mean WTP for a rain garden in our sample population is approximately $6.72 per square foot, corresponding to almost three-fourths of the installation cost. The expected adoption rate more than tripled when comparing no rebate versus a government rebate set at one-third of the installation cost, indicating that economic incentives matter. There is substantial heterogeneity in the WTP among households. Higher levels of WTP are estimated for households with higher environmental concern for the Chesapeake Bay and local streams, garden experience, higher income, and non-senior citizen adults. We conclude that a cost-share rebate approach is likely to significantly affect household adoption decisions, and the partial contributions paid by households can assist with lowering the substantial compliance costs for local governments to meet water quality requirements.

Comparison of the characteristics of fire and non-fire households in the 2004-2005 survey of fire department-attended and unattended fires.

PubMed

Greene, Michael A

2012-06-01

Comparison of characteristics of fire with non-fire households to determine factors differentially associated with fire households (fire risk factors). National household telephone survey in 2004-2005 by the US Consumer Product Safety Commission with 916 fire households and a comparison sample of 2161 non-fire households. There were an estimated 7.4 million fires (96.6% not reported to fire departments) with 130,000 injuries. Bivariate analysis and multivariate logistic regression analyses to assess differences in household characteristics. Significant factors associated with fire households were renting vs. owning (OR 1.988 p<0.0001); household members under 18 year of age (OR 1.277 p<0.0001); lack of residents over 64 years old (OR 0.552 p=0.0007); and college or higher education (some college OR 1.444 p=0.0360, college graduate OR 1.873, p<0.0001, postgraduate OR 2.156 p<0.0001). Not significant were age of house; race; ethnicity; and income. Number of smokers was borderline significant (OR 1.132 p=0.1019) but was significant in the subset of fire households with non-cooking fires (OR 1.383 p=0.0011). Single family houses were associated with non-fire households in the bivariate analysis but not in the multivariate analyses. Renting, household members under 18 years old and smokers are risk factors for unattended fires, similar to the literature for fatal and injury fires. Differences included household members over 65 years old (associated with non-fire households), college/postgraduate education (associated with fire households) and lack of significance of income. Preventing cooking fires (64% of survey incidents), smoking prevention efforts and fire prevention education for families with young children have the potential for reducing unattended fires and injuries.

Household Crowding During Childhood and Long-Term Education Outcomes.

PubMed

Lopoo, Leonard M; London, Andrew S

2016-06-01

Household crowding, or having more household members than rooms in one's residence, could potentially affect a child's educational attainment directly through a number of mechanisms. We use U.S. longitudinal data from the Panel Study of Income Dynamics to derive new measures of childhood crowding and estimate negative associations between crowding during one's high school years and, respectively, high school graduation by age 19 and maximum education at age 25. These negative relationships persist in multivariate models in which we control for the influence of a variety of factors, including socioeconomic status and housing-cost burden. Given the importance of educational attainment for a range of midlife and later-life outcomes, this study suggests that household crowding during one's high school years is an engine of cumulative inequality over the life course.

Household responses to school closure resulting from outbreak of influenza B, North Carolina.

PubMed

Johnson, April J; Moore, Zack S; Edelson, Paul J; Kinnane, Lynda; Davies, Megan; Shay, David K; Balish, Amanda; McCarron, Meg; Blanton, Lenee; Finelli, Lyn; Averhoff, Francisco; Bresee, Joseph; Engel, Jeffrey; Fiore, Anthony

2008-07-01

School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy's effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure. Closure was considered appropriate by 201 (91%) households. No adults missed work to solely provide childcare, and only 22 (10%) households required special childcare arrangements; 2 households incurred additional costs. Eighty-nine percent of children visited at least 1 public location during the closure despite county recommendations to avoid large gatherings. Although behavior and attitudes might differ during a pandemic, these results suggest short-term closure did not cause substantial hardship for parents. Pandemic planning guidance should address the potential for transmission in public areas during school closure.

Women's Land Tenure Security and Household Human Capital: Evidence from Ethiopia's Land Certification.

PubMed

Muchomba, Felix M

2017-10-01

This paper examines the impact of Ethiopia's gendered land certification programs on household consumption of healthcare, food, education, and clothing. Ethiopia embarked on a land tenure reform program in 1998, after years of communism during which all land was nationalized. The reform began in Tigray region where land certificates were issued to household heads, who were primarily male. In a second phase carried out in 2003-2005, three other regions issued land certificates jointly to household heads and spouses, presenting variation in land tenure security by gender. Results using household panel data show that joint land certification to spouses was accompanied by increased household consumption of healthcare and homegrown food and decreased education expenditure, compared to household-head land certification. Joint land certification was also accompanied by increased consumption of women's and girls' clothing, and decreased men's clothing expenditures indicating results may be explained by a shift in the gender balance of power within households. Analysis on the incidence and duration of illness indicates that increased healthcare expenditures after joint land certification may be due to joint certification households seeking more effective treatment than head-only certification households for household members who fell ill or suffered injuries.

Household economic modelsof gill net fishermen at Madura strait

NASA Astrophysics Data System (ADS)

Primyastanto, M.

2018-04-01

The purposes of this research was to analyze household economic models of gill net fishermen at Madura strait. 30 families of gillnet fishermenwere used for purposive sampling. Data analysis used descriptive qualitative and quantitative (regression analysis). Quantitative descriptive analysis was used to analyze research and compare to factors that affecting household economic models of gill net fishermen family. Research results showed tha thousehold economic models of gill net fishermen at Madura strait was production value level or fishermen revenue at sea was strongly influenced byp roduction asset production, education level, fuel, and work flow. Work flow rate of fishermen families affected by asset production, non fisheries workflow and number of male workforce. Non fishing income level was strongly influenced by non-fishery business assets, number of family members owned andnon-fishing work flow. Spending levels of gill net fishermen at Madura strait was affected by fishing income, non-fishing income, fishermen wife education and fishermen family members.

Catastrophic health expenditure: a comparative analysis of empty-nest and non-empty-nest households with seniors in Shandong, China

PubMed Central

Yang, Tingting; Chu, Jie; Zhou, Chengchao; Medina, Alexis; Li, Cuicui; Jiang, Shan; Zheng, Wengui; Sun, Liyuan; Liu, Jing

2016-01-01

Objective The aim of this study was to compare the catastrophic health expenditure (CHE) prevalence and its determinants between empty-nest and non-empty-nest elderly households. Setting Shandong province of China. Participants A total of 2761 elderly households are included in the analysis. Results CHE incidence among elderly households was 44.9%. The CHE incidence of empty-nest singles (59.3%, p=0.000, OR=3.19) and empty-nest couples (52.9%, p=0.000, OR=2.45) are both statistically higher than that of non-empty-nest elderly households (31.4%). An inverse association was observed between CHE incidence and income level in all elderly household types. Factors including 1 or more household elderly members with non-communicable chronic diseases in the past 6 months, 1 or more elderly household members being hospitalised in the past year and lower household income, are significant risk factors for CHE in all 3 household types (p<0.05). Health insurance status was found to be a significant determinant of CHE among empty-nest singles and non-empty-nest households (p<0.05). Conclusions CHE incidence among elderly households is high in China. Empty-nest households are at higher risk for CHE than non-empty-nest households. Based on these findings, we suggest that special insurance be developed to broaden the coverage of health services and heighten the reimbursement rate for empty-nest elderly in the existing health insurance schemes. Financial and social protection interventions are also essential for identified at-risk subgroups among different types of elderly households. PMID:27381206

The Nexus between Routine Household Chores and a Filial Heart

ERIC Educational Resources Information Center

Li, Shi

2017-01-01

The findings of a seven-year national investigation about filial piety in China released in November 2015 indicate that an adult daughter has a stronger affective bond with old parents than an adult son. One major construct to distinguish family roles of daughters and sons is participation with household chores. By employing some psychological and…

GDNF and NGF family members and receptors in human fetal and adult spinal cord and dorsal root ganglia.

PubMed

Josephson, A; Widenfalk, J; Trifunovski, A; Widmer, H R; Olson, L; Spenger, C

2001-11-12

We describe the expression of mRNA encoding ligands and receptors of members of the GDNF family and members of the neurotrophin family in the adult human spinal cord and dorsal root ganglia (DRG). Fetal human spinal cord and ganglia were investigated for the presence of ligands and receptors of the neurotrophin family. Tissues were collected from human organ donors and after routine elective abortions. Messenger RNA was found encoding RET, GFR alpha-1, BDNF, trkB, and trkC in the adult human spinal cord and BDNF, NT-3, p75, trkB, and trkC in the fetal human spinal cord. The percentage of adult human DRG cells expressing p75, trkA, trkB, or trkC was 57, 46, 29, and 24%, respectively, and that of DRG cells expressing RET, GFR alpha-1, GFR alpha-2, or GFR alpha-3 was 79, 20, 51, and 32%, respectively. GFR alpha-2 was expressed selectively in small, GFR alpha-3 principally in small and GFR alpha-1 and RET in both large and small adult human DRG neurons. p75 and trkB were expressed by a wide range of DRG neurons while trkA was expressed in most small diameter and trkC primarily in large DRG neurons. Fetal DRG cells were positive for the same probes as adult DRG cells except for NT-3, which was only found in fetal DRG cells. Messenger RNA species only expressed at detectable levels in fetal but not adult spinal cord tissues included GDNF, GFR alpha-2, NT-3, and p75. Notably, GFR alpha-2, which is expressed in the adult rat spinal cord, was not found in the adult human spinal cord. Copyright 2001 Wiley-Liss, Inc.

7 CFR 1400.208 - Family members.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Family members. 1400.208 Section 1400.208 Agriculture... SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.208 Family members. (a) Notwithstanding... persons, a majority of whom are family members, an adult family member who makes a significant...

7 CFR 1400.208 - Family members.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Family members. 1400.208 Section 1400.208 Agriculture... SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.208 Family members. (a) Notwithstanding... persons, a majority of whom are family members, an adult family member who makes a significant...

Food insufficiency in the households of reproductive-age Ecuadorian women: association with food and nutritional status indicators.

PubMed

Weigel, M Margaret; Armijos, Maria Mercedes

2015-01-01

Data from a nationally representative survey of Ecuadorian households with reproductive-aged women (n = 10,784) were used to analyze the prevalence of household food insufficiency (HFI) and its association with sociodemographic characteristics, food acquisition and expenditure patterns, dietary diversity, and anthropometric indicators. Fifteen percent of households had food insufficiency and 15% had marginal food sufficiency. HFI was associated with poverty-linked indicators. Marginally food sufficient households reported social and economic capital than food which appeared protective against HFI. Food insufficiency was associated with reduced household acquisition/expenditures on high quality protein and micronutrient-rich food sources. HFI was not associated with adult or adolescent female overweight/obesity but was associated with short adult stature (< 1.45 m). The ongoing nutrition transition in Ecuador is expected to continue to modify population food security, diet, and nutrition. Systematic surveillance of household level food security is needed to inform recent food-related policies and programs implemented by the Ecuadorian government.

Vaccine history, gender and influenza vaccination in a household context.

PubMed

Mamelund, Svenn-Erik; Riise Bergsaker, Marianne A

2011-11-28

Few studies have investigated the effect of the history of vaccination on the current influenza vaccine uptake. The objective of this paper is to study the effects of vaccine history, for each sex separately, on the likelihood of vaccine uptake among single-head households and two-person households, controlling not only for the respondents' own prior vaccination history but also the history of vaccination among possible co-residents. We used logistic regression and data from a nationally representative telephone survey of the non-institutionalized Norwegian population aged ≥ 65 years to estimate our models (N=354). The survey was carried out in November 2008. The lowest vaccine uptake was found among those who live alone with no prior history of vaccination and among those who live in two-person households where both members had no prior history of vaccination (10-22%). Those who live in two-person households where both members had previously been vaccinated had the highest vaccine uptake (86%). While a man who has previously been vaccinated has a higher likelihood of continued vaccination if his wife also has a prior history of vaccination, a woman with a prior history of vaccination is not dependent on her husband's prior practice with respect to the probability of continued vaccination. Of those who have no history of vaccination, more women than men are vaccinated for the first time when they have a spouse who has a history of vaccination. Our study shows that the history of vaccination of a co-resident/spouse has an effect above and beyond the respondent's own vaccination history. The results indicate that there are gender differences in the willingness to encourage family members to be vaccinated or to embark upon a familial vaccination regime in order to protect the individual's own personal health and that of other family members from influenza. To the best of our knowledge such gender differences have never been shown before in research on influenza

Comparison between household budget survey and 24-hour recall data in a nationally representative sample of Polish households.

PubMed

Sekula, W; Nelson, M; Figurska, K; Oltarzewski, M; Weisell, R; Szponar, L

2005-06-01

Household budget survey (HBS) data are used regularly for nutritional epidemiological purposes. The validity of HBS data, however, is not well established. The aim of this project was to compare HBS and individual nutrition survey (INS) data in a nationally representative sample of Polish households. Estimates of food consumption and nutrient intake were compared between household food acquisition data collected over 1 month and a single 24-hour recall collected from every household member in a nationally representative sample of Polish households surveyed between September and November 2000. To facilitate the comparison, INS food consumption data excluded food eaten away from home and were modified using a computer program to estimate food 'as purchased' (including disaggregation of recipe data) and to allow for wastage. Poland. Participants were 3716 individuals in 1215 households (representing co-operation rates of 86.2% and 89.2%, respectively). Good agreement was shown between median estimates of foods such as potatoes, vegetables (including processed), meat, meat products and poultry, and animal fats (excluding butter), but agreement was poor for bread and rolls, fruit, vegetable fats and oils, eggs and six other food groups. Estimates of energy and nutrient intake were within +/-10% with the exceptions of polyunsaturated fats, potassium and vitamin C. Possible reasons for differences in findings between the two surveys include survey bias (e.g. social approval bias leading to overreporting of fruit), seasonal variations (e.g. high potato purchases between September and November) and aspects of the methodology (e.g. HBS data were based on records collected over 1 month, whereas 24-hour recall data were based on recalls collected from all household respondents on only 1 day and averaged for each household type). HBSs provide useful data for epidemiological research, but findings need to be interpreted in the light of other data regarding consumption, and

The use of household cleaning sprays and adult asthma: an international longitudinal study.

PubMed

Zock, Jan-Paul; Plana, Estel; Jarvis, Deborah; Antó, Josep M; Kromhout, Hans; Kennedy, Susan M; Künzli, Nino; Villani, Simona; Olivieri, Mario; Torén, Kjell; Radon, Katja; Sunyer, Jordi; Dahlman-Hoglund, Anna; Norbäck, Dan; Kogevinas, Manolis

2007-10-15

Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied. To investigate the risk of new-onset asthma in relation to the use of common household cleaners. Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis. The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [CI], 1.12-1.99) and wheeze (RR, 1.39; 95% CI, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% CI, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma. Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.

Nurturing for Careers in Drug Use and Crime: Conduct Norms for Children and Juveniles in Crack-Using Households

PubMed Central

Johnson, Bruce D.; Dunlap, Eloise; Maher, Lisa

2009-01-01

A very sizable proportion of juvenile delinquents and adult criminals come from backgrounds and family kin systems having deviant parents or kin. This paper provides a focus upon the child-rearing practices directly observed by trained ethnographer during a case study of one highly criminal, drug-using household/kin network. The concrete expectations (and actual practices)—called conduct norms—with which the household adults respond to (or “nurture”) children and juveniles are delineated. While children are taught to “pay attention” to what adults do, adults typically model various deviant activities and rarely engage in conventional behaviors. Drug-using, and especially crack-using, men and women are expected not to raise (or financially support) children born to them; other kin expect to raise children of such unions. Children are not expected, nor able, to develop strong affective bonds with any household adults, and receive little or no psychological parenting. Adults do not take strong measures to protect children/juveniles from harm, and often adults are a major source of harm. In many ways the conduct norms in such crack-using households are well designed to “nurture” those persons who will be antisocial as children, delinquents as juveniles, and become criminals, drug misusers, and prostitutes in adulthood—and who have very few chances to become conventional adults. [Translations are provided in the International Abstracts Section of this issue.] PMID:9657414

Prevalence of Obesity Among Adults, by Household Income and Education - United States, 2011-2014.

PubMed

Ogden, Cynthia L; Fakhouri, Tala H; Carroll, Margaret D; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

2017-12-22

Studies have suggested that obesity prevalence varies by income and educational level, although patterns might differ between high-income and low-income countries (1-3). Previous analyses of U.S. data have shown that the prevalence of obesity varied by income and education, but results were not consistent by sex and race/Hispanic origin (4). Using data from the National Health and Nutrition Examination Survey (NHANES), CDC analyzed obesity prevalence among adults (aged ≥20 years) by three levels of household income, based on percentage (≤130%, >130% to ≤350%, and >350%) of the federal poverty level (FPL) and individual education level (high school graduate or less, some college, and college graduate). During 2011-2014, the age-adjusted prevalence of obesity among adults was lower in the highest income group (31.2%) than the other groups (40.8% [>130% to ≤350%] and 39.0% [≤130%]). The age-adjusted prevalence of obesity among college graduates was lower (27.8%) than among those with some college (40.6%) and those who were high school graduates or less (40.0%). The patterns were not consistent across all sex and racial/Hispanic origin subgroups. Continued progress is needed to achieve the Healthy People 2020 targets of reducing age-adjusted obesity prevalence to <30.5% and reducing disparities (5).

A woman's place: household labour allocation in rural Kenya.

PubMed

Neitzert, M

1994-01-01

This article synthesizes the literature on household labor allocation. The review reveals that development policies impacting on the labor market favor men over women. Male favoritism also occurs in household decision-making. Data from the 1988 Rural Labor Force Survey were used to examine rural household labor allocation in 1988 and the extent of female and male participation in home and market production and the degree of labor market discrimination against women. It is argued that the standard neoclassical model of economics does not recognize the unequal bargaining power of each member of the household in arriving at a solution to the joint welfare maximization problem. Women's position is expected to worsen during economic development. Women will have less than full participation in the labor market. Women's distinct role in household welfare provision is often disregarded. Development policy mainly focuses on market activities where women hold few positions. Labor allocation in the empirical analysis pertains to the mean hours per week in farm activities, household activities, schooling, and paid or unpaid non-farm work. Findings indicate that average earnings were lower for females than males and that returns to education and training were higher for males than females. Wage discrimination accounted for 30-66% of the earnings gap between rural men and women. Women faced discrimination on their returns to human capital and occupational choices. The concentration of women in low-paying jobs accounted for 21% of the wage gap. Women's lower education accounted for over 10%. Findings suggest that Kenyan households respond to market incentives. Women worked longer hours than men and contributed more to household welfare. Policy should focus on models of household provisioning and not on a joint utility function. Policy should encourage households to revise labor allocation strategies.

Protecting Newborns by Immunizing Family Members in a Hospital-Based Vaccine Clinic: A Successful Tdap Cocooning Program During the 2010 California Pertussis Epidemic

PubMed Central

McBane, Sarah; Wang, Wendy; Sawyer, Mark

2014-01-01

Objective Infants are at greatest risk for mortality from pertussis infection. Since 2005, the Advisory Committee on Immunization Practices has recommended a cocooning strategy of vaccinating all close contacts of infants with tetanus, diptheria, and acellular pertussis (Tdap) vaccine to reduce the risk of transmitting pertussis. Difficulties in establishing a complete cocoon have been reported in the literature. We determined whether families of newborns could be fully immunized against pertussis, thereby providing a complete cocoon of protection. Methods Tdap vaccine was offered during visiting hours to contacts aged 7 years and older and to postpartum patients who had not received Tdap vaccine during pregnancy. We then conducted retrospective phone interviews with randomly selected mothers (or other family members) to assess vaccination rates. We compared household vaccination rates during intervention and control periods and the demographic factors associated with Tdap vaccination of all members within the households. Results During the intervention period, 243 postpartum patients and 1,287 other family members of newborns were immunized, with 84.8% of all family members receiving Tdap vaccination. Seventy-six percent of households reported a complete cocoon. In the control group, 52.2% of all family members received Tdap vaccination, and 29.3% of households had a complete cocoon. In the control group, fewer family members completed Tdap vaccination in the larger households than in the smaller households (p=0.008). Conclusion A cocooning strategy can be successfully implemented, such that the majority of newborns leave the hospital with their families fully immunized against pertussis. PMID:24791022

Determinants of dietary diversity and the potential role of men in improving household nutrition in Tanzania

PubMed Central

Afari-Sefa, Victor; Lukumay, Philipo Joseph; Dubois, Thomas

2017-01-01

Good nutrition is a prerequisite for a healthy and active life, especially for agriculture-dependent households. However, diets in most households in Tanzania lack diversity because the intake of meat, poultry, fish, and vegetables and fruits is low. This study estimates factors influencing dietary diversity of the household, children under five years, and women using primary survey data. It qualitatively assesses male dietary patterns and men’s potential role in improving the nutritional status of the entire household. The findings show that the most consumed foods within the household are cereals, vegetables, oils and fats, spices, condiments and beverages. Children (d = 0.4; p<0.05) and women (d = 0.5; p<0.01) in female-headed households have low dietary diversity compared to those in male-headed households. Women and children access less diverse diets since 46% and 26%, achieved minimum dietary diversity respectively. Production of vegetables (coef. 0.34; p<0.05) play an important role in improving the dietary diversity of women. Gender (coef. 0.05; p<0.10) and education of the household head (coef. 0.02; p<0.01), food preparation and nutrition training (coef. 0.10; p<0.05) are important factors influencing dietary diversity of the members of a household. Results suggest that there is a need to support community-based programs to provide information on food and the importance of vegetables, their preparation, consumption and utilization to address food and nutrition challenges. Men can contribute towards improving household nutrition security by reducing consumption of food away from the home, especially during periods of food shortages. We recommend the use of complementary quantitative research to determine the patterns and dynamics of men’s dietary diversity and compare it with that of other household members. PMID:29232413

Household food insecurity is associated with less physical activity among children and adults in the U.S. population.

PubMed

To, Quyen G; Frongillo, Edward A; Gallegos, Danielle; Moore, Justin B

2014-11-01

Household food insecurity and physical activity are each important public-health concerns in the United States, but the relation between them has not been investigated thoroughly. This study aimed to examine the association between food insecurity and physical activity in the U.S. population. Physical activity measured by accelerometry (PAM) and physical activity measured by questionnaire (PAQ) data from the NHANES 2003-2006 were used. Individuals aged <6 y or >65 y, pregnant women, individuals with physical limitations, and individuals with family income >350% of the poverty line were excluded. Food insecurity was measured by the USDA Household Food Security Survey Module. Adjusted ORs were calculated from logistic regression to identify the association between food insecurity and adherence to the physical-activity guidelines. Adjusted coefficients were obtained from linear regression to identify the association between food insecurity with sedentary/physical-activity minutes. In children, food insecurity was not associated with adherence to physical-activity guidelines measured via PAM or PAQ and with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity than food-secure children (adjusted coefficient = -5.24, P = 0.02). In adults, food insecurity was significantly associated with adherence to physical-activity guidelines (adjusted OR = 0.72, P = 0.03 for PAM; and OR = 0.84, P < 0.01 for PAQ) but was not associated with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity, and food-insecure adults were less likely to adhere to the physical-activity guidelines than those without food insecurity. © 2014 American Society for Nutrition.

Environmental Contamination in Households of Patients with Recurrent Clostridium difficile Infection

PubMed Central

Bobr, Aleh; Kuskowski, Michael A.; Johnston, Brian D.; Sadowsky, Michael J.; Khoruts, Alexander

2016-01-01

Recurrent Clostridium difficile infection (R-CDI) is common and difficult to treat, potentially necessitating fecal microbiota transplantation (FMT). Although C. difficile spores persist in the hospital environment and cause infection, little is known about their potential presence or importance in the household environment. Households of R-CDI subjects in the peri-FMT period and of geographically matched and age-matched controls were analyzed for the presence of C. difficile. Household environmental surfaces and fecal samples from humans and pets in the household were examined. Households of post-FMT subjects were also examined (environmental surfaces only). Participants were surveyed regarding their personal history and household cleaning habits. Species identity and molecular characteristics of presumptive C. difficile isolates from environmental and fecal samples were determined by using the Pro kit (Remel, USA), Gram staining, PCR, toxinotyping, tcdC gene sequencing, and pulsed-field gel electrophoresis (PFGE). Environmental cultures detected C. difficile on ≥1 surface in 8/8 (100%) peri-FMT households, versus 3/8 (38%) post-FMT households and 3/8 (38%) control households (P = 0.025). The most common C. difficile-positive sites were the vacuum (11/27; 41%), toilet (8/30; 27%), and bathroom sink (5/29; 17%). C. difficile was detected in 3/36 (8%) fecal samples (two R-CDI subjects and one household member). Nine (90%) of 10 households with multiple C. difficile-positive samples had a single genotype present each. In conclusion, C. difficile was found in the household environment of R-CDI patients, but whether it was found as a cause or consequence of R-CDI is unknown. If household contamination leads to R-CDI, effective decontamination may be protective. PMID:26921425

Household Obesity Prevention: Take Action—a Group-Randomized Trial

PubMed Central

French, Simone A.; Gerlach, Anne F.; Mitchell, Nathan R.; Hannan, Peter J.; Welsh, Ericka M.

2018-01-01

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated. PMID:21212771

Household obesity prevention: Take Action--a group-randomized trial.

PubMed

French, Simone A; Gerlach, Anne F; Mitchell, Nathan R; Hannan, Peter J; Welsh, Ericka M

2011-10-01

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥ 12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated.

Impact of social standing on sports injury prevention in a WHO safe community: intervention outcome by household employment contract and type of sport

PubMed Central

Timpka, T; Lindqvist, K; Ekstrand, J; Karlsson, N

2005-01-01

Objectives: As physical activity is promoted as part of a healthy lifestyle, sports injuries are becoming an important public health concern in many countries. The objective of this study is to investigate rates of sports injuries before and after implementation of a WHO Safe Community program. Methods: Sports injury data were collected pre- and post-implementation from all individuals below 65 years of age during 1 year in the targeted municipality (population 41 000) and in a control municipality (population 26 000). A quasi-experimental design was used and individuals were divided into three categories based on household relationship to the labour market. Results: There were no differences between socio-economic categories regarding pre-intervention injury rates. No statistically significant post-intervention changes in injury rate were observed in the control area or among any females in either area. In the intervention area, a statistically significant (p = 0.011) decrease in injury rate was observed among male members of households in which the vocationally important member was employed. A statistically significant decrease was observed in injuries sustained in team sports among male members of households in which the vocationally important member was employed (p = 0.001) and among members of households in which the vocationally important member was self employed (p<0.05). Conclusions: The study indicates areas for improvement in the civic network based WHO Safe Community model. The results show that females, participants in individual sports, and members of non-vocationally active households were less affected by the interventions. These facts have to be addressed in planning future community based sports injury prevention programmes and their evaluations. PMID:15976170

Correlates and outcomes of worries about hypoglycemia in family members of adults with diabetes: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study.

PubMed

Nefs, Giesje; Pouwer, François; Holt, Richard I G; Skovlund, Søren; Hermanns, Norbert; Nicolucci, Antonio; Peyrot, Mark

2016-10-01

We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support. The second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study cross-sectionally surveyed 2057 family members from 17 countries. Participants completed questions about demographics, diabetes, and psychosocial functioning, including worry about overall and nocturnal hypoglycemia. Analyses included hierarchical ordinal and linear regression. Eighty-five percent of family members (n=1661) were at least occasionally very worried about the risk of hypoglycemic events overall. Correlates of worries about hypoglycemia included female gender, higher age and lower education in the family member, younger age of the person with diabetes and this person being a parent or another adult (versus spouse or partner), insulin or non-insulin injectable treatment, severe or non-severe hypoglycemia in the past 12months, and family member recognition of hypoglycemia. Elevated worries about hypoglycemia had a significant independent association with increased odds of diabetes-related family arguments and family member frustration in providing helpful support (OR range 1.60-3.72). High levels of worries about hypoglycemia were associated with increased odds of attending diabetes-related health-care visits. Worries about hypoglycemia were not associated with family member involvement in diabetes care. Similar results were found for worries about nocturnal events. Worries about hypoglycemia were common in family members and were associated with suboptimal diabetes support. This issue therefore deserves increased clinician attention. Copyright © 2016 Elsevier Inc. All rights reserved.

Living Arrangements and Health of Older Adults in India.

PubMed

Samanta, Tannistha; Chen, Feinian; Vanneman, Reeve

2015-11-01

We investigate the association between the multigenerational household context and health of older adults in India, taking into account potential selection effects. Using data from the India Human Development Survey (2004-05), a nationally representative multitopic data set, we employed a two-step analytical strategy--logistic regression followed by propensity score stratification method--to model the effect of contrasting living arrangement types on short-term illness. Overall, older adults living in multigenerational households have the lowest levels of short-term illness. Among them, those who live with their spouse, adult children, and young grandchildren experience the highest health gains. Health advantage diminishes when older adults live only with a spouse and adult children, and further diminishes when they live only with their spouse. Solitary living is associated with the highest likelihood of short-term morbidity. Good health is also shown to be associated with household wealth, gender, household size, and urban residence. Our study demonstrates that multigenerational households--the traditional and the most dominant form of living arrangement in India--have protective health benefits for older adults, while taking into account potential selection mechanisms. On Contrary to some epidemiological studies, we do not find any elevated risk of exposure to short-term illness, when older adults are living in households with young grandchildren. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Household Food Insecurity: Serious Concerns for Child Development. Social Policy Report. Volume 25, Number 3

ERIC Educational Resources Information Center

Fiese, Barbara H.; Gundersen, Craig; Koester, Brenda; Washington, LaTesha

2011-01-01

In 2009, 14.7% of households were food insecure at some time during the year. In other words, members of those households did not have access at all times to enough food for an active, healthy life. This is arguably the most serious nutrition-related public health problem facing the U.S. today. The serious developmental consequences of food…

Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010.

PubMed

Molla, Azaher Ali; Chi, Chunhuei; Mondaca, Alicia Lorena Núñez

2017-01-31

Predictors of high out-of-pocket household healthcare expenditure are essential for creating effective health system finance policy. In Bangladesh, 63.3% of health expenditure is out-of-pocket and born by households. It is imperative to know what determines household health expenditure. This study aims to investigate the predicting factors of high out-of-pocket household healthcare expenditure targeting to put forward policy recommendations on equity in financial burden. Bangladesh household income and expenditure survey 2010 provides data for this study. Predictors of high out-of-pocket household healthcare expenditure were analyzed using multiple linear regressions. We have modeled non-linear relationship using logarithmic form of linear regression. Heteroscedasticity and multicollinearity were checked using Breusch-Pagan/Cook-Weishberg and VIF tests. Normality of the residuals was checked using Kernel density curve. We applied required adjustment for survey data, so that standard errors and parameters estimation are valid. Presence of chronic disease and household income were found to be the most influential and statistically significant (p < 0.001) predictors of high household healthcare expenditure. Households in rural areas spend 7% less than urban dwellers. The results show that a 100% increase in female members in a family leads to a 2% decrease in household health expenditure. Household income, health shocks in families, and family size are other statistically significant predictors of household healthcare expenditure. Proportion of elderly and under-five members in the family show some positive influence on health expenditure, though statistically nonsignificant. The findings call for emphasizing prevention of chronic diseases, as it is a strong predictor of household health expenditure. Innovative insurance scheme needs to be devised to prevent household from being impoverished due to health shocks in the family. Policy makers are urged to design an

Eating together and eating alone: meal arrangements in British households.

PubMed

Yates, Luke; Warde, Alan

2017-03-01

Sociology traditionally accounts for eating in terms of the social organization of meals, their provision and consumption. A recurrent public concern is that the meal is being subverted. This paper examines meal arrangements in British households in 2012, drawing on an online survey in the format of a food diary administered to 2784 members of a supermarket consumer panel. It charts the organization of contemporary eating occasions, paying attention to socio-demographic variation in practice. Especially, it explores companionless meals, putting them in contexts of food provisioning and temporal rhythms. Findings show that eating alone is associated with simpler, quicker meals, and that it takes place most commonly in the morning and midday. Those living alone eat alone more often, but at similar meal times, and they take longer over their lone meals. Comparison with a similar study in 1955-6 suggests some fragmentation or relaxation in collective schedules. The implications are not straightforward, and the causes probably lie more in institutional shifts than personal preferences. Declining levels of commensality are, however, associated with a reduction in household size and, especially in households with children, difficulties of coordinating family members' schedules. © London School of Economics and Political Science 2016.

Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users.

PubMed

Kopp, Benjamin T; Hinton, Alice; Lu, Rong; Cooper, Sarah; Nagaraja, Haikady; Wewers, Mary Ellen

2018-04-10

Secondhand smoke exposure in children is changing as a result of new public policy and electronic nicotine products (e-cigarettes). We examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. A cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users. They were further stratified according to combustible or noncombustible product use and the presence of indoor tobacco use restrictions. Multiple logistic regression determined factors associated with indoor tobacco restrictions. A total of 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors. Urban location (odds ratio [OR] = 1.58), younger age (OR = 0.88 per 5 year), male sex (OR = 1.40), college education (OR = 1.40), household income of more than $15,000 (OR = 1.78), and being married (OR = 2.43) were associated with a higher likelihood of banning combustible products indoors. SLT (OR = 8.12) and e-cigarette (OR = 5.85) users were more likely to have indoor bans compared to combustible users. Children in the household (OR = 1.89), older age (OR = 1.12 per 5 years), and nonwhite race (OR = 1.68) were associated with a higher likelihood of banning noncombustible products indoors. Combustible (OR = 4.54) and e-cigarette (OR = 3.04) users were more likely than SLT users to have indoor bans. Indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Public policy should target modifiable risk factors for in-home secondhand smoke exposure. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All

Impact of Illness and Medical Expenditure on Household Consumptions: A Survey in Western China

PubMed Central

Fang, Kuangnan; Jiang, Yefei; Shia, BenChang; Ma, Shuangge

2012-01-01

Background The main goal of this study is to examine the associations between illness conditions and out-of-pocket medical expenditure with other types of household consumptions. In November and December of 2011, a survey was conducted in three cities in western China, namely Lan Zhou, Gui Lin and Xi An, and their surrounding rural areas. Results Information on demographics, income and consumption was collected on 2,899 households. Data analysis suggested that the presence of household members with chronic diseases was not associated with characteristics of households or household heads. The presence of inpatient treatments was significantly associated with the age of household head (p-value 0.03). The level of per capita medical expense was significantly associated with household size, presence of members younger than 18, older than 65, basic health insurance coverage, per capita income, and household head occupation. Adjusting for confounding effects, the presence of chronic diseases was negatively associated with the amount of basic consumption (p-value 0.02) and the percentage of basic consumption (p-value 0.01), but positively associated with the percentage of insurance expense (p-value 0.02). Medical expenditure was positively associated with all other types of consumptions, including basic, education, saving and investment, entertainment, insurance, durable goods, and alcohol/tobacco. It was negatively associated with the percentage of basic consumption, saving and investment, and insurance. Conclusions Early studies conducted in other Asian countries and rural China found negative associations between illness conditions and medical expenditure with other types of consumptions. This study was conducted in three major cities and surrounding areas in western China, which had not been well investigated in published literature. The observed consumption patterns were different from those in early studies, and the negative associations were not observed. This

The impact of ART initiation on household food security over time.

PubMed

Patenaude, Bryan N; Chimbindi, Natsayi; Pillay, Deenan; Bärnighausen, Till

2018-02-01

While evidence suggests that adequate nutrition contributes to the efficacy of ART, the potential causal impact of ART initiation on household food security has not been thoroughly examined. In this study, we present some of the first causal evidence of the impact of ART initiation on household food security. We employ a quasi-experimental design, regression discontinuity, over 5540 individuals from an ongoing population cohort study in KwaZulu-Natal, South Africa, by utilizing the CD4 count-based ART eligibility threshold to examine the impact of ART initiation on household food security. We find that ART initiation causes a significant increase in the probability of food insecurity in the first year, which diminishes to zero within three years of initiation. Within the first year, ART initiation was found to significantly increase the probabilities that (1) the surveyed adult had missed any food in the past month by 10.2 percentage points (coefficient = 0.102, 95%CI = [0.039, 0.166]); (2) any adult in the household had missed a meal in the past month by 15.2 percentage points (coefficient = 0.152, 95%CI = [0.073, 0.231]); and (3) any child in the household had missed a meal in the past month by 8.9 percentage points (coefficient = 0.0898, 95%CI = [0.0317, 0.148]). While we cannot definitively isolate the mechanistic pathways from ART to household food security, our results are consistent with ART affecting food security through household resource strain and patient appetite recovery. Several policies could mitigate the negative impact of ART on food security, in particular food parcels or food vouchers for ART patients in the first two years after treatment initiation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using DNA fingerprints to infer familial relationships within NHANES III households

PubMed Central

Katki, Hormuzd A.; Sanders, Christopher L.; Graubard, Barry I.; Bergen, Andrew W.

2009-01-01

Developing, targeting, and evaluating genomic strategies for population-based disease prevention require population-based data. In response to this urgent need, genotyping has been conducted within the Third National Health and Nutrition Examination (NHANES III), the nationally-representative household-interview health survey in the U.S. However, before these genetic analyses can occur, family relationships within households must be accurately ascertained. Unfortunately, reported family relationships within NHANES III households based on questionnaire data are incomplete and inconclusive with regards to actual biological relatedness of family members. We inferred family relationships within households using DNA fingerprints (Identifiler®) that contain the DNA loci used by law enforcement agencies for forensic identification of individuals. However, performance of these loci for relationship inference is not well understood. We evaluated two competing statistical methods for relationship inference on pairs of household members: an exact likelihood ratio relying on allele frequencies to an Identical By State (IBS) likelihood ratio that only requires matching alleles. We modified these methods to account for genotyping errors and population substructure. The two methods usually agree on the rankings of the most likely relationships. However, the IBS method underestimates the likelihood ratio by not accounting for the informativeness of matching rare alleles. The likelihood ratio is sensitive to estimates of population substructure, and parent-child relationships are sensitive to the specified genotyping error rate. These loci were unable to distinguish second-degree relationships and cousins from being unrelated. The genetic data is also useful for verifying reported relationships and identifying data quality issues. An important by-product is the first explicitly nationally-representative estimates of allele frequencies at these ubiquitous forensic loci. PMID

How Do We Promote Health?: From the Words of African American Older Adults With Dementia and Their Family Members.

PubMed

Epps, Fayron; Skemp, Lisa; Specht, Janet K

2016-11-01

As population diversity increases, understanding what health promotion means to ethnically diverse older adults and their family members aids in the design of health programming. This understanding is particularly relevant for the African American population who experience a high prevalence of Alzheimer's disease and related dementias (ADRD). The purpose of the current study was to describe family members' definition of health, health promotion activities (HPAs), barriers to HPAs, and the perceived effectiveness of HPAs for African American older adults with ADRD. A qualitative descriptive design was used to collect data from African American family caregivers (n = 26) and care recipients (n = 18). Transcripts, journals, and field notes were reviewed using inductive content analysis. Common health promotion activities included taking care of self, positive attitude on life, social engagement, spiritual and religious activity, stimulation and active movement, and financial stability. This research informs person-centered care strategies for African American families caring for older adults with ADRD. [Res Gerontol Nurs. 2016; 9(6):278-287.]. Copyright 2016, SLACK Incorporated.

Household Composition and Longitudinal Health Outcomes for Older Mexican Return Migrants

PubMed Central

Mudrazija, Stipica; López-Ortega, Mariana; Vega, William A.; Robledo, Luis Miguel Gutiérrez; Sribney, William

2016-01-01

Mexican return migrant population is increasing, yet our knowledge about their lives after resettlement in Mexico remains fragmentary. Using 2001–2012 longitudinal data from the Mexican Health and Aging Study, we investigate difference in household composition for older migrants who returned from the United States compared to nonmigrants. Furthermore, we fit a Cox proportional hazards model to assess the relationship between household composition and health and functional trajectories of return migrants and nonmigrants. The results indicate that return migrants with long duration of U.S. stay have different household composition than nonmigrants or short-term migrants: On average, they have smaller household size, including fewer females who may be available to offer assistance to older adults. Presence of middle-age females in the household has positive effects on health and functional trajectories. We highlight implications of this research for policy makers in Mexico and the United States. PMID:26966255

Consumption of food away from home in Bangladesh: Do rich households spend more?

PubMed

Mottaleb, Khondoker A; Rahut, Dil Bahadur; Mishra, Ashok K

2017-12-01

While consumption of food away from home (FAFH) is an established phenomenon among households in the developed countries, FAFH is a growing phenomenon in many middle-income and rapidly growing developing countries. Although, studies are available on the factors affecting consumption of FAFH in developed countries, there is a paucity of such studies in developing countries. This study examines households' choice of and expenditures on FAFH. We used information from Bangladeshi households and applied a double-hurdle regression model estimation procedure. Findings show that, in general, rich households are spending proportionately less on FAFH and, over time, the trend is continuing. Although households with female members who work in the non-farm sector are more likely to consume FAFH, educated household heads and spouses, and particularly urban households are less likely to consume and spend on FAFH. As the problem of food adulteration by dishonest sellers is rampant in Bangladesh, perhaps it discourages rich, urban and households headed by educated heads and spouses to consume and spend more on FAFH. Based on the findings, some points of interventions are also prescribed in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

PubMed Central

Pavlinac, Patricia B.; Naulikha, Jaqueline M.; Chaba, Linda; Kimani, Naomi; Sangaré, Laura R.; Yuhas, Krista; Singa, Benson O.; John-Stewart, Grace; Walson, Judd L.

2014-01-01

Among human immunodeficiency virus (HIV) -infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared with 17.2% in the 3 months before filter provision (odds ratio [OR] = 0.39, 95% confidence interval [95% CI] = 0.23–0.66, P < 0.001). The association was similar among 231 participants who were already taking daily cotrimoxazole prophylaxis before being given a filter (OR = 0.47, 95% CI = 0.25–0.88, P = 0.019). Educational reinforcement was also associated with a modest reduction in self-reported diarrhea (OR = 0.50, 95% CI = 0.20–0.99, P = 0.047). Provision and reinforcement of water filters may confer significant benefit in reducing diarrhea among HIV-infected persons, even when cotrimoxazole prophylaxis is already being used. PMID:24842881

Cumulative childhood stress and autoimmune diseases in adults.

PubMed

Dube, Shanta R; Fairweather, DeLisa; Pearson, William S; Felitti, Vincent J; Anda, Robert F; Croft, Janet B

2009-02-01

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with >or=2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05). Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Growing up with Parental Alcohol Abuse: Exposure to Childhood Abuse, Neglect, and Household Dysfunction.

ERIC Educational Resources Information Center

Dube, Shanta R.; Anda, Robert F.; Felitti, Vincent J.; Croft, Janet B.; Edwards, Valerie J.; Giles, Wayne H.

2001-01-01

A study involving 8,629 adults examined the association between parental alcohol abuse and child abuse, neglect, and other household dysfunction. Compared to households without alcohol abuse, the adjusted odds ratio for each category of adverse childhood experience was 2 to 13 times higher if parents abused alcohol. (Contains references.) (CR)

Prevalence of household firearms and firearm-storage practices in the 50 states and the District of Columbia: findings from the Behavioral Risk Factor Surveillance System, 2002.

PubMed

Okoro, Catherine A; Nelson, David E; Mercy, James A; Balluz, Lina S; Crosby, Alex E; Mokdad, Ali H

2005-09-01

To examine the prevalence of household firearms and firearm-storage practices in the 50 states and the District of Columbia and estimate the number of children exposed to unsafe storage practices. We analyzed data from the 2002 cross-sectional Behavioral Risk Factor Surveillance System survey of 240735 adults from randomly selected households with telephones in the 50 states and the District of Columbia. Nationally, 32.6% of adults reported that firearms were kept in or around their home. The prevalence of adults with household firearms ranged from 5.2% in the District of Columbia to 62.8% in Wyoming (median: 40.8%). The prevalence of adults with loaded household firearms ranged from 1.6% in Hawaii, Massachusetts, and New Jersey to 19.2% in Alabama (median: 7.0%), and the prevalence of adults with loaded and unlocked household firearms ranged from 0.4% in Massachusetts to 12.7% in Alabama (median: 4.2%). Among adults with children and youth <18 years old, the prevalence of loaded household firearms ranged from 1.0% to 13.4% (median: 5.3%), and the prevalence of loaded and unlocked household firearms ranged from 0.3% to 7.3% (median: 2.3%); in each instance, Massachusetts had the lowest prevalence and Alabama had the highest. Findings indicate that approximately 1.69 million (95% confidence interval: 1.57-1.82 million) children and youth in the United States <18 years old are living with loaded and unlocked household firearms. Substantial state variations exist in the prevalence of household firearms and firearm-storage practices. It is vital that surveillance systems such as the Behavioral Risk Factor Surveillance System continue to monitor the prevalence of household firearms and firearm-storage practices so that future interventions to promote safe storage of firearms can be evaluated and more widely implemented based on their efficacy.

Household water insecurity after a historic flood: Diarrhea and dehydration in the Bolivian Amazon.

PubMed

Rosinger, Asher Y

2018-01-01

While 884 million people worldwide lack access to clean water, millions live in flood-prone regions. Unexpected flooding increases risk of diarrheal diseases and is expected to occur with increased frequency in the 21st century. Water insecurity is linked to mental distress in water scarce regions, yet this construct has not been examined closely among populations living in flood-prone regions. This paper examines how differences in water sources and lifestyle among Tsimane' forager-horticulturalists in lowland Bolivia are related to water insecurity after a historic flood in 2014, and in turn, how water insecurity is associated with diarrhea and dehydration. Pre-flood data come from qualitative interviews with 36 household heads, anthropometrics, participant observation, and water quality analysis between September 2013-January 2014 used to create a locally-adapted water insecurity questionnaire. Water insecurity was measured after the historic flood; no pre-flood water insecurity measures are available. Post-flood data were collected through surveys, water quality analysis, and health exams using near-exhaustive sampling in two villages, yielding 118 adults and 115 children (aged 2-12 years) in 62 households between March-April 2014. Overall, 89% of adults reported medium or high water insecurity. Only hand-pumps tested negative for pathogenic bacteria both pre- and post-flood. Tobit regressions suggest that hand-pumps (when available) and adult age were associated with lower water insecurity scores. Multiple logistic regressions suggest that adults with high water insecurity were more likely to report diarrhea than adults with low (Odds Ratio [OR] 9.2; 95% CI: 1.27-67.1). Children from households with medium (OR: 6.8; 95% CI: 1.41-32.5) or high (OR: 14.0; 95% CI: 2.40-81.5) water insecurity had significantly higher odds of dehydration than children in households with low water insecurity. Catastrophic flooding may systematically increase dimensions of household

[Household care for ill and disabled persons: challenges for the Mexican health care system].

PubMed

Nigenda, Gustavo; López-Ortega, Mariana; Matarazzo, Cecilia; Juárez-Ramírez, Clara

2007-01-01

To identify the pattern of time devoted by members of Mexican households to providing care to ill and disabled family members. To analyze the mechanisms used by families to provide care to an ill or disabled member. The database of the 2002 National Survey of Time Use was explored to accomplish the first objective. The second objective was accomplished by collecting primary data through in-depth interviews and focal groups in Coahuila, Sinaloa, Zacatecas, Jalisco, Oaxaca and Yucatán from June to December 2004. It was estimated that 1,738,756 persons spent time providing care to ill persons and 1,496,616 to disabled persons, over the reference period of the survey. There are important differences in the dedication of hours by gender and education level. Moreover, households tend to reorganize their structure to provide care to ill and disabled members. Women tend to have more responsibilities in the process. There are important differences in the care of ill and of the disabled in terms of the physical and emotional stress produced in the caregiver. The implications of results in the care of ill and disabled populations are highly relevant for the future of the Mexican health care system. Population aging and the increase of chronic diseases call for a reinforced relationship between institutional and household care so as to complement capacities, a situation already taking place in other countries.

The effects of household wealth on HIV prevalence in Manicaland, Zimbabwe – a prospective household census and population-based open cohort study

PubMed Central

Schur, Nadine; Mylne, Adrian; Mushati, Phyllis; Takaruza, Albert; Ward, Helen; Nyamukapa, Constance; Gregson, Simon

2015-01-01

Introduction Intensified poverty arising from economic decline and crisis may have contributed to reductions in HIV prevalence in Zimbabwe. Objectives To assess the impact of the economic decline on household wealth and prevalent HIV infection using data from a population-based open cohort. Methods Household wealth was estimated using data from a prospective household census in Manicaland Province (1998 to 2011). Temporal trends in summed asset ownership indices for sellable, non-sellable and all assets combined were compared for households in four socio-economic strata (small towns, agricultural estates, roadside settlements and subsistence farming areas). Multivariate logistic random-effects models were used to measure differences in individual-level associations between prevalent HIV infection and place of residence, absolute wealth group and occupation. Results Household mean asset scores remained similar at around 0.37 (on a scale of 0 to 1) up to 2007 but decreased to below 0.35 thereafter. Sellable assets fell substantially from 2004 while non-sellable assets continued increasing until 2008. Small-town households had the highest wealth scores but the gap to other locations decreased over time, especially for sellable assets. Concurrently, adult HIV prevalence fell from 22.3 to 14.3%. HIV prevalence was highest in better-off locations (small towns) but differed little by household wealth or occupation. Initially, HIV prevalence was elevated in women from poorer households and lower in men in professional occupations. However, most recently (2009 to 2011), men and women in the poorest households had lower HIV prevalence and men in professional occupations had similar prevalence to unemployed men. Conclusions The economic crisis drove more households into extreme poverty. However, HIV prevalence fell in all socio-economic locations and sub-groups, and there was limited evidence that increased poverty contributed to HIV prevalence decline. PMID:26593453

Child size and household characteristics in rural Timor-Leste.

PubMed

Reghupathy, Nadine; Judge, Debra S; Sanders, Katherine A; Amaral, Pedro Canisio; Schmitt, Lincoln H

2012-01-01

The main objective was to determine those characteristics of the family and household that affects child health (as measured by child size for age) in the rural Ossu area of Timor-Leste. Interviews of parents in 102 households assessed reproductive histories, the amount and type of resources available and family composition (number, sex, and age of members). Height, weight, and mid-upper arm circumference were measured for all children in the household. To standardize for age and sex, raw measures were transformed into WHO Z scores and compared across households. Children were low in both height and weight relative to international standards and older children compared with international standards more poorly than under-fives. There was no evidence of sex difference in relative growth. The number of children in a household was negatively associated with height but not weight and positively with BMI. Children living in the villages more distant from Ossu town center had significantly lower Z scores for height than children in town. No crop or livestock indices were related to growth. Fostered children did not show growth different from biological children, but biological children in households with fostered children were slightly larger for age. Short stature inflates BMI and harvest season measures may have captured short-term increases in children's energy balance. Social networks may increase child well-being by moving children toward resource richer households. Social and cultural factors influence resource allocations among children and their health in rural Timor-Leste. 2011 Wiley Periodicals, Inc.

Catastrophic health expenditure: a comparative analysis of empty-nest and non-empty-nest households with seniors in Shandong, China.

PubMed

Yang, Tingting; Chu, Jie; Zhou, Chengchao; Medina, Alexis; Li, Cuicui; Jiang, Shan; Zheng, Wengui; Sun, Liyuan; Liu, Jing

2016-07-05

The aim of this study was to compare the catastrophic health expenditure (CHE) prevalence and its determinants between empty-nest and non-empty-nest elderly households. Shandong province of China. A total of 2761 elderly households are included in the analysis. CHE incidence among elderly households was 44.9%. The CHE incidence of empty-nest singles (59.3%, p=0.000, OR=3.19) and empty-nest couples (52.9%, p=0.000, OR=2.45) are both statistically higher than that of non-empty-nest elderly households (31.4%). An inverse association was observed between CHE incidence and income level in all elderly household types. Factors including 1 or more household elderly members with non-communicable chronic diseases in the past 6 months, 1 or more elderly household members being hospitalised in the past year and lower household income, are significant risk factors for CHE in all 3 household types (p<0.05). Health insurance status was found to be a significant determinant of CHE among empty-nest singles and non-empty-nest households (p<0.05). CHE incidence among elderly households is high in China. Empty-nest households are at higher risk for CHE than non-empty-nest households. Based on these findings, we suggest that special insurance be developed to broaden the coverage of health services and heighten the reimbursement rate for empty-nest elderly in the existing health insurance schemes. Financial and social protection interventions are also essential for identified at-risk subgroups among different types of elderly households. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Complex Households and the Distribution of Multiple Resources in Later Life: Findings From a National Survey.

PubMed

Kim, Juyeon; Waite, Linda J

2016-02-01

The availability of social and financial resources has profound implications for health and well-being in later life. Older adults often share resources with others who live with them, sometimes in households including relatives or friends. We examine differences in social support, social connections, money, and the household environment across types of living arrangements, develop hypotheses from two theoretical perspectives, one focusing on obligations toward kin, and one focused on social exchange within households, and test them using data from the National Social Life, Health, and Aging Project. We find that availability of resources is not consistently associated with the presence of grandchildren and other young relatives, but often differs with presence of other adults. These findings suggest that a single type of resource tells us little about the distribution of the resources of older adults, and call on us to examine multiple resources simultaneously. © The Author(s) 2015.

Complex Households and the Distribution of Multiple Resources in Later Life: Findings from A National Survey

PubMed Central

Kim, Juyeon; Link, Arts; Waite, Linda

2016-01-01

The availability of social and financial resources has profound implications for health and well-being in later life. Older adults often share resources with others who live with them, sometimes in households including relatives or friends. We examine differences in social support, social connections, money, and the household environment across types of living arrangements, develop hypotheses from two theoretical perspectives, one focusing on obligations toward kin, and one focused on social exchange within households, and test them using data from the National Social Life, Health, and Aging Project. We find that availability of resources is not consistently associated with the presence of grandchildren and other young relatives, but often differs with presence of other adults. These findings suggest that a single type of resource tells us little about the distribution of the resources of older adults, and call on us to examine multiple resources simultaneously. PMID:25904682

How can we better capture food away from Home? Lessons from India's linking person-level meal and household-level food data.

PubMed

Fiedler, John L; Yadav, Suryakant

2017-10-01

Despite acknowledged shortcomings, household consumption and expenditure surveys (HCES) are increasingly being used to proxy food consumption because they are relatively more available and affordable than surveys using more precise dietary assessment methods. One of the most common, significant sources of HCES measurement error is their under-estimation of food away from home (FAFH). In 2011, India's National Survey Sample Organization introduced revisions in its HCES questionnaire that included replacing "cooked meals"-the single item in the food consumption module designed to capture FAFH at the household level-with five more detailed and explicitly FAFH sub-categories. The survey also contained a section with seven, household member-specific questions about meal patterns during the reference period and included three sources of meals away from home (MAFH) that overlapped three of the new FAFH categories. By providing a conceptual framework with which to organize and consider each household member's meal pattern throughout the reference period, and breaking down the recalling (or estimating) process into household member-specific responses, we assume the MAFH approach makes the key respondent's task less memory- and arithmetically-demanding, and thus more accurate than the FAFH household level approach. We use the MAFH estimates as a reference point, and approximate one portion of FAFH measurement error as the differences in MAFH and FAFH estimates. The MAFH estimates reveal marked heterogeneity in intra-household meal patterns, reflecting the complexity of the HCES's key informant task of reporting household level data, and underscoring its importance as a source of measurement error. We find the household level-based estimates of FAFH increase from just 60.4% of the individual-based estimates in the round prior to the questionnaire modifications to 96.7% after the changes. We conclude that the MFAH-FAFH linked approach substantially reduced FAFH measurement

Head Lice in Norwegian Households: Actions Taken, Costs and Knowledge

PubMed Central

Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

2012-01-01

Introduction Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. Materials and Methods A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. Results 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Conclusions Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households. PMID:22393437

Head lice in Norwegian households: actions taken, costs and knowledge.

PubMed

Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

2012-01-01

Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households.

Promoting household water treatment through women's self help groups in Rural India: assessing impact on drinking water quality and equity.

PubMed

Freeman, Matthew C; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

2012-01-01

Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent

High diversity of Staphylococcus aureus and Staphylococcus pseudintermedius lineages and toxigenic traits in healthy pet-owning household members. Underestimating normal household contact?

PubMed

Gómez-Sanz, Elena; Torres, Carmen; Lozano, Carmen; Zarazaga, Myriam

2013-01-01

Forty-three unrelated pet-owning households were screened in Spain to study the Staphylococcus aureus and Staphylococcus pseudintermedius nasal carriage, their genetic lineages and virulence traits. Sixty-seven healthy owners and 66 healthy pets were investigated. Isolates characterization was performed and potential interspecies transmission was assessed. S. aureus was present in 51.2% of households studied while S. pseudintermedius in 30.2%. Twenty-eight owners (41.8%) carried S. aureus: one methicillin-resistant S. aureus (MRSA) [t5173-ST8-SCCmecIVa] and 27 methicillin-susceptible S. aureus (MSSA). Three owners (4.5%) were colonized by methicillin-susceptible S. pseudintermedius (MSSP). Fifteen pets (22.7%) carried S. pseudintermedius: two methicillin-resistant S. pseudintermedius (MRSP) [ST71-SCCmecII/III; ST92-SCCmecV] and 13 MSSP; in addition, 8 pets (12.1%) presented MSSA. High diversity of spa and sequence types (STs) was detected. Typical livestock-associated S. aureus lineages (CC398, CC9) were observed in humans and/or companion animals and hospital and/or community-acquired S. aureus lineages (CC45, CC121, CC5, CC8) were detected among pets. Almost 40% of S. pseudintermedius were multidrug-resistant. S. aureus isolates harboured a remarkable high number of virulence genes. The expA gene was detected in 3 S. pseudintermedius isolates. Identical strains from both owners and their pets were identified in 5 households (11.6%): (a) four MSSA (t073-ST45/CC45, t159-ST121/CC121, t209-ST109/CC9, t021-ST1654([new])/singleton) and (b) one multidrug-resistant MSSP (ST142([new])). Highly clonally diverse and toxigenic S. aureus and S. pseudintermedius are common colonizers of healthy humans and pets. The presence of these bacterial species, virulence genes, and interspecies transmission detected, points out to consider pet ownership as a risk factor to acquire, maintain and spread, potential pathogenic bacteria. Copyright © 2012 Elsevier Ltd. All rights reserved.

A child's house: social memory, identity, and the construction of childhood in early postclassic Mexican households.

PubMed

De Lucia, Kristin

2010-01-01

Despite the recent attention given to the archaeology of childhood, households continue to be treated by archaeologists as the product of adult behavior and activities. Yet children shaped the decisions and motivations of adults and influenced the structure and organization of daily activities and household space. Further, children's material culture serves to both create and disrupt social norms and daily life, making children essential to understanding broader mechanisms of change and continuity. Thus, archaeologists should reconceptualize houses as places of children. This research brings together multiple lines of evidence from the Early Postclassic site of Xaltocan, Mexico, including ethnohistory, burials, and figurines to reconstruct the social roles and identities of children and to problematize our understanding of households. I argue that thinking of houses as places of children enables us to see that children were essential to daily practice, the construction and transmission of social identity, and household economic success.

Perspectives of Mothers in Farmworker Households on Reducing the Take-Home Pathway of Pesticide Exposure

PubMed Central

Strong, Larkin L.; Sharks, Helene E.; Meischke, Hendrika; Thompson, Beti

2014-01-01

Farmworkers carry pesticide residue home on their clothing, boots, and skin, placing other household members at risk, particularly children. Specific precautions are recommended to reduce this take-home pathway, yet few studies have examined the perspectives of farmworkers and other household members regarding these behaviors and the reasons for or against adoption. The authors conducted semistructured interviews with 37 Mexican/Mexican-American women in farmworker households to explore the family and cultural context in which pesticide safety practices are performed and to identify factors that facilitate or hinder their adoption. Whereas women could describe the take-home pathway, they were less able to connect it with their family’s susceptibility to pesticide exposure. Women experienced difficulty integrating the prevention behaviors into their everyday lives because of competing responsibilities, conflicts with their husbands’ intentions and with cultural health beliefs, perceived lack of control, and community barriers that interfered with women’s motivations. Implications for practice are discussed. PMID:19136611

Household Size and the Decision to Purchase Health Insurance in Cambodia: Results of a Discrete-Choice Experiment with Scale Adjustment.

PubMed

Ozawa, Sachiko; Grewal, Simrun; Bridges, John F P

2016-04-01

Community-based health insurance (CBHI) schemes have been introduced in low- and middle-income countries to increase health service utilization and provide financial protection from high healthcare expenditures. We assess the impact of household size on decisions to enroll in CBHI and demonstrate how to correct for group disparity in scale (i.e. variance differences). A discrete choice experiment was conducted across five CBHI attributes. Preferences were elicited through forced-choice paired comparison choice tasks designed based on D-efficiency. Differences in preferences were examined between small (1-4 family members) and large (5-12 members) households using conditional logistic regression. Swait and Louviere test was used to identify and correct for differences in scale. One-hundred and sixty households were surveyed in Northwest Cambodia. Increased insurance premium was associated with disutility [odds ratio (OR) 0.61, p < 0.01], while significant increase in utility was noted for higher hospital fee coverage (OR 10.58, p < 0.01), greater coverage of travel and meal costs (OR 4.08, p < 0.01), and more frequent communication with the insurer (OR 1.33, p < 0.01). While the magnitude of preference for hospital fee coverage appeared larger for the large household group (OR 14.15) compared to the small household group (OR 8.58), differences in scale were observed (p < 0.05). After adjusting for scale (k, ratio of scale between large to small household groups = 1.227, 95 % confidence interval 1.002-1.515), preference differences by household size became negligible. Differences in stated preferences may be due to scale, or variance differences between groups, rather than true variations in preference. Coverage of hospital fees, travel and meal costs are given significant weight in CBHI enrollment decisions regardless of household size. Understanding how community members make decisions about health insurance can inform low- and middle-income countries' paths

Confidence to cook vegetables and the buying habits of Australian households.

PubMed

Winkler, Elisabeth; Turrell, Gavin

2009-10-01

Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30; 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22; 95% CI 0.09 to 0.53) and other adults (OR 0.43; 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25; 95% CI 1.24 to 4.08), low education (OR 6.60; 95% CI 2.08 to 20.91), lower household income (OR 2.98; 95% CI 1.02 to 8.72) and living with other adults (OR 0.53; 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60; 95% CI 14.66 to 22.54), older (difference: 8.69; 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47; 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86; 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable

Household demography and early childhood mortality in a rice-farming village in Northern Laos.

PubMed

Tomita, Shinsuke; Parker, Daniel M; Jennings, Julia A; Wood, James

2015-01-01

This paper extends Alexandr Chayanov's model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years' worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household's consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov's model still has theoretical relevance and deserves to be revived.

Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey.

PubMed

Cetorelli, Valeria; Sasson, Isaac; Shabila, Nazar; Burnham, Gilbert

2017-05-01

In August 2014, the so-called Islamic State of Iraq and Syria (ISIS) attacked the Yazidi religious minority living in the area of Mount Sinjar in Nineveh governorate, Iraq. We conducted a retrospective household survey to estimate the number and demographic profile of Yazidis killed and kidnapped. The survey covered the displaced Yazidi population from Sinjar residing in camps in the Kurdistan Region of Iraq. Fieldwork took place between 4 November and 25 December, 2015. A systematic random sample of 1,300 in-camp households were interviewed about the current household composition and any killings and kidnappings of household members by ISIS. Of the 1,300 interviewed households, 988 were Yazidi from Sinjar. Yazidi households contained 6,572 living residents at the time of the survey; 43 killings and 83 kidnappings of household members were reported. We calculated the probability of being killed and kidnapped by dividing the number of reported killings and kidnappings by the number of sampled Yazidis at risk, adjusting for sampling design. To obtain the overall toll of killings and kidnappings, those probabilities were multiplied by the total Yazidi population living in Sinjar at the time of the ISIS attack, estimated at roughly 400,000 by the United Nations and Kurdish officials. The demographic profile of those killed and kidnapped was examined, distinguishing between children and adults and females and males. We estimated that 2.5% of the Yazidi population was either killed or kidnapped over the course of a few days in August 2014, amounting to 9,900 (95% CI 7,000-13,900) people in total. An estimated 3,100 (95% CI 2,100-4,400) Yazidis were killed, with nearly half of them executed-either shot, beheaded, or burned alive-while the rest died on Mount Sinjar from starvation, dehydration, or injuries during the ISIS siege. The estimated number kidnapped is 6,800 (95% CI 4,200-10,800). Escapees recounted the abuses they had suffered, including forced religious

Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey

PubMed Central

Cetorelli, Valeria; Burnham, Gilbert

2017-01-01

Background In August 2014, the so-called Islamic State of Iraq and Syria (ISIS) attacked the Yazidi religious minority living in the area of Mount Sinjar in Nineveh governorate, Iraq. We conducted a retrospective household survey to estimate the number and demographic profile of Yazidis killed and kidnapped. Methods and findings The survey covered the displaced Yazidi population from Sinjar residing in camps in the Kurdistan Region of Iraq. Fieldwork took place between 4 November and 25 December, 2015. A systematic random sample of 1,300 in-camp households were interviewed about the current household composition and any killings and kidnappings of household members by ISIS. Of the 1,300 interviewed households, 988 were Yazidi from Sinjar. Yazidi households contained 6,572 living residents at the time of the survey; 43 killings and 83 kidnappings of household members were reported. We calculated the probability of being killed and kidnapped by dividing the number of reported killings and kidnappings by the number of sampled Yazidis at risk, adjusting for sampling design. To obtain the overall toll of killings and kidnappings, those probabilities were multiplied by the total Yazidi population living in Sinjar at the time of the ISIS attack, estimated at roughly 400,000 by the United Nations and Kurdish officials. The demographic profile of those killed and kidnapped was examined, distinguishing between children and adults and females and males. We estimated that 2.5% of the Yazidi population was either killed or kidnapped over the course of a few days in August 2014, amounting to 9,900 (95% CI 7,000–13,900) people in total. An estimated 3,100 (95% CI 2,100–4,400) Yazidis were killed, with nearly half of them executed—either shot, beheaded, or burned alive—while the rest died on Mount Sinjar from starvation, dehydration, or injuries during the ISIS siege. The estimated number kidnapped is 6,800 (95% CI 4,200–10,800). Escapees recounted the abuses they had

Examining effects of food insecurity and food choices on health outcomes in households in poverty.

PubMed

Lombe, Margaret; Nebbitt, Von Eugene; Sinha, Aakanksha; Reynolds, Andrew

2016-07-01

Evidence documenting effects of food assistance programs, household food insecurity, and nutrition knowledge on health outcomes is building. Using data from a sub-sample of adults who are 185% of the poverty line from the 2007-2008 National Health and Nutrition Examination Survey (N = 2,171), we examine whether household food insecurity, food stamp take-up, and use of informal food supports are associated with health risk among low-income households. Findings indicate that while nutrition knowledge provides protection against health risk in food secure households, the health benefits of nutrition knowledge were not evident in food insecure households. We discuss these findings in light of current policy and practice interventions that recognize the importance of providing healthy, affordable food options for food insecure households.

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that

Self-medication with antibiotics in Serbian households: a case for action?

PubMed

Tomas, Ana; Paut Kusturica, Milica; Tomić, Zdenko; Horvat, Olga; Djurović Koprivica, Daniela; Bukumirić, Dragica; Sabo, Ana

2017-06-01

Background Irregular antibiotic use, including self-medication contributes to the development of antibiotic resistance. One method of accessing antibiotic use in the community is through obtaining an in house inventory of drugs. Objective The aim of this study was to investigate the extent of storage and self-medication with antibiotics agents in households in Novi Sad, Serbia. Setting Households in Novi Sad. Method The study was performed during a 4-month period (October 2015-January 2016) using a sample of 112 households in Novi Sad, Serbia. Two trained interviewers performed the survey by visiting each household. The study consisted of making an inventory of all drugs in household and a semi-structured interview about drug use practices and perceptions. Main outcome measure Number of antibiotics obtained without prescription. Results Out of 112 surveyed households, antibiotics were encountered in 55 (49.1%). Antibiotics constituted 11.98% (92/768) of total number of drug items in households. Out of all antibiotics in households, 41 (44.57%) were not in current use, and presented left-overs from previous treatment. Antibiotics were usually acquired with prescription (67, 67.7%), while about a quarter of packages were used for self-medication-purchased at pharmacy without prescription (19, 20.65%) or obtained through friends or family member (6, 6.52%).The most commonly used antibiotics for self-medication was amoxicillin (reported indications included common cold, cough, pharyngitis and tooth-ache). Conclusion Antibiotics were present in large share of households in Novi Sad. Self-medication with antibiotics and sale of antibiotics without prescription represent an important problem in Serbia.

Household Air Pollution Exposure and Influence of Lifestyle on Respiratory Health and Lung Function in Belizean Adults and Children: A Field Study.

PubMed

Kurti, Stephanie P; Kurti, Allison N; Emerson, Sam R; Rosenkranz, Richard R; Smith, Joshua R; Harms, Craig A; Rosenkranz, Sara K

2016-06-28

Household air pollution (HAP) contributes to the global burden of disease. Our primary purpose was to determine whether HAP exposure was associated with reduced lung function and respiratory and non-respiratory symptoms in Belizean adults and children. Our secondary purpose was to investigate whether lifestyle (physical activity (PA) and fruit and vegetable consumption (FV)) is associated with reported symptoms. Belizean adults (n = 67, 19 Male) and children (n = 23, 6 Male) from San Ignacio Belize and surrounding areas participated in this cross-sectional study. Data collection took place at free walk-in clinics. Investigators performed initial screenings and administered questionnaires on (1) sources of HAP exposure; (2) reported respiratory and non-respiratory symptoms and (3) validated lifestyle questionnaires. Participants then performed pulmonary function tests (PFTs) and exhaled breath carbon monoxide (CO). There were no significant associations between HAP exposure and pulmonary function in adults. Increased exhaled CO was associated with a significantly lower forced expiratory volume in 1-s divided by forced vital capacity (FEV₁/FVC) in children. Exposed adults experienced headaches, burning eyes, wheezing and phlegm production more frequently than unexposed adults. Adults who met PA guidelines were less likely to experience tightness and pressure in the chest compared to those not meeting guidelines. In conclusion, adults exposed to HAP experienced greater respiratory and non-respiratory symptoms, which may be attenuated by lifestyle modifications.

Household Air Pollution Exposure and Influence of Lifestyle on Respiratory Health and Lung Function in Belizean Adults and Children: A Field Study

PubMed Central

Kurti, Stephanie P.; Kurti, Allison N.; Emerson, Sam R.; Rosenkranz, Richard R.; Smith, Joshua R.; Harms, Craig A.; Rosenkranz, Sara K.

2016-01-01

Household air pollution (HAP) contributes to the global burden of disease. Our primary purpose was to determine whether HAP exposure was associated with reduced lung function and respiratory and non-respiratory symptoms in Belizean adults and children. Our secondary purpose was to investigate whether lifestyle (physical activity (PA) and fruit and vegetable consumption (FV)) is associated with reported symptoms. Belizean adults (n = 67, 19 Male) and children (n = 23, 6 Male) from San Ignacio Belize and surrounding areas participated in this cross-sectional study. Data collection took place at free walk-in clinics. Investigators performed initial screenings and administered questionnaires on (1) sources of HAP exposure; (2) reported respiratory and non-respiratory symptoms and (3) validated lifestyle questionnaires. Participants then performed pulmonary function tests (PFTs) and exhaled breath carbon monoxide (CO). There were no significant associations between HAP exposure and pulmonary function in adults. Increased exhaled CO was associated with a significantly lower forced expiratory volume in 1-s divided by forced vital capacity (FEV1/FVC) in children. Exposed adults experienced headaches, burning eyes, wheezing and phlegm production more frequently than unexposed adults. Adults who met PA guidelines were less likely to experience tightness and pressure in the chest compared to those not meeting guidelines. In conclusion, adults exposed to HAP experienced greater respiratory and non-respiratory symptoms, which may be attenuated by lifestyle modifications. PMID:27367712

Family Meal Frequency and Association with Household Food Availability in United States Multi-Person Households: National Health and Nutrition Examination Survey 2007-2010.

PubMed

Newman, Sarah L; Tumin, Rachel; Andridge, Rebecca; Anderson, Sarah E

2015-01-01

Family meals are associated with a healthier diet among children and adolescents, but how family meal frequency varies in the U.S. population overall by household food availability and sociodemographic characteristics is not well characterized. The U.S. National Health and Nutrition Examination Survey 2007-2010 assessed the frequency of family meals eaten at home in the past week and the household availability of fruits, dark green vegetables, salty snacks, and sugar-sweetened beverages. Computer-assisted face-to-face interviews with a selected adult (≥18 years) who owned or rented the home (i.e., the household reference person). We analyzed information on family meal frequency for 18,031 participants living in multi-person households in relation to sociodemographic characteristics and food availability. Among the U.S. population living in households of two or more individuals, the prevalence (95% confidence interval) of having 0-2, 3-6 and ≥7 family meals/week was 18.0% (16.6-19.3), 32.4% (31.0-33.9), and 49.6% (47.8-51.4), respectively. Greater household availability of fruits and dark green vegetables and less availability of salty snacks and sugar-sweetened beverages was associated with more frequent family meals. Family meals were more prevalent in low-income households and those in which the reference person was ≥65 years, married, or had less than high school education. About half of the US population living in households of 2 or more people shares meals frequently with their family at home. Family meal frequency was positively associated with a healthier pattern of household food availability.

Family Meal Frequency and Association with Household Food Availability in United States Multi-Person Households: National Health and Nutrition Examination Survey 2007-2010

PubMed Central

Newman, Sarah L.; Tumin, Rachel; Andridge, Rebecca; Anderson, Sarah E.

2015-01-01

Objective Family meals are associated with a healthier diet among children and adolescents, but how family meal frequency varies in the U.S. population overall by household food availability and sociodemographic characteristics is not well characterized. Design The U.S. National Health and Nutrition Examination Survey 2007–2010 assessed the frequency of family meals eaten at home in the past week and the household availability of fruits, dark green vegetables, salty snacks, and sugar-sweetened beverages. Setting Computer-assisted face-to-face interviews with a selected adult (≥18 years) who owned or rented the home (i.e., the household reference person). Subjects We analyzed information on family meal frequency for 18,031 participants living in multi-person households in relation to sociodemographic characteristics and food availability. Results Among the U.S. population living in households of two or more individuals, the prevalence (95% confidence interval) of having 0–2, 3–6 and ≥7 family meals/week was 18.0% (16.6–19.3), 32.4% (31.0–33.9), and 49.6% (47.8–51.4), respectively. Greater household availability of fruits and dark green vegetables and less availability of salty snacks and sugar-sweetened beverages was associated with more frequent family meals. Family meals were more prevalent in low-income households and those in which the reference person was ≥65 years, married, or had less than high school education. Conclusions About half of the US population living in households of 2 or more people shares meals frequently with their family at home. Family meal frequency was positively associated with a healthier pattern of household food availability. PMID:26636976

Where It's at! The Role of Best Friends and Peer Group Members in Young Adults' Alcohol Use

ERIC Educational Resources Information Center

Overbeek, Geertjan; Bot, Sander M.; Meeus, Wim H. J.; Sentse, Miranda; Knibbe, Ronald A.; Engels, Rutger

2011-01-01

We examined the hypothesis that best friends and members from a broader peer group would not differ in the amount of influence they have on young adults' alcohol consumption and that what counts would be the mere presence of drinking peers in a given context--irrespective of the type of relationship such peers would have with the target young…

Organ S values and effective doses for family members exposed to adult patients following I-131 treatment: A Monte Carlo simulation study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Eun Young; Lee, Choonsik; Mcguire, Lynn

Purpose: To calculate organ S values (mGy/Bq-s) and effective doses per time-integrated activity (mSv/Bq-s) for pediatric and adult family members exposed to an adult male or female patient treated with I-131 using a series of hybrid computational phantoms coupled with a Monte Carlo radiation transport technique.Methods: A series of pediatric and adult hybrid computational phantoms were employed in the study. Three different exposure scenarios were considered: (1) standing face-to-face exposures between an adult patient and pediatric or adult family phantoms at five different separation distances; (2) an adult female patient holding her newborn child, and (3) a 1-yr-old child standingmore » on the lap of an adult female patient. For the adult patient model, two different thyroid-related diseases were considered: hyperthyroidism and differentiated thyroid cancer (DTC) with corresponding internal distributions of {sup 131}I. A general purpose Monte Carlo code, MCNPX v2.7, was used to perform the Monte Carlo radiation transport.Results: The S values show a strong dependency on age and organ location within the family phantoms at short distances. The S values and effective dose per time-integrated activity from the adult female patient phantom are relatively high at shorter distances and to younger family phantoms. At a distance of 1 m, effective doses per time-integrated activity are lower than those values based on the NRC (Nuclear Regulatory Commission) by a factor of 2 for both adult male and female patient phantoms. The S values to target organs from the hyperthyroid-patient source distribution strongly depend on the height of the exposed family phantom, so that their values rapidly decrease with decreasing height of the family phantom. Active marrow of the 10-yr-old phantom shows the highest S values among family phantoms for the DTC-patient source distribution. In the exposure scenario of mother and baby, S values and effective doses per time

Passing by the girls? Remittance allocation for educational expenditures and social inequality in Nepal's households 2003–2004.

PubMed

Vogel, Ann; Korinek, Kim

2012-01-01

We examine the utilization of remittances for expenditures associated with development, specifically children's education. We use household-level data from the Nepal Living Standards Survey (NLSS II, 2003–04) to separate remittance effects from general household income effects to demonstrate the migration–development relationship reflected in child schooling investment. We find that family-household remittances are spent on education of children, but the expenditures are disproportionately for boys' schooling. Only when girls are members of higher-income households do greater schooling expenditures go to them. This gender-discriminating pattern at the household level contrasts with the call for universal and gender-equal education.

Understanding household preferences for hurricane risk mitigation information: evidence from survey responses.

PubMed

Chatterjee, Chiradip; Mozumder, Pallab

2014-06-01

Risk information is critical to adopting mitigation measures, and seeking risk information is influenced by a variety of factors. An essential component of the recently adopted My Safe Florida Home (MSFH) program by the State of Florida is to provide homeowners with pertinent risk information to facilitate hurricane risk mitigation activities. We develop an analytical framework to understand household preferences for hurricane risk mitigation information through allowing an intensive home inspection. An empirical analysis is used to identify major drivers of household preferences to receive personalized information regarding recommended hurricane risk mitigation measures. A variety of empirical specifications show that households with home insurance, prior experience with damages, and with a higher sense of vulnerability to be affected by hurricanes are more likely to allow inspection to seek information. However, households with more members living in the home and households who live in manufactured/mobile homes are less likely to allow inspection. While findings imply MSFH program's ability to link incentives offered by private and public agencies in promoting mitigation, households that face a disproportionately higher level of risk can get priority to make the program more effective. © 2014 Society for Risk Analysis.

[Household food security: comparing an alternative method to a classical one].

PubMed

Herrán, Oscar F; Quintero, Doris C; Prada, Gloria E

2010-08-01

Establishing the performance of the US Environmental Protection Agency (EPA) household food security scale (EPSA) which is being used in Latin-America and the Caribbean, compared to a traditionally-used method (food insecurity scale) which has led to establishing food security at individual and population level. The performance of the household food security scale (EPSA) was evaluated during 2007-2008 and compared to that of the food insecurity (FI) scale based on the energy usually consumed. Two hundred and eleven household participated in the study. The person responsible for preparing food in the home answered the EPSA questionnaire. Another household member filled in a form recording the last twenty-four hours' household consumption (R24H) (on two different occasions). The study was validated by food insecurity from R24H and supposed food security from the EPSA questionnaire. Food insecurity by R24H was 48.8 % and 19.4 % on the EPSA. The EPSA had 16.5 % sensitivity and 77.8 % specificity. Agreement between both methods according to Cohen's Kappa was -0.06 (-0.20-0.03 CI). Assuming equivalence of methods, the EPSA greatly underestimated household food insecurity. The EPSA results compared to those arising from the R24H were not very coherent. Some implications are discussed regarding related public policy.

Rural Household Demographics, Livelihoods and the Environment

PubMed Central

de Sherbinin, Alex; VanWey, Leah; McSweeney, Kendra; Aggarwal, Rimjhim; Barbieri, Alisson; Henry, Sabina; Hunter, Lori M.; Twine, Wayne

2008-01-01

This paper reviews and synthesizes findings from scholarly work on linkages among rural household demographics, livelihoods and the environment. Using the livelihood approach as an organizing framework, we examine evidence on the multiple pathways linking environmental variables and the following demographic variables: fertility, migration, morbidity and mortality, and lifecycles. Although the review draws on studies from the entire developing world, we find the majority of micro-level studies have been conducted in either marginal (mountainous or arid) or frontier environments, especially Amazonia. Though the linkages are mediated by many complex and often context-specific factors, there is strong evidence that dependence on natural resources intensifies when households lose human and social capital through adult morbidity and mortality, and qualified evidence for the influence of environmental factors on household decision-making regarding fertility and migration. Two decades of research on lifecycles and land-cover change at the farm level have yielded a number of insights about how households make use of different land-use and natural resource management strategies at different stages. A thread running throughout the review is the importance of managing risk through livelihood diversification, ensuring future income security, and culture-specific norms regarding appropriate and desirable activities and demographic responses. Recommendations for future research are provided. PMID:19190718

Growing up in a permissive household: what deters at-risk adolescents from heavy drinking?

PubMed

Tucker, Joan S; Ellickson, Phyllis L; Klein, David J

2008-07-01

This study identified psychosocial factors that may deter adolescents living in permissive households from heavy drinking in Grades 9 and 11. Longitudinal data were obtained from 710 youth who completed surveys from Grades 7 to 11. Permissive household was defined based on adolescent reports of whether the parents (1) would be upset if the adolescent drank or used marijuana, (2) knew their child's whereabouts when the adolescent was away from home, and (3) set curfews. Frequency of heavy drinking in the last 30 days was the number of days the adolescent had at least three alcoholic drinks. Three quarters of adolescents from permissive households reported heavy drinking at Grade 9, with less frequent heavy drinking among those who concurrently reported less exposure to peer and adult drinking, less peer approval of drinking, weaker positive beliefs about drinking, a stronger academic orientation, higher resistance self-efficacy, and less delinquency. Further, social influences and alcohol beliefs predicted the frequency of heavy drinking 2 years later among adolescents from permissive households. Although most of these factors were also relevant for adolescents from nonpermissive households, social influences, alcohol beliefs and resistance self-efficacy were stronger predictors of heavy drinking at Grade 9 among youth from permissive households. Growing up in a permissive household was associated with heavy drinking. Nonetheless, several psychosocial factors were associated with less frequent heavy drinking even within this at-risk population. Alcohol prevention programs that target pro-drinking peer and adult influences, positive attitudes toward drinking, and resistance self-efficacy may be particularly important in deterring heavy drinking among adolescents living in permissive households.

Household effects of school closure during pandemic (H1N1) 2009, Pennsylvania, USA.

PubMed

Gift, Thomas L; Palekar, Rakhee S; Sodha, Samir V; Kent, Charlotte K; Fagan, Ryan P; Archer, W Roodly; Edelson, Paul J; Marchbanks, Tiffany; Bhattarai, Achuyt; Swerdlow, David; Ostroff, Stephen; Meltzer, Martin I

2010-08-01

To determine the effects of school closure, we surveyed 214 households after a 1-week elementary school closure because of pandemic (H1N1) 2009. Students spent 77% of the closure days at home, 69% of students visited at least 1 other location, and 79% of households reported that adults missed no days of work to watch children.

The Effect of the Presence of Others on Caloric Intake in Homebound Older Adults

PubMed Central

Locher, Julie L.; Robinson, Caroline O.; Roth, David L.; Ritchie, Christine S.; Burgio, Kathryn L.

2008-01-01

Background Undernutrition in homebound older adults is a significant problem. The purpose of this study was to investigate the effect of the presence of others, both within the household and during meals, on caloric intake in homebound older adults. Methods In-depth interviews and three 24-hour dietary recalls were obtained from 50 older adults who were receiving home health services. Descriptive statistics were used to characterize participants, and hierarchical linear modeling was performed to evaluate predictors of caloric intake per meal. Results Participants’ mean age was 77. Females composed 65% and African Americans composed 42% of the sample. Analyses are based on 553 meal observations. The majority (84%) of participants consumed all meals for each of the 3 days of data collection; however, they consumed an average of only 1305 calories per day. Hierarchical linear modeling analysis indicated that persons who had others present during meals consumed an average of 114.0 calories more per meal than those who ate alone (p = .009) and that women consumed 76.7 fewer calories per meal than did men (p = .045). The presence of others within the household had no effect on caloric intake. Conclusion This research suggests that a simple and inexpensive way to increase caloric intake in homebound older adults is to make arrangements for family members or caregivers to eat with them. PMID:16339337

The health and economic impact of fireworks-related injuries in Iran: a household survey following the New Year's Festival in Tehran.

PubMed

Saadat, Soheil; Naseripour, Masood; Smith, Gary A

2010-07-01

Fireworks are used worldwide as a part of national and cultural celebrations. Personal use of fireworks is associated with serious injuries. The "Last Wednesday Eve Festival" is celebrated on the evening before the last wednesday of the Persian calendar year. In recent years, fireworks have been widely used during the festival, which has resulted in injuries. The aim of this study was to determine the incidence and risk factors of fireworks-related injuries associated with the Last Wednesday Eve Festival, in Tehran, Iran. A household survey of residents of greater Tehran, using a random cluster sampling design was performed. Number of fireworks-related injuries, expenditures for fireworks and medical treatment of fireworks-related injuries, length of hospital stay for treatment of these injuries and the personal property damage was gathered. Interviews were conducted of 2475 households in greater Tehran. At least one member of 19.8% of these households had used fireworks during the 2007 Last Wednesday Eve Festival. Fireworks-related injuries were more common among households whose members had used homemade fireworks than among households whose members had used only commercially made fireworks (OR=16.5, 95% CI: 5.7-47.5). Forty-five households reported that they had sustained personal property damage caused by fireworks during the festival, costing a mean of US$ 36.60. Households with at least one injured member spent a mean of US$ 441.90 for medical care and a mean of US$ 70.80 for other expenses related to seeking medical care. The overall incidence of fireworks-related injury among household members was 0.2% (95% CI: 0.1-0.3%). Fireworks-related injury incidence was highest in the 10-19 age group. The total estimated number of fireworks-related injuries in Tehran during the 2007 Last Wednesday Eve Festival was approximately 17,000. Among the 20 injured individuals, 4 persons (20.0%) were hospitalised for a mean of 2.8 days. The personal use of fireworks in Iran

The impact of family status on gender identity and on sex-typing of household tasks in Israel.

PubMed

Kulik, Liat

2005-06-01

The author examined differences in sex-typing of household tasks (adult gender roles and children's chores) and differences in gender identity among adult Israelis. The author compared 2 groups of participants: single people without children (single-family participants; n = 62) and married people with children (full-family participants; n = 62). Regarding sex-typing of household tasks and direct assessments of masculine and feminine identity, there were no differences between single-family participants and full-family participants. However, family status affected self-assessments of gender identity that were based on cultural definitions of masculine and feminine attributes. Furthermore, correlations between direct assessments of gender identity and sex-typing of household tasks differed according to family status.

Selling my sheep to pay for medicines - household priorities and coping strategies in a setting without universal health coverage.

PubMed

Husøy, Onarheim Kristine; Molla, Sisay Mitike; Muluken, Gizaw; Marie, Moland Karen; Frithof, Norheim Ole; Ingrid, Miljeteig

2018-03-02

The first month of life is the period with the highest risk of dying. Despite knowledge of effective interventions, newborn mortality is high and utilization of health care services remains low in Ethiopia. In settings without universal health coverage, the economy of a household is vulnerable to illness, and out-of-pocket payments may limit families' opportunities to seek health care for newborns. In this paper we explore intra-household resource allocation, focusing on how families prioritize newborn health versus other household needs and their coping strategies for managing these priorities. A qualitative study was conducted in 2015 in Butajira, Ethiopia, comprising observation, semi-structured interviews, and focus group discussions with household members, health workers, and community members. Household members with hospitalized newborns or who had experienced neonatal death were primary informants. In this predominantly rural and poor district, households struggled to pay out-of-pocket for services such as admission, diagnostics, drugs, and transportation. When newborns fell ill, families made hard choices balancing concerns for newborn health and other household needs. The ability to seek care, obtain services, and follow medical advice depended on the social and economic assets of the household. It was common to borrow money from friends and family, or even to sell a sheep or the harvest, if necessary. In managing household priorities and high costs, families waited before seeking health care, or used cheaper traditional medicines. For poor families with no money or opportunity to borrow, it became impossible to follow medical advice or even seek care in the first place. This had fatal health consequences for the sick newborns. While improving neonatal health is prioritized at policy level in Ethiopia, poor households with sick neonates may prioritize differently. With limited money at hand and high direct health care costs, families balanced conflicting

Enduring starvation in silent population: a study on prevalence and factors contributing to household food security in the tribal population in Bankura, West Bengal.

PubMed

Mukhopadhyay, Dipta Kanti; Mukhopadhyay, Sujishnu; Biswas, Akhil Bandhu

2010-01-01

Strengthening food security enhancement intervention should be based on the assessment of household food security and its correlates. The objective was to find out the prevalence and factors contributing to household food security in a tribal population in Bankura. A cross-sectional study was conducted among 267 tribal households in Bankura-I CD Block selected through cluster random sampling. Household food security was assessed using a validated Bengali version of Household Food Security Scale-Short Form along with the collection of information regarding the monthly per capita expenditure (MPCE), total to earning member ratio, BPL card holding, utilization of the public distribution system (PDS) and receipt of any social assistance through a house-to-house survey. Overall, 47.2% of study households were food secure whereas 29.6% and 23.2% were low and very low food secure, respectively. MPCE ≥ Rs. 356, total to earning member ratio ≤ 4:1, regular utilization of PDS, and nonholding of the BPL card were significantly related with household food security.

Identifying and assessing views among physically-active adult gym members in Israel on dietary supplements.

PubMed

Druker, Inbal; Gesser-Edelsburg, Anat

2017-01-01

Sports dietary supplements are available for sale in public places including sports clubs. Although there is uncertainty regarding their safety, many gym members who regularly work out consume them. The present study aimed to identify the approaches and perspectives of the public who work out in gyms and take dietary supplements. It examined how professionals view sports dietary supplement consumption, and how they communicate this issue to gym members. The literature discusses the prevalence of SDS use among athletes, but rarely discusses or compares between the risk perceptions of gym members, trainers, and dietitians, who represent the physically-active general public, regarding SDS. We conducted constructivist qualitative research in semi-structured one-on-one interviews ( n  = 34). We held in-depth interviews ( n  = 20) with a heterogeneous population of adult gym members who take dietary supplements, and ( n  = 14) with dietitians and fitness trainers. The main finding was a gap in risk perception of dietary supplement use between dietitians, gym members and fitness trainers. There was low risk perception among dietary supplements consumers. Trainers believed that benefits of supplement consumption exceeded risk, and therefore they did not convey a message to their clients about risk. In contrast, dietitians interviewed for this study renounced general use of sports dietary supplements and doubted whether trainers had proper nutritional knowledge to support it. Lack of awareness of risks suggests that there is a need for communication on this issue. We recommend that professionals (physicians and dietitians) be present in sports clubs that sell such products in an uncontrolled way.

Extended producer responsibility: The impact of organizational dimensions on WEEE collection from households.

PubMed

Corsini, Filippo; Rizzi, Francesco; Frey, Marco

2017-01-01

Extended Producer Responsibility (EPR) has been the backbone of product life cycle management in Europe since the 2000s. Unfortunately, EPR implementation has multiple impacts on the supply chain and, thus, its consequences are not always easily manageable. Although several studies have explored various examples within the EU, the determinants of the effectiveness of EPR management are still not fully understood. This research seeks to bridge this gap by making use of quantitative analyses to investigate how key issues related to: WEEE Directive transposition and organizational settings adopted by each Member State, influenced the results achieved in those Member States in terms of collection from households. In details, a latent class analysis (LCA) has been used to analyse different EPR management strategies based on the policy set, the supply chain structure, and the performance of the household collection of electronic waste. Results highlight the strong connection between allocation of responsibility and organizational model adopted in Member States and performance related to small households equipment's. Conclusions shows the need for stronger coordination of EPR and waste policies in order to achieve adequate levels of Waste Electrical and Electronic Equipment (WEEE) collection, the need of a clear delineation of the responsibilities of each subject of the supply chain and also the importance of "clearing houses" in moderating the impacts of short-sighted competition between collective schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Associations of occupational, transportation, household and leisure-time physical activity patterns with metabolic risk factors among middle-aged adults in a middle-income country.

PubMed

Chu, Anne H Y; Moy, Foong Ming

2013-01-01

This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults. The study was performed in Kuala Lumpur, Malaysia from August 2010-August 2011. Body mass index (BMI), waist circumference, systolic/diastolic blood pressure, and fasting blood glucose/lipid profile were measured in 686 Malay participants (mean age 45.9 ± 6.5 years). Self-reported physical activity was obtained with the validated IPAQ (Malay version) and categorized into low-, moderate- and high-activity levels across occupational, transportation, household and leisure-time domains. Participants spent most of their time on household (567.5, 95% CI: 510-630 MET-minutes/week) and occupational activities (297, 95% CI: 245-330 MET-minutes/week). After adjusted for gender and smoking, participants with low-activity levels in occupational, transport and household domains were associated with significantly higher odds for metabolic syndrome (2.02, 95% CI: 1.33-3.05; 1.49, 95% CI: 1.01-2.21; 1.96, 95% CI: 1.33-2.91). Significantly higher odds for obesity and abdominal obesity were consistently reported among those with low-activity levels across all four domains. High-activity levels in occupational, transportation and household domains were each negatively associated with metabolic syndrome among our cohort. Increase participation of physical activity across all four domains (including leisure-time activity) should be encouraged. Copyright © 2012 Elsevier Inc. All rights reserved.

Household Effects of School Closure during Pandemic (H1N1) 2009, Pennsylvania, USA

PubMed Central

Palekar, Rakhee S.; Sodha, Samir V.; Kent, Charlotte K.; Fagan, Ryan P.; Archer, W. Roodly; Edelson, Paul J.; Marchbanks, Tiffany; Bhattarai, Achuyt; Swerdlow, David; Ostroff, Stephen; Meltzer, Martin I.

2010-01-01

To determine the effects of school closure, we surveyed 214 households after a 1-week elementary school closure because of pandemic (H1N1) 2009. Students spent 77% of the closure days at home, 69% of students visited at least 1 other location, and 79% of households reported that adults missed no days of work to watch children. PMID:20678335

Face mask use and control of respiratory virus transmission in households.

PubMed

MacIntyre, C Raina; Cauchemez, Simon; Dwyer, Dominic E; Seale, Holly; Cheung, Pamela; Browne, Gary; Fasher, Michael; Wood, James; Gao, Zhanhai; Booy, Robert; Ferguson, Neil

2009-02-01

Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non-fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time. We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease. However, during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced.

Unsafe disposal of feces of children <3 years among households with latrine access in rural Bangladesh: Association with household characteristics, fly presence and child diarrhea

PubMed Central

Ercumen, Ayse; Ashraf, Sania; Rahman, Mahbubur; Shoab, Abul K.; Luby, Stephen P.; Unicomb, Leanne

2018-01-01

Background Young children frequently defecate in the living environment in low-income countries. Unsafe child feces disposal has been associated with risk of diarrhea. Additionally, reported practices can underestimate socially undesirable unhygienic behaviors. This analysis aimed to assess (1) the sensitivity of reported child feces disposal practices as an indicator for observed presence of human feces in the domestic environment, (2) household characteristics associated with reported unsafe feces disposal and (3) whether unsafe feces disposal is associated with fly presence and diarrhea among children <3 years. Methods We recorded caregiver-reported feces disposal practices for children <3 years; unsafe disposal was defined as feces put/rinsed into a drain, ditch, bush or garbage heap or left on the ground and safe disposal as feces put/rinsed into latrine or specific pit or buried. We conducted spot checks for human feces, counted flies in the compound and recorded caregiver-reported child diarrhea prevalence among 803 rural Bangladeshi households. We assessed associations using generalized estimating equations (GEE) and generalized linear models (GLM) with robust standard errors. Results Unsafe disposal of child feces was reported by 80% of households. Reported disposal practices had high sensitivity (91%) but low positive predictive value (15%) as an indicator of observed feces in the compound. Unsafe disposal was more common among households that reported daily adult open defecation (PR: 1.13, 1.02–1.24) and had children defecating in a nappy or on the ground versus in a potty (PR: 2.92, 1.98–4.32), and less common in households where adults reported always defecating in latrines (PR: 0.91, 0.84–0.98). The presence of observed human feces was similarly associated with these household characteristics. Reported unsafe feces disposal or observed human feces were not associated with fly detection or child diarrhea. Conclusion Despite access to on

Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean Countries.

PubMed

Knaul, Felicia Marie; Wong, Rebeca; Arreola-Ornelas, Héctor; Méndez, Oscar

2011-01-01

Compare patterns of catastrophic health expenditures in 12 countries in Latin America and the Caribbean. Prevalence of catastrophic expenses was estimated uniformly at the household level using household surveys. Two types of prevalence indicators were used based on out-of-pocket health expense: a) relative to an international poverty line, and b) relative to the household's ability to pay net of their food basket. Ratios of catastrophic expenditures were estimated across subgroups defined by economic and social variables. The percent of households with catastrophic health expenditures ranged from 1 to 25% in the twelve countries. In general, rural residence, lowest quintile of income, presence of older adults, and lack of health insurance in the household are associated with higher propensity of catastrophic health expenditures. However, there is vast heterogeneity by country. Cross national studies may serve to examine how health systems contribute to the social protection of Latin American households.

Modelling Status Food Security Households Disease Sufferers Pulmonary Tuberculosis Uses the Method Regression Logistics Binary

NASA Astrophysics Data System (ADS)

Wulandari, S. P.; Salamah, M.; Rositawati, A. F. D.

2018-04-01

Food security is the condition where the food fulfilment is managed well for the country till the individual. Indonesia is one of the country which has the commitment to create the food security becomes main priority. However, the food necessity becomes common thing means that it doesn’t care about nutrient standard and the health condition of family member, so in the fulfilment of food necessity also has to consider the disease suffered by the family member, one of them is pulmonary tuberculosa. From that reasons, this research is conducted to know the factors which influence on household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya by using binary logistic regression method. The analysis result by using binary logistic regression shows that the variables wife latest education, house density and spacious house ventilation significantly affect on household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya, where the wife education level is University/equivalent, the house density is eligible or 8 m2/person and spacious house ventilation 10% of the floor area has the opportunity to become food secure households amounted to 0.911089. While the chance of becoming food insecure households amounted to 0.088911. The model household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya has been conformable, and the overall percentages of those classifications are at 71.8%.

Role of farmer group institutions in increasing farm production and household food security

NASA Astrophysics Data System (ADS)

Rahmadanih; Bulkis, S.; Arsyad, M.; Amrullah, A.; Viantika, N. M.

2018-05-01

Food productions and food security are still becomes serious issue in agriculture development. The research objectives are (1) Examining the role of Farmer Group in increasing farm production and (2) Analyzing the role of Farmer Group in relationship with the household food security. The research was conducted in Soppeng District, South Sulawesi, Indonesia by taking unit of analysis at household level of Farmer Group members. Sample were 6 farmer groups, consisting of 365 households. The Results showed that the Farmer Group has a good role as a production, collaboration and market unit to increase farming production (score 2.3-2.6), but haven’t much impact to increase household food security. Rice production are 4.2 – 6.2 tons per hectare and household food security level are “low and marginal food secure” (mean score 4 and 6). Nevertheless, the role of Farmer Group showed a positive relationship with the level of household food security. So, it is necessarry to increase the role of Farmer Group in order to increase income and household food security based on Farmer Group’s needs and potencies through facilitation of (a) seed and water/irrigation availability, (b) preparing organization rules (AD/ART) and (c) appropriate training and education of food and nutrition.

Household's willingness to pay for arsenic safe drinking water in Bangladesh.

PubMed

Khan, Nasreen Islam; Brouwer, Roy; Yang, Hong

2014-10-01

This study examines willingness to pay (WTP) in Bangladesh for arsenic (As) safe drinking water across different As-risk zones, applying a double bound discrete choice value elicitation approach. The study aims to provide a robust estimate of the benefits of As safe drinking water supply, which is compared to the results from a similar study published almost 10 years ago using a single bound estimation procedure. Tests show that the double bound valuation design does not suffer from anchoring or incentive incompatibility effects. Health risk awareness levels are high and households are willing to pay on average about 5 percent of their disposable average annual household income for As safe drinking water. Important factors influencing WTP include the bid amount to construct communal deep tubewell for As safe water supply, the risk zone where respondents live, household income, water consumption, awareness of water source contamination, whether household members are affected by As contamination, and whether they already take mitigation measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Epidemiology and etiology of influenza-like-illness in households in Vietnam; it's not all about the kids!

PubMed

Nguyen, Diep Ngoc Thi; Mai, Le Quynh; Bryant, Juliet E; Hang, Nguyen Le Khanh; Hoa, Le Nguyen Minh; Nadjm, Behzad; Thai, Pham Quang; Duong, Tran Nhu; Anh, Dang Duc; Horby, Peter; van Doorn, H Rogier; Wertheim, Heiman F L; Fox, Annette

2016-09-01

Household studies provide opportunities to understand influenza-like-illness (ILI) transmission, but data from (sub)tropical developing countries are scarce. To determine the viral etiology and epidemiology of ILI in households. ILI was detected by active case finding amongst a cohort of 263 northern Vietnam households between 2008 and 2013. Health workers collected nose and throat swabs for virus detection by multiplex real-time RT-PCR. ILI was detected at least once in 219 (23.7%) of 945 household members. 271 (62.3%) of 435 nose/throat swabs were positive for at least one of the 15 viruses tested. Six viruses predominated amongst positive swabs: Rhinovirus (28%), Influenza virus (17%), Coronavirus (8%), Enterovirus (5%), Respiratory syncytial virus (3%), Metapneumovirus virus (2.5%) and Parainfluenza virus 3 (1.8%). There was no clear seasonality, but 78% of episodes occurred in Winter/Spring for Influenza compared to 32% for Rhinovirus. Participants, on average, suffered 0.49 ILI, and 0.29 virus-positive ILI episodes, with no significant effects of gender, age, or household size. In contrast to US and Australian community studies, the frequency of ILI decreased as the number of household members aged below 5 years increased (p=0.006). The findings indicate the need for tailored ILI control strategies, and for better understanding of how local childcare practices and seasonality may influence transmission and the role of children. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey.

PubMed

Stewart, Barclay T; Lafta, Riyadh; Esa Al Shatari, Sahar A; Cherewick, Megan; Flaxman, Abraham; Hagopian, Amy; Burnham, Gilbert; Kushner, Adam L

2016-01-01

Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. A two-stage, cluster randomised, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Nine hundred households totaling 5148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15-64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30-8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system, many injuries resulted in life

Fall injuries in Baghdad from 2003 to 2014: results of a randomized household cluster survey

PubMed Central

Stewart, Barclay T; Lafta, Riyadh; Shatari, Sahar A Esa Al; Cherewick, Megan; Flaxman, Abraham; Hagopian, Amy; Burnham, Gilbert; Kushner, Adam L

2015-01-01

Introduction Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Results Nine hundred households totaling 5,148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15 - 64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30 – 8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Conclusion Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system

Interior Immigration Enforcement and Political Participation of U.S. Citizens in Mixed-Status Households.

PubMed

Amuedo-Dorantes, Catalina; Lopez, Mary J

2017-12-01

The 2000s have witnessed an expansion of interior immigration enforcement in the United States. At the same time, the country has experienced a major demographic transformation, with the number of U.S. citizens living in mixed-status households-that is, households where at least one family member is an unauthorized migrant-reaching 16 million. U.S. citizens living in mixed-status households are personally connected to the struggles experienced by their unauthorized family members. For them, immigration policy is likely to shape their current and future voting behavior. Using data from the 2002-2014 Current Population Survey Voting and Registration Supplements, we examine whether intensified immigration enforcement has affected the political engagement of U.S. citizens living in mixed-status households. We find that immigration enforcement has chilled their electoral participation by lowering their propensity to register by 5 %; however, it has not visibly affected their voting propensity among those registered. Importantly, their lower voting registration likelihood does not seem to reflect indifference for community and public matters, given that it has been accompanied by greater involvement in civic forms of political participation, such as volunteering. Understanding how immigration policy affects the political participation of a fast-growing segment of the electorate is imperative because they will inevitably constitute a rapidly rising political force in future elections.

[Family care for the aged in multigenerational households (author's transl)].

PubMed

Klusmann, D; Lüders, I; Bruder, J; Lauter, H

1981-09-01

Multigenerational household with widowed elderly above the age of 70 have been studied by interviewing the aged person and his/her daughter/daughter in law. The sample is described according to household composure and some sociodemographic characteristics. Data analysis focused on the relationship between variables in the elderly person and variables in the daughter/daughter in law. Psychic and somatic well-being in the relatives can be predicted by the degree of competence/dependency in the aged family member, but less so with a general health assessment. Organic brain conditions in the aged parents seem to have most adverse effects on the daughter/daughter in law when they are of a moderate degree.

Preliminary Findings of a Randomized Trial of Non-Pharmaceutical Interventions to Prevent Influenza Transmission in Households

PubMed Central

Cowling, Benjamin J.; Fung, Rita O. P.; Cheng, Calvin K. Y.; Fang, Vicky J.; Chan, Kwok Hung; Seto, Wing Hong; Yung, Raymond; Chiu, Billy; Lee, Paco; Uyeki, Timothy M.; Houck, Peter M.; Peiris, J. S. Malik; Leung, Gabriel M.

2008-01-01

Background There are sparse data on whether non-pharmaceutical interventions can reduce the spread of influenza. We implemented a study of the feasibility and efficacy of face masks and hand hygiene to reduce influenza transmission among Hong Kong household members. Methodology/Principal Findings We conducted a cluster randomized controlled trial of households (composed of at least 3 members) where an index subject presented with influenza-like-illness of <48 hours duration. After influenza was confirmed in an index case by the QuickVue Influenza A+B rapid test, the household of the index subject was randomized to 1) control or 2) surgical face masks or 3) hand hygiene. Households were visited within 36 hours, and 3, 6 and 9 days later. Nose and throat swabs were collected from index subjects and all household contacts at each home visit and tested by viral culture. The primary outcome measure was laboratory culture confirmed influenza in a household contact; the secondary outcome was clinically diagnosed influenza (by self-reported symptoms). We randomized 198 households and completed follow up home visits in 128; the index cases in 122 of those households had laboratory-confirmed influenza. There were 21 household contacts with laboratory confirmed influenza corresponding to a secondary attack ratio of 6%. Clinical secondary attack ratios varied from 5% to 18% depending on case definitions. The laboratory-based or clinical secondary attack ratios did not significantly differ across the intervention arms. Adherence to interventions was variable. Conclusions/Significance The secondary attack ratios were lower than anticipated, and lower than reported in other countries, perhaps due to differing patterns of susceptibility, lack of significant antigenic drift in circulating influenza virus strains recently, and/or issues related to the symptomatic recruitment design. Lessons learnt from this pilot have informed changes for the main study in 2008. Trial Registration

Household dynamics and socioeconomic conditions in the context of incident adolescent orphaning in KwaZulu-Natal, South Africa

PubMed Central

DeSilva, Mary Bachman; Skalicky, Anne; Beard, Jennifer; Cakwe, Mandisa; Zhuwau, Tom; Quinlan, Tim; Simon, Jonathon L.

2012-01-01

We compared demographics, socioeconomic status, and food insecurity between households with and without recent orphans in a region of high HIV/AIDS mortality in South Africa. We recruited a cohort of 197 recent orphans and 528 non-orphans ages 9–15 and their households using stratified cluster sampling. Households were classified into three groups: orphan-only (N=50); non-orphan-only (N=377); and mixed (N=210). Between September 2004 and May 2007, households were interviewed three times regarding demographics, income and assets, and food insecurity. Baseline bivariate associations were assessed using chi-square- and t-tests. Longitudinal bivariate associations and multivariate models were tested using generalized estimating equations. At baseline, mixed households generally exhibited greater characteristics of vulnerability than orphan and non-orphan households. They were larger, had older, less educated household heads, and reported a much smaller annual per capita income. Orphan households were more likely to report a death in the previous year, and less likely to have an adult employed. These differences persisted over the study. Even non-orphan households exhibited characteristics of vulnerability, with 14% reporting a death one year before baseline, 45% of whom were prime-age adults. At baseline, a much smaller proportion of orphan households reported receiving the child support grant than the other household types, but notably, there were no differences among households in receipt of the grant by Round 3. Household food insecurity was highly prevalent: more than one in five orphan-only and mixed households reported being food insecure in the previous month. These findings suggest that the effects of HIV/AIDS only exacerbate existing high levels of poverty in the district, as virtually all households are vulnerable regardless of orphan status. Community-level programs must help families address a spectrum of needs, including food security, caregiving, and

Promoting Household Water Treatment through Women's Self Help Groups in Rural India: Assessing Impact on Drinking Water Quality and Equity

PubMed Central

Freeman, Matthew C.; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

2012-01-01

Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent

Staple Food Self-Sufficiency of Farmers Household Level in The Great Solo

NASA Astrophysics Data System (ADS)

Darsono

2017-04-01

Analysis of food security level of household is a novelty of measurement standards which usually includes regional and national levels. With household approach is expected to provide the basis of sharp food policy formulation. The purpose of this study are to identify the condition of self-sufficiency in staple foods, and to find the main factors affecting the dynamics of self-sufficiency in staple foods on farm household level in Great Solo. Using primary data from 50 farmers in the sample and secondary data in Great Solo (Surakarta city, Boyolali, Sukoharjo, Karanganyar, Wonogiri, Sragen and Klaten). Compiled panel data were analyzed with linear probability regression models to produce a good model. The results showed that farm households in Great Solo has a surplus of staple food (rice) with an average consumption rate of 96.8 kg/capita/year. This number is lower than the national rate of 136.7 kg/capita/year. The main factors affecting the level of food self-sufficiency in the farmer household level are: rice production, rice consumption, land tenure, and number of family members. Key recommendations from this study are; improvement scale of the land cultivation for rice farming and non-rice diversification consumption.

Financial exploitation of older adults: a population-based prevalence study.

PubMed

Peterson, Janey C; Burnes, David P R; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Wells, Martin T; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Pillemer, Karl A; Lachs, Mark S

2014-12-01

Financial exploitation is the most common and least studied form of elder abuse. Previous research estimating the prevalence of financial exploitation of older adults (FEOA) is limited by a broader emphasis on traditional forms of elder mistreatment (e.g., physical, sexual, emotional abuse/neglect). 1) estimate the one-year period prevalence and lifetime prevalence of FEOA; 2) describe major FEOA types; and 3) identify factors associated with FEOA. Prevalence study with a random, stratified probability sample. Four thousand, one hundred and fifty-six community-dwelling, cognitively intact adults age ≥ 60 years. New York State. Comprehensive tool developed for this study measured five FEOA domains: 1) stolen or misappropriated money/property; 2) coercion resulting in surrendering rights/property; 3) impersonation to obtain property/services; 4) inadequate contributions toward household expenses, but respondent still had enough money for necessities and 5) respondent was destitute and did not receive necessary assistance from family/friends. One-year period FEOA prevalence was 2.7% (95% CI, 2.29-3.29) and lifetime prevalence was 4.7% (95% CI, 4.05-5.34). Greater relative risk (RR) of one-year period prevalence was associated with African American/black race (RR, 3.80; 95 % CI, 1.11-13.04), poverty (RR, 1.72; 95 % CI, 1.09-2.71), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.06-1.27), and ≥ 1 instrumental activity of daily living (IADL) impairments (RR, 1.69; 95 % CI, 1.12-2.53). Greater RR of lifetime prevalence was associated with African American/black race (RR, 2.61; 95 % CI, 1.37-4.98), poverty (RR, 1.47; 95 % CI, 1.04-2.09), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.12-1.21), and having ≥1 IADL (RR, 1.45; 95 % CI, 1.11-1.90) or ≥1 ADL (RR, 1.52; 95 % CI, 1.06-2.18) impairment. Living with a spouse/partner was associated with a significantly lower RR of lifetime prevalence (RR, 0.39; 95 % CI, 0

Household Hazardous Materials and Their Labels: A Reference for Teachers.

ERIC Educational Resources Information Center

Dean, Lillian F.

Household hazardous materials are products or wastes which are toxic, corrosive, reactive, and/or ignitable. Although common products such as pesticides, oils, gasoline, solvents, cleaners, and polishes are hazardous, students and adults are not always aware of potential dangers. This sourcebook contains definitions and examples of household…

Symposium on 'Intervention policies for deprived households' Policy initiatives to address low-income households' nutritional needs in the UK.

PubMed

Dowler, Elizabeth

2008-08-01

Members of low-income households in the UK are more likely to have patterns of food and nutrient intakes that are less inclined to lead to good health outcomes in the short and long term. Health inequalities, including the likelihood of child and adulthood obesity, have long been documented in the UK and show little sign of improving so far, despite 10 years of attention from a government that has committed itself to addressing them. Following the Acheson Inquiry into Inequalities in Health (1998) in England a number of initiatives to tackle inequalities in food and diet were established, both nationally and within the devolved nations of Scotland, Wales and Northern Ireland. Nevertheless, until recently, there has been no overall strategic policy addressing the food and nutritional needs of low-income households. The present paper reviews how the problems have been constructed and understood and how they have been addressed, briefly drawing on recent evaluations of food and nutrition policies in Scotland and Wales. The contemporary challenge is to frame cross-cutting policy initiatives that move beyond simple targeting and local actions, encompass a life-course approach and recognise both the diversity of households that fall into 'low-income' categories and the need for 'upstream' intervention.

Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003).

PubMed Central

Lopman, Ben A.; Barnabas, Ruanne; Hallett, Timothy B.; Nyamukapa, Constance; Mundandi, Costa; Mushati, Phyllis; Garnett, Geoff P.; Gregson, Simon

2006-01-01

OBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household mortality, (2) repeated household censuses, and (3) an adult cohort study with linked HIV testing from Manicaland, with a mathematical model fitted to local age-specific HIV prevalence (1998 -2000). FINDINGS: The crude death rate from the single question (29 per 1000 person-years) was roughly consistent with that from the mathematical model (22 -25 per 1000 person-years), but much higher than that from the household censuses (12 per 1000 person-years). Adult mortality in the household censuses (males 0.65; females 0.51) was lower than in the cohort study (males 0.77; females 0.57), while mathematical models gave a much higher estimate, especially for females (males 0.80 -0.83; females 0.75 -0.80). The population attributable fraction of adult deaths due to HIV was 0.61 for men and 0.70 for women, with life expectancy estimated to be 34.3 years for males and 38.2 years for females. CONCLUSION: Each method for estimating adult mortality had limitations in terms of loss to follow-up (cohort study), under-ascertainment (household censuses), transparency of underlying processes (single question), and sensitivity to parameterization (mathematical model). However, these analyses make clear the advantages of longitudinal cohort data, which provide more complete ascertainment than household censuses, highlight possible inaccuracies in model assumptions, and allow direct quantification of the impact of HIV. PMID:16583077

Optimal design of studies of influenza transmission in households. I: case-ascertained studies.

PubMed

Klick, B; Leung, G M; Cowling, B J

2012-01-01

Case-ascertained household transmission studies, in which households including an 'index case' are recruited and followed up, are invaluable to understanding the epidemiology of influenza. We used a simulation approach parameterized with data from household transmission studies to evaluate alternative study designs. We compared studies that relied on self-reported illness in household contacts vs. studies that used home visits to collect swab specimens for virological confirmation of secondary infections, allowing for the trade-off between sample size vs. intensity of follow-up given a fixed budget. For studies estimating the secondary attack proportion, 2-3 follow-up visits with specimens collected from all members regardless of illness were optimal. However, for studies comparing secondary attack proportions between two or more groups, such as controlled intervention studies, designs with reactive home visits following illness reports in contacts were most powerful, while a design with one home visit optimally timed also performed well.

Use of household supermarket sales data to estimate nutrient intakes: a comparison with repeat 24-hour dietary recalls.

PubMed

Eyles, Helen; Jiang, Yannan; Ni Mhurchu, Cliona

2010-01-01

Electronic supermarket sales data provide a promising, novel way of estimating nutrient intakes. However, little is known about how these data reflect the nutrients consumed by an individual household member. A cross-sectional survey of 49 primary household shoppers (age [mean+/-standard deviation age]=48+/-14 years; 84% female) from Wellington, New Zealand, was undertaken. Three months of baseline electronic supermarket sales data were compared with individual dietary intakes estimated from four random 24-hour dietary recalls collected during the same 3-month period. Spearman rank correlations between household purchases and individual intakes ranged from 0.54 for percentage of energy from saturated fat (P<0.001) to 0.06 for sodium (P=0.68). Other correlation coefficients were: percentage of energy from carbohydrate, 0.48; and protein, 0.44; energy density of nonbeverages, 0.37 (kcal/oz); percentage of energy from total fat, 0.34; sugar, 0.33 (oz/kcal); and energy density of beverages, 0.09 (oz/kcal; all P values <0.05). This research suggests that household electronic supermarket sales data may be a useful surrogate measure of some nutrient intakes of individuals, particularly percentage of energy from saturated and total fat. In the case of a supermarket intervention, an effect on household sales of percentage energy from saturated and total fat is also likely to impact the saturated and total fat intake of individual household members. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

20 CFR 656.19 - Live-in household domestic service workers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... statement describing the household living accommodations, including the following: (i) Whether the residence is a house or apartment; (ii) The number of rooms in the residence; (iii) The number of adults and...) That the alien will reside on the employer's premises; (v) Complete details of the duties to be...

The influence of the rural health security schemes on health utilization and household impoverishment in rural China: data from a household survey of western and central China

PubMed Central

2010-01-01

Background The New Rural Cooperative Medical Scheme (NRCMS, voluntary health insurance) and the Medical Financial Assistance (MFA, financial relief program) were established in 2003 for rural China. The aim of this study was to document their coverage, assess their effectiveness on access to in-patient care and protection against financial catastrophe and household impoverishment due to health spending, and identify the factors predicting impoverishment with and without these schemes. Methods A cross-sectional household survey was conducted in 2008 in Hebei and Shaanxi provinces and the Inner Mongolia Autonomous Region using a multi-stage sampling technique. Information on personal demographic characteristics, chronic illness status, health care use, household expenditure, and household health spending were collected by interview. Results NRCMS covered 90.8% of the studied individuals and among the designated poor, 7.6% had their premiums paid by MFA. Of those referred for hospitalization in the year prior to the interview, 34.3% failed to comply, mostly (80.2%) owing to financial constraints. There was no significant difference in the unmet need for admission between the insured with NRCMS and the uninsured. Before reimbursement, the incidence of catastrophic health payment (household health spending more than 40% of household's capacity to pay) and medical impoverishment (household per capita income falling below the poverty line due to medical expense) was 14.3% and 8.2%, respectively. NRCMS prevented 9.9% of the households from financial catastrophe and 7.7% from impoverishment, whereas MFA kept just one household from impoverishment and had no effect on financial catastrophe. Household per capita expenditure and household chronic disease proportion (proportion of members of a household with chronic illness) were the most important determinants of the unmet need for admission, risk of being impoverished and the chance of not being saved from impoverishment

BIOAVAILABILITY OF PBDES IN MALE RATS FROM ORALLY ADMINISTERED HOUSEHOLD DUST

EPA Science Inventory

Recently, household dust has been implicated as a major source of polybrominated diphenyl ether (PBDE) exposure in humans. This finding has very important implications especially for young children, who are thought to ingest more dust than adults, and may be more susceptible t...

Antibody titers for canine parvovirus type-2, canine distemper virus, and canine adenovirus type-1 in adult household dogs.

PubMed

Taguchi, Masayuki; Namikawa, Kazuhiko; Maruo, Takuya; Orito, Kensuke; Lynch, Jonathan; Sahara, Hiroeki

2011-09-01

Serum antibody titers for canine parvovirus type-2 (CPV-2), canine distemper virus (CDV) and canine adenovirus type-1 (CAV-1) were investigated in 1031 healthy adult household dogs (2 to 18 years old) given an annual inoculation in the previous 11 to 13 months. The number of dogs retaining significant titers of antibodies against CPV-2, CDV, and CAV-1 were 888 (86%), 744 (72%), and 732 (71%), respectively. There were no differences between males and females in antibody titers against the 3 viruses. Antibody titer for CPV-2 was significantly higher in younger dogs than in older dogs, CDV antibody was significantly higher in older dogs than in younger dogs, and CAV titer was not associated with age.

Antibody titers for canine parvovirus type-2, canine distemper virus, and canine adenovirus type-1 in adult household dogs

PubMed Central

Taguchi, Masayuki; Namikawa, Kazuhiko; Maruo, Takuya; Orito, Kensuke; Lynch, Jonathan; Sahara, Hiroeki

2011-01-01

Serum antibody titers for canine parvovirus type-2 (CPV-2), canine distemper virus (CDV) and canine adenovirus type-1 (CAV-1) were investigated in 1031 healthy adult household dogs (2 to 18 years old) given an annual inoculation in the previous 11 to 13 months. The number of dogs retaining significant titers of antibodies against CPV-2, CDV, and CAV-1 were 888 (86%), 744 (72%), and 732 (71%), respectively. There were no differences between males and females in antibody titers against the 3 viruses. Antibody titer for CPV-2 was significantly higher in younger dogs than in older dogs, CDV antibody was significantly higher in older dogs than in younger dogs, and CAV titer was not associated with age. PMID:22379198

SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study.

PubMed

Rivera, Rebecca L; Maulding, Melissa K; Abbott, Angela R; Craig, Bruce A; Eicher-Miller, Heather A

2016-11-01

Food insecurity is negatively associated with US children's dietary intake and health. The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) aims to alleviate food insecurity by offering nutrition, budgeting, and healthy lifestyle education to low-income individuals and families. The objective of this study was to evaluate the long-term impact of the Indiana SNAP-Ed on food security among households with children. A randomized, controlled, parallel study design with SNAP-Ed as an intervention was carried out during a 4- to 10-wk intervention period. Intervention group participants received the first 4 Indiana SNAP-Ed curriculum lessons. Study participants (n = 575) were adults aged ≥18 y from low-income Indiana households with ≥1 child living in the household. Both treatment groups completed an assessment before and after the intervention period and 1 y after recruitment. The 18-item US Household Food Security Survey Module was used to classify the primary outcomes of food security for the household and adults and children in the household. A linear mixed model was used to compare intervention with control group effects over time on food security. Mean ± SEM changes in household food security score and food security score among household adults from baseline to 1-y follow-up were 1.2 ± 0.4 and 0.9 ± 0.3 units lower, respectively, in the intervention group than in the control group (P < 0.01). The mean change in food security score from baseline to 1-y follow-up among household children was not significantly different in the intervention group compared with the control group. SNAP-Ed improved food security over a longitudinal time frame among low-income Indiana households with children in this study. SNAP-Ed may be a successful intervention to improve food security. © 2016 American Society for Nutrition.

Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014.

PubMed

Ogden, Cynthia L; Carroll, Margaret D; Fakhouri, Tala H; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

2018-02-16

Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (≤130%, >130% to ≤350%, and >350% of the federal poverty level [FPL]) and head of household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).

Measuring the Impact of Convenient Water Supply on Household Time Use in Rural Ethiopia

NASA Astrophysics Data System (ADS)

Cook, J.; Masuda, Y.; Fortmann, L.; Smith-Nilson, M.; Gugerty, M.

2012-12-01

What is the impact of providing convenient water supply on water carriers' pattern of time use? How much of the freed time is re-allocated to paid market work, education (for girls), agricultural labor, or leisure? Do women report spending more time on activities they enjoy? Does convenient water supply lead to a re-allocation of leisure time to other household members? These questions are an important, but largely missing, piece of the economic evidence base for investment in the water supply sector. Cairncross and Valdmanis (2007) observe that "given the relevance of the time-saving benefit to water supply policy and the fact that the benefit is usually uppermost in the mind of the consumer, it is remarkable how few data have been collected on the amounts of time spent collecting water". We address this gap by measuring changes in time use among female water carriers before and after new water systems are installed in three rural villages in the Oromia region of Ethiopia. The timing of completion of the projects in the three villages was staggered over time for logistical reasons, so our quasi-experimental design allows us to control for any region-wide changes in time use. Because of low literacy levels, we used a pictorial time use elicitation approach based on respondents' recall of the previous day as well as the standard questions used in the DHS and LSMS ("how many minutes..."). We measured time use for all household members over the age of 10. We use this unique panel dataset with both pre- and post-project time use data to examine not only the effect on water carriers' time use but also any intra-household reallocation of time savings. In total, we interviewed 454 randomly-selected households in the three villages over three rainy seasons, and collected time use information on 1,590 household members. Primary water carriers spend (pre-project) an average of 110 minutes per day collecting water, roughly representative of water collection times reported in

Are the Chinese Saving for Old Age?: The Relationship between Future Pension Benefits of 45-60 Years Old Chinese and Current Household Expenditures.

PubMed

van Dullemen, C E; Nagel, I; de Bruijn, J M G

2017-01-01

Worldwide, older people's support used to be the adult children's responsibility. In China, two generations after introducing the one-child policy in the late 70-ies, this becomes an increasingly demanding obligation. The Chinese government took the responsibility to mitigating old- age poverty risks and realized unprecedented progress in pension coverage. At the same time, the household savings increased to about 30 % of disposable income. Built on previous research on the politics of ageing, this study analyses households responses to the established governmental and firm pension programs as well as to the New Rural Pension Scheme (NRPS), introduced in 2009. The central question is: will participation in the established and new pension programs lead to higher current Chinese household expenditures and therefore to lower savings? The China Health and Retirement Longitudinal Study (CHARLS) dataset of 2011 offered the opportunity to study the influence of the recently introduced NRPS. We find that Chinese households with members between 45 and 60 years who expect future benefits of NRPS do not have higher expenditures than those not covered by NRPS. For the participants in the established, mostly urban pension programs a correlation was found with higher current expenditures (28 % more spending on basic needs, 80 % more on luxury) However, further analysis shows that this correlation cannot be interpreted as a causal relationship. This implies that coverage by pensions, be it in urban or rural programs, does not determine higher current expenditures and lower savings.

Household Demography and Early Childhood Mortality in a Rice-Farming Village in Northern Laos

PubMed Central

Tomita, Shinsuke; Parker, Daniel M.; Jennings, Julia A.; Wood, James

2015-01-01

This paper extends Alexandr Chayanov’s model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years’ worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household’s consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov’s model still has theoretical relevance and deserves to be revived. PMID:25775467

Associations between neighbourhood and household environmental variables and fruit consumption: exploration of mediation by individual cognitions and habit strength in the GLOBE study.

PubMed

Tak, Nannah I; te Velde, Saskia J; Kamphuis, Carlijn Bm; Ball, Kylie; Crawford, David; Brug, Johannes; van Lenthe, Frank J

2013-03-01

The present study examined associations of several home and neighbourhood environmental variables with fruit consumption and explored whether these associations were mediated by variables derived from the Theory of Planned Behaviour (TPB) and by habit strength. Data of the Dutch GLOBE study on household and neighbourhood environment, fruit intake and related factors were used, obtained by self-administered questionnaires (cross-sectional), face-to-face interviews and audits. The city of Eindhoven in the Netherlands Adults (n 333; mean age 58 years, 54% female). Multiple mediation analyses were conducted using regression analyses to assess the association between environmental variables and fruit consumption, as well as mediation of these associations by TPB variables and by habit strength. Intention, perceived behaviour control, subjective norm and habit strength were associated with fruit intake. None of the neighbourhood environmental variables was directly or indirectly associated with fruit intake. The home environmental variable 'modelling behaviour by family members' was indirectly, but not directly, associated with fruit intake. Habit strength and perceived behaviour control explained most of the mediated effect (71.9%). Modelling behaviour by family members was indirectly associated with fruit intake through habit strength and perceived behaviour control. None of the neighbourhood variables was directly or indirectly, through any of the proposed mediators, associated with adult fruit intake. These findings suggest that future interventions promoting fruit intake should address a combination of the home environment (especially modelling behaviour by family members), TPB variables and habit strength for fruit intake.

Social influence and motivation to change health behaviors among Mexican origin adults: Implications for diet and physical activity

PubMed Central

Ashida, Sato; Wilkinson, Anna V.; Koehly, Laura M.

2011-01-01

Purpose To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Design Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Setting Families from an ongoing population-based cohort in Houston, TX. Subjects 475 adults from 161 Mexican origin families. Out of 347 households contacted, 162 (47%) participated. Measures Family health history, social networks, and motivation to change behaviors. Analysis Two-level logistic regression modeling. Results Having at least one network member who encourages one to eat more fruits and vegetables (p=.010) and to engage in regular physical activity (p=.046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encouragers for these behaviors. Conclusions Identification of new encouragers within networks and targeting natural encouragers (e.g., children, spouses) may increase the efficacy of interventions to motivate behavioral changes among Mexican origin adults. PMID:22208416

Social influence and motivation to change health behaviors among Mexican-origin adults: implications for diet and physical activity.

PubMed

Ashida, Sato; Wilkinson, Anna V; Koehly, Laura M

2012-01-01

To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Families from an ongoing population-based cohort in Houston, Texas. 475 adults from 161 Mexican-origin families. Out of 347 households contacted, 162 (47%) participated. Family health history, social networks, and motivation to change behaviors. Two-level logistic regression modeling. Having at least one network member who encourages one to eat more fruits and vegetables (p = .010) and to engage in regular physical activity (p = .046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encouragers for these behaviors. Identification of new encouragers within networks and targeting natural encouragers (e.g., children, spouses) may increase the efficacy of interventions to motivate behavioral changes among Mexican-origin adults.

Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study.

PubMed

Puts, Martine T E; Sattar, Schroder; McWatters, Kara; Lee, Katherine; Kulik, Michael; MacDonald, Mary-Ellen; Jang, Raymond; Amir, Eitan; Krzyzanowska, Monika K; Leighl, Natasha; Fitch, Margaret; Joshua, Anthony M; Warde, Padraig; Tourangeau, Ann E; Alibhai, Shabbir M H

2017-03-01

Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis. There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the

The role of hypoglycemia in the burden of living with diabetes among adults with diabetes and family members: results from the DAWN2 study in The Netherlands.

PubMed

Nefs, Giesje; Pouwer, François

2018-01-18

To examine the relation between self-reported hypoglycemic events, worries about these episodes, and the burden of diabetes in adults with diabetes and family members from The Netherlands. As part of the second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study, 412 Dutch adults with type 1 or type 2 diabetes and 86 family members completed questions about the burden of living with diabetes, the frequency of hypoglycemia, worries about these events, and several demographic and clinical factors. Analyses included hierarchical logistic regression. In total, 41% of people with diabetes and 56% of family members considered diabetes at least somewhat of a burden. In people with diabetes, diabetes burden was independently associated with self-reported current insulin use (fully adjusted OR = 2.75, 95% CI 1.49-5.10), self-reported frequent non-severe hypoglycemia in the past year (OR = 2.45, 1.25-4.83), self-reported severe hypoglycemia in the past year (OR = 1.91, 1.02-3.58), and being very worried about hypoglycemia at least occasionally (OR = 3.64, 2.18-6.10). For family members, the odds of experiencing living with diabetes as a burden was increased only for participants who were at least occasionally very worried about hypoglycemia (adjusted OR = 5.07, 1.12-23.00). Approximately half of adults with diabetes and adult family members experienced at least some diabetes burden. In both groups, diabetes burden appeared to be associated with being very worried about hypoglycemia at least occasionally. If these results are replicated, new intervention studies could test new ways of decreasing the traumatic consequences of previous or anticipated hypoglycemic events for people with diabetes and family members.

77 FR 65894 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... drinking water distribution systems. A study conducted in Norway from 2003-2004 found that people exposed... or adult household member employed at daycare, pets in the household and other animal contact, and...

Obesity and household food insecurity: evidence from a sample of rural households in Malaysia.

PubMed

Shariff, Z Mohd; Khor, G L

2005-09-01

The study examined nutritional outcomes related to body fat accumulation of food insecurity among women from selected rural communities in Malaysia. Cross-sectional study. Rural communities (seven villages and two palm plantations) in a district with high percentage of welfare recipients. Malay (n = 140) and Indian (n = 60) women were interviewed and measured for demographic, socioeconomic, anthropometric, dietary and physical activity information. The women were measured for their body mass index and waist circumference (WC). Energy and nutrient intakes, food group intake and food variety score were analyzed from 24 h dietary recalls and food-frequency questionnaire. Daily physical activity of the women was examined as the number of hours spent in economic, domestic, leisure and sport activities. Using the Radimer/Cornell Hunger and Food Insecurity Instrument, 58% of the women reported some degree of food insecurity (household insecure 14%, adult insecure 9.5% and child hunger 34.5%). In general, food-insecure women had lower years of education, household income and income per capita, more children and mothers as housewives. More than 50% of food-insecure women were overweight and obese than women from food-secure households (38%). Similarly, more food-insecure women (32-47%) had at-risk WC (> or = 88 cm) than food-secure women (29%). Food-insecure women spent significantly more time in domestic and leisure activities than food-secure women. Overweight and abdominal adiposity among the women were associated with a number of independent variables, such as women as housewives, women with more children, larger household size, food insecurity, shorter time spent in economic activities, longer time spent in leisure activities and lower food variety score. After adjusting for factors that are related to both adiposity and food insecurity, women from food-insecure households were significantly more likely to have at-risk WC, but not obese. Among this sample of rural

Household food insecurity and coping strategies in a poor rural community in Malaysia

PubMed Central

Khor, Geok Lin

2008-01-01

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that

Using people to cope with the hunger: social networks and food transfers amongst HIV/AIDS afflicted households in KwaZulu-Natal, South Africa.

PubMed

Kaschula, Sarah

2011-10-01

Household afflicted by HIV/AIDS are particularly prone to food insecurity. This article explores the role of community networks in meeting household food deficits. One hundred households exhibiting a range (0-5) of HIV/AIDS proxies related to orphan fostering, prime adult chronic illness and mortality were visited at quarterly intervals for a year. At each assessment, donated food types consumed in the past 48 h were recorded, and household food security was monitored through an experiential measure. Factors determining access to donated foods were explored qualitatively by means of participant observation and semi-structured interviews. Poor households with prime adult chronic illness were prone to food insecurity, and used the most donated foods. However, not all households perceived to be afflicted with HIV/AIDS were able to access donated foods due to stigma and social exclusion. Concerted action must be taken by government, non-government and community agents if social food transfer networks are to be transformed into coordinated community action.

Household Coverage of Fortified Staple Food Commodities in Rajasthan, India.

PubMed

Aaron, Grant J; Sodani, Prahlad R; Sankar, Rajan; Fairhurst, John; Siling, Katja; Guevarra, Ernest; Norris, Alison; Myatt, Mark

2016-01-01

A spatially representative statewide survey was conducted in Rajasthan, India to assess household coverage of atta wheat flour, edible oil, and salt. An even distribution of primary sampling units were selected based on their proximity to centroids on a hexagonal grid laid over the survey area. A sample of n = 18 households from each of m = 252 primary sampling units PSUs was taken. Demographic data on all members of these households were collected, and a broader dataset was collected about a single caregiver and a child in the first 2 years of life. Data were collected on demographic and socioeconomic status; education; housing conditions; recent infant and child mortality; water, sanitation, and hygiene practices; food security; child health; infant and young child feeding practices; maternal dietary diversity; coverage of fortified staples; and maternal and child anthropometry. Data were collected from 4,627 households and the same number of caregiver/child pairs. Atta wheat flour was widely consumed across the state (83%); however, only about 7% of the atta wheat flour was classified as fortifiable, and only about 6% was actually fortified (mostly inadequately). For oil, almost 90% of edible oil consumed by households in the survey was classified as fortifiable, but only about 24% was fortified. For salt, coverage was high, with almost 85% of households using fortified salt and 66% of households using adequately fortified salt. Iodized salt coverage was also high; however, rural and poor population groups were less likely to be reached by the intervention. Voluntary fortification of atta wheat flour and edible oil lacked sufficient industry consolidation to cover significant portions of the population. It is crucial that appropriate delivery channels are utilized to effectively deliver essential micronutrients to at-risk population groups. Government distribution systems are likely the best means to accomplish this goal.

Who Matters for Children’s Early Development? Race/Ethnicity and Extended Household Structures in the United States

PubMed Central

Fomby, Paula; Dennis, Jeff A.

2011-01-01

Taking advantage of recent data that permit an assessment of the importance of extended household members in operationalizing the relationship between family structure and children’s early development, this study incorporated coresident grandparents, other kin, and nonkin to investigate the associations between extended household structure and U.S. children’s cognitive and behavioral outcomes at age 2. Analyses assessed whether these relationships differed for Latino, African American, and White children and tested four potential explanations for such differences. Nationally representative data came from the Early Childhood Longitudinal Study-Birth Cohort of 2001 (N ≈ 8,450). Extended household structures were much more prevalent in households of young African American and Latino children than among Whites. Nuclear households were beneficial for White children, but living with a grandparent was associated with the highest cognitive scores for African American children. Nuclear, vertically extended, and laterally extended households had similar associations with Latino children’s cognitive and behavior scores. Results suggest that expanded indicators of household structure that include grandparents, other kin, and nonkin are useful for understanding children’s early development. PMID:21927627

Changes in the living arrangement and risk of stroke in Japan; does it matter who lives in the household? Who among the family matters?

PubMed

Eshak, Ehab Salah; Iso, Hiroyasu; Honjo, Kaori; Noda, Ai; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

Previous studies have suggested associations of family composition with morbidity and mortality; however, the evidence of associations with risk of stroke is limited. We sought to examine the impact of changes in the household composition on risk of stroke and its types in Japanese population. Cox proportional hazard modelling was used to assess the risk of incident stroke and stroke types within a cohort of 77,001 Japanese men and women aged 45-74 years who experienced addition and/or loss of family members [spouse, child(ren), parent(s) and others] to their households over a five years interval (between 1990-1993 and 1995-1998). During 1,043,446 person-years of the follow-up for 35,247 men and 41,758 women, a total of 3,858 cases of incident stroke (1485 hemorrhagic and 2373 ischemic) were documented. When compared with a stable family composition, losing at least one family member was associated with 11-15% increased risk of stroke in women and men; hazard ratios (95% confidence interval) were 1.11 (1.01-1.22) and 1.15 (1.05-1.26), respectively. The increased risk was associated with the loss of a spouse, and was evident for ischemic stroke in men and hemorrhagic stroke in women. The addition of any family members to the household was not associated with risk of stroke in men, whereas the addition of a parent (s) to the household was associated with increased risk in women: 1.49 (1.09-2.28). When the loss of a spouse was accompanied by the addition of other family members to the household, the increased risk of stroke disappeared in men: 1.18 (0.85-1.63), but exacerbated in women: 1.58 (1.19-2.10). In conclusion, men who have lost family members, specifically a spouse have higher risk of ischemic stroke, and women who gained family members; specifically a parent (s) had the higher risk of hemorrhagic stroke than those with a stable family composition.

Agricultural Work Force Households: How Much Do They Depend on Farming? Background for Agricultural Policy. Agriculture Information Bulletin Number 547.

ERIC Educational Resources Information Center

Cox, E. Jane; Oliveira, Victor J.

According to data from the 1985 Agricultural Work Force Survey, over 13.5 million of the 17.6 million agricultural work force household members (77 percent) lived in households headed by a farm worker. Some farm workers worked on the farm as their primary job, whereas others primarily worked off the farm. Farm work was an occasional form of…

An Intercity Outbreak of Meningococcal Meningitis in Adults

PubMed Central

Oill, Phyllis A.; Chow, Anthony W.; Roberto, Ronald R.; Guze, Lucien B.

1978-01-01

An intercity outbreak of meningococcal meningitis occurred in five adults, with the acute onset of symptoms developing in two of the patients after they returned to Los Angeles from the San Francisco Bay area. The secondary attack rate was 36.4 percent in this entirely adult household. The authors review reports of secondary cases in civilian epidemics, as well as recommendations for chemoprophylaxis in household contacts. PMID:636407

78 FR 76529 - Members of a Family for Purpose of Filing CBP Family Declaration