Sample records for representative household sample

  1. RECRUITING FOR A LONGITUDINAL STUDY OF CHILDREN'S HEALTH USING A HOUSEHOLD-BASED PROBABILITY SAMPLING APPROACH

    EPA Science Inventory

    The sampling design for the National Children¿s Study (NCS) calls for a population-based, multi-stage, clustered household sampling approach (visit our website for more information on the NCS : www.nationalchildrensstudy.gov). The full sample is designed to be representative of ...

  2. 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 numerous factors that may affect consumption need to be taken into account.

  3. NHEXAS PHASE I MARYLAND STUDY--PESTICIDE METABOLITES IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticide Metabolites in Urine data set contains analytical results for measurements of up to 9 pesticides in 345 urine samples over 79 households. Each sample was collected from the primary respondent within each household during the study and represented the first morning ...

  4. NHEXAS PHASE I MARYLAND STUDY--METALS IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Urine data set contains analytical results for measurements of up to 3 metals in 376 urine samples over 80 households. Each sample was collected from the primary respondent within each household during the study and represented the first morning void of either Day ...

  5. Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey.

    PubMed

    Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Subramaniam, Mayoori

    2015-11-01

    To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators. Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011. A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women. Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview. Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ) <-2), wasting (weight-for-height Z-score (WHZ) <-2) and underweight (weight-for-age Z-score (WAZ) <-2) were 41·6% (95% CI 38·9, 44·3%), 11·5% (95% CI 9·8, 13·2%) and 30·1% (95% CI 27·5, 32·8%), respectively. Prevalences of stunting, severe stunting (HAZ<-3) and underweight by level of household food insecurity were statistically significant (P<0·001). By multiple linear regression analyses and after adjustment for sociodemographic, child and environmental factors, household food access insecurity score was associated with HAZ (β=-0·02, P=0·01) and WAZ (β=-0·01, P=0·01) but was not associated with WHZ and BMI-for-age Z-score. A 10-point increase in household food access insecurity score was associated with a decrease in HAZ of 0·2 (95% CI 0·05, 0·39) and decrease in WAZ of 0·1 (95% CI 0·03, 0·27). Our results from a nationally representative sample confirm the previously reported association of household food insecurity with stunting and underweight. Community nutrition interventions may use household food insecurity scales for identifying those households where children may be at risk of growth faltering.

  6. Design and Field Procedures in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A)

    PubMed Central

    Kessler, Ronald C.; Avenevoli, Shelli; Costello, E. Jane; Green, Jennifer Greif; Gruber, Michael J.; Heeringa, Steven; Merikangas, Kathleen R.; Pennell, Beth-Ellen; Sampson, Nancy A.; Zaslavsky, Alan M.

    2009-01-01

    An overview is presented of the design and field procedures of the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a US face-to-face household survey of the prevalence and correlates of DSM-IV mental disorders. The survey was based on a dual-frame design that included 904 adolescent residents of the households that participated in the US National Comorbidity Survey Replication (85.9% response rate) and 9,244 adolescent students selected from a nationally representative sample of 320 schools (74.7% response rate). After expositing the logic of dual-frame designs, comparisons are presented of sample and population distributions on Census socio-demographic variables and, in the school sample, school characteristics. These document only minor differences between the samples and the population. The results of statistical analysis of the bias-efficiency trade-off in weight trimming are then presented. These show that modest trimming meaningfully reduces mean squared error. Analysis of comparative sample efficiency shows that the household sample is more efficient than the school sample, leading to the household sample getting a higher weight relative to its size in the consolidated sample relative to the school sample. Taken together, these results show that the NCS-A is an efficient sample of the target population with good representativeness on a range of socio-demographic and geographic variables. PMID:19507169

  7. 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

  8. The National Comorbidity Survey Adolescent Supplement (NCS-A): II. Overview and Design

    PubMed Central

    Kessler, Ronald C.; Avenevoli, Shelli; Costello, E. Jane; Green, Jennifer Greif; Gruber, Michael J.; Heeringa, Steven; Merikangas, Kathleen R.; Pennell, Beth-Ellen; Sampson, Nancy A.; Zaslavsky, Alan M.

    2009-01-01

    OBJECTIVE To present an overview of the design and field procedures of the National Comorbidity Survey Replication Adolescent Supplement (NCS-A) METHOD The NCS-A is a nationally representative face-to-face household survey of the prevalence and correlates of DSM-IV mental disorders among US adolescents (ages 13–17) that was carried out between February 2001 and January 2004 by the Survey Research Center of the Institute for Social Research at the University of Michigan. The sample was based on a dual-frame design that included 904 adolescent residents of the households that participated in the National Comorbidity Survey Replication (85.9% response rate) and 9244 adolescent students selected from a representative sample of 320 schools in the same nationally representative sample of counties as the NCS-R (74.7% response rate). RESULTS Comparisons of sample and population distributions on Census socio-demographic variables and, in the school sample, school characteristics documented only minor differences that were corrected with post-stratification weighting. Comparisons of DSM-IV disorder prevalence estimates among household vs. school sample respondents in counties that differed in the use of replacement schools for originally selected schools that refused to participate showed that the use of replacement schools did not introduce bias into prevalence estimates. CONCLUSIONS The NCS-A is a rich nationally representative dataset that will substantially increase understanding of the mental health and well-being of adolescents in the United States. PMID:19242381

  9. Family Cash-Flow Budgeting.

    ERIC Educational Resources Information Center

    Beutler, Ivan F.; Mason, Jerald W.

    1987-01-01

    Distribution for a formalized budget variable is reported for a representative sample of families. Most households reported little, if any, formal planning. Compared to informal planners, formal planners are more likely to have the following characteristics: younger, more years of education, two-spouse households, and high circumstantial demands.…

  10. At-School Victimization and Violence Exposure Assessed in a National Household Survey of Children and Youth

    ERIC Educational Resources Information Center

    Finkelhor, David; Vanderminden, Jennifer; Turner, Heather; Shattuck, Anne; Hamby, Sherry

    2016-01-01

    This national household telephone survey of youth and parents assessed exposure to a broad range of at-school victimizations among a representative sample of 3,391 children and youth ages 5 to 17. Nearly half the sample (48%) had been exposed to at least one form of victimization at school during the past year (in 2011), most of which was…

  11. Age, Marital Processes, and Depressed Affect

    ERIC Educational Resources Information Center

    Bookwala, Jamila; Jacobs, Jamie

    2004-01-01

    Purpose: We examined age-cohort differences in the interrelationships among marital processes and depressed affect. Design and Methods: We used data from individuals in first marriages that participated in the National Survey of Families and Households (NSFH). The NSFH interviewed one adult per household of a nationally representative sample.…

  12. Iodine Status of Women of Reproductive Age in Sierra Leone and Its Association with Household Coverage with Adequately Iodized Salt

    PubMed Central

    Rohner, Fabian; Wirth, James P.; Woodruff, Bradley A.; Chiwile, Faraja; Yankson, Hannah; Sesay, Fatmata; Koroma, Aminata S.; Petry, Nicolai; Pyne-Bailey, Solade; Dominguez, Elisa; Kupka, Roland; Hodges, Mary H.; de Onis, Mercedes

    2016-01-01

    Salt iodization programs are a public health success in tackling iodine deficiency. Yet, a large proportion of the world’s population remains at risk for iodine deficiency. In a nationally representative cross-sectional survey in Sierra Leone, household salt samples and women’s urine samples were quantitatively analyzed for iodine content. Salt was collected from 1123 households, and urine samples from 817 non-pregnant and 154 pregnant women. Household coverage with adequately iodized salt (≥15 mg/kg iodine) was 80.7%. The median urinary iodine concentration (UIC) of pregnant women was 175.8 µg/L and of non-pregnant women 190.8 µg/L. Women living in households with adequately iodized salt had higher median UIC (for pregnant women: 180.6 µg/L vs. 100.8 µg/L, respectively, p < 0.05; and for non-pregnant women: 211.3 µg/L vs. 97.8 µg/L, p < 0.001). Differences in UIC by residence, region, household wealth, and women’s education were much smaller in women living in households with adequately iodized salt than in households without. Despite the high household coverage of iodized salt in Sierra Leone, it is important to reach the 20% of households not consuming adequately iodized salt. Salt iodization has the potential for increasing equity in iodine status even with the persistence of other risk factors for deficiency. PMID:26848685

  13. Households encountering with catastrophic health expenditures in Ferdows, Iran.

    PubMed

    Ghoddoosinejad, Javad; Jannati, Ali; Gholipour, Kamal; Baghban Baghestan, Elham

    2014-08-01

    Out-of-pocket payments are the main sources of healthcare financing in most developing countries. Healthcare services can impose a massive cost burden on households, especially in developing countries. The purpose of this study was to calculate households encountered with catastrophic healthcare expenditures in Ferdows, Iran. The sample included 100 households representing 20% of all households in Ferdows, Iran. The data were collected using self-administered questionnaire. The ability to pay of households was calculated, and then if costs of household health were at least 40% of their ability to pay, it was considered as catastrophic expenditures. Rate of households encountered to catastrophic health expenditures was estimated to be 24%, of which dentistry services had the highest part in catastrophic health expenditures. Low ability to pay of households should be supported against these expenditures. More equitable health system would solve the problem, although more financial aid should be provided for households encountered to catastrophic costs.

  14. THE NORTH CAROLINA HERALD PILOT STUDY

    EPA Science Inventory



    The sampling design for the National Children's Study (NCS) calls for a population-based, multi-stage, clustered household sampling approach. The full sample is designed to be representative of both urban and rural births in the United States, 2007-2011. While other sur...

  15. Understanding perception of wood household furniture: application of a policy capturing approach

    Treesearch

    David Brinberg; Matthew Bumgardner; Kim Daniloski

    2007-01-01

    Consumer and retailer perceptions of wood household furniture were modeled using a policy capturing approach. A sample of consumers and retailers evaluated four pictures of wood furniture on eight visual cues deemed representative of the furniture purchasing environment. These cues were then regressed on respondents' judgment of willingness to pay for each...

  16. Household economic strategies and nutritional anthropometry of women in American Samoa and highland Bolivia.

    PubMed

    Bindon, James R; Vitzthum, Virginia J

    2002-04-01

    This study compares findings from research projects involving different genetic, environmental, and cultural contexts: a study of lifestyle and health from American Samoa (ASLS) and the Bolivian project. Reproduction and Ecology in Provincia Aroma (REPA). This paper presents analyses of varying economic strategies and their association with nutritional status indicators in each population. The ASLS sample includes 66 Samoan women and the REPA sample includes 210 Aymara women. Principle components analysis of household economic resources within each sample extracted two significant factors: one represents modernizing influences including education and occupational status, and the other represents ethnographically salient traditional economic behavior. The traditional pattern includes adding household members in Samoa and selling agricultural products in Bolivia. This analysis places each woman along two continua, traditional and modern, based on her household mobilization of economic resources, permitting an understanding of the patterns underlying household economic behavior that is not possible in univariate analyses of socioeconomic variables. For the Bolivian women the strategy involving more education and higher occupational status was associated with higher measures of several nutritional status indicators, including body mass index, arm muscle area, and peripheral skinfolds. But among the Samoan women, where substantial obesity was the norm, there were no significant differences in anthropometric measurements based on economic strategies. These data argue for the importance of directly measuring the potential consequences of variation in household economic strategies rather than merely inferring such, and of assessing ethnographically relevant aspects of household economic production rather than limiting analyses to non-context-specific economic indicators such as income. This focus on household strategy is likely to be fruitful especially where economic and nutritional conditions are marginal. The findings from Bolivia also support efforts in developing countries to improve girls' education, and thereby occupational prospects, as a means to improve their health status as women.

  17. Household Expenditure on Tobacco Consumption in a Poverty-Stricken Rural District in Sri Lanka.

    PubMed

    Perera, K Manuja N; Guruge, G N Duminda; Jayawardana, Pushpa L

    2017-03-01

    Tobacco is a determinant of poverty and a barrier for development. Monaragala, a rural, agricultural district, reports the highest poverty-related indicators in southern Sri Lanka. A cross-sectional study was used to describe the household expenditure on tobacco and its association with food- and education-related expenditures at household level. This study used a 4-stage cluster sampling method to recruit a representative sample of 1160 households. Response rate was 98.6%. Median monthly household income was LKR 20 000 (interquartile range [IQR] = LKR 12 000-30 000). The median monthly expenditure on tobacco was LKR 1000 (IQR = LKR 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR = LKR 2000-3600).The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR = 2.0-10.0) and a mean of 7.4% (7.6). The poorest reported the highest mean proportionate expenditure (9.8%, SD = 10) from the household income. Household expenditure on tobacco negatively associated with expenditure on education.

  18. Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India.

    PubMed

    Biran, A; Jenkins, M W; Dabrase, P; Bhagwat, I

    2011-07-01

    To explore and explain patterns of use of communal latrine facilities in urban poverty pockets. Six poverty pockets with communal latrine facilities representing two management models (Sulabh and municipal) were selected. Sampling was random and stratified by poverty pocket population size. A seventh, community-managed facility was also included. Data were collected by exit interviews with facility users and by interviews with residents from a randomly selected representative sample of poverty pocket households, on social, economic and demographic characteristics of households, latrine ownership, defecation practices, costs of using the facility and distance from the house to the facility. A tally of facility users was kept for 1 day at each facility. Data were analysed using logistic regression modelling to identify determinants of communal latrine usage. Communal latrines differed in their facilities, conditions, management and operating characteristics, and rates of usage. Reported usage rates among non-latrine-owning households ranged from 15% to 100%. There was significant variation in wealth, occupation and household structure across the poverty pockets as well as in household latrine ownership. Households in pockets with municipal communal latrine facilities appeared poorer. Households in pockets with Sulabh-managed communal facilities were significantly more likely to own a household latrine. Determinants of communal facility usage among households without a latrine were access and convenience (distance and opening hours), facility age, cleanliness/upkeep and cost. The ratio of male to female users was 2:1 across all facilities for both adults and children. Provision of communal facilities reduces but does not end the problem of open defecation in poverty pockets. Women appear to be relatively poorly served by communal facilities and, cost is a barrier to use by poorer households. Results suggest improving facility convenience and access and modifying fee structures could lead to increased rates of usage. Attention to possible barriers to usage at household level associated particularly with having school-age children and with pre-school childcare needs may also be warranted. © 2011 Blackwell Publishing Ltd.

  19. Faecal contamination of household drinking water in Rwanda: A national cross-sectional study.

    PubMed

    Kirby, Miles A; Nagel, Corey L; Rosa, Ghislaine; Iyakaremye, Laurien; Zambrano, Laura Divens; Clasen, Thomas F

    2016-11-15

    Unsafe drinking water is a leading cause of morbidity and mortality, especially among young children in low-income settings. We conducted a national survey in Rwanda to determine the level of faecal contamination of household drinking water and risk factors associated therewith. Drinking water samples were collected from a nationally representative sample of 870 households and assessed for thermotolerant coliforms (TTC), a World Health Organization (WHO)-approved indicator of faecal contamination. Potential household and community-level determinants of household drinking water quality derived from household surveys, the 2012 Rwanda Population and Housing Census, and a precipitation dataset were assessed using multivariate logistic regression. Widespread faecal contamination was present, and only 24.9% (95% CI 20.9-29.4%, n=217) of household samples met WHO Guidelines of having no detectable TTC contamination, while 42.5% (95% CI 38.0-47.1%, n=361) of samples had >100TTC/100mL and considered high risk. Sub-national differences were observed, with poorer water quality in rural areas and Eastern province. In multivariate analyses, there was evidence for an association between detectable contamination and increased open waste disposal in a sector, lower elevation, and water sources other than piped to household or rainwater/bottled. Risk factors for intermediate/high risk contamination (>10TTC/100mL) included low population density, increased open waste disposal, lower elevation, water sources other than piped to household or rainwater/bottled, and occurrence of an extreme rain event the previous day. Modelling suggests non-household-based risk factors are determinants of water quality in this setting, and these results suggest a substantial proportion of Rwanda's population are exposed to faecal contamination through drinking water. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Measuring coverage in MNCH: total survey error and the interpretation of intervention coverage estimates from household surveys.

    PubMed

    Eisele, Thomas P; Rhoda, Dale A; Cutts, Felicity T; Keating, Joseph; Ren, Ruilin; Barros, Aluisio J D; Arnold, Fred

    2013-01-01

    Nationally representative household surveys are increasingly relied upon to measure maternal, newborn, and child health (MNCH) intervention coverage at the population level in low- and middle-income countries. Surveys are the best tool we have for this purpose and are central to national and global decision making. However, all survey point estimates have a certain level of error (total survey error) comprising sampling and non-sampling error, both of which must be considered when interpreting survey results for decision making. In this review, we discuss the importance of considering these errors when interpreting MNCH intervention coverage estimates derived from household surveys, using relevant examples from national surveys to provide context. Sampling error is usually thought of as the precision of a point estimate and is represented by 95% confidence intervals, which are measurable. Confidence intervals can inform judgments about whether estimated parameters are likely to be different from the real value of a parameter. We recommend, therefore, that confidence intervals for key coverage indicators should always be provided in survey reports. By contrast, the direction and magnitude of non-sampling error is almost always unmeasurable, and therefore unknown. Information error and bias are the most common sources of non-sampling error in household survey estimates and we recommend that they should always be carefully considered when interpreting MNCH intervention coverage based on survey data. Overall, we recommend that future research on measuring MNCH intervention coverage should focus on refining and improving survey-based coverage estimates to develop a better understanding of how results should be interpreted and used.

  1. Measuring Coverage in MNCH: Total Survey Error and the Interpretation of Intervention Coverage Estimates from Household Surveys

    PubMed Central

    Eisele, Thomas P.; Rhoda, Dale A.; Cutts, Felicity T.; Keating, Joseph; Ren, Ruilin; Barros, Aluisio J. D.; Arnold, Fred

    2013-01-01

    Nationally representative household surveys are increasingly relied upon to measure maternal, newborn, and child health (MNCH) intervention coverage at the population level in low- and middle-income countries. Surveys are the best tool we have for this purpose and are central to national and global decision making. However, all survey point estimates have a certain level of error (total survey error) comprising sampling and non-sampling error, both of which must be considered when interpreting survey results for decision making. In this review, we discuss the importance of considering these errors when interpreting MNCH intervention coverage estimates derived from household surveys, using relevant examples from national surveys to provide context. Sampling error is usually thought of as the precision of a point estimate and is represented by 95% confidence intervals, which are measurable. Confidence intervals can inform judgments about whether estimated parameters are likely to be different from the real value of a parameter. We recommend, therefore, that confidence intervals for key coverage indicators should always be provided in survey reports. By contrast, the direction and magnitude of non-sampling error is almost always unmeasurable, and therefore unknown. Information error and bias are the most common sources of non-sampling error in household survey estimates and we recommend that they should always be carefully considered when interpreting MNCH intervention coverage based on survey data. Overall, we recommend that future research on measuring MNCH intervention coverage should focus on refining and improving survey-based coverage estimates to develop a better understanding of how results should be interpreted and used. PMID:23667331

  2. Radon in harvested rainwater at the household level, Palestine.

    PubMed

    Al-Khatib, Issam A; Al Zabadi, Hamzeh; Saffarini, Ghassan

    2017-04-01

    The main objective of this study was to assess Radon concentration in the harvested rainwater (HRW) at the household level in Yatta area, Palestine. HRW is mainly used for drinking as it is the major source of water for domestic uses due to water scarcity. Ninety HRW samples from the household cisterns were collected from six localities (a town and five villages) and Radon concentrations were measured. The samples were randomly collected from different households to represent the Yatta area. Fifteen samples were collected from each locality at the same day. RAD7 device was used for analysis and each sample was measured in duplicate. Radon concentrations ranged from 0.037 to 0.26 Bq/L with a mean ± standard deviation of 0.14 ± 0.06 Bq/L. The estimated annual effective radiation doses for babies, children and adults were all far below the maximum limit of 5 mSvy -1 set by the National Council on Radiation Protection and Measurements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Occurrence of Legionella in UK household showers.

    PubMed

    Collins, Samuel; Stevenson, David; Bennett, Allan; Walker, Jimmy

    2017-04-01

    Household water systems have been proposed as a source of sporadic, community acquired Legionnaires' disease. Showers represent a frequently used aerosol generating device in the domestic setting yet little is known about the occurrence of Legionella spp. in these systems. This study has investigated the prevalence of Legionella spp. by culture and qPCR in UK household showers. Ninety nine showers from 82 separate properties in the South of England were sampled. Clinically relevant Legionella spp. were isolated by culture in 8% of shower water samples representing 6% of households. Legionella pneumophila sg1 ST59 was isolated from two showers in one property and air sampling demonstrated its presence in the aerosol state. A further 31% of showers were positive by Legionella spp. qPCR. By multi-variable binomial regression modelling Legionella spp. qPCR positivity was associated with the age of the property (p=0.02), the age of the shower (p=0.01) and the frequency of use (p=0.09). The concentration of Legionella spp. detected by qPCR was shown to decrease with increased frequency of use (p=0.04) and more frequent showerhead cleaning (p=0.05). There was no association between Legionella spp. qPCR positivity and the cold water supply or the showerhead material (p=0.65 and p=0.71, respectively). Household showers may be important reservoirs of clinically significant Legionella and should be considered in source investigations. Simple public health advice may help to mitigate the risk of Legionella exposure in the domestic shower environment. Crown Copyright © 2016. Published by Elsevier GmbH. All rights reserved.

  4. Modeling Optimal Cutoffs for the Brazilian Household Food Insecurity Measurement Scale in a Nationwide Representative Sample.

    PubMed

    Interlenghi, Gabriela S; Reichenheim, Michael E; Segall-Corrêa, Ana M; Pérez-Escamilla, Rafael; Moraes, Claudia L; Salles-Costa, Rosana

    2017-07-01

    Background: This is the second part of a model-based approach to examine the suitability of the current cutoffs applied to the raw score of the Brazilian Household Food Insecurity Measurement Scale [Escala Brasileira de Insegurança Alimentar (EBIA)]. The approach allows identification of homogeneous groups who correspond to severity levels of food insecurity (FI) and, by extension, discriminant cutoffs able to accurately distinguish these groups. Objective: This study aims to examine whether the model-based approach for identifying optimal cutoffs first implemented in a local sample is replicated in a countrywide representative sample. Methods: Data were derived from the Brazilian National Household Sample Survey of 2013 ( n = 116,543 households). Latent class factor analysis (LCFA) models from 2 to 5 classes were applied to the scale's items to identify the number of underlying FI latent classes. Next, identification of optimal cutoffs on the overall raw score was ascertained from these identified classes. Analyses were conducted in the aggregate data and by macroregions. Finally, model-based classifications (latent classes and groupings identified thereafter) were contrasted to the traditionally used classification. Results: LCFA identified 4 homogeneous groups with a very high degree of class separation (entropy = 0.934-0.975). The following cutoffs were identified in the aggregate data: between 1 and 2 (1/2), 5 and 6 (5/6), and 10 and 11 (10/11) in households with children and/or adolescents <18 y of age (score range: 0-14), and 1/2, between 4 and 5 (4/5), and between 6 and 7 (6/7) in adult-only households (range: 0-8). With minor variations, the same cutoffs were also identified in the macroregions. Although our findings confirm, in general, the classification currently used, the limit of 1/2 (compared with 0/1) for separating the milder from the baseline category emerged consistently in all analyses. Conclusions: Nationwide findings corroborate previous local evidence that households with an overall score of 1 are more akin to those scoring negative on all items. These results may contribute to guide experts' and policymakers' decisions on the most appropriate EBIA cutoffs. © 2017 American Society for Nutrition.

  5. Household Food Insecurity May Predict Underweightand Wasting among Children Aged 24-59 Months.

    PubMed

    Abdurahman, Ahmed A; Mirzaei, Khadijeh; Dorosty, Ahmed Reza; Rahimiforoushani, A; Kedir, Haji

    2016-01-01

    The aim of this study was to examine the association between household food insecurity and nutritional status among children aged 24-59 months in Haromaya District. Children (N = 453) aged 24-59 months were recruited in a community-based cross-sectional survey with a representative sample of households selected by a multistage sampling procedure in Haromaya District. Household Food Insecurity Access Scale and anthropometry were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. The prevalences of stunting, underweight, and wasting among children aged 24-59 months were 61.1%, 28.1%, and 11.8%, respectively. The mean household food insecurity access scale score was 3.34, and 39.7% of households experienced some degree of food insecurity. By logistic regression analysis and after adjusting for the confounding factors, household food insecurity was significantly predictive of underweight (AOR = 2.48, CI = 1.17-5.24, p = .05) and chronic energy deficiency (AOR = 0.47, CI = 0.23-0.97, p = .04) and marginally significant for wasting (AOR = 0.53, CI = 0.27-1.03, p = .06). It is concluded that household food security improves child growth and nutritional status.

  6. Factors associated with child hunger among food insecure households in Bangladesh.

    PubMed

    Haque, Md Ahshanul; Farzana, Fahmida Dil; Sultana, Sabiha; Raihan, Mohammad Jyoti; Rahman, Ahmed Shafiqur; Waid, Jillian L; Choudhury, Nuzhat; Ahmed, Tahmeed

    2017-02-16

    Hunger is associated with food insecurity at the household level and is considered as a global public health problem with long term adverse consequences on children's health. This study aims to determine the factors associated with child hunger from a nationally representative sample in Bangladesh among food insecure households. Data was derived from the Food Security and Nutritional Surveillance Project; 14,712 children aged 6-59 months belonging to food insecure households contributed to the analysis. Information on food security at the household level was collected for 30 days preceding the survey. Descriptive statistics served to illustrate the variables studied and multiple logistic regression analysis was conducted to identify the significant risk factors for child hunger. Overall 10% of the children were found to be hungry. After adjusting for seasonality, residence type and education level of household head, the variables - female headed households [OR: 1.87 (1.43-2.45); p < 0.001], severely food insecure households [OR: 10.5 (1.43-76.6); p < 0.05], households having women with no education [OR: 1.56 (1.27-1.92); p < 0.05], poorest asset quintile [OR: 1.50 (1.11-2.15); p < 0.05] and the amount of rice consumed per household per week [OR: 0.94 (0.92-0.96); p < 0.001] were found to be significantly and independently associated with child hunger. Out of the potential risk factors examined, our study found significant and independent association of five variables with child hunger: sex of the household head, household food insecurity status, educational status of household women and asset index. Despite all sampled household being food insecure, degree of household food insecurity status appeared to be the strongest predictor of child hunger.

  7. Bias of health estimates obtained from chronic disease and risk factor surveillance systems using telephone population surveys in Australia: results from a representative face-to-face survey in Australia from 2010 to 2013.

    PubMed

    Dal Grande, Eleonora; Chittleborough, Catherine R; Campostrini, Stefano; Taylor, Anne W

    2016-04-18

    Emerging communication technologies have had an impact on population-based telephone surveys worldwide. Our objective was to examine the potential biases of health estimates in South Australia, a state of Australia, obtained via current landline telephone survey methodologies and to report on the impact of mobile-only household on household surveys. Data from an annual multi-stage, systematic, clustered area, face-to-face population survey, Health Omnibus Survey (approximately 3000 interviews annually), included questions about telephone ownership to assess the population that were non-contactable by current telephone sampling methods (2006 to 2013). Univariable analyses (2010 to 2013) and trend analyses were conducted for sociodemographic and health indicator variables in relation to telephone status. Relative coverage biases (RCB) of two hypothetical telephone samples was undertaken by examining the prevalence estimates of health status and health risk behaviours (2010 to 2013): directory-listed numbers, consisting mainly of landline telephone numbers and a small proportion of mobile telephone numbers; and a random digit dialling (RDD) sample of landline telephone numbers which excludes mobile-only households. Telephone (landline and mobile) coverage in South Australia is very high (97%). Mobile telephone ownership increased slightly (7.4%), rising from 89.7% in 2006 to 96.3% in 2013; mobile-only households increased by 431% over the eight year period from 5.2% in 2006 to 27.6% in 2013. Only half of the households have either a mobile or landline number listed in the telephone directory. There were small differences in the prevalence estimates for current asthma, arthritis, diabetes and obesity between the hypothetical telephone samples and the overall sample. However, prevalence estimate for diabetes was slightly underestimated (RCB value of -0.077) in 2013. Mixed RCB results were found for having a mental health condition for both telephone samples. Current smoking prevalence was lower for both hypothetical telephone samples in absolute differences and RCB values: -0.136 to -0.191 for RDD landline samples and -0.129 to -0.313 for directory-listed samples. These findings suggest landline-based sampling frames used in Australia, when appropriately weighted, produce reliable representative estimates for some health indicators but not for all. Researchers need to be aware of their limitations and potential biased estimates.

  8. Coping with unreliable public water supplies: Averting expenditures by households in Kathmandu, Nepal

    NASA Astrophysics Data System (ADS)

    Pattanayak, Subhrendu K.; Yang, Jui-Chen; Whittington, Dale; Bal Kumar, K. C.

    2005-02-01

    This paper investigates two complementary pieces of data on households' demand for improved water services, coping costs and willingness to pay (WTP), from a survey of 1500 randomly sampled households in Kathmandu, Nepal. We evaluate how coping costs and WTP vary across types of water users and income. We find that households in Kathmandu Valley engage in five main types of coping behaviors: collecting, pumping, treating, storing, and purchasing. These activities impose coping costs on an average household of as much as 3 U.S. dollars per month or about 1% of current incomes, representing hidden but real costs of poor infrastructure service. We find that these coping costs are almost twice as much as the current monthly bills paid to the water utility but are significantly lower than estimates of WTP for improved services. We find that coping costs are statistically correlated with WTP and several household characteristics.

  9. The State of Our Nation's Youth, 1999-2000.

    ERIC Educational Resources Information Center

    Horatio Alger Association of Distinguished Americans, Inc., Alexandria, VA.

    This report details findings of a national questionnaire survey of the attitudes and plans of American adolescents. Participating were 1,327 students between 14 and 18 years of age in a nationally representative sample. To permit regional comparisons, the questionnaires were mailed to representative households within each of the nine United States…

  10. 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.

  11. 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.

  12. Polybrominated Diphenyl Ethers in Residential Dust: Sources of Variability

    PubMed Central

    Whitehead, Todd P.; Brown, F. Reber; Metayer, Catherine; Park, June-Soo; Does, Monique; Petreas, Myrto X.; Buffler, Patricia A.; Rappaport, Stephen M.

    2013-01-01

    We characterized the sources of variability for polybrominated diphenyl ethers (PBDEs) in residential dust and provided guidance for investigators who plan to use residential dust to assess exposure to PBDEs. We collected repeat dust samples from 292 households in the Northern California Childhood Leukemia Study during two sampling rounds (from 2001–2007 and during 2010) using household vacuum cleaners and measured 22 PBDEs using high resolution gas chromatography-high resolution mass spectrometry. Median concentrations for individual PBDEs ranged from <0.1–2,500 ng per g of dust. For each of eight representative PBDEs, we used a random-effects model to apportion total variance into regional variability (0–11%), intra-regional between-household variability (17–50%), within-household variability over time (38–74%), and within-sample variability (0–23%) and we used a mixed-effects model to identify determinants of PBDE levels. Regional differences in PBDE dust levels were associated with residential characteristics that differed by region, including the presence of furniture with exposed or crumbling foam and the recent installation of carpets in the residence. Intra-regional differences between households were associated with neighborhood urban density, racial and ethnic characteristics, and to a lesser extent, income. For some PBDEs, a decreasing time trend explained a modest fraction of the within-household variability; however, most of the within-household variability was unaccounted for by our mixed-effects models. Our findings indicate that it may be feasible to use residential dust for retrospective assessment of PBDE exposures in studies of children’s health (e.g., the Northern California Childhood Leukemia Study). PMID:23628589

  13. Microbial Diversity and Putative Opportunistic Pathogens in Dishwasher Biofilm Communities

    PubMed Central

    2018-01-01

    ABSTRACT Extreme habitats are not only limited to natural environments, but also exist in manmade systems, for instance, household appliances such as dishwashers. Limiting factors, such as high temperatures, high and low pHs, high NaCl concentrations, presence of detergents, and shear force from water during washing cycles, define microbial survival in this extreme system. Fungal and bacterial diversity in biofilms isolated from rubber seals of 24 different household dishwashers was investigated using next-generation sequencing. Bacterial genera such as Pseudomonas, Escherichia, and Acinetobacter, known to include opportunistic pathogens, were represented in most samples. The most frequently encountered fungal genera in these samples belonged to Candida, Cryptococcus, and Rhodotorula, also known to include opportunistic pathogenic representatives. This study showed how specific conditions of the dishwashers impact the abundance of microbial groups and investigated the interkingdom and intrakingdom interactions that shape these biofilms. The age, usage frequency, and hardness of incoming tap water of dishwashers had significant impact on bacterial and fungal community compositions. Representatives of Candida spp. were found at the highest prevalence (100%) in all dishwashers and are assumed to be one of the first colonizers in recently purchased dishwashers. Pairwise correlations in tested microbiomes showed that certain bacterial groups cooccur, as did the fungal groups. In mixed bacterial-fungal biofilms, early adhesion, contact, and interactions were vital in the process of biofilm formation, where mixed complexes of bacteria and fungi could provide a preliminary biogenic structure for the establishment of these biofilms. IMPORTANCE Worldwide demand for household appliances, such as dishwashers and washing machines, is increasing, as is the number of immunocompromised individuals. The harsh conditions in household dishwashers should prevent the growth of most microorganisms. However, our research shows that persisting polyextremotolerant groups of microorganisms in household appliances are well established under these unfavorable conditions and supported by the biofilm mode of growth. The significance of our research is in identifying the microbial composition of biofilms formed on dishwasher rubber seals, how diverse abiotic conditions affect microbiota, and which key microbial members were represented in early colonization and contamination of dishwashers, as these appliances can present a source of domestic cross-contamination that leads to broader medical impacts. PMID:29330184

  14. Measuring progress toward the Millennium Development Goals and the missing millions.

    PubMed

    Carr-Hill, Roy A

    2013-01-01

    The 2015 target date for achieving the Millennium Development Goals (MDGs) is fast approaching, but there is very little discussion of the validity of the indicators used to measure progress. In particular, there has been little attention given to the problems that arise when assessments of progress are based on household surveys. These are inappropriate for obtaining information about the poorest of the poor. Typically, they omit by design those not in households because they are homeless; those who are in institutions; and mobile, nomadic or pastoralist populations; and, in practice, household surveys will typically under-represent those in fragile, disjointed or multiple occupancy households; and those in urban slums and insecure areas of a country. Those six subgroups constitute a pretty comprehensive ostensive definition of the "poorest of the poor." Between 300 and 500 million people--mainly in developing countries--will be missed worldwide from the sampling frames of household surveys.

  15. Highly reported prevalence of drinking and driving in Brazil: data from the first representative household study.

    PubMed

    Pechansky, Flavio; De Boni, Raquel; Diemen, Lísia Von; Bumaguin, Daniela; Pinsky, Ilana; Zaleski, Marcos; Caetano, Raul; Laranjeira, Ronaldo

    2009-06-01

    Brazil lacks information about driving under the influence of alcohol (DUI) originated from representative samples obtained from the general population. 333 subjects with a valid driver's license and drinking in the last 12 months were drawn from a multistaged sample of 2,346 adults from the first Brazilian Household Survey of Patterns of Alcohol Use. A multivariate analysis was conducted to understand the associations between risk factors and driving after drinking three or more drinks. the overall DUI prevalence reported in the sample was 34.7% - 42.5% among males and 9.2% among females. Being male (OR = 6.0, 95% CI 2.9-12.6), having a previous DUI accident (OR = 7.9, 95% CI 2.5-24.9), binging in the last year (OR = 2.2, 95% CI 1.03-4.5) and having an unfavorable opinion towards policies (OR = 2.9, 95% CI 1.4-6.2) remained associated with heavy drinking and driving after model adjustments. This was the first study evaluating driving under the influence of alcohol in a representative sample of the Brazilian population. The prevalence of DUI found is alarming, and possibly underestimated in the sample. Results demonstrate the need for more studies on this association and show directions towards preventive strategies for the specific high-risk group of male drivers with previous problems with alcohol and unfavorable opinions about prevention policies.

  16. Project monitor. Final report. [Allegheny County, PA

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

    Hammond, P.Y.; Beck, P.; Doctors, S.I.

    1979-04-27

    Results are reported of a study of consumers' energy attitudes and behavior. Household consumers and small business consumers (both retail and manufacturing) responded to the survey, but only the household results are reported. The study sought to understand energy-related behavior at the level where the various components of energy policy intersect. Attempts are made to attain this goal by determining the extent to which various properties of the individuals and firms are associated with various amounts of conservation. A representative sample of the adult population in Allegheny County, Pennsylvania was interviewed. Part I introduces the measures of household conservation tomore » be used in the survey. Part II analyzes each of the types of energy conservation - general, winterization, heating, cooling, appliance, transportation, and electricity reductions - and relates them to demographic, situation, attitudinal, and perceptual variables in the household sample. Part III deals with the impacts of Project Pacesetter and the United Mine Workers' strike against the coal operators - particularly, the impact of the coal strike on household residents of Allegheny County. Part IV summarizes the findings and uses them for recommendations regarding energy conservation policy. Additional data are presented in 4 appendices. (MCW)« less

  17. Food Insecurity and the Negative Impact on Brazilian Children's Health-Why Does Food Security Matter for Our Future Prosperity? Brazilian National Survey (PNDS 2006/07).

    PubMed

    Poblacion, Ana Paula; Cook, John T; Marín-León, Leticia; Segall-Corrêa, Ana Maria; Silveira, Jonas A C; Konstantyner, Tulio; Taddei, José Augusto A C

    2016-12-01

    Food insecurity (FI) refers to limited or uncertain access to food resulting from financial constraints. Numerous studies have shown association between FI and adverse health outcomes among adults and children around the world, but in Brazil, such information is scarce, especially if referring to nationally representative information. To test for an independent association between FI and health outcomes. Most recent Brazilian Demographic and Health Survey using nationally representative complex probability sampling. Participants were 3923 children <5 years of age, each representing a household. Data from the validated Brazilian Food Insecurity Scale were dichotomized as food secure (food security/mild FI) or food insecure (moderate FI/severe FI). Poisson regression was used to test for associations between FI and various health indicators. Models adjusted for socioeconomic and demographic variables showed that children hospitalized for pneumonia or diarrhea were 30% more prevalent in FI households (adjusted prevalence ratio [aPR]: 1.3; 1.1-1.6). Underweight children were 40% more prevalent in FI households (aPR: 1.4; 1.1-1.7). Children who didn't eat meat and fruits and vegetables every day were 20% and 70% more prevalent in FI households (aPR: 1.2; 1.1-1.4 and aPR: 1.7; 1.3-2.3), respectively. Children who grow up in food-insecure households have been shown to have worse health conditions than those in food-secure households. Consequently, their human capital accumulation and work-life productivity are likely to be reduced in the future, leading them into adulthood less capable of generating sufficient income, resulting in a cycle of intergenerational poverty and FI. © The Author(s) 2016.

  18. Rationale, design, and analysis of combined Brazilian household budget survey and food intake individual data.

    PubMed

    Sichieri, R; Pereira, R A; Martins, A; Vasconcellos, Abpa; Trichopoulou, A

    2008-03-17

    Data on food intake at the individual level and its statistical distribution in population groups defined by age, gender, or geographic areas are important in planning public health and nutrition programs. However, individual-based surveys in representative population samples are expensive to perform. In Brazil, an individual based survey is under consideration to be conducted alongside the household budget survey (HBS), which will be carried out in 2008-2009. This paper presents the methodological framework of dietary data collection and indicates the directions to combining both sources of data. The 2008-2009 Brazilian HBS sample will include 60,000 households. Of the selected HBS households, 30% will be randomly sampled to gather data on individual food intake. Therefore, individual dietary intake data is expected to be gathered for 70,000 individuals. Data collection procedures will comprise: completion of a diary with information regarding food purchases during a seven-day period; registration of all items consumed during two non-consecutive days for all 10 year-old or older members of the household. The sample will be large enough to capture the variation between individuals, and the two records will assure the estimation of the variation within individuals for food groups, energy and nutrients. Data on individual dietary intake and food family budget will be stratified by the five regions of the country and by rural or urban. A pilot study has been conducted in two states, and it indicated that combining individual and budgetary data in a survey is feasible. This kind of study will allow us to estimate correlations between individual intake and household purchases, overcoming the limitations of individual dietary surveys, and enhancing the HBS with information on eating out and intra-familiar distribution of food.

  19. Medicine expenses and obesity in Brazil: an analysis based on the household budget survey.

    PubMed

    Canella, Daniela S; Novaes, Hillegonda M D; Levy, Renata B

    2016-01-20

    Obesity can be considered a global public health problem that affects virtually all countries worldwide and results in greater use of healthcare services and higher healthcare costs. We aimed to describe average monthly household medicine expenses according to source of funding, public or private, and to estimate the influence of the presence of obese residents in households on total medicine expenses. This study was based on data from the 2008-2009 Brazilian Household Budget Survey, with a representative population sample of 55,970 households as study units. Information on nutritional status and medicines acquired and their cost in the past 30 days were analyzed. A two-part model was employed to assess the influence of obesity on medicine expenses, with monthly household medicine expenses per capita as outcome, presence of obese in the household as explanatory variable, and adjustment for confounding variables. Out-of-pocket expenses on medicines were always higher than the cost of medicines obtained through the public sector, and 32 % of households had at least one obese as resident. Monthly household expenses on medicines per capita in households with obese was US$ 20.40, 16 % higher than in households with no obese. An adjusted model confirmed that the presence of obese in the households increased medicine expenses. Obesity is associated with additional medicine expenses, increasing the negative impact on household budgets and public expenditure.

  20. Wealth status and sex differential of household head: implication for source of drinking water in Nigeria.

    PubMed

    Morakinyo, Oyewale Mayowa; Adebowale, Stephen Ayo; Oloruntoba, Elizabeth Omoladun

    2015-01-01

    Source of potable water has implication on the population health. Availability of Improved Drinking Water Sources (IDWS) is a problem in developing countries, but variation exists across segments of the population. This study therefore examined the relationship between wealth status, sex of household head and source of potable water. The 2013 Nigeria Demographic and Health Survey data was used. A representative sample of 40,680 households was selected for the survey, with a minimum target of 943 completed interviews per state covering the entire population residing in non-institutional dwelling units in the country. Households where information on drinking water sources was not reported were excluded, thus reducing the sample to 38021. The dependent and key independent variables were IDWS and Wealth Index respectively. Data were analysed using Chi-square and binary logistic regression (α = .05). Households that used IDWS were headed by females (66.7 %) than males (58.7 %). Highest proportion of households who used IDWS was found in the rich wealth index group (76.7 %). The likelihood of using IDWS was higher in household headed by females (OR = 1.41; C.I = 1.33-1.49, p <0.001). Households that belong to rich wealth index and middle class were 5.06(C.I = 4.81-5.32, p <0.001) and 2.62(C.I = 2.46-2.78, p <0.001) respectively times more likely to IDWS than the poor. This pattern was sustained when other confounding variables were introduced into the regression equation as control. Households headed by women used improved drinking water sources than those headed by men. However, wealth index has strong influence on the strength of relationship between sex of household head and improved drinking water sources.

  1. Anti-PGL1 salivary IgA/IgM, serum IgG/IgM, and nasal Mycobacterium leprae DNA in individuals with household contact with leprosy.

    PubMed

    Brito e Cabral, Paula; Júnior, José Evandro Cunha; de Macedo, Alexandre Casimiro; Alves, Alexandre Rodrigues; Gonçalves, Thially Braga; Brito e Cabral, Tereza Cristina; Gondim, Ana Paula Soares; Pinto, Maria Isabel Moraes; Oseki, Karen Tubono; Camara, Lilia Maria Carneiro; Rabenhorst, Silvia Helena Barem; Nagao-Dias, Aparecida Tiemi

    2013-11-01

    Leprosy household contacts represent a group at high risk of developing the disease. The aim of this study was to detect Mycobacterium leprae subclinical infection in this group through serological and molecular parameters. Serum anti-PGL1 IgG/IgM and salivary anti-PGL1 IgA/IgM was investigated using an ELISA, and nasal carriage of M. leprae DNA was detected by PCR, in leprosy household contacts of paucibacillary (PB) and multibacillary (MB) household leprosy patients (n=135), their index cases (n=30), and in persons living in a low endemic city (n=17). Salivary anti-PGL1 IgA and IgM and serum anti-PGL1 IgG showed good correlation comparing contacts and index cases (p<0.01, p<0.005, and p<0.0001, respectively). This was not observed for serum anti-PGL1 IgM (p>0.05). A high frequency of anti-PGL1 IgM positivity was found in IgG-negative samples (p<0.0001). For IgG-positive samples, IgM antibodies were also positive in most of the samples. None of the 17 volunteers living in a low endemic city presented seropositivity for IgG; however, two of them showed positivity for anti-PGL1 IgM. M. leprae DNA was found in the nasal swabs of nine out of the 85 MB household leprosy contacts (10.6%) and in three out of the 50 PB household leprosy contacts (6.0%). We strongly suggest that serum IgG/IgM and salivary anti-PGL1 IgA/IgM measurements are used to follow leprosy household contacts. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  2. Measuring rural women's work and class position.

    PubMed

    Deere, C D; León de Leal, M

    1979-01-01

    On the basis of experience gained in researching the economic roles of rural women in a national level study in Colombia and in a regional level study in Peru, some of the methodological problems of measuring rural women's economic participation by sample survey are considered. The specific objective of the sample surveys was to quantify the existing sexual division of labor among the peasant population. The rural household was the unit of analysis, and the focus of measurement was the division of labor by sex in such activities as daily maintenance, household production, and income-generating activitives pursued outside the household. The focus of the survey questionnaire is on the sexual division of labor, but it necessarily must be related to another series of socioeconomic or cultural variables for analysis. The selection of these variables needs to be derived from the hypotheses guiding the study, yet much attention must be given to narrowing the range of inquiry. The time constraint on the length of the questionnaire requires that certain choices be made in terms of the complementary variables to be included. The most important problem in the design of a representative sample survey is the selection of the population to be sampled. The choice of population needs to be compatible with the theoretical framework. Since the interest was to measure the sexual division of labor in terms of class formation, the sample had to be representative of the different class strata in the rural areas. The measurement of access to means of production ideally should be quantitative and qualitative. The choice of the population to be sampled is also constrained by the available data base, a particular problem in rural areas.

  3. Individual, household, and community level risk factors of stunting in children younger than 5 years: Findings from a national surveillance system in Nepal.

    PubMed

    Dorsey, Jamie L; Manohar, Swetha; Neupane, Sumanta; Shrestha, Binod; Klemm, Rolf D W; West, Keith P

    2018-01-01

    Despite substantial reductions in recent years in Nepal, stunting prevalence in children younger than 5 years remains high and represents a leading public health concern. To identify factors contributing to the stunting burden, we report multilevel risk factors associated with stunting in 4,853 children aged 6-59 months in a nationally and agroecologically representative random sample from the first year of the Policy and Science for Health, Agriculture, and Nutrition Community Studies, a community-based observational, mixed-panel study. Mixed effects logistic regressions controlling for multilevel clustering in the study design were used to examine the association of individual-, household-, and community-level factors associated with stunting. Stunting prevalence was 38% in our sample. After adjustment for potential confounding variables, maternal factors, including maternal height and education, were generally the strongest individual-level risk factors for stunting, adjusted odds ratio (AOR) = 2.52, 95% CI [1.96, 3.25], short (<145 cm) versus not short mothers; AOR = 2.09, 95% CI [1.48, 2.96], uneducated mothers versus secondary school graduates. Among the household- and community-level factors, household expenditure and community infrastructure (presence of paved roads, markets, or hospitals) were strongly, inversely associated with increased stunting risk, AOR = 1.68, 95% CI [1.27, 2.24], lowest versus highest household expenditure quintile; AOR = 2.38, 95% CI [1.36, 4.14], less developed (lacking paved roads, markets, or hospitals) versus more developed communities. Although most factors associated with stunting are not rapidly modifiable, areas for future research and possible interventions emerged. © 2017 John Wiley & Sons Ltd.

  4. [Household waste management in the health district of Builaska in Mbuji-Mayi, Democratic Republic of Congo].

    PubMed

    Kangoy, Kasangye; Ngoyi, John; Mudimbiyi, Olive

    2016-01-01

    The presence of household waste on public roads affects environmental health leading to unsanitary conditions which may cause disease outbreaks, some of which may occur in epidemic form. Over the past two decades, waste management has become increasingly complex both for developing and underdeveloping countries. This study aims to determine the types of waste and the management of waste generated by the households. This descriptive cross-sectional study conducted in the health district of Bulaska, Kasai Oriental, is a forward-looking approach based upon interview and active observation. The questionnaire was addressed to the head of household or the delegate out of 170 households, representing a convenience sample, from 21 to 25 June 2010. This study revealed that: 94.7% of respondents who answered our questionnaire were female; 47% of respondents had a primary level of study; 41.1% of respondents were housewives; the average household size was 7 people per household; in 83.5% of cases the wastes generated were solid. 50% of households in the health area used public road for trash disposal. Given the results of this study, further development of awareness programs on environmental sanitation is necessary.

  5. Residential Energy Consumption Survey (RECS)

    EIA Publications

    2028-01-01

    EIA administers the Residential Energy Consumption Survey (RECS) to a nationally representative sample of housing units. Traditionally, specially trained interviewers collect energy characteristics on the housing unit, usage patterns, and household demographics. Data include energy costs and usage for heating, cooling, appliances and other end uses.

  6. Evaluation of Respondent-Driven Sampling

    PubMed Central

    McCreesh, Nicky; Frost, Simon; Seeley, Janet; Katongole, Joseph; Tarsh, Matilda Ndagire; Ndunguse, Richard; Jichi, Fatima; Lunel, Natasha L; Maher, Dermot; Johnston, Lisa G; Sonnenberg, Pam; Copas, Andrew J; Hayes, Richard J; White, Richard G

    2012-01-01

    Background Respondent-driven sampling is a novel variant of link-tracing sampling for estimating the characteristics of hard-to-reach groups, such as HIV prevalence in sex-workers. Despite its use by leading health organizations, the performance of this method in realistic situations is still largely unknown. We evaluated respondent-driven sampling by comparing estimates from a respondent-driven sampling survey with total-population data. Methods Total-population data on age, tribe, religion, socioeconomic status, sexual activity and HIV status were available on a population of 2402 male household-heads from an open cohort in rural Uganda. A respondent-driven sampling (RDS) survey was carried out in this population, employing current methods of sampling (RDS sample) and statistical inference (RDS estimates). Analyses were carried out for the full RDS sample and then repeated for the first 250 recruits (small sample). Results We recruited 927 household-heads. Full and small RDS samples were largely representative of the total population, but both samples under-represented men who were younger, of higher socioeconomic status, and with unknown sexual activity and HIV status. Respondent-driven-sampling statistical-inference methods failed to reduce these biases. Only 31%-37% (depending on method and sample size) of RDS estimates were closer to the true population proportions than the RDS sample proportions. Only 50%-74% of respondent-driven-sampling bootstrap 95% confidence intervals included the population proportion. Conclusions Respondent-driven sampling produced a generally representative sample of this well-connected non-hidden population. However, current respondent-driven-sampling inference methods failed to reduce bias when it occurred. Whether the data required to remove bias and measure precision can be collected in a respondent-driven sampling survey is unresolved. Respondent-driven sampling should be regarded as a (potentially superior) form of convenience-sampling method, and caution is required when interpreting findings based on the sampling method. PMID:22157309

  7. Urban and Suburban Residents' Perceptions of Farmers and Agriculture.

    ERIC Educational Resources Information Center

    Molnar, Joseph J.; Duffy, Patricia A.

    Attitudes about farming and government agricultural policies differed among residential categories ranging from urban to rural. A mail survey gathered 3,232 completed questionnaires from a national random sample of 9,250 households. Statistical weighting made respondent categories representative of national proportions. Although respondents…

  8. Ability to Pay for Future National Health Financing Scheme among Malaysian Households.

    PubMed

    Aizuddin, Azimatun Noor; Aljunid, Syed Mohamed

    Malaysia is no exception to the challenging health care financing phenomenon of globalization. The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme. This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia. A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households. Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  9. Survey of Recipients of WAP Services Assessment of Household Budget and Energy Behaviors Pre to Post Weatherization DOE

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

    Tonn, Bruce Edward; Rose, Erin M.; Hawkins, Beth A.

    This report presents results from the national survey of weatherization recipients. This research was one component of the retrospective and Recovery Act evaluations of the U.S. Department of Energy s Weatherization Assistance Program. Survey respondents were randomly selected from a nationally representative sample of weatherization recipients. The respondents and a comparison group were surveyed just prior to receiving their energy audits and then again approximately 18 months post-weatherization. This report focuses on budget issues faced by WAP households pre- and post-weatherization, whether household energy behaviors changed from pre- to post, the effectiveness of approaches to client energy education, and usemore » and knowledge about thermostats.« less

  10. 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.

  11. Does sampling using random digit dialling really cost more than sampling from telephone directories: Debunking the myths

    PubMed Central

    Yang, Baohui; Eyeson-Annan, Margo

    2006-01-01

    Background Computer assisted telephone interviewing (CATI) is widely used for health surveys. The advantages of CATI over face-to-face interviewing are timeliness and cost reduction to achieve the same sample size and geographical coverage. Two major CATI sampling procedures are used: sampling directly from the electronic white pages (EWP) telephone directory and list assisted random digit dialling (LA-RDD) sampling. EWP sampling covers telephone numbers of households listed in the printed white pages. LA-RDD sampling has a better coverage of households than EWP sampling but is considered to be more expensive due to interviewers dialling more out-of-scope numbers. Methods This study compared an EWP sample and a LA-RDD sample from the New South Wales Population Health Survey in 2003 on demographic profiles, health estimates, coefficients of variation in weights, design effects on estimates, and cost effectiveness, on the basis of achieving the same level of precision of estimates. Results The LA-RDD sample better represented the population than the EWP sample, with a coefficient of variation of weights of 1.03 for LA-RDD compared with 1.21 for EWP, and average design effects of 2.00 for LA-RDD compared with 2.38 for EWP. Also, a LA-RDD sample can save up to 14.2% in cost compared to an EWP sample to achieve the same precision for health estimates. Conclusion A LA-RDD sample better represents the population, which potentially leads to reduced bias in health estimates, and rather than costing more than EWP actually costs less. PMID:16504117

  12. Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?

    PubMed Central

    Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Liu, Guoxiang; Hao, Yanhua; Ning, Ning

    2014-01-01

    Objective To determine whether the New Cooperative Medical Insurance Scheme (NCMS) is associated with decreased levels of catastrophic health expenditure and reduced impoverishment due to medical expenses in rural households of China. Methods An analysis of a national representative sample of 38,945 rural households (129,635 people) from the 2008 National Health Service Survey was performed. Logistic regression models used binary indicator of catastrophic health expenditure as dependent variable, with household consumption, demographic characteristics, health insurance schemes, and chronic illness as independent variables. Results Higher percentage of households experiencing catastrophic health expenditure and medical impoverishment correlates to increased health care need. While the higher socio-economic status households had similar levels of catastrophic health expenditure as compared with the lowest. Households covered by the NCMS had similar levels of catastrophic health expenditure and medical impoverishment as those without health insurance. Conclusion Despite over 95% of coverage, the NCMS has failed to prevent catastrophic health expenditure and medical impoverishment. An upgrade of benefit packages is needed, and effective cost control mechanisms on the provider side needs to be considered. PMID:24714605

  13. Household food insecurity and food expenditure in Bolivia, Burkina Faso, And the Philippines.

    PubMed

    Melgar-Quinonez, Hugo R; Zubieta, Ana C; MkNelly, Barbara; Nteziyaremye, Anastase; Gerardo, Maria Filipinas D; Dunford, Christopher

    2006-05-01

    This study examined the association between food insecurity, determined by a modified version of the U.S. Household Food Security Survey Module (US HFSSM), and total daily per capita (DPC) consumption (measured as household expenditures) in Bolivia, Burkina Faso, and the Philippines. Household food insecurity was determined by an adapted 9-item US HFSSM version. A short version of the World Bank's Living Standards Measurement Study (LSMS) consumption module measured household expenditures. Focus groups were used to adapt the survey instrument to each local context. The sample (n approximately 330 per country) includes residents of urban and rural areas. A 12-month food expenditure aggregate was generated as part of the total household expenditures calculation. DPC food expenditure, which represented over 60% of the total household consumption, as well as expenditures on specific food groups correlated with food insecurity both as a continuous Food Insecurity Score (FinSS) and a tricategorical food insecurity status variable. ANOVA and regression analysis were executed adjusting for social and demographic covariates. Food-secure households have significantly higher (P < 0.05) total DPC food expenditures as well as expenditures on animal source foods, vegetables, and fats and oils than moderately and severely food-insecure households. The results offer evidence that the US HFSSM is able to discriminate between households at different levels of food insecurity status in diverse developing world settings.

  14. 78 FR 69103 - 30-Day Notice of Proposed Information Collection: Quality Control for Rental Assistance Subsidy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... Information Collection: Quality Control for Rental Assistance Subsidy Determinations AGENCY: Office of the... Collection Title of Information Collection: Quality Control for Rental Assistance Subsidy Determinations. OMB... Quality Control process involves selecting a nationally representative sample of assisted households to...

  15. 75 FR 1415 - Submission for OMB Review: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... Department of Labor--Bureau of Labor Statistics (BLS), Office of Management and Budget, Room 10235... Statistics. Type of Review: Revision of a currently approved collection. Title of Collection: The Consumer... sector. The data are collected from a national probability sample of households designed to represent the...

  16. Food insecurity in veteran households: findings from nationally representative data.

    PubMed

    Miller, Daniel P; Larson, Mary Jo; Byrne, Thomas; DeVoe, Ellen

    2016-07-01

    The present study is the first to use nationally representative data to compare rates of food insecurity among households with veterans of the US Armed Forces and non-veteran households. We used data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement to identify rates of food insecurity and very low food security in veteran and non-veteran households. We estimated the odds and probability of food insecurity in veteran and non-veteran households in uncontrolled and controlled models. We replicated these results after separating veteran households by their most recent period of service. We weighted models to create nationally representative estimates. Nationally representative data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement. US households (n 388 680). Uncontrolled models found much lower rates of food insecurity (8·4 %) and very low food security (3·3 %) among veteran households than in non-veteran households (14·4 % and 5·4 %, respectively), with particularly low rates among households with older veterans. After adjustment, average rates of food insecurity and very low food security were not significantly different for veteran households. However, the probability of food insecurity was significantly higher among some recent veterans and significantly lower for those who served during the Vietnam War. Although adjusting eliminated many differences between veteran and non-veteran households, veterans who served from 1975 and onwards may be at higher risk for food insecurity and should be the recipients of targeted outreach to improve nutritional outcomes.

  17. Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

    PubMed

    Dunn, Richard A; Tan, Andrew K G

    2011-01-01

    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. © 2011 Wiley Periodicals, Inc.

  18. CIHR Candrive Cohort Comparison with Canadian Household Population Holding Valid Driver's Licenses.

    PubMed

    Gagnon, Sylvain; Marshall, Shawn; Kadulina, Yara; Stinchcombe, Arne; Bédard, Michel; Gélinas, Isabelle; Man-Son-Hing, Malcolm; Mazer, Barbara; Naglie, Gary; Porter, Michelle M; Rapoport, Mark; Tuokko, Holly; Vrkljan, Brenda

    2016-06-01

    We investigated whether convenience sampling is a suitable method to generate a sample of older drivers representative of the older-Canadian driver population. Using equivalence testing, we compared a large convenience sample of older drivers (Candrive II prospective cohort study) to a similarly aged population of older Canadian drivers. The Candrive sample consists of 928 community-dwelling older drivers from seven metropolitan areas of Canada. The population data was obtained from the Canadian Community Health Survey - Healthy Aging (CCHS-HA), which is a representative sample of older Canadians. The data for drivers aged 70 and older were extracted from the CCHS-HA database, for a total of 3,899 older Canadian drivers. Two samples were demonstrated as equivalent on socio-demographic, health, and driving variables that we compared, but not on driving frequency. We conclude that convenience sampling used in the Candrive study created a fairly representative sample of Canadian older drivers, with a few exceptions.

  19. Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care.

    PubMed

    Larson, Charles P; Saha, Unnati Rani; Islam, Rafiqul; Roy, Nikhil

    2006-12-01

    Monitoring for disparities in health and services received based upon gender, income, and geography should continue as renewed efforts to reduce under-five mortality are made in response to millennium development goal #4. The purpose of this survey was to provide a nationally representative description of current childhood diarrhoea management practices and disparities in Bangladesh. A nationally representative, cross-sectional, cluster-sample survey was carried out in randomly selected rural and urban populations across Bangladesh. The survey was completed over an 8 month period between November 2003 and June 2004. A total of 7308 children with a prevalent diarrhoeal illness episode within 560 clusters were identified and enrolled in the survey. In 61% of the cases help was sought from a health care provider, with over 90% practicing in the private sector. Caretaker practice disparities favouring males and higher income households were identified. Significant trends (P < 0.001) favouring higher income households were found for having sought help from any provider or a licensed doctor and for treating their child with oral rehydration solution or an antibiotic. Female children in urban households were less likely to be seen by a licensed allopath, adj OR 0.73 (95% CI 0.57, 0.94). Among rural households gender disparities were limited to females being less likely to receive an antibiotic, adj OR 0.74 (95% CI 0.65, 0.86). Households seeking help from a health provider overwhelmingly utilize the private sector in Bangladesh. Gender inequities in the utilization of licensed providers and purchase of antibiotics, favouring males were identified. Findings suggest that higher income, urban households tend to practice greater gender discrimination. In order to better understand health dynamics in urban populations, in particular slum-dwellers, there is a need to disaggregate survey data by household location.

  20. Household food insecurity during childhood and adolescent misconduct.

    PubMed

    Jackson, Dylan B; Vaughn, Michael G

    2017-03-01

    A large body of research has found that household food insecurity can interfere with the healthy development of children. The link between household food insecurity during childhood and misbehaviors during adolescence, however, is not commonly explored. The objective of the current study is to assess whether household food insecurity across childhood predicts four different forms of misconduct during early adolescence. Data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K), a nationally representative sample of U.S. children, were employed in the present study. Associations between household food insecurity during childhood and adolescent misconduct were examined using Logistic and Negative Binomial Regression. Analyses were performed separately for males and females. The results revealed that household food insecurity and food insecurity persistence were predictive of most forms of misconduct for males, and were consistently predictive of engagement in multiple forms of misconduct and a greater variety of forms of misconduct for males. For females, however, household food insecurity generally failed to predict adolescent misconduct. The behavioral development of males during adolescence appears to be sensitive to the presence and persistence of household food insecurity during childhood. Future research should seek to replicate and extend the present findings to late adolescence and adulthood. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Socioeconomic status and tobacco expenditures among Moroccans: results of the "Maroc Tabagisme" survey.

    PubMed

    Tachfouti, Nabil; Berraho, Mohammed; Elfakir, Samira; Serhier, Zineb; Elrhazi, Karima; Slama, Karen; Najjari, Chakib

    2010-01-01

    To investigate the relationship of sociodemographic and economic characteristics to tobacco expenses among Moroccan daily smokers. Cross-sectional ("Maroc Tabagisme" Survey) study. Random sample of 9195 subjects representative of the Moroccan population. Household subjects 15 years and older. Data were collected from selected households using a questionnaire about smoking, educational level, occupation, and household monthly income. Associations between sociodemographic and economic characteristics, smoking status, and tobacco expenses were assessed by multivariate analysis in a sample of 5959 respondents who provided details about their family income. Of 5959 participants, 28.5% of men and 2.8% of women were daily smokers. Compared with students, the odds of daily smoking were higher among blue-collar workers (odds ratio, 2.66). Tobacco expenses increased with higher family monthly income (p < .001). Moreover, smokers whose family monthly income was less than 1000 Moroccan dirham (MAD) spent 50.9% on tobacco, while those with family monthly income of 6000 MAD or higher spent 13.0 %on tobacco. There was a strong association between tobacco expenses and sociodemographic and economic characteristics. Among households with low monthly income, up to half of the monthly income is spent on tobacco.

  2. Evaluation of respondent-driven sampling.

    PubMed

    McCreesh, Nicky; Frost, Simon D W; Seeley, Janet; Katongole, Joseph; Tarsh, Matilda N; Ndunguse, Richard; Jichi, Fatima; Lunel, Natasha L; Maher, Dermot; Johnston, Lisa G; Sonnenberg, Pam; Copas, Andrew J; Hayes, Richard J; White, Richard G

    2012-01-01

    Respondent-driven sampling is a novel variant of link-tracing sampling for estimating the characteristics of hard-to-reach groups, such as HIV prevalence in sex workers. Despite its use by leading health organizations, the performance of this method in realistic situations is still largely unknown. We evaluated respondent-driven sampling by comparing estimates from a respondent-driven sampling survey with total population data. Total population data on age, tribe, religion, socioeconomic status, sexual activity, and HIV status were available on a population of 2402 male household heads from an open cohort in rural Uganda. A respondent-driven sampling (RDS) survey was carried out in this population, using current methods of sampling (RDS sample) and statistical inference (RDS estimates). Analyses were carried out for the full RDS sample and then repeated for the first 250 recruits (small sample). We recruited 927 household heads. Full and small RDS samples were largely representative of the total population, but both samples underrepresented men who were younger, of higher socioeconomic status, and with unknown sexual activity and HIV status. Respondent-driven sampling statistical inference methods failed to reduce these biases. Only 31%-37% (depending on method and sample size) of RDS estimates were closer to the true population proportions than the RDS sample proportions. Only 50%-74% of respondent-driven sampling bootstrap 95% confidence intervals included the population proportion. Respondent-driven sampling produced a generally representative sample of this well-connected nonhidden population. However, current respondent-driven sampling inference methods failed to reduce bias when it occurred. Whether the data required to remove bias and measure precision can be collected in a respondent-driven sampling survey is unresolved. Respondent-driven sampling should be regarded as a (potentially superior) form of convenience sampling method, and caution is required when interpreting findings based on the sampling method.

  3. The Citizens' Viewpoint: Higher Education in Alabama, 1981.

    ERIC Educational Resources Information Center

    Owings, Thomas G.

    Results of a survey assessing public opinions and attitudes about higher education in Alabama are presented. A representative sample of 736 households was contacted by telephone, and 546 agreed to be interviewed. The survey was designed to evaluate public opinions and attitudes about higher education teaching, research, service, finance,…

  4. Financial Arrangements and Relationship Quality in Low-Income Couples

    ERIC Educational Resources Information Center

    Addo, Fenaba R.; Sassler, Sharon

    2010-01-01

    This study explored the association between household financial arrangements and relationship quality using a representative sample of low-income couples with children. We detailed the banking arrangements couples utilize, assessed which factors relate to holding a joint account versus joint and separate, only separate, or no account, and analyzed…

  5. Household characteristics for older adults and study background from SAGE Ghana Wave 1.

    PubMed

    Biritwum, Richard B; Mensah, George; Minicuci, Nadia; Yawson, Alfred E; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

    2013-06-11

    Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at 29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE.

  6. Household characteristics for older adults and study background from SAGE Ghana Wave 1

    PubMed Central

    Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

    2013-01-01

    Background Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18–49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at 29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Conclusion Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE. PMID:23759325

  7. Financial burden of household out-of-pocket expenditures for prescription drugs: Cross-sectional analysis based on national survey data

    PubMed Central

    McLeod, Logan; Bereza, Basil G; Shim, Minsup; Grootendorst, Paul

    2011-01-01

    Background Commentaries on the adequacy of insurance coverage for prescription drugs available to Canadians have emphasized differences in the coverage provided by different provincial governments. Less is known about the actual financial burden of prescription drug spending and how this burden varies by province of residence, affluence and source of primary drug coverage. Methods We used data from a nationally representative household expenditure survey to analyze the financial burden of prescription drugs. We focused on the drug budget share (defined as the share of the household budget spent on prescription drugs), considering how it varied by province, total household budget and likely primary source of drug insurance coverage (i.e., provincial government plan for senior citizens, social assistance plan or private coverage). We examined both “typical” households (at the median of the distribution of the drug budget share) and households with relatively large shares (in the top 5%). Finally, we estimated the percentage of households with catastrophic drug expenditures (defined as a drug budget share of 10% or more) and the average catastrophic drug expenditures. Results Senior, social assistance and general population households accounted for 21.1%, 8.9% and 69.9% of the sample of 14 430 respondents to the 2006 Survey of Household Spending, respectively. The median drug budget share in Canada was 1.1% for senior households (range 0.4% [Ontario] to 3.6% [Saskatchewan]) and 0.1% for both social assistance households and general population households, with little appreciable variation across provinces for these latter 2 categories. The 95th percentile drug budget share in Canada was 7.4% for senior households (range 3.5% [Ontario] to 12.7% [Saskatchewan]), 5.4% for social assistance households (range 2.3% [British Columbia] to 13.0% [Prince Edward Island]) and 2.6% for general population households (range 2.1% [Ontario] to 5.4% [Prince Edward Island]). The interprovincial range of the 95th percentile drug budget share was 10.7 percentage points for social assistance households, 9.2 percentage points for senior households and 3.3 percentage points for general population households. Interpretation For most households, the financial burden of prescription drug expenditures appeared to be relatively small, with little interprovincial variation. However, a small number of households incurred catastrophic drug costs. These households were concentrated in the groups that traditionally benefit from provincial government drug plans. It is likely that some households did not purchase needed prescription drugs because of the expense, so our estimates of the financial burden of catastrophic prescription drug expenditures therefore represent a lower bound. PMID:22046212

  8. [Study of access to health care and drugs in Cameroon: 1. Methods and validation].

    PubMed

    Commeyras, Christophe; Ndo, Jean Rolin; Merabet, Omar; Koné, Hamidou; Rakotondrabé, Faraniaina Patricia

    2005-01-01

    During the 1980s, an economic depression and the concomitant decrease in the national health budget modified the population's health behavior. Improvement of the economy since the late 1990s makes it possible to renew the national health policy. To prepare the highly indebted and poor countries' program (HIPC), the Minister of Health and its partners commissioned a survey to measure the population's real access to health care and the factors that determine this accessibility and to propose concrete corrective actions. To fulfill these objectives, the steering committee decided to analyze health care demand, through a national population survey, and supply capacity, through a national survey of pharmacies and other drug dispensers. A survey of persons using medications will also be conducted (Fig.1). Focusing on this component of health care is justified by these findings: 95% of persons feeling ill buy drugs, whereas only 31% consult a physician or other healthcare provider, and half of the average household's health expenditures are for drugs. Financial, geographic, social and quality indicators were defined to measure accessibility and its determining factors (Table 1). The smallest administrative unit, the health area (HA), was chosen as the sampling unit, to enable us to survey together healthcare demand, supply and consumption according to different concentrations of supply and demand . It behaves as a cluster of sampling units of different populations: drug retailers of all sectors, drug users, households, and ill persons within the households. The HA samples include Yaounde and Douala, with urban and rural sub-samples, for which sampling ratios increase with the diversity of supply and demand, according to several pre-defined factors. The study includes 400 HAs, covering more than one third of the population (Table 2). Within these HAs, 900 pharmacies and other formal drug retailers, 709 street vendors, 4,505 households, 2,532 ill persons in these households, 4,121 pharmacy customers and 850 customers of street vendors were surveyed, i.e., more than 13,600 questionnaires. Assessment of data quality shows that the sample is representative of the national population for its socioeconomic characteristics. Its geographic distribution, even after correction, nonetheless favors urban areas, where both supply and demand are high. Generalizing the 3 sub-samples to the national level thus requires caution, especially for the geographic distribution. Other limitations and possible biases are described and evaluated. However, the retrospective demographic and statistic evaluation shows that the samples are representative of their population and that the data quality can be considered good. This article describes the background of this study and justifies its methodological choices. Future publications will analyze the data collected.

  9. Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana

    PubMed Central

    Wright, Jim; Dzodzomenyo, Mawuli; Wardrop, Nicola A.; Johnston, Richard; Hill, Allan; Aryeetey, Genevieve; Adanu, Richard

    2016-01-01

    There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012−2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision. PMID:27005650

  10. Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

    PubMed

    Wright, Jim; Dzodzomenyo, Mawuli; Wardrop, Nicola A; Johnston, Richard; Hill, Allan; Aryeetey, Genevieve; Adanu, Richard

    2016-03-09

    There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012-2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision.

  11. "Girl Power!": The Relationship between Women's Autonomy and Children's Immunization Coverage in Ethiopia.

    PubMed

    Ebot, Jane O

    2015-09-18

    Although immunizations are efficient and cost effective methods of reducing child mortality, worldwide, approximately 2 million children die yearly of vaccine-preventable diseases. Researchers and health organizations have detailed information on the positive relationship between women's autonomy and children's health outcomes in developing countries. This study investigates the links between women's household autonomy and children's immunization status using data from a nationally representative sample of children aged 12-30 months (N = 2941) from the 2011 Ethiopia Demographic and Health Survey. The results showed that women's socioeconomic status and household autonomy were significantly associated with children's immunization status. Overall, the implications of this study align with those of the Millennium Development Goal #3: improvements in women's household autonomy are linked to more positive child health outcomes.

  12. Evaluation of the National Weather Service Extreme Cold Warning Experiment in North Dakota

    PubMed Central

    Chiu, Cindy H.; Vagi, Sara J.; Wolkin, Amy F.; Martin, John Paul; Noe, Rebecca S.

    2016-01-01

    Dangerously cold weather threatens life and property. During periods of extreme cold due to wind chill, the National Weather Service (NWS) issues wind chill warnings to prompt the public to take action to mitigate risks. Wind chill warnings are based on ambient temperatures and wind speeds. Since 2010, NWS has piloted a new extreme cold warning issued for cold temperatures in wind and nonwind conditions. The North Dakota Department of Health, NWS, and the Centers for Disease Control and Prevention collaborated in conducting household surveys in Burleigh County, North Dakota, to evaluate this new warning. The objectives of the evaluation were to assess whether residents heard the new warning and to determine if protective behaviors were prompted by the warning. This was a cross-sectional survey design using the Community Assessment for Public Health Emergency Response (CASPER) methodology to select a statistically representative sample of households from Burleigh County. From 10 to 11 April 2012, 188 door-to-door household interviews were completed. The CASPER methodology uses probability sampling with weighted analysis to estimate the number and percentage of households with a specific response within Burleigh County. The majority of households reported having heard both the extreme cold and wind chill warnings, and both warnings prompted protective behaviors. These results suggest this community heard the new warning and took protective actions after hearing the warning. PMID:27239260

  13. First-Year Evaluation of Mexico's Tax on Nonessential Energy-Dense Foods: An Observational Study.

    PubMed

    Batis, Carolina; Rivera, Juan A; Popkin, Barry M; Taillie, Lindsey Smith

    2016-07-01

    In an effort to prevent continued increases in obesity and diabetes, in January 2014, the Mexican government implemented an 8% tax on nonessential foods with energy density ≥275 kcal/100 g and a peso-per-liter tax on sugar-sweetened beverages (SSBs). Limited rigorous evaluations of food taxes exist worldwide. The objective of this study was to examine changes in volume of taxed and untaxed packaged food purchases in response to these taxes in the entire sample and stratified by socioeconomic status (SES). This study uses data on household packaged food purchases representative of the Mexican urban population from The Nielsen Company's Mexico Consumer Panel Services (CPS). We included 6,248 households that participated in the Nielsen CPS in at least 2 mo during 2012-2014; average household follow-up was 32.7 mo. We analyzed the volume of purchases of taxed and untaxed foods from January 2012 to December 2014, using a longitudinal, fixed-effects model that adjusted for preexisting trends to test whether the observed post-tax trend was significantly different from the one expected based on the pre-tax trend. We controlled for household characteristics and contextual factors like minimum salary and unemployment rate. The mean volume of purchases of taxed foods in 2014 changed by -25 g (95% confidence interval = -46, -11) per capita per month, or a 5.1% change beyond what would have been expected based on pre-tax (2012-2013) trends, with no corresponding change in purchases of untaxed foods. Low SES households purchased on average 10.2% less taxed foods than expected (-44 [-72, -16] g per capita per month); medium SES households purchased 5.8% less taxed foods than expected (-28 [-46, -11] g per capita per month), whereas high SES households' purchases did not change. The main limitations of our findings are the inability to infer causality because the taxes were implemented at the national level (lack of control group), our sample is only representative of urban areas, we only have 2 y of data prior to the tax, and, as with any consumer panel survey, we did not capture all foods purchased by the household. Household purchases of nonessential energy-dense foods declined in the first year after the implementation of Mexico's SSB and nonessential foods taxes. Future studies should evaluate the impact of the taxes on overall energy intake, dietary quality, and food purchase patterns (see S1 Abstract in Spanish).

  14. Parameters of Household Composition as Demographic Measures

    ERIC Educational Resources Information Center

    Akkerman, Abraham

    2005-01-01

    Cross-sectional data, such as Census statistics, enable the re-enactment of household lifecourse through the construction of the household composition matrix, a tabulation of persons in households by their age and by the age of their corresponding household-heads. Household lifecourse is represented in the household composition matrix somewhat…

  15. Breastfeeding Initiation and Duration in Coresident Grandparent, Mother and Infant Households

    PubMed Central

    Pilkauskas, Natasha V.

    2014-01-01

    Objectives In the U.S., the prevalence of three-generation households, where a grandparent, parent and child coreside, has increased in the last decade. Three-generation coresidence during infancy is particularly common and as many as 15% of infants live in a three-generation household shortly after birth. Although prior research has linked family structure with breastfeeding behavior, no research has studied whether breastfeeding behavior varies by grandparent coresidence. This study is the first to investigate the association between three-generation coresidence and breastfeeding behaviors. Methods This paper uses two data sets, the Early Childhood Longitudinal Study – Birth Cohort (n~8250), a nationally representative study of U.S. children, and the Fragile Families and Child Wellbeing Study (n=4,053), an urban sample of mostly low-income unmarried U.S. mothers, to study the association between three-generation coresidence and breastfeeding initiation and duration using multivariate logistic regressions with extensive socio-demographic controls. Results Three-generation coresidence was associated with lower odds of breastfeeding initiation among the less advantaged mothers but not in the nationally representative sample of mothers. In comparison, three-generation coresidence was associated with lower odds of breastfeeding for six months or greater in both study samples. Conclusions Three-generation coresidence is generally associated with fewer breastfeeding behaviors. Three-generation coresidence may serve as a marker for differences in the likelihood of breastfeeding that can help inform public health strategies aimed at increasing breastfeeding rates. Research studying interventions with grandparents and the effects on breastfeeding behaviors may be a useful next step in public health promotion of breastfeeding. PMID:24549650

  16. Nebraska Indochinese Refugee Needs Assessment.

    ERIC Educational Resources Information Center

    Nebraska Univ., Lincoln.

    This is the report of a study in which the needs of Nebraska Indochinese refugees were assessed by in-person interviews in 115 households representing 30% of the Indochinese households in the State. These households included five ethnic groups (ethnic Vietnamese, Chinese Vietnamese, Cambodians, Laotians, and Hmong) and were representatives of the…

  17. How well do antenatal clinic (ANC) attendees represent the general population? A comparison of HIV prevalence from ANC sentinel surveillance sites with a population-based survey of women aged 15-49 in Cambodia.

    PubMed

    Saphonn, Vonthanak; Hor, Leng Bun; Ly, Sun Penh; Chhuon, Samrith; Saidel, Tobi; Detels, Roger

    2002-04-01

    The purpose of this study was to evaluate whether HIV-1 prevalence among antenatal clinic (ANC) attendees in Cambodia provided a reasonable estimate of HIV-1 prevalence among all women 15-49 years. METHODS Antenatal clinic attendees in five HIV sentinel surveillance sites (five provinces) were selected by consecutive sampling (n = 1695). The population survey of females by household was carried out in the same five areas. Household females aged 15-49 years were selected using a three-stage cluster sampling design (n = 3066). Serum-based HIV ELISA testing was done for both ANC attendees and household females. The HIV prevalence for ANC attendees and household females were compared by age group and urban versus rural location. The overall prevalence of HIV-1 infection among ANC attendees (1.62%, 95% CI : 1.26-1.98) was similar to the overall prevalence obtained from the general population of household females (1.24%, 95% CI : 0.92-1.55) in the same catchment areas in Cambodia. In the rural areas, the overall HIV prevalence among ANC attendees (2.18%, 95% CI : 1.59-2.77) was significantly higher than among the household females (0.86%, 95% CI : 0.49-1.23) after adjustment for age distribution and education level. In the 15-24 age group in rural areas, the HIV prevalence of ANC women was 2.71% (95% CI : 0.96-4.46) compared with 0.77% (95% CI : 0.02-1.53) in household females. Although ANC data can be used to estimate trends over time, it should be realized that ANC data may overestimate the actual prevalence in the younger age group in rural areas in Cambodia.

  18. Assessment of Emergency Preparedness of Households in Israel for War--Current Status.

    PubMed

    Bodas, Moran; Siman-Tov, Maya; Kreitler, Shulamith; Peleg, Kobi

    2015-08-01

    In recent decades, many efforts have been made, both globally and locally, to enhance household preparedness for emergencies. In the State of Israel in particular, substantial investment has been made throughout the years in preparing the population for one of the major threats to the civilian population--a rapidly deteriorating regional conflict that involves high-trajectory weapons (ie, rocket and missile fire) launched at the home front. The purpose of this study was to examine the current preparedness level of the Israeli public for this threat and determine the correlates of such preparedness with known factors. A telephone-based, random sampling of 503 households representative of the Israeli population was carried out during October 2013. The questionnaire examined the level of household preparedness as well as attitudes towards threat perception, responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the level of preparedness in the general population and to find correlates to this preparedness in attitudes and demographic variables. More than half of the sample reported complying with 50% or fewer of the actions recommended by the Israeli Home Front Command. Having an increased sense of preparedness and willingness to search for related information were positively correlated with actual household preparedness, and the latter was also found to be the most predictive variable of household preparedness. Although the overall household preparedness reported is mediocre, the level of preparedness found in this study suggests better preparedness of the population in Israel for its primary threat. The findings suggest that in order to promote preparedness of the Israeli public for war, emphasis should be put on increasing the public demand for information and encouraging people to evaluate their sense of preparedness.

  19. Assessing Literacy: The Framework for the National Adult Literacy Survey.

    ERIC Educational Resources Information Center

    Campbell, Anne; And Others

    To satisfy federal requirements, the National Center for Education Statistics and the Division of Adult Education and Literacy planned a nationally representative household sample survey to assess the literacy skills of the adult population of the United States, to be conducted by the Educational Testing Service with the assistance of Westat, Inc.…

  20. The Gender Division of Labor in Two-Earner Marriages: Dimensions of Variability and Change.

    ERIC Educational Resources Information Center

    Ferree, Myra Marx

    1991-01-01

    Examined data drawn from representative sample survey of two-earner households (n=382 couples) on division of domestic labor. Concludes that implicitly and explicitly gendered expectations that both husbands and wives bring to thinking about housework play significant role in shaping degree of egalitarianism in practice. (Author/NB)

  1. Fruit and Vegetable Intake among Urban Community Gardeners

    ERIC Educational Resources Information Center

    Alaimo, Katherine; Packnett, Elizabeth; Miles, Richard A.; Kruger, Daniel J.

    2008-01-01

    Objective: To determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults. Design: Data were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented. Setting:…

  2. Parental Educational Attainment and Sense of Control in Mid-and Late-Adulthood

    ERIC Educational Resources Information Center

    Ward, Michael M.

    2013-01-01

    Sense of control is greater among children who grow up in households of higher socioeconomic status. It is unclear if this childhood advantage persists throughout life or if schooling and adulthood experiences override any early childhood advantage. Using data from 2 nationally representative samples of primarily middle-aged (National Survey of…

  3. The Relationship between Education and Work Credentials. Data Point. NCES 2015-556

    ERIC Educational Resources Information Center

    Hudson, Lisa; Ewert, Stephanie

    2015-01-01

    This Data Point uses data from the U.S. Census Bureau's Survey of Income and Program Participation (SIPP), a nationally representative sample survey of households. The SIPP provides information on many topics, including income, participation in government programs, family dynamics, and education. This report uses new SIPP data on professional…

  4. Choice in a World of New School Types

    ERIC Educational Resources Information Center

    Butler, J. S.; Carr, Douglas A.; Toma, Eugenia F.; Zimmer, Ron

    2013-01-01

    As school choice options have evolved over recent years, it is important to understand what family and school factors are associated with the enrollment decisions families make. Use of restricted-access data from the Early Childhood Longitudinal Study allowed us to identify household location from a nationally representative sample of students and…

  5. Epidemiology of Attention Problems among Turkish Children and Adolescents: A National Study

    ERIC Educational Resources Information Center

    Erol, Nese; Simsek, Zeynep; Oner, Ozgur; Munir, Kerim

    2008-01-01

    Objective: To evaluate the epidemiology of attention problems using parent, teacher, and youth informants among a nationally representative Turkish sample. Method: The children and adolescents, 4 to 18 years old, were selected from a random household survey. Attention problems derived from the Child Behavior Checklist (CBCL) (N = 4,488), Teacher…

  6. Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality.

    PubMed

    L'Engle, Kelly; Sefa, Eunice; Adimazoya, Edward Akolgo; Yartey, Emmanuel; Lenzi, Rachel; Tarpo, Cindy; Heward-Mills, Nii Lante; Lew, Katherine; Ampeh, Yvonne

    2018-01-01

    Generating a nationally representative sample in low and middle income countries typically requires resource-intensive household level sampling with door-to-door data collection. High mobile phone penetration rates in developing countries provide new opportunities for alternative sampling and data collection methods, but there is limited information about response rates and sample biases in coverage and nonresponse using these methods. We utilized data from an interactive voice response, random-digit dial, national mobile phone survey in Ghana to calculate standardized response rates and assess representativeness of the obtained sample. The survey methodology was piloted in two rounds of data collection. The final survey included 18 demographic, media exposure, and health behavior questions. Call outcomes and response rates were calculated according to the American Association of Public Opinion Research guidelines. Sample characteristics, productivity, and costs per interview were calculated. Representativeness was assessed by comparing data to the Ghana Demographic and Health Survey and the National Population and Housing Census. The survey was fielded during a 27-day period in February-March 2017. There were 9,469 completed interviews and 3,547 partial interviews. Response, cooperation, refusal, and contact rates were 31%, 81%, 7%, and 39% respectively. Twenty-three calls were dialed to produce an eligible contact: nonresponse was substantial due to the automated calling system and dialing of many unassigned or non-working numbers. Younger, urban, better educated, and male respondents were overrepresented in the sample. The innovative mobile phone data collection methodology yielded a large sample in a relatively short period. Response rates were comparable to other surveys, although substantial coverage bias resulted from fewer women, rural, and older residents completing the mobile phone survey in comparison to household surveys. Random digit dialing of mobile phones offers promise for future data collection in Ghana and may be suitable for other developing countries.

  7. Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality

    PubMed Central

    Sefa, Eunice; Adimazoya, Edward Akolgo; Yartey, Emmanuel; Lenzi, Rachel; Tarpo, Cindy; Heward-Mills, Nii Lante; Lew, Katherine; Ampeh, Yvonne

    2018-01-01

    Introduction Generating a nationally representative sample in low and middle income countries typically requires resource-intensive household level sampling with door-to-door data collection. High mobile phone penetration rates in developing countries provide new opportunities for alternative sampling and data collection methods, but there is limited information about response rates and sample biases in coverage and nonresponse using these methods. We utilized data from an interactive voice response, random-digit dial, national mobile phone survey in Ghana to calculate standardized response rates and assess representativeness of the obtained sample. Materials and methods The survey methodology was piloted in two rounds of data collection. The final survey included 18 demographic, media exposure, and health behavior questions. Call outcomes and response rates were calculated according to the American Association of Public Opinion Research guidelines. Sample characteristics, productivity, and costs per interview were calculated. Representativeness was assessed by comparing data to the Ghana Demographic and Health Survey and the National Population and Housing Census. Results The survey was fielded during a 27-day period in February-March 2017. There were 9,469 completed interviews and 3,547 partial interviews. Response, cooperation, refusal, and contact rates were 31%, 81%, 7%, and 39% respectively. Twenty-three calls were dialed to produce an eligible contact: nonresponse was substantial due to the automated calling system and dialing of many unassigned or non-working numbers. Younger, urban, better educated, and male respondents were overrepresented in the sample. Conclusions The innovative mobile phone data collection methodology yielded a large sample in a relatively short period. Response rates were comparable to other surveys, although substantial coverage bias resulted from fewer women, rural, and older residents completing the mobile phone survey in comparison to household surveys. Random digit dialing of mobile phones offers promise for future data collection in Ghana and may be suitable for other developing countries. PMID:29351349

  8. Nutritional status of indigenous children: findings from the First National Survey of Indigenous People’s Health and Nutrition in Brazil

    PubMed Central

    2013-01-01

    Introduction The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. Methods A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. Results Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. Conclusions The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples. PMID:23552397

  9. Prevalence of drug and alcohol use in urban Afghanistan: epidemiological data from the Afghanistan National Urban Drug Use Study (ANUDUS).

    PubMed

    Cottler, Linda B; Ajinkya, Shaun; Goldberger, Bruce A; Ghani, Mohammad Asrar; Martin, David M; Hu, Hui; Gold, Mark S

    2014-10-01

    Previous attempts to assess the prevalence of drug use in Afghanistan have focused on subgroups that are not generalisable. In the Afghanistan National Urban Drug Use Study, we assessed risk factors and drug use in Afghanistan through self-report questionnaires that we validated with laboratory test confirmation using analysis of hair, urine, and saliva. The study took place between July 13, 2010, to April 25, 2012, in 11 Afghan provinces. 2187 randomly selected households completed a survey, representing 19 025 household members. We completed surveys with the female head of the household about past and current drug use among members of their household. We also obtained hair, urine, and saliva samples from 5236 people in these households and tested them for metabolites of 13 drugs. Of 2170 households with biological samples tested, 247 (11·4%) tested positive for any drug. Overall, opioids were the most prevalent drug in the biological samples (5·6%), although prescription drugs (prescription pain pills, sedatives, and tranquilliser) were the most commonly reported in the past 30 days in the questionnaires (7·6%). Of individuals testing positive for at least one substance, opioids accounted for more than 50% of substance use in women and children, but only a third of substances in men, who predominantly tested positive for cannabinoids. After controlling for age with direct standardisation, individual prevalence of substance use (from laboratory tests) was 7·2% (95% CI 6·1-8·3) in men and 3·1% (2·5-3·7) in women-with a national prevalence of 5·1% (4·4-5·8) and a prevalence of 5·0% (4·1-5·8) in Kabul. Concordance between laboratory test results and self-reports was high. These data suggest the female head of household to be a knowledgeable informant for household substance use. They also might provide insight into new avenues for targeted behavioural interventions and prevention messages. Copyright © 2014 Cottler et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

  10. Women, family, and work in Indonesian transmigration.

    PubMed

    Watkins, J F; Leinbach, T R; Falconer, K F

    1993-04-01

    The gender contribution to employment may be a critical factor in determining household economic viability. The significance for the resettlement program of the poor and landless from Indonesia's Inner Islands to the Outer Islands is clear. The aim of this paper is to examine the nature and extent of the role of women in off-farm employment (OFE) in a sample of South Sumatra, Indonesia transmigrants during the summer of 1989 at 9 different sites with different agricultural environments, settlement histories, and access to markets. A summary is provided of the literature on women's work and peasant household economies in Indonesia. Spatial and structural characteristics of employment among transmigrant women are described as well as life course influences on men's and women's OFE. A descriptive and explanatory model is presented that characterizes women's work and includes the influences of changing family structure on time allocation. Women's work appears fundamentally different from men's; household domestic work has a degree of flexibility in timing and tasks can be accomplished simultaneously. The hypothesis is that women will try to maximize their levels of flexibility and simultaneity in their income generating efforts. Discussion focuses on several theories of peasant household economies: 1) the Chayanov peasant model which posits that labor allocation for farm production in order to satisfy consumption needs is dependent on household demographic structure and the consumer labor balance; and 2) the New Home Economics theory which emphasizes the single utility function of the household. The villages represent 3 irrigated rice-growing and double cropping areas with established infrastructures and access to markets; 3 area with tidal swamp rice production and few resources; and area with rainfed rice production and limited resources and an area with ample resources; and 2 areas with smallholder rubber production. There were 560 ethnically Javanese households included in the sample, with an average proportion of 10% in each settlement. OFE is either on scheme, which means within the transmigration scheme and involves short distances to work, or off scheme, which entails longer work trips. 61% of the sample were involved in on scheme and 42% were involved in off scheme OFE, of which 10% were heads of households and 4% were spouses.

  11. Healthcare service problems reported in a national survey of South Africans.

    PubMed

    Hasumi, Takahiro; Jacobsen, Kathryn H

    2014-08-01

    To identify common types of health service problems reported by South African adults during their most recent visit to a healthcare provider. Secondary analysis of South Africa's cross-sectional General Household Survey (GHS). Nationally representative weighted sample of households in South Africa. 23,562 household representatives interviewed during the 2010 GHS. Problems experienced during the most recent visit to the usual healthcare provider. In total, 43.8% of participants reported experiencing at least one problem during their last visit; 19.1% reported multiple problems. The most common problems experienced were a long waiting time (34.8% of household representatives), needed drugs not being available (14.1%) and staff who were rude or uncaring or turned patients away (10.1%). Of the 73.6% of participants using public providers, 54.9% reported at least one problem; of the 26.4% of participants using private providers, only 18.0% reported a problem, usually cost. Similar differences in reported problems at public and private providers were reported for all racial/ethnic groups and income groups. Black Africans reported more problems than other population groups due in large part to being significantly more likely to use public providers. Addressing commonly reported problem areas-in particular, long waiting times, unavailable medications and staff who are perceived as being unfriendly-might help prevent delayed care seeking, increase the acceptability of healthcare services and reduce remaining health disparities in South Africa. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Estimations of daily energy and nutrient availability based on nationally representative household budget survey data. The Data Food Networking (DAFNE) project.

    PubMed

    Naska, A; Oikonomou, E; Trichopoulou, A; Wagner, K; Gedrich, K

    2007-12-01

    To describe a cost-efficient method for estimating energy and nutrient availability using household budget survey (HBS) data. Four different approaches were tested and the results were compared with published nutrient intake data. The selected method was exemplarily applied in German and Greek data. Germany, 1998; Greece, 1998/99. Nationally representative HBSs. Comparisons showed that HBS-based estimates were generally close to intake data when results were presented as contributions to daily energy intake. Daily energy and protein availabilities were similar in Germany and Greece. Differences were observed in the availability of carbohydrates (German households reported a 5 percentage points higher contribution to daily energy availability) and lipids (Greek households recorded higher values for total fat, but lower values for saturated fat). Meat, added lipids and potatoes were important energy suppliers in Germany, whereas in Greece the first three energy suppliers were added lipids, cereals and meat. In both countries, meat, cereals, milk and cheese were important protein sources and cereals, potatoes, fruits and nuts contributed more than 60% of the daily carbohydrate availability. Added lipids were the major source of fat in the daily diet of both countries, but their contribution amounted to less than one-third in Germany and two-thirds in Greece. National HBS data can be used for monitoring and comparing nutrient availability among representative population samples of different countries. The ground is set for the development of a harmonised food composition table to be applied to HBS food data at international level.

  13. Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014.

    PubMed

    Shrestha, Sudeep; Thorne-Lyman, Andrew L; Manohar, Swetha; Shrestha, Binod; Neupane, Sumanta; Rajbhandary, Ruchita; Shrestha, Raman; Klemm, Rolf Dw; Nonyane, Bareng As; Adhikari, Ramesh K; Webb, Patrick; West, Keith P

    2018-01-01

    Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015. A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. Two midyear surveys in Nepal revealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunting noted in previous years. The same period saw a slight reduction in wasting and improved household food security.

  14. Means-Tested Public Assistance Programs and Adolescent Political Socialization.

    PubMed

    Barnes, Carolyn Y; Hope, Elan C

    2017-07-01

    In recent years, scholars have pointed to the politically demobilizing effects of means-tested assistance programs on recipients. In this study, we bridge the insights from policy feedback literature and adolescent political socialization research to examine how receiving means-tested programs shapes parent influence on adolescent political participation. We argue that there are differences in pathways to political participation through parent political socialization and youth internal efficacy beliefs for adolescents from households that do or do not receive means-tested assistance. Using data from a nationally representative sample of 536 Black, Latino, and White adolescents (50.8% female), we find that adolescents from means-tested assistance households report less parent political socialization and political participation. For all youth, parent political socialization predicts adolescent political participation. Internal political efficacy is a stronger predictor of political participation for youth from a non-means-tested assistance household than it is for youth from a household receiving means-tested assistance. These findings provide some evidence of differential paths to youth political participation via exposure to means-tested programs.

  15. Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community.

    PubMed

    Nagata, Jason M; Fiorella, Kathryn J; Salmen, Charles R; Hickey, Matthew D; Mattah, Brian; Magerenge, Richard; Milner, Erin M; Weiser, Sheri D; Bukusi, Elizabeth A; Cohen, Craig R

    2015-01-01

    The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.

  16. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    PubMed Central

    Wedgworth, Jessica C.; Brown, Joe; Johnson, Pauline; Olson, Julie B.; Elliott, Mark; Forehand, Rick; Stauber, Christine E.

    2014-01-01

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts. PMID:25046635

  17. Microbiological and Chemical Quality of Packaged Sachet Water and Household Stored Drinking Water in Freetown, Sierra Leone

    PubMed Central

    Jalloh, Mohamed F.; Saquee, George; Bain, Robert E. S.; Bartram, Jamie K.

    2015-01-01

    Packaged drinking water (PW) sold in bottles and plastic bags/sachets is widely consumed in low- and middle-income countries (LMICs), and many urban users in sub-Saharan Africa (SSA) rely on packaged sachet water (PSW) as their primary source of water for consumption. However, few rigorous studies have investigated PSW quality in SSA, and none have compared PSW to stored household water for consumption (HWC). A clearer understanding of PSW quality in the context of alternative sources is needed to inform policy and regulation. As elsewhere in SSA, PSW is widely consumed in Sierra Leone, but government oversight is nearly nonexistent. This study examined the microbiological and chemical quality of a representative sample of PSW products in Freetown, Sierra Leone at packaged water manufacturing facilities (PWMFs) and at points of sale (POSs). Samples of HWC were also analyzed for comparison. The study did not find evidence of serious chemical contamination among the parameters studied. However, 19% of 45 PSW products sampled at the PWMF contained detectable Escherichia coli (EC), although only two samples exceeded 10 CFU/100 mL. Concentrations of total coliforms (TC) in PSW (but not EC) increased along the supply chain. Samples of HWC from 60 households in Freetown were significantly more likely to contain EC and TC than PSW at the point of production (p<0.01), and had significantly higher concentrations of both bacterial indicators (p<0.01). These results highlight the need for additional PSW regulation and surveillance, while demonstrating the need to prioritize the safety of HWC. At present, PSW may be the least unsafe option for many households. PMID:26162082

  18. Microbiological and Chemical Quality of Packaged Sachet Water and Household Stored Drinking Water in Freetown, Sierra Leone.

    PubMed

    Fisher, Michael B; Williams, Ashley R; Jalloh, Mohamed F; Saquee, George; Bain, Robert E S; Bartram, Jamie K

    2015-01-01

    Packaged drinking water (PW) sold in bottles and plastic bags/sachets is widely consumed in low- and middle-income countries (LMICs), and many urban users in sub-Saharan Africa (SSA) rely on packaged sachet water (PSW) as their primary source of water for consumption. However, few rigorous studies have investigated PSW quality in SSA, and none have compared PSW to stored household water for consumption (HWC). A clearer understanding of PSW quality in the context of alternative sources is needed to inform policy and regulation. As elsewhere in SSA, PSW is widely consumed in Sierra Leone, but government oversight is nearly nonexistent. This study examined the microbiological and chemical quality of a representative sample of PSW products in Freetown, Sierra Leone at packaged water manufacturing facilities (PWMFs) and at points of sale (POSs). Samples of HWC were also analyzed for comparison. The study did not find evidence of serious chemical contamination among the parameters studied. However, 19% of 45 PSW products sampled at the PWMF contained detectable Escherichia coli (EC), although only two samples exceeded 10 CFU/100 mL. Concentrations of total coliforms (TC) in PSW (but not EC) increased along the supply chain. Samples of HWC from 60 households in Freetown were significantly more likely to contain EC and TC than PSW at the point of production (p<0.01), and had significantly higher concentrations of both bacterial indicators (p<0.01). These results highlight the need for additional PSW regulation and surveillance, while demonstrating the need to prioritize the safety of HWC. At present, PSW may be the least unsafe option for many households.

  19. Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.

    PubMed

    Wedgworth, Jessica C; Brown, Joe; Johnson, Pauline; Olson, Julie B; Elliott, Mark; Forehand, Rick; Stauber, Christine E

    2014-07-18

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.

  20. What are farmers really planting? Measuring the presence and effectiveness of Bt cotton in Pakistan.

    PubMed

    Spielman, David J; Zaidi, Fatima; Zambrano, Patricia; Khan, Asif Ali; Ali, Shaukat; Cheema, H Masooma Naseer; Nazli, Hina; Khan, Rao Sohail Ahmad; Iqbal, Arshad; Zia, Muhammad Amir; Ali, Ghulam Muhammad

    2017-01-01

    Genetically modified, insect-resistant Bacillus thuringiensis (Bt) cotton is cultivated extensively in Pakistan. Past studies, however, have raised concerns about the prevalence of Bt cotton varieties possessing weak or nonperforming insect-resistance traits conferred by the cry gene. We examine this issue using data drawn from a representative sample of cotton-growing households that were surveyed in six agroclimatic zones spanning 28 districts in Pakistan in 2013, as well as measurements of Cry protein levels in cotton tissue samples collected from the sampled households' main fields. The resultant dataset combines information from 593 sampled households with corresponding plant tissue diagnostics from 70 days after sowing, as well as information from 589 sampled households with corresponding diagnostics from 120 days after sowing. Our analysis indicates that 11 percent of farmers believed they were cultivating Bt cotton when, in fact, the Cry toxin was not present in the tested tissue at 70 days after sowing (i.e., a Type I error). The analysis further indicates that 5 percent of farmers believed they were cultivating non-Bt cotton when, in fact, the Cry toxin was present in the tested tissue (i.e., a Type II error). In addition, 17 percent of all sampled farmers were uncertain whether or not they were cultivating Bt cotton. Overall, 33 percent of farmers either did not know or were mistaken in their beliefs about the presence of the cry gene in the cotton they cultivated. Results also indicate that toxic protein levels in the plant tissue samples occurred below threshold levels for lethality in a significant percentage of cases, although these measurements may also be affected by factors related to tissue sample collection, handling, storage, and testing procedures. Nonetheless, results strongly suggest wide variability both in farmers' beliefs and in gene expression. Such variability has implications for policy and regulation in Pakistan's transgenic cotton seed market.

  1. Differences in self-rated health by employment contract and household structure among Japanese employees: a nationwide cross-sectional study.

    PubMed

    Kachi, Yuko; Inoue, Mariko; Nishikitani, Mariko; Yano, Eiji

    2014-01-01

    The aim of this study was to examine whether the association between employment contract and self-rated health differs by household structure in a representative sample of employees in Japan. The participants were 81,441 male and 64,471 female employees aged 18-59 years who had participated in the 2010 Comprehensive Survey of Living Conditions. We assessed the interactive effect of employment contract (permanent or precarious) and household structure (couple only, couple with children, single parent, single person, or other multi-person) on fair/poor health, adjusting for covariates by using logistic regression. We then calculated the relative poverty rate by employment contract and household structure. The interaction effect was significant for women (p<0.001) but not for men (p=0.413). A higher percentage of female precarious workers who lived in single-parent households (20.2%) reported fair/poor health compared with those in other types of households (10.4-13.2%), although the prevalence of fair/poor health did not differ substantially by household structure among female permanent workers. The relative poverty rates of female precarious workers who lived in single-parent households were higher compared with those of other female workers. Our results suggest that female precarious workers are not a homogeneous group and that those living in single-parent households suffer from poor health due to low income and insufficient coverage by insurance firms and family-based safety nets.

  2. Influence of sociodemographic characteristics on different dimensions of household food insecurity in Montevideo, Uruguay.

    PubMed

    Rossi, Máximo; Ferre, Zuleika; Curutchet, María Rosa; Giménez, Ana; Ares, Gastón

    2017-03-01

    To determine the factor structure of the Latin American & Caribbean Household Food Security Scale (ELCSA) and to study the influence of sociodemographic characteristics on each of the identified dimensions in Montevideo, Uruguay. Cross-sectional survey with a representative sample of urban households. Household food insecurity was measured using the ELCSA. The percentage of respondents who gave affirmative responses for each of the items of the ELCSA was determined. Exploratory factor analysis was carried out to determine the ELCSA's factor structure. A probit model was used to determine the impact of some individual and household sociodemographic characteristics on the identified dimensions of food insecurity. Metropolitan area centred on Montevideo, the capital city of Uruguay, April-September 2014. Adults aged between 18 and 93 years (n 742). The percentage of affirmative responses to the items of the ELCSA ranged from 4·4 to 31·7 %. Two factors were identified in the exploratory factor analysis performed on data from households without children under 18 years old, whereas three factors were identified for households with children. The identified factors were associated with different severity levels of food insecurity. Likelihood of experiencing different levels of food insecurity was affected by individual characteristics of the respondent as well as characteristics of the household. The influence of sociodemographic variables varied among the ELCSA dimensions. Household income had the largest influence on all dimensions, which indicates a strong relationship between income and food insecurity.

  3. [Changes in the consumption of dairy products, sugary drinks and processed juices in the Chilean population].

    PubMed

    Crovetto, Mirta M; Uauy, Ricardo

    2014-12-01

    Nowadays, Chilean population tends to replace or eat a lower amount of food with health protective properties and a higher proportion of unhealthy foodstuff. To describe and compare the intake of dairy products, sugary drinks and processed juices among Chileans. An analysis of data compiled from the Survey on Household Budget and Expenses carried out by the Chilean National Institute of Statistics (INE), using a representative sample of households. The sample was surveyed between 1987 and 2007. The analysis was performed for all households surveyed and for households belonging to the second (highest incomes) and fifth quintile (lowest incomes). The Chilean Food Guide and the international recommendations of the Institute of Medicine of the United States and the American Heart Association (in the case of sugars) were used as reference. Even though the intake of dairy products increased during the period of the survey, it was lower than the intake of sugary drinks and juices, which increased. Also, calcium recommendations were not covered. On the other hand, the intake of added sugars increased to figures over current recommendations. The intake of dairy products and calcium is below the recommended amounts established by international organisms, and added sugars intake is greater than the advisable levels recommended by international organisms.

  4. Who Is Doing the Housework in Multicultural Britain?

    PubMed Central

    Kan, Man-Yee; Laurie, Heather

    2016-01-01

    There is an extensive literature on the domestic division of labour within married and cohabiting couples and its relationship to gender equality within the household and the labour market. Most UK research focuses on the white majority population or is ethnicity ‘blind’, effectively ignoring potentially significant intersections between gender, ethnicity, socio-economic position and domestic labour. Quantitative empirical research on the domestic division of labour across ethnic groups has not been possible due to a lack of data that enables disaggregation by ethnic group. We address this gap using data from a nationally representative panel survey, Understanding Society, the UK Household Longitudinal Study containing sufficient sample sizes of ethnic minority groups for meaningful comparisons. We find significant variations in patterns of domestic labour by ethnic group, gender, education and employment status after controlling for individual and household characteristics. PMID:29416186

  5. Rationale, design and methodology for the Navajo Health and Nutrition Survey.

    PubMed

    White, L L; Goldberg, H I; Gilbert, T J; Ballew, C; Mendlein, J M; Peter, D G; Percy, C A; Mokdad, A H

    1997-10-01

    As recently as 1990, there was no reservation-wide, population-based health status information about Navajo Indians. To remedy this shortcoming, the Navajo Health and Nutrition Survey was conducted from 1991 to 1992 to assess the health and nutritional status of Navajo Reservation residents using a population-based sample. Using a three-stage design, a representative sample of reservation households was selected for inclusion. All members of selected households 12 y of age and older were invited to participate. A total of 985 people in 459 households participated in the study. Survey protocols were modeled on those of previous national surveys and included a standard blood chemistry profile, complete blood count, oral glucose tolerance test, blood pressure, anthropometric measurements, a single 24-h dietary recall and a questionnaire on health behaviors. The findings from this survey, reported in the accompanying papers, inform efforts to prevent and control chronic disease among the Navajo. Lessons learned from this survey may be of interest to those conducting similar surveys in other American Indian and Alaska Native populations.

  6. Selection within households in health surveys

    PubMed Central

    Alves, Maria Cecilia Goi Porto; Escuder, Maria Mercedes Loureiro; Claro, Rafael Moreira; da Silva, Nilza Nunes

    2014-01-01

    OBJECTIVE To compare the efficiency and accuracy of sampling designs including and excluding the sampling of individuals within sampled households in health surveys. METHODS From a population survey conducted in Baixada Santista Metropolitan Area, SP, Southeastern Brazil, lowlands between 2006 and 2007, 1,000 samples were drawn for each design and estimates for people aged 18 to 59 and 18 and over were calculated for each sample. In the first design, 40 census tracts, 12 households per sector, and one person per household were sampled. In the second, no sampling within the household was performed and 40 census sectors and 6 households for the 18 to 59-year old group and 5 or 6 for the 18 and over age group or more were sampled. Precision and bias of proportion estimates for 11 indicators were assessed in the two final sets of the 1000 selected samples with the two types of design. They were compared by means of relative measurements: coefficient of variation, bias/mean ratio, bias/standard error ratio, and relative mean square error. Comparison of costs contrasted basic cost per person, household cost, number of people, and households. RESULTS Bias was found to be negligible for both designs. A lower precision was found in the design including individuals sampling within households, and the costs were higher. CONCLUSIONS The design excluding individual sampling achieved higher levels of efficiency and accuracy and, accordingly, should be first choice for investigators. Sampling of household dwellers should be adopted when there are reasons related to the study subject that may lead to bias in individual responses if multiple dwellers answer the proposed questionnaire. PMID:24789641

  7. Indoor air quality for poor families: new evidence from Bangladesh.

    PubMed

    Dasgupta, S; Huq, M; Khaliquzzaman, M; Pandey, K; Wheeler, D

    2006-12-01

    Poor households in Bangladesh depend heavily on wood, dung and other biomass fuels for cooking. This paper provides a detailed analysis of the implications for indoor air pollution (IAP), drawing on new 24-h monitoring data for respirable airborne particulates (PM10). A stratified sample of 236 households was selected in Dhaka and Narayanganj, with a particular focus on fuel use, cooking locations, structural materials, ventilation practices, and other potential determinants of exposure to IAP. At each household, PM10 concentrations in the kitchen and living room were monitored for a 24-h period during December, 2003-February, 2004. Concentrations of 300 microg/m3 or greater are common in our sample, implying widespread exposure to a serious health hazard. A regression analysis for these 236 households was then conducted to explore the relationships between PM10 concentrations, fuel choices and a large set of variables that describe household cooking and ventilation practices, structure characteristics and building materials. As expected, our econometric results indicate that fuel choice significantly affects indoor pollution levels: natural gas and kerosene are significantly cleaner than biomass fuels. However, household-specific factors apparently matter more than fuel choice in determining PM10 concentrations. In some biomass-burning households, concentrations are scarcely higher than in households that use natural gas. Our results suggest that cross-household variation is strongly affected by structural arrangements: cooking locations, construction materials, and ventilation practices. A large variation in PM10 was also found during the 24-h cycle within households. For example, within the 'dirtiest' firewood-using household in our sample, readings over the 24-h cycle vary from 68 to 4864 microg/m3. Such variation occurs because houses can recycle air very quickly in Bangladesh. After the midday meal, when ventilation is common, air quality in many houses goes from very dirty to reasonably clean within an hour. Rapid change also occurs within households: diffusion of pollution from kitchens to living areas is nearly instantaneous in many cases, regardless of internal space configuration, and living-area concentrations are almost always in the same range as kitchen concentrations. By implication, exposure to dangerous indoor pollution levels is not confined to cooking areas. To assess the broader implications for poor Bangladeshi households, we extrapolate our regression results to representative 600 household samples from rural, peri-urban and urban areas in six regions: Rangpur in the north-west, Sylhet in the north-east, Rajshahi and Jessore in the west, Faridpur in the center, and Cox's Bazar in the south-east. Our results indicate great geographic variation, even for households in the same per capita income group. This variation reflects local differences in fuel use and, more significantly, construction practices that affect ventilation. For households with per capita income

  8. No independent association between insufficient sleep and childhood obesity in the National Survey of Children's Health.

    PubMed

    Hassan, Fauziya; Davis, Matthew M; Chervin, Ronald D

    2011-04-15

    Prior studies have supported an association between insufficient sleep and childhood obesity, but most have not examined nationally representative samples or considered potential sociodemographic confounders. The main objective of this study was to use a large, nationally representative dataset to examine the possibility that insufficient sleep is associated with obesity in children, independent of sociodemographic factors. The National Survey of Children's Health is a national survey of U.S. households contacted by random digit dialing. In 2003, caregivers of 102,353 US children were surveyed. Age- and sex-specific body mass index (BMI) based on parental report of child height and weight, was available for 81,390 children aged 6-17 years. Caregivers were asked, "How many nights of sufficient sleep did your child have in the past week?" The odds of obesity (BMI ≥ 95th percentile) versus healthy weight (BMI 5th-84th percentile) was regressed on reported nights of sufficient sleep per week (categorized as 0-2, 3-5, or 6-7). Sociodemographic variables included gender, race, household education, and family income. Analyses incorporated sampling weights to derive nationally representative estimates for a 2003 population of 34 million youth. Unadjusted bivariate analyses indicated that children aged 6-11 years with 0-2 nights of sufficient sleep, in comparison to those with 6-7 nights, were more likely to be obese (OR = 1.7, 95% CI [1.2-2.3]). Among children aged 12-17 years, odds of obesity were lower among children with 3-5 nights of sufficient sleep in comparison to those with 6-7 nights (0.8, 95% CI: 0.7-0.9). However, in both age groups, adjustment for race/ethnicity, gender, family income, and household education left no remaining statistical significance for the association between sufficient nights of sleep and BMI. In this national sample, insufficient sleep, as judged by parents, is inconsistently associated with obesity in bivariate analyses, and not associated with obesity after adjustment for sociodemographic variables. These findings from a nationally representative sample are necessarily subject to parental perceptions, but nonetheless serve as an important reminder that the role of insufficient sleep in the childhood obesity epidemic remains unproven.

  9. First-Year Evaluation of Mexico’s Tax on Nonessential Energy-Dense Foods: An Observational Study

    PubMed Central

    Rivera, Juan A.; Popkin, Barry M.; Taillie, Lindsey Smith

    2016-01-01

    Background In an effort to prevent continued increases in obesity and diabetes, in January 2014, the Mexican government implemented an 8% tax on nonessential foods with energy density ≥275 kcal/100 g and a peso-per-liter tax on sugar-sweetened beverages (SSBs). Limited rigorous evaluations of food taxes exist worldwide. The objective of this study was to examine changes in volume of taxed and untaxed packaged food purchases in response to these taxes in the entire sample and stratified by socioeconomic status (SES). Methods and Findings This study uses data on household packaged food purchases representative of the Mexican urban population from The Nielsen Company’s Mexico Consumer Panel Services (CPS). We included 6,248 households that participated in the Nielsen CPS in at least 2 mo during 2012–2014; average household follow-up was 32.7 mo. We analyzed the volume of purchases of taxed and untaxed foods from January 2012 to December 2014, using a longitudinal, fixed-effects model that adjusted for preexisting trends to test whether the observed post-tax trend was significantly different from the one expected based on the pre-tax trend. We controlled for household characteristics and contextual factors like minimum salary and unemployment rate. The mean volume of purchases of taxed foods in 2014 changed by -25 g (95% confidence interval = -46, -11) per capita per month, or a 5.1% change beyond what would have been expected based on pre-tax (2012–2013) trends, with no corresponding change in purchases of untaxed foods. Low SES households purchased on average 10.2% less taxed foods than expected (-44 [–72, –16] g per capita per month); medium SES households purchased 5.8% less taxed foods than expected (-28 [–46, –11] g per capita per month), whereas high SES households’ purchases did not change. The main limitations of our findings are the inability to infer causality because the taxes were implemented at the national level (lack of control group), our sample is only representative of urban areas, we only have 2 y of data prior to the tax, and, as with any consumer panel survey, we did not capture all foods purchased by the household. Conclusions Household purchases of nonessential energy-dense foods declined in the first year after the implementation of Mexico’s SSB and nonessential foods taxes. Future studies should evaluate the impact of the taxes on overall energy intake, dietary quality, and food purchase patterns (see S1 Abstract in Spanish). PMID:27379797

  10. 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.

  11. Domestic violence is associated with adult and childhood asthma prevalence in India.

    PubMed

    Subramanian, S V; Ackerson, Leland K; Subramanyam, Malavika A; Wright, Rosalind J

    2007-06-01

    Little is known on the influence of stressful psychosocial circumstances in predicting asthma. We examine the link between asthma prevalence and domestic violence (DV) in a nationally representative sample of adults and children in India. Analyses were based on the 1998-99 cross-sectional nationally representative Indian National Family Health Survey administered in 92 486 households. Individual-level prevalence of asthma was the primary outcome for this study. Exposure to DV was based on women's self-report of DV. In adjusted models, women who experienced DV either recently or in the past were at greater risk of being asthmatic [odds ratio (OR) range 1.26-1.37], compared with those who did not report any abuse. In households where women reported to have experienced DV, asthma risk was higher for all individuals in those households (OR range 1.15-1.19). The association between household DV and individual risk for asthma was also observed in gender-stratified analysis, and also in age-stratified analysis, with strong association observed in age groups of under-five, 5-14, 15-24 and 25-44 years. We find a consistent association between being exposed to, and having experienced, DV and asthma prevalence. Stress-induced mechanisms, partially captured through violence and social circumstances, may be a critical explanatory link in furthering our understanding of the social disparities in asthma.

  12. National Prevalence and Exposure Risk for Cockroach Allergen in U.S. Households

    PubMed Central

    Cohn, Richard D.; Arbes, Samuel J.; Jaramillo, Renee; Reid, Laura H.; Zeldin, Darryl C.

    2006-01-01

    We characterized the prevalence of cockroach allergen exposure in a nationally representative sample of U.S. homes and assessed risk factors for elevated concentrations. Design We used data from the National Survey of Lead and Allergens in Housing, a population-based cross-sectional survey. Participants Participants were residents of 831 U.S. homes in the survey. Evaluations/Measurements We analyzed allergen, questionnaire, and observational data of 831 U.S. homes. Results Cockroach allergen (Bla g 1) concentrations exceed 2.0 U/g, a level associated with allergic sensitization, in 11% of U.S. living room floors and 13% of kitchen floors. Concentrations exceed 8.0 U/g, a level associated with asthma morbidity, in 3% of living room floors and 10% of kitchen floors. Elevated concentrations were observed in high-rise apartments, urban settings, pre-1940 constructions, and households with incomes < $20,000. Odds of having concentrations > 8.0 U/g were greatest when roach problems were reported or observed and increased with the number of cockroaches observed and with indications of recent cockroach activity. Conclusions Household cockroach allergen exposure is characterized in a nationally representative context. The allergen is prevalent in many settings, at levels that may contribute to allergic sensitization and asthma morbidity. Relevance to Clinical or Professional Practice Likelihood of exposure can be assessed by consideration of demographic and household determinants. PMID:16581539

  13. Child abuse in blended households: reports from runaway and homeless youth.

    PubMed

    McRee, Nick

    2008-04-01

    Building upon prior research that reveals an elevated risk of abuse to children in blended households, the study considers whether risk of abuse varies by the type of non-related parent figure (i.e., stepparent, adoptive parent, or cohabiting adult) in residence. A sample of 40,000 youths that sought services from runaway and homeless youth shelters in the US was examined. Holding constant the presence of a natural parent, the study evaluated the risk of abuse by the presence and type of an additional parent figure in the home. Compared with other household types, an elevated risk of sexual and physical abuse was observed for youths from homes with a non-related parent figure in residence. Among youths from blended homes, the risk of abuse was not found to vary as a function of the type of non-related parent figure in the home. The study results are consistent with prior research that shows the presence of a non-related parent figure in a household is associated with a greater than expected risk of sexual or physical abuse to children. However, the findings suggest that the particular role or status of non-related parents may not be a meaningful risk factor when considering intervention strategies in suspected cases of abuse in blended households. The sample probably represents family conditions that are significantly worse for children than what would be found in the general population, and thus the results of this study should not be generalized to the population at large.

  14. Home Literacy, Television Viewing, Fidgeting and ADHD in Young Children

    ERIC Educational Resources Information Center

    Froiland, John Mark; Davison, Mark L.

    2016-01-01

    Factors related to parent ratings of young children's (mean age = 3.72, range = 3-6) fidgeting and reports of attention-deficit hyperactivity disorder (ADHD) were examined in a nationally representative sample of US families via the National Household Education Surveys. In structural equation models, the number of television hours viewed daily was…

  15. Assessing Changes in Socioemotional Adjustment across Early School Transitions--New National Scales for Children at Risk

    ERIC Educational Resources Information Center

    McDermott, Paul A.; Watkins, Marley W.; Rovine, Michael J.; Rikoon, Samuel H.

    2013-01-01

    This article reports the development and evidence for validity and application of the Adjustment Scales for Early Transition in Schooling (ASETS). Based on primary analyses of data from the Head Start Impact Study, a nationally representative sample (N = 3077) of randomly selected children from low-income households is configured to inform…

  16. From Pump to Plug: Measuring the Public's Attitude about Plug-In Electric

    Science.gov Websites

    -National Benchmark Report, presents the findings of a study on the public's sentiments regarding PEVs, with February 2015, the study covered a 1,015-household sample designed to be representative of the U.S . population. NREL plans to repeat the study annually to track changing consumer perceptions. Consumer Views

  17. Can the rural poor in India afford to treat non-communicable diseases.

    PubMed

    Binnendijk, Erika; Koren, Ruth; Dror, David M

    2012-11-01

    Non-communicable diseases (NCD) are on the increase in low-income countries, where healthcare costs are paid mostly out-of-pocket. We investigate the financial burden of NCD vs. communicable diseases (CD) among rural poor in India and assess whether they can afford to treat NCD. We used data from two household surveys undertaken in 2009-2010 among 7389 rural poor households (39 205 individuals) in Odisha and Bihar. All persons from the sampled households, irrespective of age and gender, were included in the analysis. We classify self-reported illnesses as NCD, CD or 'other morbidities' following the WHO classification. Non-communicable diseases accounted for around 20% of the diseases in the month preceding the survey in Odisha and 30% in Bihar. The most prevalent NCD, representing the highest share in outpatient costs, were musculoskeletal, digestive and cardiovascular diseases. Cardiovascular and digestive problems also generated the highest inpatient costs. Women, older persons and less-poor households reported higher prevalence of NCD. Outpatient costs (consultations, medicines, laboratory tests and imaging) represented a bigger share of income for NCD than for CD. Patients with NCD were more likely to report a hospitalisation. Patients with NCD in rural poor settings in India pay considerably more than patients with CD. For NCD cases that are chronic, with recurring costs, this would be aggravated. The cost of NCD care consumes a big part of the per person share of household income, obliging patients with NCD to rely on informal intra-family cross-subsidisation. An alternative solution to finance NCD care for rural poor patients is needed. © 2012 Blackwell Publishing Ltd.

  18. Female Participation in Household Decision Making and the Justification of Wife Beating in Bangladesh.

    PubMed

    Alam, Md Shahin; Tareque, Md Ismail; Peet, Evan D; Rahman, Md Mosfequr; Mahmud, Tanvir

    2018-04-01

    We examined female participation in household decision making and its association with the justification of wife beating in Bangladesh. We used nationally representative data from the 2014 Bangladesh Demographic and Health Survey. Our sample consisted of currently married women of age 15 to 49 years ( n = 16,463). Chi-square tests and multilevel logistic regression models were performed. Approximately 84% of women in the survey were participants in at least one household decision, and 72% reported that wife beating is not justified in any circumstance. Women who reported their participation in at least one type of household decision less frequently reported that wife beating could be justified than those who did not participate in any household decisions (adjusted odds ratio = 1.49; 95% confidence interval = [1.25, 1.78]). In addition to participation in household decision making, other factors including age at first marriage, females' and their husbands' education, religion, parity, contraceptive use, and socioeconomic status were associated with the justification of wife beating. The results indicate that female participation in household decision making is significantly associated with the justification of wife beating in Bangladesh. Further study is needed, but the results suggest that policy makers should consider interventions proven to empower women and lead to increased participation in decision making as methods that may reduce domestic violence against women.

  19. Satellite-aided survey sampling and implementation in low- and middle-income contexts: a low-cost/low-tech alternative.

    PubMed

    Haenssgen, Marco J

    2015-01-01

    The increasing availability of online maps, satellite imagery, and digital technology can ease common constraints of survey sampling in low- and middle-income countries. However, existing approaches require specialised software and user skills, professional GPS equipment, and/or commercial data sources; they tend to neglect spatial sampling considerations when using satellite maps; and they continue to face implementation challenges analogous to conventional survey implementation methods. This paper presents an alternative way of utilising satellite maps and digital aides that aims to address these challenges. The case studies of two rural household surveys in Rajasthan (India) and Gansu (China) compare conventional survey sampling and implementation techniques with the use of online map services such as Google, Bing, and HERE maps. Modern yet basic digital technology can be integrated into the processes of preparing, implementing, and monitoring a rural household survey. Satellite-aided systematic random sampling enhanced the spatial representativeness of the village samples and entailed savings of approximately £4000 compared to conventional household listing, while reducing the duration of the main survey by at least 25 %. This low-cost/low-tech satellite-aided survey sampling approach can be useful for student researchers and resource-constrained research projects operating in low- and middle-income contexts with high survey implementation costs. While achieving transparent and efficient survey implementation at low costs, researchers aiming to adopt a similar process should be aware of the locational, technical, and logistical requirements as well as the methodological challenges of this strategy.

  20. A two-stage cluster sampling method using gridded population data, a GIS, and Google Earth(TM) imagery in a population-based mortality survey in Iraq.

    PubMed

    Galway, Lp; Bell, Nathaniel; Sae, Al Shatari; Hagopian, Amy; Burnham, Gilbert; Flaxman, Abraham; Weiss, Wiliam M; Rajaratnam, Julie; Takaro, Tim K

    2012-04-27

    Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys. We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described. Sampling is a challenge in retrospective population-based mortality studies and alternatives that improve on the conventional approaches are needed. The sampling strategy presented here was designed to generate a representative sample of the Iraqi population while reducing the potential for bias and considering the context specific challenges of the study setting. This sampling strategy, or variations on it, are adaptable and should be considered and tested in other conflict settings.

  1. A two-stage cluster sampling method using gridded population data, a GIS, and Google EarthTM imagery in a population-based mortality survey in Iraq

    PubMed Central

    2012-01-01

    Background Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys. Results We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described. Conclusion Sampling is a challenge in retrospective population-based mortality studies and alternatives that improve on the conventional approaches are needed. The sampling strategy presented here was designed to generate a representative sample of the Iraqi population while reducing the potential for bias and considering the context specific challenges of the study setting. This sampling strategy, or variations on it, are adaptable and should be considered and tested in other conflict settings. PMID:22540266

  2. [Poverty profile regarding households participating in a food assistance program].

    PubMed

    Álvarez-Uribe, Martha C; Aguirre-Acevedo, Daniel C

    2012-06-01

    This study was aimed at establishing subgroups having specific socioeconomic characteristics by using latent class analysis as a method for segmenting target population members of the MANA-ICBF supplementary food program in the Antioquia department of Colombia and determine their differences regarding poverty and health conditions in efficiently addressing pertinent resources, programs and policies. The target population consisted of 200,000 children and their households involved in the MANA food assistance program; a representative sample by region was used. Latent class analysis was used, as were the expectation-maximization and Newton Raphson algorithms for identifying the appropriate number of classes. The final model classified the households into four clusters or classes, differing according to well-defined socio-demographic conditions affecting children's health. Some homes had a greater depth of poverty, therefore lowering the families' quality of life and affecting the health of the children in this age group.

  3. Income and health in Accra, Ghana: results from a time use and health study.

    PubMed

    Fink, Günther; Weeks, John R; Hill, Allan G

    2012-10-01

    This paper uses newly collected household survey data from Accra, Ghana, to investigate whether incomes affect acute and chronic health outcomes in settings that can be considered representative for the large and rapidly growing urban centers of sub-Saharan Africa. The Time Use and Health Study in Accra collected information on incomes, current health status, and health care use from 5,484 persons in 1,250 households, each repeatedly sampled on a rolling basis for a period of 13 weeks. Data collection took place during September 2008-March 2010 to capture seasonal variations. The study found that incomes varied widely between households, and that a high fraction of persons lived below the poverty line. Despite this level of income poverty and an overall remarkably high burden of treatable disease, no systematic differences in self-reported and objectively measured health conditions were detected across socioeconomic groups.

  4. Family and housing instability: Longitudinal impact on adolescent emotional and behavioral well-being.

    PubMed

    Fowler, Patrick J; Henry, David B; Marcal, Katherine E

    2015-09-01

    This study investigated the longitudinal effects of family structure changes and housing instability in adolescence on functioning in the transition to adulthood. A model examined the influence of household composition changes and mobility in context of ethnic differences and sociodemographic risks. Data from the National Longitudinal Study of Adolescent Health measured household and residential changes over a 12-month period among a nationally representative sample of adolescents. Assessments in young adulthood measured rates of depression, criminal activity, and smoking. Findings suggested housing mobility in adolescence predicted poorer functioning across outcomes in young adulthood, and youth living in multigenerational homes exhibited greater likelihood to be arrested than adolescents in single-generation homes. However, neither family structure changes nor its interaction with residential instability or ethnicity related to young adult outcomes. Findings emphasized the unique influence of housing mobility in the context of dynamic household compositions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Medicines discarded in household garbage: analysis of a pharmaceutical waste sample in Vienna

    PubMed Central

    2014-01-01

    Objectives To analyze a sample of pharmaceutical waste drawn from household garbage in Vienna, with the aim to learn whether and which medicines end up unused in normal household waste. Methods We obtained a pharmaceutical waste sample from the Vienna Municipal Waste Department. This was drawn by their staff in a representative search in October and November 2009. We did a manual investigation of the sample which contained packs and loose blisters, excluded medical devices and traced loose blisters back to medicines packs. We reported information on the prescription status, origin, therapeutic group, dose form, contents and expiry date. We performed descriptive statistics for the total data set and for sub-groups (e.g. items still containing some of original content). Results In total, 152 packs were identified, of which the majority was prescription-only medicines (74%). Cardiovascular medicines accounted for the highest share (24%). 87% of the packs were in oral form. 95% of the packs had not expired. 14.5% of the total data set contained contents but the range of content left in the packs varied. Results on the packs with contents differed from the total: the shares of Over-the Counter medicines (36%), of medicines of the respiratory system (18%) and of the musculo-skeletal system (18%), for dermal use (23%) and of expired medicines (19%) were higher compared to the full data set. Conclusions The study showed that some medicines end up unused or partially used in normal household garbage in Vienna. Our results did not confirm speculations about a high percentage of unused medicines improperly discarded. There is room for improved patient information and counseling to enhance medication adherence and a proper discharge of medicines. PMID:25848546

  6. Medicines discarded in household garbage: analysis of a pharmaceutical waste sample in Vienna.

    PubMed

    Vogler, Sabine; Leopold, Christine; Zuidberg, Christel; Habl, Claudia

    2014-01-01

    To analyze a sample of pharmaceutical waste drawn from household garbage in Vienna, with the aim to learn whether and which medicines end up unused in normal household waste. We obtained a pharmaceutical waste sample from the Vienna Municipal Waste Department. This was drawn by their staff in a representative search in October and November 2009. We did a manual investigation of the sample which contained packs and loose blisters, excluded medical devices and traced loose blisters back to medicines packs. We reported information on the prescription status, origin, therapeutic group, dose form, contents and expiry date. We performed descriptive statistics for the total data set and for sub-groups (e.g. items still containing some of original content). In total, 152 packs were identified, of which the majority was prescription-only medicines (74%). Cardiovascular medicines accounted for the highest share (24%). 87% of the packs were in oral form. 95% of the packs had not expired. 14.5% of the total data set contained contents but the range of content left in the packs varied. Results on the packs with contents differed from the total: the shares of Over-the Counter medicines (36%), of medicines of the respiratory system (18%) and of the musculo-skeletal system (18%), for dermal use (23%) and of expired medicines (19%) were higher compared to the full data set. The study showed that some medicines end up unused or partially used in normal household garbage in Vienna. Our results did not confirm speculations about a high percentage of unused medicines improperly discarded. There is room for improved patient information and counseling to enhance medication adherence and a proper discharge of medicines.

  7. Unwanted childbearing and household food insecurity in the United States

    PubMed Central

    Patel, SA; Surkan, PJ

    2015-01-01

    Household food insecurity is a population health concern disproportionately affecting families with children in the United States. Unwanted childbearing may place unanticipated strain on families to meet basic needs, heightening the risk for household food insecurity. We investigated the association between mother’s and father’s report of unwanted childbearing and exposure to household food insecurity among children residing in two-parent households in the United States. Data from the Early Childhood Longitudinal Study - Birth Cohort, a nationally representative cohort of US children (n~6,150) were used to estimate the odds of household food insecurity when children were aged 9 months and 2 years, separately, based on parental report of unwanted childbearing. The majority of children were reported as wanted by both parents (74.4%). Of the sample, report of unwanted childbearing by father-only was 20.0%, mother-only was 3.4%, and joint mother and father was 2.2%. Household food insecurity was higher when children were 9 months compared to 2 years. In adjusted models accounting for confounders, children born to mothers and fathers who jointly reported unwanted childbearing were at higher odds of exposure to household food insecurity at 9 months (AOR=3.31; 95% CI: 1.97,5.57) and 2 years (AOR=2.52; 95% CI: 1.12,5.68). In two-parent households, we found children raised by parents reporting unwanted childbearing were more likely to be exposed to food insecurity and potentially related stressors. Further studies that prospectively measure wantedness before the child’s birth will aid in confirming the direction of this association. PMID:25138233

  8. Comparisons of Gambling and Alcohol Use among College Students and Noncollege Young People in the United States

    ERIC Educational Resources Information Center

    Barnes, Grace M.; Welte, John W.; Hoffman, Joseph H.; Tidwell, Marie-Cecile O.

    2010-01-01

    Objective: Gambling and alcohol use were compared for college and noncollege young adults in the US population. Participants: Participants were 1,000 respondents aged 18 to 21. Methods: Data were analyzed from a representative household sample of US young people aged 14 to 21 years old. Telephone interviews were conducted between August 2005 and…

  9. Are Oppositional-Defiant and Hyperactive-Inattentive Symptoms Developmental Precursors to Conduct Problems in Late Childhood?: Genetic and Environmental Links

    ERIC Educational Resources Information Center

    Lahey, Benjamin B.; Van Hulle, Carol A.; Rathouz, Paul J.; Rodgers, Joseph Lee; D'Onofrio, Brian M.; Waldman, Irwin D.

    2009-01-01

    Inattentive-hyperactive and oppositional behavior have been hypothesized to be developmental precursors to conduct problems. We tested these hypotheses using a longitudinal sample of 6,466 offspring of women selected from nationally representative US households. Conduct problems across 8-13 years were robustly predicted by conduct problems at 4-7…

  10. Childhood Sexual Abuse Associated with Dating Partner Violence and Suicidal Ideation in a Representative Household Sample in Hong Kong

    ERIC Educational Resources Information Center

    Chan, Ko Ling; Yan, Elsie; Brownridge, Douglas A.; Tiwari, Agnes; Fong, Daniel Y. T.

    2011-01-01

    This study investigated the prevalence and impact of childhood sexual abuse (CSA) on future intimate partner violence (IPV) in dating relationship in Hong Kong, China. A total of 1,154 Chinese adult respondents engaged in dating relationships were interviewed face-to-face about their CSA histories, childhood witnessing of parental violence, adult…

  11. Defining and Assessing Parent Empowerment and Its Relationship to Academic Achievement Using the National Household Education Survey: A Focus on Marginalized Parents

    ERIC Educational Resources Information Center

    Kim, Jungnam

    2012-01-01

    Marginalized parents experience multiple and complex challenges in terms of social isolation, exclusion, and powerlessness. This empirical study investigated the effects of parent empowerment on academic outcomes using a large national representative sample and should provide insights about the importance of parent empowerment in education and…

  12. Parent-Child Connectedness and Long-Term Risk for Suicidal Ideation in a Nationally Representative Sample of US Adolescents.

    PubMed

    Kuramoto-Crawford, S Janet; Ali, Mir M; Wilcox, Holly C

    2017-09-01

    Few studies have addressed on the role of parent-child connectedness (PCC) on adolescents' risk for suicidal ideation from a longitudinal, developmental perspective. This study examined PCC during adolescence and risk of suicidal ideation into adulthood among a nationally representative sample of American adolescents. The study includes 13,234 adolescents aged 11-18 from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who were surveyed during adolescence (1994-1995) and then again in early adulthood (2008-2009). Multinomial logistic regression estimated the association between PCC during adolescence and having ideation during the adolescence period only, in adulthood only, and in both adolescence and adulthood as compared with those without suicidal ideation. After adjusting for depressive symptoms and other parent and adolescent characteristics, adolescents in two-parent households who reported higher PCC during adolescence had lower relative risk of having ideation during adolescence alone and in both adolescence and adulthood. In mother-only households, higher mother connectedness was also associated with decreased risk of having adolescent ideation. PCC is an important modifiable target for the prevention of suicidal ideation from adolescence into adulthood.

  13. Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon.

    PubMed

    Jomaa, Lamis; Naja, Farah; Cheaib, Ruba; Hwalla, Nahla

    2017-06-12

    Mixed evidence exists with respect to the association between household food insecurity (HFIS) and obesity in low-to-middle income countries (LMICs), particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition. A cross-sectional study was conducted among a representative sample of households (n = 378) in Beirut, Lebanon. Surveys were completed with mothers of children <18 years. HFIS was measured using a locally-validated, Arabic-translated Household Food Insecurity Access Scale (HFIAS). Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure) and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming <2/3rd Dietary Reference Intakes (DRIs) for nutrients among mothers from food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2) and at-risk waist circumference (WC ≥ 80 cm) among mothers. HFIS was found among 50% of study sample and was inversely associated with household income and mother's educational level, even after adjusting for other socioeconomic variables (p < 0.01). Mothers in food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming <2/3rd the DRI's for key micronutrients (potassium, folate, and vitamin C) compared to secure ones. Adjusting for socioeconomic correlates, food insecure mothers had 1.73 odds of obesity (95% CI: 1.02-2.92) compared to food secure mothers. High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure households had a high risk of dietary inadequacy and obesity. Adequate evidence-based public health strategies are needed to reduce the vulnerability of mothers to food insecurity in LMIC settings and alleviate their risk of a high burden of nutrient insecurity and obesity.

  14. Use of Lot quality assurance sampling surveys to evaluate community health worker performance in rural Zambia: a case of Luangwa district.

    PubMed

    Mwanza, Moses; Zulu, Japhet; Topp, Stephanie M; Musonda, Patrick; Mutale, Wilbroad; Chilengi, Roma

    2017-04-17

    The Better Health Outcomes through Mentoring and Assessment (BHOMA) project is a cluster randomized controlled trial aimed at reducing age-standardized mortality rates in three rural districts through involvement of Community Health Workers (CHWs), Traditional Birth Attendants (TBAs), and Neighborhood Health Committees (NHCs). CHWs conduct quarterly surveys on all households using a questionnaire that captures key health events occurring within their catchment population. In order to validate contact with households, we utilize the Lot Quality Assurance Sampling (LQAS) methodology. In this study, we report experiences of applying the LQAS approach to monitor performance of CHWs in Luangwa District. Between April 2011 and December 2013, seven health facilities in Luangwa district were enrolled into the BHOMA project. The health facility catchment areas were divided into 33 geographic zones. Quality assurance was performed each quarter by randomly selecting zones representing about 90% of enrolled catchment areas from which 19 households per zone where also randomly identified. The surveys were conducted by CHW supervisors who had been trained on using the LQAS questionnaire. Information collected included household identity number (ID), whether the CHW visited the household, duration of the most recent visit, and what health information was discussed during the CHW visit. The threshold for success was set at 75% household outreach by CHWs in each zone. There are 4,616 total households in the 33 zones. This yielded a target of 32,212 household visits by community health workers during the 7 survey rounds. Based on the set cutoff point for passing the surveys (at least 75% households confirmed as visited), only one team of CHWs at Luangwa high school failed to reach the target during round 1 of the surveys; all the teams otherwise registered successful visits in all the surveys. We have employed the LQAS methodology for assurance that quarterly surveys were successfully done. This methodology proved helpful in identifying poorly performing CHWs and could be useful for evaluating CHW performance in other areas. Identifier: NCT01942278 . Date of Registration: September 2013.

  15. Drivers and socioeconomic impacts of tourism participation in protected areas.

    PubMed

    Liu, Wei; Vogt, Christine A; Luo, Junyan; He, Guangming; Frank, Kenneth A; Liu, Jianguo

    2012-01-01

    Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems for long-term sustainability of protected areas.

  16. A Population-Based Comparison of Female and Male Same-Sex Parent and Different-Sex Parent Households.

    PubMed

    Bos, Henny M W; Kuyper, Lisette; Gartrell, Nanette K

    2018-03-01

    This investigation compared Dutch same-sex parent and different-sex parent households on children's psychological well-being, parenting stress, and support in child rearing. It was also assessed whether associations among children's well-being, parenting stress, and support in child rearing were different in the two household types. Data were based on a nationally representative survey (N = 25,250). Matching was used to enhance similarity in background characteristics between both types of families. Parental and child characteristics were matched for 43 female same-sex parent, 52 male same-sex parent, and 95 different-sex parent households with offspring between 5 and 18 years old. No significant differences were found on children's well-being, problems in the parent-child relationship, being worried about the child, or the use of formal and informal support between mothers in same-sex and different-sex parent households or for fathers in same-sex and different-sex parent households. Regarding perceived confidence in child rearing, fathers in same-sex parent households and mothers in different-sex parent households felt less competent than their counterparts. Neither the associations between children's well-being and the predictors (parenting stress variables) nor those between support and the predictors (parenting stress and children's well-being) differed along household type. In this population-based study, the similarity in child outcomes regardless of household type confirms the results of prior investigations based on convenience samples. These findings are pertinent to family therapists, practitioners, court officials, and policymakers who seek information on parenting experiences and child outcomes in female and male same-sex parent families. © 2017 Family Process Institute.

  17. Drivers and Socioeconomic Impacts of Tourism Participation in Protected Areas

    PubMed Central

    Liu, Wei; Vogt, Christine A.; Luo, Junyan; He, Guangming; Frank, Kenneth A.; Liu, Jianguo

    2012-01-01

    Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems for long-term sustainability of protected areas. PMID:22558149

  18. Household income determines access to specialized pediatric chronic pain treatment in Germany.

    PubMed

    Ruhe, Ann-Kristin; Wager, Julia; Hirschfeld, Gerrit; Zernikow, Boris

    2016-04-21

    Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain. Families presenting to a specialized pain center (N = 1,001) provided information on 'household income, 'parental education' and 'occupation' to aid the evaluation of their SES. To assess whether the SES of the clinical sample is representative of the general population, it was compared to data from a community sample (N = 14,558). For the clinical sample, travel distance to the clinic was described in relation to the 75% catchment area. Multiple logistic regression was used to analyze the association between SES and the journey from outside the catchment area. The SES was significantly higher in the clinical sample than in the community sample. Within the clinical sample, the distance traveled to the pain center increased with increasing SES. The 75% catchment area was 143 miles for families with the highest SES and 78 miles for the lowest SES. 'Household income' predicted travel distance (OR 1.32 (1.12-1.56)). Education and occupational status were not significant predictors of travel from outside the catchment area. In Germany, specialized care for children with chronic pain is subject to disparities in access. Future activities should focus on identifying barriers to access and seeking to prevent inequalities in specialized pediatric health care delivery. Increasing the number of specialized treatment facilities could improve access to specialized pediatric pain treatment, regardless of socioeconomic determinants.

  19. Check in the Mail or More in the Paycheck: Does the Effectiveness of Fiscal Stimulus Depend on How It Is Delivered?†

    PubMed Central

    Sahm, Claudia R.; Shapiro, Matthew D.; Slemrod, Joel

    2013-01-01

    Recent fiscal policies, including the 2008 stimulus payments and the 2009 Making Work Pay Tax Credit, aimed to increase household spending. This paper quantifies the spending response to these policies and examines differences in spending by whether the stimulus was delivered as a one-time payment or as a flow of payments from reduced withholding. Based on responses from a representative sample of households in the Thomson Reuters University of Michigan Surveys of Consumers, the paper finds that the reduction in withholding in 2009 boosted spending at roughly half the rate (13 percent) as the one-time payments (25 percent) in 2008. PMID:23970951

  20. Severe food insecurity is associated with obesity among Brazilian adolescent females.

    PubMed

    Kac, Gilberto; Velásquez-Melendez, Gustavo; Schlüssel, Michael M; Segall-Côrrea, Ana Maria; Silva, Antônio Am; Pérez-Escamilla, Rafael

    2012-10-01

    To determine whether household food insecurity (HFI) is associated with a higher prevalence of excessive weight (EW) in a large random sample of Brazilian female adolescents. Nationally representative cross-sectional study. EW was the outcome variable (BMI ≥ 85th percentile of WHO reference for adolescents aged 15-18 years and BMI ≥ 25 kg/m(2) for those aged 19 years). HFI was measured with the Brazilian Food Insecurity Scale. Associations were measured using crude and adjusted prevalence ratios (PR) with 95 % confidence intervals through Poisson regression models taking into account the complex sampling design. Data were derived from the third wave of the Demographic and Health Survey conducted in 2006-2007, in Brazil. The sample included 1529 female adolescents aged 15-19 years. The prevalence of any level of HFI was 40.8 %, with 26.6 % of households experiencing mild, 9.4 % moderate and 4.8 % severe food insecurity. The overall prevalence of EW was 21.9 % (12.9 % were overweight and 9.0 % obese). EW prevalence among those living in severely, moderately and mildly food-insecure households was 36.8 %, 14.9 % and 16.5 %, respectively (P for the overall association = 0.036). Women living in severely food-insecure households had an increased prevalence of EW compared with their food-secure counterparts (PR = 1.96; 95 % CI 1.18, 3.27; P = 0.007), after adjusting for important confounders. The study suggests that severe but not mild or moderate HFI is independently associated with EW among adolescents residing in Brazil, a middle-income country undergoing the nutrition transition.

  1. Inverse association between social support and household food insecurity in a metropolitan area of Rio de Janeiro, Brazil.

    PubMed

    Interlenghi, Gabriela dos Santos; Salles-Costa, Rosana

    2015-11-01

    To verify the association between perceived social support and household food insecurity (HFI). A cross-sectional survey. A population-based study with a representative sample of households from a metropolitan area of Rio de Janeiro, Brazil, conducted in 2010. HFI was estimated with the Brazilian Food Insecurity Scale (EBIA). Social support was assessed using the adapted and validated Brazilian version of the Medical Outcomes Study Social Support Survey. Multinomial logistic regression was used to evaluate the association between social support and HFI, adjusting for potential confounders. Adults (n 1022) aged 19-60 years old (27% men, 73% women) who were responsible for feeding the household. Individuals with high scores of social support were less likely to experience moderate HFI (OR=0·96; 95% CI 0·94, 0·99) and severe HFI (OR=0·96; 95% CI 0·94, 0·98). These findings indicate that social support may contribute to reducing HFI in populations vulnerable to poverty. Strategies to increase social relationships should be encouraged in this group to enhance their perceived social support.

  2. Unemployment and household food hardship in the economic recession.

    PubMed

    Huang, Jin; Kim, Youngmi; Birkenmaier, Julie

    2016-02-01

    The present study examined the association between unemployment and household food insecurity during the 2007-2009 economic recession in the USA. Longitudinal survey of the Survey of Income and Program Participation (SIPP; 2008-2011). Food insecurity was measured by five questions excerpted from an eighteen-item Food Security Scale. Unemployment was measured by a dichotomous indicator, the number of job losses and the total duration of all episodes in the observation period. As nationally representative data, the SIPP interviewed respondents in multiple waves with a time interval of four months. The study created two analytic samples including working-age household heads employed at the beginning of the observation period. The size of the two samples was 14,417 and 13,080. Unemployment was positively associated with food insecurity (OR=1.55; 95% CI 1.32, 1.83; P<0.001). Similar results were obtained when the analysis controlled for food insecurity status measured before unemployment (OR=1.54; 95% CI 1.27, 1.88; P<0.001). For households with the same duration of unemployment, one more episode of unemployment increased the odds of food insecurity by 8% (OR=1.08; 95% CI 1.00, 1.18; P<0.001). More in-depth understanding of the relationship between unemployment and food insecurity is useful to better identify and serve the at-risk population. Connecting unemployment assistance closely to nutrition assistance could lower the prevalence of food insecurity among unemployed households. Public policy should better account for both episodes and duration of unemployment to reduce food insecurity.

  3. After the flood: an evaluation of in-home drinking water treatment with combined flocculent-disinfectant following Tropical Storm Jeanne -- Gonaives, Haiti, 2004.

    PubMed

    Colindres, Romulo E; Jain, Seema; Bowen, Anna; Mintz, Eric; Domond, Polyana

    2007-09-01

    Tropical Storm Jeanne struck Haiti in September 2004, causing widespread flooding which contaminated water sources, displaced thousands of families and killed approximately 2,800 people. Local leaders distributed PūR, a flocculent-disinfectant product for household water treatment, to affected populations. We evaluated knowledge, attitudes, practices, and drinking water quality among a sample of PūR recipients. We interviewed representatives of 100 households in three rural communities who received PūR and PūR-related education. Water sources were tested for fecal contamination and turbidity; stored household water was tested for residual chlorine. All households relied on untreated water sources (springs [66%], wells [15%], community taps [13%], and rivers [6%]). After distribution, PūR was the most common in-home treatment method (58%) followed by chlorination (30%), plant-based flocculation (6%), boiling (5%), and filtration (1%). Seventy-eight percent of respondents correctly answered five questions about how to use PūR; 81% reported PūR easy to use; and 97% reported that PūR-treated water appears, tastes, and smells better than untreated water. Although water sources tested appeared clear, fecal coliform bacteria were detected in all sources (range 1 - >200 cfu/100 ml). Chlorine was present in 10 (45%) of 22 stored drinking water samples in households using PūR. PūR was well-accepted and properly used in remote communities where local leaders helped with distribution and education. This highly effective water purification method can help protect disaster-affected communities from waterborne disease.

  4. Extensive Household Outbreak of Urinary Tract Infection and Intestinal Colonization due to Extended-Spectrum β-Lactamase-Producing Escherichia coli Sequence Type 131.

    PubMed

    Madigan, Theresa; Johnson, James R; Clabots, Connie; Johnston, Brian D; Porter, Stephen B; Slater, Billie S; Banerjee, Ritu

    2015-07-01

    Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Molecular Analysis of Shower Curtain Biofilm Microbes

    PubMed Central

    Kelley, Scott T.; Theisen, Ulrike; Angenent, Largus T.; Amand, Allison St.; Pace, Norman R.

    2004-01-01

    Households provide environments that encourage the formation of microbial communities, often as biofilms. Such biofilms constitute potential reservoirs for pathogens, particularly for immune-compromised individuals. One household environment that potentially accumulates microbial biofilms is that provided by vinyl shower curtains. Over time, vinyl shower curtains accumulate films, commonly referred to as “soap scum,” which microscopy reveals are constituted of lush microbial biofilms. To determine the kinds of microbes that constitute shower curtain biofilms and thereby to identify potential opportunistic pathogens, we conducted an analysis of rRNA genes obtained by PCR from four vinyl shower curtains from different households. Each of the shower curtain communities was highly complex. No sequence was identical to one in the databases, and no identical sequences were encountered in the different communities. However, the sequences generally represented similar phylogenetic kinds of organisms. Particularly abundant sequences represented members of the α-group of proteobacteria, mainly Sphingomonas spp. and Methylobacterium spp. Both of these genera are known to include opportunistic pathogens, and several of the sequences obtained from the environmental DNA samples were closely related to known pathogens. Such organisms have also been linked to biofilm formation associated with water reservoirs and conduits. In addition, the study detected many other kinds of organisms at lower abundances. These results show that shower curtains are a potential source of opportunistic pathogens associated with biofilms. Frequent cleaning or disposal of shower curtains is indicated, particularly in households with immune-compromised individuals. PMID:15240300

  6. Moving on From Representativeness: Testing the Utility of the Global Drug Survey.

    PubMed

    Barratt, Monica J; Ferris, Jason A; Zahnow, Renee; Palamar, Joseph J; Maier, Larissa J; Winstock, Adam R

    2017-01-01

    A decline in response rates in traditional household surveys, combined with increased internet coverage and decreased research budgets, has resulted in increased attractiveness of web survey research designs based on purposive and voluntary opt-in sampling strategies. In the study of hidden or stigmatised behaviours, such as cannabis use, web survey methods are increasingly common. However, opt-in web surveys are often heavily criticised due to their lack of sampling frame and unknown representativeness. In this article, we outline the current state of the debate about the relevance of pursuing representativeness, the state of probability sampling methods, and the utility of non-probability, web survey methods especially for accessing hidden or minority populations. Our article has two aims: (1) to present a comprehensive description of the methodology we use at Global Drug Survey (GDS), an annual cross-sectional web survey and (2) to compare the age and sex distributions of cannabis users who voluntarily completed (a) a household survey or (b) a large web-based purposive survey (GDS), across three countries: Australia, the United States, and Switzerland. We find that within each set of country comparisons, the demographic distributions among recent cannabis users are broadly similar, demonstrating that the age and sex distributions of those who volunteer to be surveyed are not vastly different between these non-probability and probability methods. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining in-depth understanding of stigmatised behaviours and are appropriate, as long as they are not used to estimate drug use prevalence of the general population.

  7. Moving on From Representativeness: Testing the Utility of the Global Drug Survey

    PubMed Central

    Barratt, Monica J; Ferris, Jason A; Zahnow, Renee; Palamar, Joseph J; Maier, Larissa J; Winstock, Adam R

    2017-01-01

    A decline in response rates in traditional household surveys, combined with increased internet coverage and decreased research budgets, has resulted in increased attractiveness of web survey research designs based on purposive and voluntary opt-in sampling strategies. In the study of hidden or stigmatised behaviours, such as cannabis use, web survey methods are increasingly common. However, opt-in web surveys are often heavily criticised due to their lack of sampling frame and unknown representativeness. In this article, we outline the current state of the debate about the relevance of pursuing representativeness, the state of probability sampling methods, and the utility of non-probability, web survey methods especially for accessing hidden or minority populations. Our article has two aims: (1) to present a comprehensive description of the methodology we use at Global Drug Survey (GDS), an annual cross-sectional web survey and (2) to compare the age and sex distributions of cannabis users who voluntarily completed (a) a household survey or (b) a large web-based purposive survey (GDS), across three countries: Australia, the United States, and Switzerland. We find that within each set of country comparisons, the demographic distributions among recent cannabis users are broadly similar, demonstrating that the age and sex distributions of those who volunteer to be surveyed are not vastly different between these non-probability and probability methods. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining in-depth understanding of stigmatised behaviours and are appropriate, as long as they are not used to estimate drug use prevalence of the general population. PMID:28924351

  8. Migration of refugees and non-refugees to Amman, 1948-1977.

    PubMed

    Samha, M

    1980-12-01

    The migration to the city of Amman, Jordan during periods of war and peace over the past 3 decades was studied in an attempt to discover patterns of migration to Amman, to better understand their nature, to determine the constraints of migration, and to discover its motivation by resorting in part to classification and in part to analysis. The data were derived from a household survey of the amman population that covered 1750 randomly selected households and was conducted in 1977. The study was confined to compulsory migration resulting from the events in Palestine in 1948 and from the occupation of the West Bank of Jordan in 1965 and to voluntary internal migration arising from the lack of equal social and economic opportunities in different parts of the country. The 1977 survey, which covered 1355 households that had migrated to Amman, revealed that 703 were refugee households, representing the equivalent of 52% of all migrant households. The occupation of Palestine in 1948 led to a sharp influx of refugees to Amman with refugees making up 34.4% of the total number of migrants to Amman. In 1967 refugees from Gaza and the West Bank constituted 59.2% of the total number of migrants to Amman. Around 23% of all refugees are refugees for the 2nd time. Most of the refugees went directly to Amman with only a small minority (14%) moving to the city in stages, and most of these were 1948 refugees. The size and trend of migration to Amman was linked to a great extent, to the movement of refugees, which represented more than 1/2 of the migration to the city. The occupation of Palestine in 1948 led to the concentration of economic activities in the East Bank of Jordan. This meant migration east as far as the refugees from occupied Palestine and the migrants from the West Bank were concerned. As a consequence, Amman became the major attraction. The sample icluded 532 households that had migrated internally to Amman. It represented the voluntary migration to Amman from the West Bank. More households migrated from the West Bank than from the East Bank until 1967. Following occupation, migration from the West Bank dropped, and internal migration from the East Bank to the city became dominant. The scarcity of economic opportunities in most of the other Jordanian cities markedly limited the possibility that migrants would move in stages. Migration for employment reasons accounted for 31% of the households that moved to Amman, and better working opportunities accounted for the migration of 30%. Another 21% moved because the head of the household was seeking employment.

  9. Methodology of Global Adult Tobacco Survey (GATS), Malaysia, 2011

    PubMed Central

    Omar, Azahadi; Yusoff, Muhammad Fadhli Mohd; Hiong, Tee Guat; Aris, Tahir; Morton, Jeremy; Pujari, Sameer

    2015-01-01

    Introduction Malaysia participated in the second phase of the Global Adult Tobacco Survey (GATS) in 2011. GATS, a new component of the Global Tobacco Surveillance System, is a nationally representative household survey of adults 15 years old or above. The objectives of GATS Malaysia were to (i) systematically monitor tobacco use among adults and track key indicators of tobacco control and (ii) track the implementation of some of the Framework Convention of Tobacco Control (FCTC)-recommended demand related policies. Methods GATS Malaysia 2011 was a nationwide cross-sectional survey using multistage stratified sampling to select 5112 nationally representative households. One individual aged 15 years or older was randomly chosen from each selected household and interviewed using handheld device. GATS Core Questionnaire with optional questions was pre-tested and uploaded into handheld devices after repeated quality control processes. Data collectors were trained through a centralized training. Manuals and picture book were prepared to aid in the training of data collectors and during data collection. Field-level data were aggregated on a daily basis and analysed twice a week. Quality controls were instituted to ensure collection of high quality data. Sample weighting and analysis were conducted with the assistance of researchers from the Centers for Disease Control and Prevention, Atlanta, USA Results GATS Malaysia received a total response rate of 85.3% from 5112 adults surveyed. Majority of the respondents were 25–44 years old and Malays. Conclusions The robust methodology used in the GATS Malaysia provides national estimates for tobacco used classified by socio-demographic characteristics and reliable data on various dimensions of tobacco control. PMID:26451348

  10. Household location choices: implications for biodiversity conservation.

    PubMed

    Peterson, M Nils; Chen, Xiaodong; Liu, Jianguo

    2008-08-01

    Successful conservation efforts require understanding human behaviors that directly affect biodiversity. Choice of household location represents an observable behavior that has direct effects on biodiversity conservation, but no one has examined the sociocultural predictors of this choice relative to its environmental impacts. We conducted a case study of the Teton Valley of Idaho and Wyoming (U.S.A.) that (1) explored relationships between sociodemographic variables, environmental attitudes, and the environmental impact of household location choices, (2) assessed the potential for small household sizes in natural areas to multiply the environmental impacts of household location decisions, and (3) evaluated how length of residency predicted the environmental attitudes of people living in natural areas. We collected sociodemographic data, spatial coordinates, and land-cover information in a survey of 416 households drawn from a random sample of Teton Valley residents (95% compliance rate). Immigrants (respondents not born in the study area) with the lowest education levels and least environmentally oriented attitudes lived in previously established residential areas in disproportionately high numbers, and older and more educated immigrants with the most environmentally oriented attitudes lived in natural areas in disproportionately high numbers. Income was not a significant predictor of household location decisions. Those living in natural areas had more environmental impact per person because of the location and because small households (<3 people/household) were 4 times as likely in natural areas as large households. Longer residency in natural areas predicted less environmentally oriented attitudes, suggesting that living in natural areas does not foster more concern for nature. Because populaces are rapidly aging, growing more educated, and potentially growing more environmentally oriented, these patterns are troubling for biodiversity conservation. Our results demonstrate a need for environmentalists to make household location decisions that reflect their environmental attitudes and future research to address how interactions between education level, environmental attitudes, population aging, and household location choices influence biodiversity conservation.

  11. Social determinants of household food expenditure in Australia: the role of education, income, geography and time.

    PubMed

    Venn, Danielle; Dixon, Jane; Banwell, Cathy; Strazdins, Lyndall

    2018-04-01

    To examine socio-economic status (SES) and time-related factors associated with less healthy food purchases in Australia. Data were from the 2009/10 Household Expenditure Survey (HES) conducted by the Australian Bureau of Statistics. Regression analysis was used to examine the associations between the proportion of the household food budget spent on various food types (processed and unprocessed foods, foods purchased from takeaways and restaurants) and SES and time constraint variables. Australia, 2009-2010. Nationally representative sample of Australian households. Household income seems to be the most important correlate with food expenditure patterns once other SES indicators are controlled for. Time constraints appear to explain some, but not all, of the adjusted SES gradients in food expenditure. Comparing home food consumption categories (processed and unprocessed foods) with foods purchased away from home (takeaway and restaurant foods) shows that wealthier, more highly educated and least disadvantaged households spend relatively less of their total food budget on processed and unprocessed foods prepared at home and more on foods purchased away from home at restaurants. Simple SES gradients in dietary behaviour are influenced by correlations between different SES indicators and between SES and time constraints. Examining these factors separately obscures some of the possible causal effects of disadvantage on healthy eating. When formulating policy responses to unhealthy diets, policy makers should consider alternative sources of disadvantage, including time pressure.

  12. The National Children's Study: Recruitment Outcomes Using the Provider-Based Recruitment Approach.

    PubMed

    Hale, Daniel E; Wyatt, Sharon B; Buka, Stephen; Cherry, Debra; Cislo, Kendall K; Dudley, Donald J; McElfish, Pearl Anna; Norman, Gwendolyn S; Reynolds, Simone A; Siega-Riz, Anna Maria; Wadlinger, Sandra; Walker, Cheryl K; Robbins, James M

    2016-06-01

    In 2009, the National Children's Study (NCS) Vanguard Study tested the feasibility of household-based recruitment and participant enrollment using a birth-rate probability sample. In 2010, the NCS Program Office launched 3 additional recruitment approaches. We tested whether provider-based recruitment could improve recruitment outcomes compared with household-based recruitment. The NCS aimed to recruit 18- to 49-year-old women who were pregnant or at risk for becoming pregnant who lived in designated geographic segments within primary sampling units, generally counties. Using provider-based recruitment, 10 study centers engaged providers to enroll eligible participants at their practice. Recruitment models used different levels of provider engagement (full, intermediate, information-only). The percentage of eligible women per county ranged from 1.5% to 57.3%. Across the centers, 3371 potential participants were approached for screening, 3459 (92%) were screened and 1479 were eligible (43%). Of those 1181 (80.0%) gave consent and 1008 (94%) were retained until delivery. Recruited participants were generally representative of the county population. Provider-based recruitment was successful in recruiting NCS participants. Challenges included time-intensity of engaging the clinical practices, differential willingness of providers to participate, and necessary reliance on providers for participant identification. The vast majority of practices cooperated to some degree. Recruitment from obstetric practices is an effective means of obtaining a representative sample. Copyright © 2016 by the American Academy of Pediatrics.

  13. The National Children’s Study: Recruitment Outcomes Using the Provider-Based Recruitment Approach

    PubMed Central

    Wyatt, Sharon B.; Buka, Stephen; Cherry, Debra; Cislo, Kendall K.; Dudley, Donald J.; McElfish, Pearl Anna; Norman, Gwendolyn S.; Reynolds, Simone A.; Siega-Riz, Anna Maria; Wadlinger, Sandra; Walker, Cheryl K.; Robbins, James M.

    2016-01-01

    OBJECTIVE: In 2009, the National Children’s Study (NCS) Vanguard Study tested the feasibility of household-based recruitment and participant enrollment using a birth-rate probability sample. In 2010, the NCS Program Office launched 3 additional recruitment approaches. We tested whether provider-based recruitment could improve recruitment outcomes compared with household-based recruitment. METHODS: The NCS aimed to recruit 18- to 49-year-old women who were pregnant or at risk for becoming pregnant who lived in designated geographic segments within primary sampling units, generally counties. Using provider-based recruitment, 10 study centers engaged providers to enroll eligible participants at their practice. Recruitment models used different levels of provider engagement (full, intermediate, information-only). RESULTS: The percentage of eligible women per county ranged from 1.5% to 57.3%. Across the centers, 3371 potential participants were approached for screening, 3459 (92%) were screened and 1479 were eligible (43%). Of those 1181 (80.0%) gave consent and 1008 (94%) were retained until delivery. Recruited participants were generally representative of the county population. CONCLUSIONS: Provider-based recruitment was successful in recruiting NCS participants. Challenges included time-intensity of engaging the clinical practices, differential willingness of providers to participate, and necessary reliance on providers for participant identification. The vast majority of practices cooperated to some degree. Recruitment from obstetric practices is an effective means of obtaining a representative sample. PMID:27251870

  14. The impact of internal displacement on child mortality in post-earthquake Haiti: a difference-in-differences analysis.

    PubMed

    Chen, Bradley; Halliday, Timothy J; Fan, Victoria Y

    2016-07-19

    The Haiti earthquake in 2010 resulted in 1.5 million internally displaced people (IDP), yet little is known about the impact of displacement on health. In this study, we estimate the impact of displacement on infant and child mortality and key health-behavior mechanisms. We employ a difference-in-differences (DID) design with coarsened exact matching (CEM) to ensure comparability among groups with different displacement status using the 2012 Haiti Demographic and Health Survey (DHS). The participants are 21,417 births reported by a nationally representative sample of 14,287 women aged 15-49. The main independent variables are household displacement status which includes households living in camps, IDP households (not in camps), and households not displaced. The main outcomes are infant and child mortality; health status (height-for-age, anemia); uptake of public health interventions (bed net use, spraying against mosquitoes, and vaccinations); and other conditions (hunger; cholera). Births from the camp households have higher infant mortality (OR = 2.34, 95 % CI 1.15 to 4.75) and child mortality (OR = 2.34, 95 % CI 1.10 to 5.00) than those in non-camp IDP households following the earthquake. These odds are higher despite better access to food, water, bed net use, mosquito spraying, and vaccines among camp households. IDP populations are heterogeneous and households that are displaced outside of camps may be self-selected or self-insured. Meanwhile, even households not displaced by a disaster may face challenges in access to basic necessities and health services. Efforts are needed to identify vulnerable populations to provide targeted assistance in post-disaster relief.

  15. Health and vulnerability to poverty in Ghana: evidence from the Ghana Living Standards Survey Round 5

    PubMed Central

    2012-01-01

    Background An understanding of the complex relationship between health status and welfare is crucial for critical policy interventions. However, the focus of most policies in developing regions has been on current welfare to the neglect of forward-looking welfare analysis. The absence of adequate research in the area of future poverty or vulnerability to poverty has also contributed to the focus on current welfare. The objectives of this study were to estimate vulnerability to poverty among households in Ghana and examine the relationship between health status and vulnerability to poverty. Method The study used cross section data from the Fifth Round of the Ghana Living Standards Survey (GLSS 5) with a nationally representative sample of 8,687 households from all administrative regions in Ghana. A three-step Feasible Generalized Least Squares (FGLS) estimation procedure was employed to estimate vulnerability to poverty and to model the effect of health status on expected future consumption and variations in future consumption. Vulnerability to poverty estimates were also examined against various household characteristics. Results Using an upper poverty line, the estimates of vulnerability show that about 56% of households in Ghana are vulnerable to poverty in the future and this is higher than the currently observed poverty level of about 29%. Households with ill members were vulnerable to poverty. Moreover, households with poor hygiene conditions were also vulnerable to future poverty. The vulnerability to poverty estimates were, however, sensitive to the poverty line used and varied with household characteristics. Conclusion The results imply that policies directed towards poverty reduction need to take into account the vulnerability of households to future poverty. Also, hygienic conditions and health status of households need not be overlooked in poverty reduction strategies. PMID:22827954

  16. NAEP Profiles of Literacy. An Assessment of Young Adults. Development Plan, April 1985.

    ERIC Educational Resources Information Center

    Kirsch, Irwin

    The National Assessment of Educational Progress (NAEP) has acted to provide a new perspective with its 1985 survey of the literacy skills of young Americans aged 21-25. In the Spring of 1985, NAEP began screening 40,000 households to identify a nationally representative sample of between 3,600 and 5,000 young adults aged 21-25 and several hundred…

  17. Technical Report and Data File User's Manual: For the 2003 National Assessment of Adult Literacy. NCES 2009-476

    ERIC Educational Resources Information Center

    Baldi, Stephane, Ed.; Kutner, Mark; Greenberg, Elizabeth; Jin, Ying; Baer, Justin; Moore, Elizabeth; Dunleavy, Eric; Berlin, Martha; Mohadjer, Leyla; Binzer, Greg; Krenzke, Thomas; Hogan, Jacqueline; Amsbary, Michelle; Forsyth, Barbara; Clark, Lyn; Annis, Terri; Bernstein, Jared; White, Sheida

    2009-01-01

    The 2003 National Assessment of Adult Literacy (NAAL) assessed the English literacy skills of a nationally representative sample of more than 19,000 U.S. adults (age 16 and older) residing in households and correctional institutions. NAAL is the first national assessment of adult literacy since the 1992 National Adult Literacy Survey (NALS). The…

  18. Soil-Transmitted Helminth Eggs Are Present in Soil at Multiple Locations within Households in Rural Kenya.

    PubMed

    Steinbaum, Lauren; Njenga, Sammy M; Kihara, Jimmy; Boehm, Alexandria B; Davis, Jennifer; Null, Clair; Pickering, Amy J

    2016-01-01

    Almost one-quarter of the world's population is infected with soil-transmitted helminths (STH). We conducted a study to determine the prevalence and location of STH-Ascaris, Trichuris, and hookworm spp.-egg contamination in soil within rural household plots in Kenya. Field staff collected soil samples from July to September 2014 from the house entrance and the latrine entrance of households in Kakamega County; additional spatial sampling was conducted at a subset of households (N = 22 samples from 3 households). We analyzed soil samples using a modified version of the US Environmental Protection Agency (EPA) method for enumerating Ascaris in biosolids. We found 26.8% of households had one or more species of STH eggs present in the soil in at least one household location (n = 18 out of 67 households), and Ascaris was the most commonly detected STH (19.4%, n = 13 out of 67 households). Prevalence of STH eggs in soil was equally likely at the house entrance (19.4%, N = 67) as at the latrine entrance (11.3%, N = 62) (p = 0.41). We also detected STH eggs at bathing and food preparation areas in the three houses revisited for additional spatial sampling, indicating STH exposure can occur at multiple sites within a household plot, not just near the latrine. The highest concentration of eggs in one house occurred in the child's play area. Our findings suggest interventions to limit child exposure to household soil could complement other STH control strategies.

  19. Field efficacy evaluation and post-treatment contamination risk assessment of an ultraviolet disinfection and safe storage system.

    PubMed

    Reygadas, Fermin; Gruber, Joshua S; Ray, Isha; Nelson, Kara L

    2015-11-15

    Inconsistent use of household water treatment and safe storage (HWTS) systems reduces their potential health benefits. Ultraviolet (UV) disinfection is more convenient than some existing HWTS systems, but it does not provide post-treatment residual disinfectant, which could leave drinking water vulnerable to recontamination. In this paper, using as-treated analyses, we report on the field efficacy of a UV disinfection system at improving household drinking water quality in rural Mexico. We further assess the risk of post-treatment contamination from the UV system, and develop a process-based model to better understand household risk factors for recontamination. This study was part of a larger cluster-randomized stepped wedge trial, and the results complement previously published population-level results of the intervention on diarrheal prevalence and water quality. Based on the presence of Escherichia coli (proportion of households with ≥ 1 E. coli/100 mL), we estimated a risk difference of -28.0% (95% confidence interval (CI): -33.9%, -22.1%) when comparing intervention to control households; -38.6% (CI: -48.9%, -28.2%) when comparing post- and pre-intervention results; and -37.1% (CI: -45.2%, -28.9%) when comparing UV disinfected water to alternatives within the household. We found substantial increases in post-treatment E. coli contamination when comparing samples from the UV system effluent (5.0%) to samples taken from the storage container (21.1%) and drinking glasses (26.0%). We found that improved household infrastructure, additional extractions from the storage container, additional time from when the storage container was filled, and increased experience of the UV system operator were associated with reductions in post-treatment contamination. Our results suggest that the UV system is efficacious at improving household water quality when used as intended. Promoting safe storage habits is essential for an effective UV system dissemination. The drinking glass appears to represent a small but significant source of recontamination that is likely to impact all HWTS systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Hand washing behavior and associated factors in Vietnam based on the Multiple Indicator Cluster Survey, 2010–2011

    PubMed Central

    To, Kien Gia; Lee, Jong-Koo; Nam, You-Seon; Trinh, Oanh Thi Hoang; Van Do, Dung

    2016-01-01

    Background Handwashing is a cost-effective way of preventing communicable diseases such as respiratory and food-borne illnesses. However, handwashing rates are low in developing countries. Target 7C of the seventh Millennium Development Goals was to increase by half the proportion of people with sustainable access to safe drinking water and basic sanitation by 2015. Studies have found that better access to improved water sources and sanitation is associated with higher rates of handwashing. Objective Our goal was to describe handwashing behaviour and identify the associated factors in Vietnamese households. Design Data from 12,000 households participating in the Vietnam Multiple Indicator Cluster Survey 2011 were used. The survey used a multistage sampling method to randomly select 100 clusters and 20 households per cluster. Self-administered questionnaires were used to collect data from a household representative. Demographic variables, the presence of a specific place for handwashing, soap and water, access to improved sanitation, and access to improved water sources were tested for association with handwashing behaviour in logistic regression. Results Almost 98% of households had a specific place for handwashing, and 85% had cleansing materials and water at such a place. The prevalence of handwashing in the sample was almost 85%. Educational level, ethnicity of the household head, and household wealth were factors associated with handwashing practice (p<0.05). Those having access to an improved sanitation facility were more likely to practise handwashing [odds ratio (OR)=1.69, 95% confidence interval (CI): 1.37–2.09, p<0.001], as were those with access to improved water sources (OR=1.74, 95% CI: 1.37–2.21, p<0.001). Conclusions Households with low education, low wealth, belonging to ethnic minorities, and with low access to improved sanitation facilities and water sources should be targeted for interventions implementing handwashing practice. In addition, the availability of soap and water at handwashing sites should be increased and practical teaching programs should be deployed in order to increase handwashing rates. PMID:26950556

  1. [Epidemiology of ageing in Northeastern Brazil: results of a household survey].

    PubMed

    Coelho Filho, J M; Ramos, L R

    1999-10-01

    The population of Brazil is ageing very rapidly, and the care of the elderly is an emerging priority. Up to this date, there is no comprehensive study addressing the profile of the elderly in Northeastern Brazil. The objective is to compile the multidimensional profile of the elderly residents in a metropolitan area of Northeastern Brazil. Six hundred sixty-seven elderly (60 years and over), residents in the city of Fortaleza, Ceará, Brazil, constituting a multistage random sample stratified by socioeconomic status. The data was gathered by household survey using a multidimensional functional assessment questionnaire. The majority of the elderly were living in multigenerational households (75,3%). More than half (51,9%) lived without the spouse; 92,4% mentioned at least one disease; 26,4% were considered psychiatric cases; 47,7% showed loss of autonomy; 6,6% were hospitalized, and 61,4% used health services within the twelve and six months preceding the interview, respectively. The prevalence of multigenerational households, loss of autonomy and psychiatric morbidity were higher in the poorest areas. The elderly population in the city of Fortaleza lives mainly in multigenerational households, with physical and mental morbidity rates particularly high in poor areas, they represent special concern in terms of burden for the social and health services in the next decades

  2. Comparing Methods of Assessing Dog Rabies Vaccination Coverage in Rural and Urban Communities in Tanzania

    PubMed Central

    Sambo, Maganga; Johnson, Paul C. D.; Hotopp, Karen; Changalucha, Joel; Cleaveland, Sarah; Kazwala, Rudovick; Lembo, Tiziana; Lugelo, Ahmed; Lushasi, Kennedy; Maziku, Mathew; Mbunda, Eberhard; Mtema, Zacharia; Sikana, Lwitiko; Townsend, Sunny E.; Hampson, Katie

    2017-01-01

    Rabies can be eliminated by achieving comprehensive coverage of 70% of domestic dogs during annual mass vaccination campaigns. Estimates of vaccination coverage are, therefore, required to evaluate and manage mass dog vaccination programs; however, there is no specific guidance for the most accurate and efficient methods for estimating coverage in different settings. Here, we compare post-vaccination transects, school-based surveys, and household surveys across 28 districts in southeast Tanzania and Pemba island covering rural, urban, coastal and inland settings, and a range of different livelihoods and religious backgrounds. These approaches were explored in detail in a single district in northwest Tanzania (Serengeti), where their performance was compared with a complete dog population census that also recorded dog vaccination status. Post-vaccination transects involved counting marked (vaccinated) and unmarked (unvaccinated) dogs immediately after campaigns in 2,155 villages (24,721 dogs counted). School-based surveys were administered to 8,587 primary school pupils each representing a unique household, in 119 randomly selected schools approximately 2 months after campaigns. Household surveys were conducted in 160 randomly selected villages (4,488 households) in July/August 2011. Costs to implement these coverage assessments were $12.01, $66.12, and $155.70 per village for post-vaccination transects, school-based, and household surveys, respectively. Simulations were performed to assess the effect of sampling on the precision of coverage estimation. The sampling effort required to obtain reasonably precise estimates of coverage from household surveys is generally very high and probably prohibitively expensive for routine monitoring across large areas, particularly in communities with high human to dog ratios. School-based surveys partially overcame sampling constraints, however, were also costly to obtain reasonably precise estimates of coverage. Post-vaccination transects provided precise and timely estimates of community-level coverage that could be used to troubleshoot the performance of campaigns across large areas. However, transects typically overestimated coverage by around 10%, which therefore needs consideration when evaluating the impacts of campaigns. We discuss the advantages and disadvantages of these different methods and make recommendations for how vaccination campaigns can be better monitored and managed at different stages of rabies control and elimination programs. PMID:28352630

  3. Prevalence of major depressive disorder and socio-demographic correlates: Results of a representative household epidemiological survey in Beijing, China.

    PubMed

    Liu, Jing; Yan, Fang; Ma, Xin; Guo, Hong-Li; Tang, Yi-Lang; Rakofsky, Jeffrey J; Wu, Xiao-Mei; Li, Xiao-Qiang; Zhu, Hong; Guo, Xiao-Bing; Yang, Yang; Li, Peng; Cao, Xin-Dong; Li, Hai-Ying; Li, Zhen-Bo; Wang, Ping; Xu, Qiu-Yue

    2015-07-01

    Major depressive disorder (MDD) is the most prevalent mental disorder in the general population and has been associated with socioeconomic factors. Beijing has undergone significant socioeconomic changes in last decade, however no large-scale community epidemiological surveys of MDD have been conducted in Beijing since 2003. To determine the prevalence of MDD and its socio-demographic correlates in a representative household sample of the general population in Beijing, China. Data were collected from the 2010 representative household epidemiological survey of mental disorders in Beijing. The multistage cluster random sampling method was used to select qualified subjects in 18 districts and counties, and then face-to-face interviews were administered using the Chinese version of Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P) during November 1, 2010 to December 31, 2010. 19,874 registered permanent residents were randomly identified and 16,032 (response rate=80.7%) completed face-to-face interviews. The time-point and life-time prevalence rates of MDD were estimated to be 1.10% (95% CI: 0.94-1.26%) and 3.56% (95% CI: 3.27-3.85%) respectively. Significant differences were found in sex, age, location of residence, marital status, education, employment status, personal/family monthly income, perception of family environment and relationship with others, when comparing residents with MDD to those without MDD. Those who were female, aged 45 or above, reported low family income, or reported an "average" or "poor" family environment were associated with a higher risk of MDD. The prevalence of MDD reported in this survey is relatively lower than that in other western countries. Female sex, age older than 45, low family income, and poor family environment appear to be independent risk factors for MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Contaminants of emerging concern in fresh leachate from landfills in the conterminous United States

    USGS Publications Warehouse

    Masoner, Jason R.; Kolpin, Dana W.; Furlong, Edward T.; Cozzarelli, Isabelle M.; Gray, James L.; Schwab, Eric A.

    2014-01-01

    To better understand the composition of contaminants of emerging concern (CECs) in landfill leachate, fresh leachate from 19 landfills was sampled across the United States during 2011. The sampled network included 12 municipal and 7 private landfills with varying landfill waste compositions, geographic and climatic settings, ages of waste, waste loads, and leachate production. A total of 129 out of 202 CECs were detected during this study, including 62 prescription pharmaceuticals, 23 industrial chemicals, 18 nonprescription pharmaceuticals, 16 household chemicals, 6 steroid hormones, and 4 plant/animal sterols. CECs were detected in every leachate sample, with the total number of detected CECs in samples ranging from 6 to 82 (median = 31). Bisphenol A (BPA), cotinine, and N,N-diethyltoluamide (DEET) were the most frequently detected CECs, being found in 95% of the leachate samples, followed by lidocaine (89%) and camphor (84%). Other frequently detected CECs included benzophenone, naphthalene, and amphetamine, each detected in 79% of the leachate samples. CEC concentrations spanned six orders of magnitude, ranging from ng L−1 to mg L−1. Industrial and household chemicals were measured in the greatest concentrations, composing more than 82% of the total measured CEC concentrations. Maximum concentrations for three household and industrial chemicals, para-cresol (7020000 ng L−1), BPA (6380000 ng L−1), and phenol (1550000 ng L−1), were the largest measured, with these CECs composing 70% of the total measured CEC concentrations. Nonprescription pharmaceuticals represented 12%, plant/animal sterols 4%, prescription pharmaceuticals 1%, and steroid hormones <1% of the total measured CEC concentrations. Leachate from landfills in areas receiving greater amounts of precipitation had greater frequencies of CEC detections and concentrations in leachate than landfills receiving less precipitation.

  5. Methodology of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

    PubMed

    Hafekost, Jennifer; Lawrence, David; Boterhoven de Haan, Katrina; Johnson, Sarah E; Saw, Suzy; Buckingham, William J; Sawyer, Michael G; Ainley, John; Zubrick, Stephen R

    2016-09-01

    To describe the study design of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The aims of the study, sample design, development of survey content, field procedures and final questionnaires are detailed. During 2013-2014, a national household survey of the mental health and wellbeing of young people was conducted involving a sample of 6310 families selected at random from across Australia. The survey included a face-to-face diagnostic interview with parents/carers of 4- to 17-year-olds and a self-report questionnaire completed by young people aged 11-17 years. The overall response rate to the survey was 55% with 6310 parents/carers of eligible households participating in the survey. In addition, 2967 or 89% of young people aged 11-17 years in these participating households completed a questionnaire. The survey sample was found to be broadly representative of the Australian population on major demographic characteristics when compared with data from the Census of Population and Housing. However, adjustments were made for an over-representation of younger children aged 4 to 7 years and also families with more than one eligible child in the household. Young Minds Matter provides updated national prevalence estimates of common child and adolescent mental disorders, describes patterns of service use and will help to guide future decisions in the development of policy and provision of mental health services for children and adolescents. Advancements in interviewing methodology, addition of a data linkage component and informed content development contributed to improved breadth and quality of the data collected. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  6. Influence of rural non-smoking adolescents' sense of coherence and exposure to household smoking on their commitment to a smoke-free lifestyle.

    PubMed

    Ayo-Yusuf, Olalekan A; Rantao, Masego M

    2013-06-13

    This 18-month longitudinal study examined the influence of adolescents' sense of coherence (SOC) and exposure to household smoking on their commitment to a smoke-free lifestyle. This study investigated a representative sample of 8th graders from 21 randomly selected high schools in the rural Limpopo Province of South Africa (n = 2,119). Of the total sample of 2,119 participants, 294 (14%) reported smoking at baseline and were therefore excluded from further analysis. Of those who did not smoke at baseline, 98.1% (n = 1,767) reported no intention of smoking in the upcoming 12 months. Of those who completed follow-up and had no intention of smoking at baseline (n = 1,316), 89.1% still did not smoke and remained committed to being smoke-free. Having a lower SOC, reporting alcohol binge-drinking at baseline, and having a household member who regularly smokes indoors (OR = 0.46: 0.26-0.82), as compared to not having any smoker in the household, were associated with lower odds of honoring a commitment to a smoke-free lifestyle. Furthermore, those who identified themselves as black Africans, as opposed to belonging to other race groups, were more likely to maintain a smoke-free lifestyle. Our findings suggest that interventions to prevent adolescent smoking should prioritize stress-coping skills and promote smoke-free homes.

  7. Soft drinks: time trends and correlates in twenty-four European countries. A cross-national study using the DAFNE (Data Food Networking) databank.

    PubMed

    Naska, Androniki; Bountziouka, Vasiliki; Trichopoulou, Antonia

    2010-09-01

    To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries. Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks. Twenty-four European countries. Nationally representative samples of households. The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household. Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents.

  8. Household food insecurity is not associated with BMI for age or weight for height among Brazilian children aged 0-60 months.

    PubMed

    Kac, Gilberto; Schlüssel, Michael M; Pérez-Escamilla, Rafael; Velásquez-Melendez, Gustavo; da Silva, Antônio Augusto Moura

    2012-01-01

    We examined the association between Household Food Insecurity (HFI), weight for height z-score (WHZ) and Body Mass Index for age z-score (BMI-Z) in a representative sample of children 0-60 months of age (n = 3,433) in five Brazilian geographical regions. Data were derived from the 2006-07 Brazilian Demographic and Health Survey. HFI was measured with the Brazilian Food Insecurity Scale. Associations were estimated using multiple linear regression models (β coefficients and 95% CI) taking into account the complex sampling design. Interaction terms between HFI and geographical region and HFI and child sex and child age were assessed. The weighted prevalence of any level of HFI was 48.6%. Severe food insecurity was more prevalent among children from the North region (16.8%), born from mothers with <4 years of schooling (15.9%) and those from families with ≥3 children (18.8%). The interaction between HFI and geographical region was non-significant for BMI-Z (P = 0.119) and WHZ (P = 0.198). Unadjusted results indicated that HFI was negatively associated with BMI-Z (moderate to severe HFI: β = -0.19, 95% CI: -0.35 - -0.03, P = 0.047), and WHZ (moderate to severe HFI: β = -0.26, 95% CI: -0.42 - -0.09, P = 0.009). Estimates lost significance after adjustments for key confounders such as mothers' skin color, mothers' years of schooling, place of household, household income quartiles, mothers' smoking habit, mothers' marital status, number of children 0-60 months in the household, and birth order. HFI is unrelated to weight outcomes among Brazilian children 0-60 months.

  9. Soil-Transmitted Helminth Eggs Are Present in Soil at Multiple Locations within Households in Rural Kenya

    PubMed Central

    Steinbaum, Lauren; Njenga, Sammy M.; Kihara, Jimmy; Boehm, Alexandria B.; Davis, Jennifer; Null, Clair; Pickering, Amy J.

    2016-01-01

    Almost one-quarter of the world’s population is infected with soil-transmitted helminths (STH). We conducted a study to determine the prevalence and location of STH—Ascaris, Trichuris, and hookworm spp.—egg contamination in soil within rural household plots in Kenya. Field staff collected soil samples from July to September 2014 from the house entrance and the latrine entrance of households in Kakamega County; additional spatial sampling was conducted at a subset of households (N = 22 samples from 3 households). We analyzed soil samples using a modified version of the US Environmental Protection Agency (EPA) method for enumerating Ascaris in biosolids. We found 26.8% of households had one or more species of STH eggs present in the soil in at least one household location (n = 18 out of 67 households), and Ascaris was the most commonly detected STH (19.4%, n = 13 out of 67 households). Prevalence of STH eggs in soil was equally likely at the house entrance (19.4%, N = 67) as at the latrine entrance (11.3%, N = 62) (p = 0.41). We also detected STH eggs at bathing and food preparation areas in the three houses revisited for additional spatial sampling, indicating STH exposure can occur at multiple sites within a household plot, not just near the latrine. The highest concentration of eggs in one house occurred in the child’s play area. Our findings suggest interventions to limit child exposure to household soil could complement other STH control strategies. PMID:27341102

  10. Counting 15 million more poor in India, thanks to tobacco.

    PubMed

    John, Rijo M; Sung, Hai-Yen; Max, Wendy B; Ross, Hana

    2011-09-01

    To quantify the impact of tobacco use and the related medical expenditure on poverty in India. Tobacco expenditure and associated medical expenditure attributable to tobacco use were subtracted from the household monthly consumption expenditure in order to derive an appropriate measure of household disposable income. The 2004 National Sample Survey, a nationally representative survey of Indian households, was used to estimate the true level of poverty. Our estimates indicate that accounting for direct expenditure on tobacco would increase the rural and the urban poverty rates by 1.5% (affecting 11.8 million people) and 0.72% (affecting 2.3 million people), respectively. Similarly, the out-of-pocket costs of tobacco-attributable medical care result in 0.09% higher poverty rates in rural areas (affecting 0.7 million people) and in 0.07% higher poverty rates in urban locations (affecting 0.23 million people). Tobacco consumption impoverishes roughly 15 million people in India. Hence tobacco control measures would not only improve public health, but would also reduce poverty in India.

  11. Socioeconomic status and smoking among thai adults: results of the National Thai Food Consumption Survey.

    PubMed

    Jitnarin, Nattinee; Kosulwat, Vongsvat; Rojroongwasinkul, Nipa; Boonpraderm, Atitada; Haddock, Christopher K; Poston, Walker S C

    2011-09-01

    The authors examined the relationship between socioeconomic status and smoking in Thai adults. A nationally representative sample of 7858 Thais adults (18 years and older) was surveyed during 2004 to 2005. Four demographic/socioeconomic indicators were examined in logistic models: gender, education, occupational status, and annual household income. Overall, 22.2% of the participants were smokers. Men were more likely to be smokers across all age groups and regions. Compared with nonsmokers, current smokers were less educated, more likely to be employed, but had lower household income. When stratified by gender, education and job levels were strongly associated with smoking prevalence among males. A significant relationship was found between annual household income and smoking. Those who lived under the poverty line were more likely to smoke than persons who lived above the poverty line in both genders. The present study demonstrated that socioeconomic factors, especially education level and occupational class, have a strong influence on smoking behavior in Thai adults.

  12. Socioeconomic Status and Smoking Among Thai Adults: Results of the National Thai Food Consumption Survey

    PubMed Central

    Jitnarin, Nattinee; Kosulwat, Vongsvat; Rojroongwasinkul, Nipa; Boonpraderm, Atitada; Haddock, Christopher K.; Poston, Walker S. C.

    2018-01-01

    The authors examined the relationship between socioeconomic status and smoking in Thai adults. A nationally representative sample of 7858 Thais adults (18 years and older) was surveyed during 2004 to 2005. Four demographic/socioeconomic indicators were examined in logistic models: gender, education, occupational status, and annual household income. Overall, 22.2% of the participants were smokers. Men were more likely to be smokers across all age groups and regions. Compared with nonsmokers, current smokers were less educated, more likely to be employed, but had lower household income. When stratified by gender, education and job levels were strongly associated with smoking prevalence among males. A significant relationship was found between annual household income and smoking. Those who lived under the poverty line were more likely to smoke than persons who lived above the poverty line in both genders. The present study demonstrated that socioeconomic factors, especially education level and occupational class, have a strong influence on smoking behavior in Thai adults. PMID:20460275

  13. Childhood exposure to domestic violence and attitude towards wife beating in adult life: a study of men in India.

    PubMed

    Zhu, Ying; Dalal, Koustuv

    2010-03-01

    This study examined men's justification of wife beating in relation to their perceived rights and autonomy using a nationally representative sample of 18,047 men in India with childhood exposure to parental violence. Five reasons for wife beating justification, four items of men's perceived rights, and five items of household autonomy were analysed using chi2 test and logistic regression. Among 18,047 participants, 67% justified wife beating. Low education, economic stress and being unmarried were generally more associated with justifying wife beating for all five reasons. Wife's refusal of sex and husband's final say on household autonomy are risk factors. Joint autonomy on household decision making and wife's autonomy on managing her own earnings are protective factors. Perceived relationship rights and autonomy are highly predictive of wife-beating justification for the men who have been exposed to parental violence during childhood. The study has significant implications for public health planners and education strategies.

  14. CHARACTERISTICS OF PERSONS WITH IMPAIRED HEARING. UNITED STATES--JULY 1962-JUNE 1963. VITAL AND HEALTH STATISTICS--DATA FROM THE NATIONAL HEALTH SURVEY, NATIONAL CENTER FOR HEALTH STATISTICS.

    ERIC Educational Resources Information Center

    LINDER, FORREST E.; AND OTHERS

    COLLECTED BY INTERVIEWERS FROM A REPRESENTATIVE SAMPLE OF 42,000 HOUSEHOLDS CONTAINING 134,000 PERSONS, THIS DATA PERTAINS TO THE HEARING-IMPAIRED POPULATION IN 1962-1963. THE REPORT PRESENTS THE SOCIAL, ECONOMIC, AND DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION WITH IMPAIRED HEARING, AND ALSO GIVES DATA ON THE UTILIZATION OF AND SATISFACTION…

  15. Mediating Pathways in the Socio-Economic Gradient of Child Development: Evidence from Children 6-42 Months in Bogota

    ERIC Educational Resources Information Center

    Rubio-Codina, Marta; Attanasio, Orazio; Grantham-McGregor, Sally

    2016-01-01

    Research has previously shown a gap of near 0.5 of a standard deviation (SD) in cognition and language development between the top and bottom household wealth quartile in children aged 6-42 months in a large representative sample of low- and middle-income families in Bogota, using the Bayley Scales of Infant and Toddler Development. The gaps in…

  16. 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.

  17. 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.

  18. Gender, marital status, and commercially prepared food expenditure.

    PubMed

    Kroshus, Emily

    2008-01-01

    Assess how per capita expenditure on commercially prepared food as a proportion of total food expenditure varies by the sex and marital status of the head of the household. Prospective cohort study, data collected by the United States Bureau of Labor Statistics 2004 Consumer Expenditure Survey. United States. Randomly selected nationally representative sample of 5744 US citizens. Per capita spending on commercially prepared food (dependent variable) for every $1 increase in total per capita food spending (independent variable). Linear regressions run separately for each permutation of gender and marital status (never married, married, divorced/separated). Proportionate per capita household expenditure on commercially prepared food was found to vary by marital status and gender. Households headed by unmarried men (both divorced/separated and never married) spent a significantly greater proportion of their food budget on commercially prepared food than their married male peers (38% and 60% higher, respectively). Regardless of marital status, households headed by women were found to spend approximately one-third of their total food budget on commercially prepared foods outside the home. Households headed by never married men spent 63% more per capita than those headed by never married women and households headed by divorced or separated men spent 37% more than those headed by divorced or separated women. Marital status is significantly related to the dietary patterns of households headed by men. In light of the high rates of divorce, separation, and delay of marriage, marriage cannot be considered an inclusive or permanent solution to changing male eating patterns. It is important that nutrition educators learn more about the dietary patterns of households headed by males outside the institution of marriage.

  19. Seasonality of the dietary dimension of household food security in urban Burkina Faso.

    PubMed

    Becquey, Elodie; Delpeuch, Francis; Konaté, Amadou M; Delsol, Hervé; Lange, Matthias; Zoungrana, Mahama; Martin-Prevel, Yves

    2012-06-01

    Food insecurity is affecting an increasing number of urban poor in the developing world. Yet seasonal characteristics of food intakes have rarely been studied in West African cities. The objective of the present study was to assess the seasonality of the dietary dimension of household food security in Ouagadougou (Burkina Faso). In 2007, two sets of data were collected during the lean and post-harvest seasons, respectively, on a representative sample of 1056 households. At each season, two non-consecutive 24 h recalls were performed at the household level. Food prices were also recorded. Household food security was assessed by the household's mean adequacy ratio (MAR) for energy and eleven micronutrients. Changes in the MAR according to the season were analysed by mixed multivariate linear regression. Results showed that intakes of energy and of ten micronutrients were significantly lower during the lean season than during the post-harvest season, leading to a lower MAR in the lean season (49·61 v. 53·57, P < 0·0001). This was related to less frequent consumption and consumption of smaller amounts of vegetables and of foods prepared at home. Food security relied heavily on food expenses (P < 0·0001) and on the price of meat/fish (P = 0·026). Households with economically dependent adults (P = 0·021) and larger households (P < 0·0001) were the most vulnerable, whereas education (P = 0·030), social network (P = 0·054) and urban origin other than Ouagadougou (P = 0·040) played a positive role in food security. To achieve food security in Ouagadougou, access to micronutrient-dense foods needs to be ensured in all seasons.

  20. Mortality in Iraq Associated with the 2003–2011 War and Occupation: Findings from a National Cluster Sample Survey by the University Collaborative Iraq Mortality Study

    PubMed Central

    Hagopian, Amy; Flaxman, Abraham D.; Takaro, Tim K.; Esa Al Shatari, Sahar A.; Rajaratnam, Julie; Becker, Stan; Levin-Rector, Alison; Galway, Lindsay; Hadi Al-Yasseri, Berq J.; Weiss, William M.; Murray, Christopher J.; Burnham, Gilbert

    2013-01-01

    Background Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011. Methods and Findings We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74–5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000–751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005–2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study. Conclusions Beyond expected rates, most mortality increases in Iraq can be attributed to direct violence, but about a third are attributable to indirect causes (such as from failures of health, sanitation, transportation, communication, and other systems). Approximately a half million deaths in Iraq could be attributable to the war. Please see later in the article for the Editors' Summary PMID:24143140

  1. Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.

    PubMed

    Hagopian, Amy; Flaxman, Abraham D; Takaro, Tim K; Esa Al Shatari, Sahar A; Rajaratnam, Julie; Becker, Stan; Levin-Rector, Alison; Galway, Lindsay; Hadi Al-Yasseri, Berq J; Weiss, William M; Murray, Christopher J; Burnham, Gilbert

    2013-10-01

    Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011. We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74-5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000-751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005-2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study. Beyond expected rates, most mortality increases in Iraq can be attributed to direct violence, but about a third are attributable to indirect causes (such as from failures of health, sanitation, transportation, communication, and other systems). Approximately a half million deaths in Iraq could be attributable to the war. Please see later in the article for the Editors' Summary.

  2. Adverse childhood experiences and later life adult obesity and smoking in the United States.

    PubMed

    Rehkopf, David H; Headen, Irene; Hubbard, Alan; Deardorff, Julianna; Kesavan, Yamini; Cohen, Alison K; Patil, Divya; Ritchie, Lorrene D; Abrams, Barbara

    2016-07-01

    Prior work demonstrates associations between physical abuse, household alcohol abuse, and household mental illness early in life with obesity and smoking. Studies, however, have not generally been in nationally representative samples and have not conducted analyses to account for bias in the exposure. We used data from the 1979 U.S. National Longitudinal Survey of Youth to test associations between measures of adverse childhood experiences with obesity and smoking and used an instrumental variables approach to address potential measurement error of the exposure. Models demonstrated associations between childhood physical abuse and obesity at age 40 years (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.00-1.52) and ever smoking (OR 1.83; 95% CI, 1.56-2.16), as well as associations between household alcohol abuse (OR 1.53; 95% CI, 1.31-1.79) and household mental illness (OR 1.29; 95% CI, 1.04-1.60) with ever smoking. We find no evidence of association modification by gender, socioeconomic position, or race and/or ethnicity. Instrumental variables analysis using a sibling's report of adverse childhood experiences demonstrated a relationship between household alcohol abuse and smoking, with a population attributable fraction of 17% (95% CI, 2.0%-37%) for ever smoking and 6.7% (95% CI, 1.6%-12%) for currently smoking. Findings suggest long-term impacts of childhood exposure to physical abuse, household alcohol abuse, and parental mental illness on obesity and smoking and that the association between household alcohol abuse and smoking is not solely due to measurement error. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data.

    PubMed

    Fiedler, John L; Lividini, Keith; Bermudez, Odilia I

    2015-02-01

    Vitamin A deficiency is a serious health problem in Bangladesh. The 2011-12 Bangladesh Micronutrient Survey found 76·8% of children of pre-school age were vitamin A deficient. In the absence of nationally representative, individual dietary assessment data, we use an alternative--household income and expenditure survey data--to estimate the potential impact of the introduction of vitamin A-fortified vegetable oil in Bangladesh. Items in the household income and expenditure survey were matched to food composition tables to estimate households' usual vitamin A intakes. Then, assuming (i) the intra-household distribution of food is in direct proportion to household members' share of the household's total adult male consumption equivalents, (ii) all vegetable oil that is made from other-than mustard seed and that is purchased is fortifiable and (iii) oil fortification standards are implemented, we modelled the additional vitamin A intake due to the new fortification initiative. Nationwide in Bangladesh. A weighted sample of 12,240 households comprised of 55,580 individuals. Ninety-nine per cent of the Bangladesh population consumes vegetable oil. The quantities consumed are sufficiently large and, varying little by socio-economic status, are able to provide an important, large-scale impact. At full implementation, vegetable oil fortification will reduce the number of persons with inadequate vitamin A intake from 115 million to 86 million and decrease the prevalence of inadequate vitamin A intake from 80% to 60%. Vegetable oil is an ideal fortification vehicle in Bangladesh. Its fortification with vitamin A is an important public health intervention.

  4. Regression Analysis to Identify Factors Associated with Household Salt Iodine Content at the Sub-National Level in Bangladesh, India, Ghana and Senegal

    PubMed Central

    Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Nahar, Baitun; Touré, Ndeye Khady; Amoaful, Esi Foriwa; Gorstein, Jonathan

    2018-01-01

    Regression analyses of data from stratified, cluster sample, household iodine surveys in Bangladesh, India, Ghana and Senegal were conducted to identify factors associated with household access to adequately iodised salt. For all countries, in single variable analyses, household salt iodine was significantly different (p < 0.05) between strata (geographic areas with representative data, defined by survey design), and significantly higher (p < 0.05) among households: with better living standard scores, where the respondent knew about iodised salt and/or looked for iodised salt at purchase, using salt bought in a sealed package, or using refined grain salt. Other country-level associations were also found. Multiple variable analyses showed a significant association between salt iodine and strata (p < 0.001) in India, Ghana and Senegal and that salt grain type was significantly associated with estimated iodine content in all countries (p < 0.001). Salt iodine relative to the reference (coarse salt) ranged from 1.3 (95% CI 1.2, 1.5) times higher for fine salt in Senegal to 3.6 (95% CI 2.6, 4.9) times higher for washed and 6.5 (95% CI 4.9, 8.8) times higher for refined salt in India. Sub-national data are required to monitor equity of access to adequately iodised salt. Improving household access to refined iodised salt in sealed packaging, would improve iodine intake from household salt in all four countries in this analysis, particularly in areas where there is significant small-scale salt production. PMID:29671774

  5. 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…

  6. Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey.

    PubMed

    Ghimire, Mamata; Ayer, Rakesh; Kondo, Masahide

    2018-02-14

    Nepal has committed to the global community to achieve universal health coverage by 2030. Nevertheless, Nepal still has a high proportion of out-of-pocket health payment and a limited risk-pooling mechanism. Out-of-pocket payment for the healthcare services could result in catastrophic health expenditure (CHE). Evidence is required to effectively channel the efforts to lower those expenses in order to achieve universal health coverage. However, little is known about CHE and its determinants in a broad national context in Nepal. Therefore, this study was conducted to explore the cumulative incidence, distribution, and determinants of CHE in Nepal. Data were obtained from the nationally representative survey, the Nepal Living Standards Survey-third undertaken in 2010/11. Information from 5988 households was used for the analyses. Households were classified as having CHE when their out-of-pocket health payment was greater than or equal to 40% of their capacity to pay. Remaining households were classified as not having CHE. Logistic regression analyses were used to identify determinants of CHE. Based on household-weighted sample, the cumulative incidence of CHE was 10.3% per month in Nepal. This incidence was concentrated in the far-western region and households in the poorer expenditure quartiles. Multivariable logistic regression revealed that households were more likely to face CHE if they; consisted of chronically ill member(s), have a higher burden of acute illness and injuries, have elderly (≥60 years) member(s), belonged to the poor expenditure quartile, and were located in the far-western region. In contrast, households were less likely to incur CHE when their household head was educated. Having children (≤5 years) in households did not significantly affect catastrophic health expenditure. This study identified a high cumulative incidence of CHE. CHE was disproportionately concentrated in the poor households and households located in the far-western region. Policy-makers should focus on prioritizing households vulnerable to CHE. Interventions to reduce economic burden of out-of-pocket healthcare payment are imperative to lower incidences of CHE among those households. Improving literacy rate might also be useful in order to lower CHE and facilitate universal health coverage.

  7. 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

  8. Chaos, Poverty, and Parenting: Predictors of Early Language Development

    PubMed Central

    Vernon-Feagans, Lynne; Garrett-Peters, Patricia; Willoughby, Mike; Mills-Koonce, Roger

    2011-01-01

    Studies have shown that distal family risk factors like poverty and maternal education are strongly related to children's early language development. Yet, few studies have examined these risk factors in combination with more proximal day-to-day experiences of children that might be critical to understanding variation in early language. Young children's exposure to a chronically chaotic household may be one critical experience that is related to poorer language, beyond the contribution of SES and other demographic variables. In addition, it is not clear whether parenting might mediate the relationship between chaos and language. The purpose of this study was to understand how multiple indicators of chaos over children's first three years of life, in a representative sample of children living in low wealth rural communities, were related to child expressive and receptive language at 36 months. Factor analysis of 10 chaos indicators over five time periods suggested two factors that were named household disorganization and instability. Results suggested that after accounting for thirteen covariates like maternal education and poverty, one of two chaos composites (household disorganization) accounted for significant variance in receptive and expressive language. Parenting partially mediated this relationship although household disorganization continued to account for unique variance in predicting early language. PMID:23049162

  9. Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers.

    PubMed

    Rothman, Emily F; Edwards, Erika M; Heeren, Timothy; Hingson, Ralph W

    2008-08-01

    Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be social).

  10. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

    PubMed

    Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

    2017-10-02

    With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect households from potentially catastrophic health expenditures.

  11. Sugar and total energy content of household food purchases in Brazil.

    PubMed

    Levy, Renata Bertazzi; Claro, Rafael Moreira; Monteiro, Carlos Augusto

    2009-11-01

    To study the role of energy derived from sugar (both table sugar and sugar added to processed foods) in the total energy content of food purchases in Brazil. Food purchase data were collected during a national household budget survey carried out between June 2002 and July 2003 on a probabilistic sample representative of all households in the country. The amount of food purchased in this 12-month period was transformed into energy and energy from sugar using food composition tables. Multiple linear regression models were used to study the association between amount of energy from sugar and total energy content of food purchases, controlling for sociodemographic variables and potential interactions between these variables and sugar purchases. There was a positive and significant association between energy from sugar and total household energy purchases. A 1 kJ increase in sugar purchase corresponded to a 3.637 kJ increase in total energy. In the absence of expenditure on meals outside the home, i.e. when household food purchases tend to approximate actual food consumption by household members, sugar purchase of 1926.35 kJ/d (the 90th percentile of the distribution of sugar purchases in Brazil) was associated, depending on income strata, with total energy purchase over 40-60 % of the recommended daily value for energy intake in Brazil. The present results corroborate the recommendations of the WHO and the Brazilian Ministry of Health regarding limiting the consumption of sugar.

  12. Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours.

    PubMed

    Martin-Biggers, Jennifer; Quick, Virginia; Zhang, Man; Jin, Yanhong; Byrd-Bredbenner, Carol

    2018-04-01

    This study examined how food-related behaviours differed in mothers and their preschool children by levels of family functioning (cohesion and conflict) and household disorganization (chaos). A nationally representative sample of mothers of preschoolers completed an online survey assessing food-related behaviours of themselves and their children. Maternal and child diet, eating behaviours, and health status; household availability of fruits/vegetables, salty/fatty snacks, and sugar-sweetened beverages; family mealtime atmosphere; and family conflict, cohesion, and household chaos were assessed with valid, reliable scales. Cluster analyses assigned families into low, middle, and high conflict, cohesion, and chaos groups. Participants (n = 550) were 72% White, and 82% had some post-secondary education. Regression analysis examining the association of cluster grouping levels on diet-related behaviour measures revealed that positive home environments (i.e., low family conflict, high family cohesion, and low household chaos) were associated with healthier food-related behaviours (e.g., increased fruits/vegetables intake), whereas negative home environments (i.e., high family conflict, low family cohesion, and high household chaos) were associated with unhealthy food-related behaviours (e.g., greater % total calories from fat) even after controlling for sociodemographic and related behavioural factors. Findings suggest family functioning and household chaos are associated with food-related behaviours. This frequently overlooked component of family interaction may affect intervention outcomes and objectives of educational and interventional initiatives. © 2017 John Wiley & Sons Ltd.

  13. Secondary analysis of a marketing research database reveals patterns in dairy product purchases over time.

    PubMed

    Van Wave, Timothy W; Decker, Michael

    2003-04-01

    Development of a method using marketing research data to assess food purchase behavior and consequent nutrient availability for purposes of nutrition surveillance, evaluation of intervention effects, and epidemiologic studies of diet-health relationships. Data collected on household food purchases accrued over a 13-week period were selected by using Universal Product Code numbers and household characteristics from a marketing research database. Universal Product Code numbers for 39,408 dairy product purchases were linked to a standard reference for food composition to estimate the nutrient content of foods purchased over time. Two thousand one hundred sixty-one households located in Victoria, Texas, and surrounding communities who were active members of a frequent shopper program. Demographic characteristics of sample households and the nutrient content of their dairy product purchases were analyzed using frequency distribution, cross tabulation, analysis of variance, and t test procedures. A method for using marketing research data was successfully used to estimate household purchases of specific foods and their nutrient content from a marketing database containing hundreds of thousands of records. Distribution of dairy product purchases and their concomitant nutrients between Hispanic and non-Hispanic households were significant (P<.01, P<.001, respectively) and sustained over time. Purchase records from large, nationally representative panels of shoppers, such as those maintained by major market research companies, might be used to accomplish detailed longitudinal epidemiologic studies or surveillance of national food- and nutrient-purchasing patterns within and between countries and segments of their respective populations.

  14. Accessibility of summer meals and the food insecurity of low-income households with children.

    PubMed

    Miller, Daniel P

    2016-08-01

    Almost no previous research has examined the impact of the US Department of Agriculture's (USDA) Summer Food Service Program and related Seamless Summer Option, which provide meals and snacks to low-income children over the summer. The present study investigated whether geographic accessibility of summer meals programme sites (a proxy for programme participation) was associated with food insecurity for low-income households. The study used data from the California Health Interview Survey (CHIS) and administrative data on summer meals sites in California. Geocoding was used to calculate driving time between CHIS households and nearby summer meals sites. Geographic accessibility was measured using a gravity model, which accounted for the spatially distributed supply of and demand for summer meals. Food insecurity and very low food security were measured using a standard six-item measure from the USDA. Low-income families with children (n 5394). A representative surveillance study of non-institutionalized households in California. Geographic accessibility was not associated with food insecurity. However, geographic accessibility was associated with a significantly lower probability of very low food security in the full sample and among households with younger children and those living in less urban areas. The USDA's summer meals programme may be effective at reducing the most severe form of food insecurity for low-income households with children. Expanding the number of summer meals sites, the number of meals served at sites and sites' hours of operation may be effective strategies to promote nutritional health over the summer months.

  15. Attitude of the stakeholders involved in the repair and second-hand sale of small household electrical and electronic equipment: Case study in Spain.

    PubMed

    Bovea, María D; Pérez-Belis, Victoria; Quemades-Beltrán, Pilar

    2017-07-01

    The European legal framework for Electrical and Electronic Equipment (EEE) and Waste Electrical and Electronic Equipment (WEEE) (Directive 2012/19/EU) prioritises reuse strategies against other valorisation options. Along these lines, this paper examines the awareness and perceptions of reusing small household EEE from the viewpoint of the different stakeholders involved in its end-of-life: repair centres, second-hand shops and consumers. Direct interviews were conducted in which an intended survey, designed specifically for each stakeholder, was answered by a representative sample of each one. The results obtained from repair centres show that small household EEE are rarely repaired, except for minor repairs such as replacing cables, and that heaters, toasters and vacuum cleaners were those most frequently repaired. The difficulty of accessing cheap spare parts or difficulties during the disassembly process are the commonest problems observed by repair technicians. The results obtained from second-hand shops show that irons, vacuum cleaners and heaters are the small household EEE that are mainly received and sold. The results according to consumers indicate that 9.6% of them take their small household EEE to be repaired, while less than 1% has ever bought a second-hand small household EEE. The main arguments for this attitude are they thought that the repair cost would be similar to the price of a new one (for repairs), and hygiene and cleaning reasons (for second-hand sales). Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Validation of spatiodemographic estimates produced through data fusion of small area census records and household microdata

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

    Rose, Amy N.; Nagle, Nicholas N.

    Techniques such as Iterative Proportional Fitting have been previously suggested as a means to generate new data with the demographic granularity of individual surveys and the spatial granularity of small area tabulations of censuses and surveys. This article explores internal and external validation approaches for synthetic, small area, household- and individual-level microdata using a case study for Bangladesh. Using data from the Bangladesh Census 2011 and the Demographic and Health Survey, we produce estimates of infant mortality rate and other household attributes for small areas using a variation of an iterative proportional fitting method called P-MEDM. We conduct an internalmore » validation to determine: whether the model accurately recreates the spatial variation of the input data, how each of the variables performed overall, and how the estimates compare to the published population totals. We conduct an external validation by comparing the estimates with indicators from the 2009 Multiple Indicator Cluster Survey (MICS) for Bangladesh to benchmark how well the estimates compared to a known dataset which was not used in the original model. The results indicate that the estimation process is viable for regions that are better represented in the microdata sample, but also revealed the possibility of strong overfitting in sparsely sampled sub-populations.« less

  17. Microbiological effectiveness and cost of boiling to disinfect drinking water in rural Vietnam.

    PubMed

    Clasen, Thomas F; Thao, Do Hoang; Boisson, Sophie; Shipin, Oleg

    2008-06-15

    Despite certain shortcomings, boiling is still the most common means of treating water in the home and the benchmark against which alternative household-based disinfection and filtration methods must be measured. We assessed the microbiological effectiveness and cost of boiling among a vulnerable population relying on unimproved water sources and commonly practicing boiling as a means of disinfecting water. In a 12 week study among 50 households from a rural community in Vietnam, boiling was associated with a 97% reduction in geometric mean thermotolerant coliforms (TTCs) (p < 0.001). Despite high levels of faecal contamination in source water, 37% of stored water samples from self-reported boilers met the WHO standard for safe drinking water (0 TTC/100 mL), and 38.3% fell within the low risk category (1--10 TTC/100 mL). Nevertheless, 60.5% of stored drinking water samples were positive for TTC, with 22.2% falling into the medium risk category (11--100 TTC/100 mL). The estimated cost of wood used to boil water was US$ 0.272 per month for wood collectors and US$ 1.68 per month for wood purchasers, representing approximately 0.48% to 1.04%, respectively, of the average monthly income of participating households.

  18. Validation of spatiodemographic estimates produced through data fusion of small area census records and household microdata

    DOE PAGES

    Rose, Amy N.; Nagle, Nicholas N.

    2016-08-01

    Techniques such as Iterative Proportional Fitting have been previously suggested as a means to generate new data with the demographic granularity of individual surveys and the spatial granularity of small area tabulations of censuses and surveys. This article explores internal and external validation approaches for synthetic, small area, household- and individual-level microdata using a case study for Bangladesh. Using data from the Bangladesh Census 2011 and the Demographic and Health Survey, we produce estimates of infant mortality rate and other household attributes for small areas using a variation of an iterative proportional fitting method called P-MEDM. We conduct an internalmore » validation to determine: whether the model accurately recreates the spatial variation of the input data, how each of the variables performed overall, and how the estimates compare to the published population totals. We conduct an external validation by comparing the estimates with indicators from the 2009 Multiple Indicator Cluster Survey (MICS) for Bangladesh to benchmark how well the estimates compared to a known dataset which was not used in the original model. The results indicate that the estimation process is viable for regions that are better represented in the microdata sample, but also revealed the possibility of strong overfitting in sparsely sampled sub-populations.« less

  19. Quantifying tap-to-household water quality deterioration in urban communities in Vellore, India: The impact of spatial assumptions.

    PubMed

    Alarcon Falconi, Tania M; Kulinkina, Alexandra V; Mohan, Venkata Raghava; Francis, Mark R; Kattula, Deepthi; Sarkar, Rajiv; Ward, Honorine; Kang, Gagandeep; Balraj, Vinohar; Naumova, Elena N

    2017-01-01

    Municipal water sources in India have been found to be highly contaminated, with further water quality deterioration occurring during household storage. Quantifying water quality deterioration requires knowledge about the exact source tap and length of water storage at the household, which is not usually known. This study presents a methodology to link source and household stored water, and explores the effects of spatial assumptions on the association between tap-to-household water quality deterioration and enteric infections in two semi-urban slums of Vellore, India. To determine a possible water source for each household sample, we paired household and tap samples collected on the same day using three spatial approaches implemented in GIS: minimum Euclidean distance; minimum network distance; and inverse network-distance weighted average. Logistic and Poisson regression models were used to determine associations between water quality deterioration and household-level characteristics, and between diarrheal cases and water quality deterioration. On average, 60% of households had higher fecal coliform concentrations in household samples than at source taps. Only the weighted average approach detected a higher risk of water quality deterioration for households that do not purify water and that have animals in the home (RR=1.50 [1.03, 2.18], p=0.033); and showed that households with water quality deterioration were more likely to report diarrheal cases (OR=3.08 [1.21, 8.18], p=0.02). Studies to assess contamination between source and household are rare due to methodological challenges and high costs associated with collecting paired samples. Our study demonstrated it is possible to derive useful spatial links between samples post hoc; and that the pairing approach affects the conclusions related to associations between enteric infections and water quality deterioration. Copyright © 2016 Elsevier GmbH. All rights reserved.

  20. How much of the cocaine market are we missing? Insights from respondent-driven sampling in a mid-sized American city.

    PubMed

    Caulkins, Jonathan P; Sussell, Jesse; Kilmer, Beau; Kasunic, Anna

    2015-02-01

    Studying markets for illegal drugs is important, but difficult. Data usually come from a selected subset of consumers, such as arrestees, treatment clients, or household survey respondents. There are rarely opportunities to study how such groups may differ from other market participants or how much of total consumption they represent. This paper uses respondent-driven sampling (RDS) of drug users in a mid-sized American city to estimate the shares of cocaine (powder and crack) users and expenditures that are attributable to different combinations of these groups. We find that those arrested in the last year accounted for 34% of past-month cocaine users and 40% of past-week cocaine spending in the RDS sample. Augmenting past-year arrestees with those who received treatment in the past year increases these values to 44% (users) and 55% (spending). Our results suggest that estimates based only on people who were arrested and/or treated in the past year would have to be inflated by 100-200% to capture the market totals. Adding those who own or rent their place of residence increased coverage in this study to 76% (users) and 81% (spending), suggesting that in theory the inflation factor could be reduced to 23-32% by supplementing data on arrestees and treatment populations with household data, although in practice rates of under-reporting by survey respondents may make coverage (sampling frame) a secondary concern for household surveys. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People’s Health and Nutrition

    PubMed Central

    2013-01-01

    Background Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil. Methods The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations. Results Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North. Conclusions The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention. PMID:23714275

  2. 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.

  3. Reducing diarrhea through the use of household-based ceramic water filters: a randomized, controlled trial in rural Bolivia.

    PubMed

    Clasen, Thomas F; Brown, Joseph; Collin, Simon; Suntura, Oscar; Cairncross, Sandy

    2004-06-01

    Ceramic water filters have been identified as one of the most promising and accessible technologies for treating water at the household level. In a six-month trial, water filters were distributed randomly to half of the 50 participating households in a rural community in Bolivia; the remaining households continued to use customary water handling practices and served as controls. In four rounds of sampling following distribution of the filters, 100% of the 96 water samples from the filter households were free of thermotolerant coliforms compared with 15.5% of the control household samples. Diarrheal disease risk for individuals in intervention households was 70% lower than for controls (95% confidence interval [CI] = 53-80%; P < 0.001). For children less than five years old, the reduction in risk was 83% (95% CI = 51-94%; P < 0.001). These results show that affordable ceramic water filters enable low-income households to treat and maintain the microbiologic quality of their drinking water.

  4. Attitudes towards smoking restrictions and tobacco advertisement bans in Georgia.

    PubMed

    Bakhturidze, George D; Mittelmark, Maurice B; Aarø, Leif E; Peikrishvili, Nana T

    2013-11-25

    This study aims to provide data on a public level of support for restricting smoking in public places and banning tobacco advertisements. A nationally representative multistage sampling design, with sampling strata defined by region (sampling quotas proportional to size) and substrata defined by urban/rural and mountainous/lowland settlement, within which census enumeration districts were randomly sampled, within which households were randomly sampled, within which a randomly selected respondent was interviewed. The country of Georgia, population 4.7 million, located in the Caucasus region of Eurasia. One household member aged between 13 and 70 was selected as interviewee. In households with more than one age-eligible person, selection was carried out at random. Of 1588 persons selected, 14 refused to participate and interviews were conducted with 915 women and 659 men. Respondents were interviewed about their level of agreement with eight possible smoking restrictions/bans, used to calculate a single dichotomous (agree/do not agree) opinion indicator. The level of agreement with restrictions was analysed in bivariate and multivariate analyses by age, gender, education, income and tobacco use status. Overall, 84.9% of respondents indicated support for smoking restrictions and tobacco advertisement bans. In all demographic segments, including tobacco users, the majority of respondents indicated agreement with restrictions, ranging from a low of 51% in the 13-25 age group to a high of 98% in the 56-70 age group. Logistic regression with all demographic variables entered showed that agreement with restrictions was higher with age, and was significantly higher among never smokers as compared to daily smokers. Georgian public opinion is normatively supportive of more stringent tobacco-control measures in the form of smoking restrictions and tobacco advertisement bans.

  5. Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation.

    PubMed

    Mabli, James; Ohls, Jim

    2015-02-01

    The Supplemental Nutrition Assistance Program (SNAP) provides nutrition assistance benefits to low-income families in an effort to reduce hunger and improve health and well-being. Because 1 in 7 Americans participate in the program each month, policymakers need to know whether the program is meeting these objectives effectively. The objective of this study was to estimate the association between SNAP participation and household food security using recent data from the largest national survey of the food security of SNAP participants to date. The analysis used a survey of nearly 6500 households and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 mo. Next, using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 mo later. Multivariate logistic regression analysis was used to estimate associations between SNAP and household food security. SNAP participation decreased the percentage of SNAP households that were food insecure in both samples by 6-17%. SNAP participation also decreased the percentage of households experiencing severe food insecurity--designated very low food security--by 12-19%. Findings were qualitatively robust to different empirical specifications. SNAP serves a vital role in improving the health and well-being of households by increasing food security. Given recent legislation to reduce program size and limit program eligibility, this study underscores SNAP's continued importance in affecting households' well-being. Future research is needed to determine whether specific groups of households experience differential improvements in food security. © 2015 American Society for Nutrition.

  6. Catastrophic healthcare payments and impoverishment in the occupied Palestinian territory.

    PubMed

    Mataria, Awad; Raad, Firas; Abu-Zaineh, Mohammad; Donaldson, Cam

    2010-01-01

    Financial protection from the risks of ill health has globally recognized importance as a principal performance goal of any health system. This type of financial protection involves minimizing catastrophic payments for healthcare and their associated impoverishing effects. Realization of this performance goal is heavily influenced by factors related to the overall policy environment and sociopolitical context in each country. To examine the incidence and intensity of catastrophic and impoverishing healthcare payments borne by Palestinian households between 1998 and 2007. The incidence and intensity of these effects are examined within the historically unique policy and socioeconomic context of the occupied Palestinian territory. A healthcare payment was considered catastrophic if it exceeded 10% of household resources, or 40% of resources net of food expenditures. The impoverishing effect of healthcare was examined by comparing poverty incidence and intensity before and after healthcare payments. The data source was a series of annual expenditure and consumption surveys covering 1998 and 2004-7, and including representative samples of Palestinian households (n = 1231-3098, per year). Total household expenditure was used as a proxy for household level of resources; and the sum of household expenses on a comprehensive list of medical goods and services was used to estimate healthcare payments. While only around 1% of the surveyed households spent ≥40% of their total household expenditures (net of food expenses) on healthcare in 1998, the percentage was almost doubled in 2007. In terms of impoverishing effect, while 11.8% of surveyed households fell into deep poverty in 1998 due to healthcare payments, 12.5% of households entered deep poverty for the same reason in 2006. Over the same period, the monthly amount by which poor households failed to reach the deep poverty line due to healthcare payments increased from $US9.4 to $US12.9. The inability of the Palestinian healthcare system to protect against the financial risks of ill health could be attributed to the prevailing sociopolitical conditions of the occupied Palestinian territory, and to some intrinsic system characteristics. It is recommended that pro-poor financing schemes be pursued to mitigate the negative impact of the recurrent health shocks affecting Palestinian households.

  7. Predictors of Behavioral Regulation in Kindergarten: Household Chaos, Parenting and Early Executive Functions

    PubMed Central

    Vernon-Feagans, Lynne; Willoughby, Michael; Garrett-Peters, Patricia

    2015-01-01

    Behavioral regulation is an important school readiness skill that has been linked to early executive function (EF) and later success in learning and school achievement. Although poverty and related risks as well as negative parenting have been associated with poorer EF and behavioral regulation, chaotic home environments may also play a role in understanding both early EF and later behavioral regulation at school age. To explore these relationships, a unique longitudinal and representative sample was used of 1292 children born to mothers who lived in low wealth rural America who were followed from birth into early elementary school. This study examined whether household chaos, which was measured across the first three years of life, predicted behavioral regulation in kindergarten above and beyond poverty related variables. In addition, this study tested whether parent responsivity and acceptance behaviors, measured during the first three years of life, as well as EF skills, which were measured when children were three to five years of age, mediated the relationship between early household chaos and kindergarten behavioral regulation. Results suggested that household chaos disorganization indirectly predicted kindergarten behavioral regulation through intermediate impacts on parenting behaviors and children's early EF skills. These findings suggest the importance of early household chaos disorganization, the parenting environment and early EF skills in understanding behavioral regulation, above and beyond poverty related risks. PMID:26751500

  8. Thermoluminescence characteristics of Israeli household salts for retrospective dosimetry in radiological events

    NASA Astrophysics Data System (ADS)

    Druzhyna, S.; Datz, H.; Horowitz, Y. S.; Oster, L.; Orion, I.

    2016-06-01

    Following a nuclear accident or terror attack involving the dispersal of radioactive substances, radiation dose assessment to first responders and the members of the public is essential. The need for a retrospective assessment of the radiation dose to those possibly affected is, therefore, obligatory. The present study examines the potential use of Israeli household salt as a retrospective dosimeter (RD). The experiments were carried out on Israeli salt samples (NaCl) following a Nielsen market track survey based on scanning data representing the barcoded market, including organized and independent retail chains and a sample of private minimarkets and supermarkets. The technique used was thermoluminescence (TL) dosimetry. Salt samples were exposed to levels of dose from 0.5 mGy to 300 Gy at the Israeli Secondary Standard Dosimetry Laboratory of the Soreq Nuclear Research Center using a calibrated 137Cs source. Our emphasis has been on a detailed investigation of the basic dosimetric characteristics of the salts including: (i) glow curve analysis (ii) individual glow peak dose response (iii) reproducibility (iv) estimation of minimal measurable dose (v) effect of nitrogen readout, (vi) influence of humidity during pre-irradiation storage and (vii) light induced fading. The results are sufficiently favorable to lead to the conclusion that the Israeli household salts can serve as a pragmatic potential candidate for RD under certain restricted conditions. Occasional pre-calibration of the major salt brands in a dedicated laboratory may be essential depending on the required accuracy in the estimation of dose and consequent clinical evaluation.

  9. Adverse childhood experiences among children placed in and adopted from foster care: Evidence from a nationally representative survey.

    PubMed

    Turney, Kristin; Wildeman, Christopher

    2017-02-01

    Despite good reason to believe that children in foster care are disproportionately exposed to adverse childhood experiences (ACEs), relatively little research considers exposure to ACEs among this group of vulnerable children. In this article, we use data from the 2011-2012 National Survey of Children's Health (NSCH), a nationally representative sample of non-institutionalized children ages 0-17 in the United States, to estimate the association between foster care placement and exposure to an array of ACEs. In adjusted logistic regression models, we find that children placed in foster care or adopted from foster care, compared to their counterparts, were more likely to experience parental divorce or separation, parental death, parental incarceration, parental abuse, violence exposure, household member mental illness, and household member substance abuse. These children were also more likely to experience ACEs than children across different thresholds of socioeconomic disadvantage (e.g., children in households with incomes below the poverty line) and across different family structures (e.g., children in single-mother families). These results advance our understanding of how children in foster care, an already vulnerable population, are disproportionately exposed to ACEs. This exposure, given the link between ACEs and health, may have implications for children's health and wellbeing throughout the life course. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Risk of viral acute gastrointestinal illness from nondisinfected drinking water distribution systems.

    PubMed

    Lambertini, Elisabetta; Borchardt, Mark A; Kieke, Burney A; Spencer, Susan K; Loge, Frank J

    2012-09-04

    Acute gastrointestinal illness (AGI) resulting from pathogens directly entering the piping of drinking water distribution systems is insufficiently understood. Here, we estimate AGI incidence from virus intrusions into the distribution systems of 14 nondisinfecting, groundwater-source, community water systems. Water samples for virus quantification were collected monthly at wells and households during four 12-week periods in 2006-2007. Ultraviolet (UV) disinfection was installed on the communities' wellheads during one study year; UV was absent the other year. UV was intended to eliminate virus contributions from the wells and without residual disinfectant present in these systems, any increase in virus concentration downstream at household taps represented virus contributions from the distribution system (Approach 1). During no-UV periods, distribution system viruses were estimated by the difference between well water and household tap virus concentrations (Approach 2). For both approaches, a Monte Carlo risk assessment framework was used to estimate AGI risk from distribution systems using study-specific exposure-response relationships. Depending on the exposure-response relationship selected, AGI risk from the distribution systems was 0.0180-0.0661 and 0.001-0.1047 episodes/person-year estimated by Approaches 1 and 2, respectively. These values represented 0.1-4.9% of AGI risk from all exposure routes, and 1.6-67.8% of risk related to drinking water exposure. Virus intrusions into nondisinfected drinking water distribution systems can contribute to sporadic AGI.

  11. 'Economy' line foods from four supermarkets and brand name equivalents: a comparison of their nutrient contents and costs.

    PubMed

    Cooper, S; Nelson, M

    2003-10-01

    Achieving healthy eating targets for low income households can be difficult because of economic barriers. Several UK supermarkets have introduced 'value line' or 'economy line' foods to improve their attractiveness to low income consumers. The costs and nutrient contents of five 'economy' line products of four major English supermarkets - Asda, KwikSave, Sainsbury and Tesco - were compared with branded (but not 'own label') equivalents. Single samples of tinned tomatoes, long-life orange juice, potatoes, sausages and white bread were purchased in each supermarket. They represented items of potential importance in relation to 'healthy' choices in the shopping baskets of low income households. Nutrients analysed were fat, sodium, potassium, iron, calcium, vitamin C, and energy. Economy line foods had a nutrient composition similar to and often better than the branded goods. The economy line products frequently had nutrient contents more in line with the Balance of Good Health (e.g. lower fat and sodium) compared with the branded goods. In terms of nutrients per pence, the economy line products were far better value for money compared with the branded lines. Economy line foods represent excellent value for money and are not nutritionally inferior to the branded products. They have a potentially important role to play in the promotion of healthy eating, especially amongst low income households.

  12. Compact development and VMT: environmental determinism, self-selection, or some of both?

    USGS Publications Warehouse

    Ewing, Reid; Hamidi, Shima; Grace, James B.

    2016-01-01

    There is a long-running debate in the planning literature about the effects of the built environment on travel behavior and the degree to which apparent effects are due to the tendency of households to self-select into neighborhoods that reinforce their travel preferences. Those who want to walk will choose walkable neighborhoods, and those who want to use transit will choose transit-served neighborhoods. These households might have walked or used transit more than their neighbors wherever they lived. Most previous studies have shown that individual attitudes attenuate the relationship between the residential environment and travel choices, and so the effect of the built environment on travel may be overestimated. But there are other researchers who argue the reverse, claiming that residential preferences reinforce built environmental influences. This study assesses the relative importance of the built environment and residential preferences/travel attitudes for a sample of 962 households in the Greater Salt Lake region using structural equation modeling. For the sake of simplicity, we extracted two factors using principal component analysis, one representing the built environment and the other representing residential preferences/attitudes. Our findings are consistent with the view that the neighborhood built environment and residential preferences both influence household’s travel, that the built environment is the stronger influence, and that the built environment affects travel through two causal pathways, one direct and the other indirect, through attitudes.

  13. Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

    PubMed

    Tester, June M; Laraia, Barbara A; Leung, Cindy W; Mietus-Snyder, Michele L

    2016-02-11

    Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

  14. Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003–2010

    PubMed Central

    Laraia, Barbara A.; Leung, Cindy W.; Mietus-Snyder, Michele L.

    2016-01-01

    Introduction Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. Methods We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003–2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Results Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14–3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11–2.82), and Apo B (OR = 1.98; 95% CI, 1.17–3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14–6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. Conclusion In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone. PMID:26866948

  15. The impact of child care problems on employment: findings from a national survey of US parents.

    PubMed

    Montes, Guillermo; Halterman, Jill S

    2011-01-01

    Many parents struggle to secure high-quality, consistent child care services, and this may impact employment decisions. Our objectives were to determine the type of employment problems that parents attribute to difficulties in securing child care and to identify whether having a child with behavior problems and/or chronic illness is independently associated with child care-related employment problems in the United States. This study included parents of children aged 0 to 13 years by using household-level sampling from the nationally representative random digit dial survey Gallup panel. We included 9 measures of child care-related employment problems. Poststratification weights were applied based on census region, income, and education by using Stata's poststratification commands. A survey was conducted of 1431 households with at least 1 parent employed. Overall, 46% of households reported 1 or more child care-related employment change. Being absent from work (21%) and changing the work schedule (27%) were the most prevalent changes reported. Two-parent households were significantly less likely to report child care-related employment changes compared with single parent households. Households with a stay-at-home parent were less likely to report child care-related absenteeism but more likely to report recently quitting work compared with households without a stay-at-home parent. Having a child with behavior problems or a serious chronic health condition was associated with double to triple odds of many child care-related employment problems. Child care-related employment problems are common among families with a child with chronic illness or behavior problems. These findings support the need for pediatricians and policy makers to strive for the implementation of more parent-friendly labor conditions. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Household Possessions Indices as Wealth Measures: A Validity Evaluation

    ERIC Educational Resources Information Center

    Traynor, Anne; Raykov, Tenko

    2013-01-01

    In international achievement studies, questionnaires typically ask about the presence of particular household assets in students' homes. Responses to the assets questions are used to compute a total score, which is intended to represent household wealth in models of test performance. This study uses item analysis and confirmatory factor analysis…

  17. The Effect of Personality Traits on Households' Financial Literacy

    ERIC Educational Resources Information Center

    Pinjisakikool, Teerapong

    2017-01-01

    This article aims at finding the relationship between households' personality traits and their financial literacy level. The data in this research are from the household survey which can represent the population in Dutch. Using the Big Five personality traits and economic locus of control--extraversion, agreeableness, conscientiousness, emotional…

  18. The Mood of American Youth 1996.

    ERIC Educational Resources Information Center

    National Association of Secondary School Principals, Reston, VA.

    This report compares results from 1996 national study of the current attitudes of American teenagers with similar 1974 and 1983 surveys. Almost 1,000 students between 13 and 17 years from households representative of the national population in geographic distribution, population density, household size, age of household head, and family income…

  19. Predictors of knowledge about tuberculosis: results from SANHANES I, a national, cross-sectional household survey in South Africa.

    PubMed

    Naidoo, Pamela; Simbayi, Leickness; Labadarios, Demetre; Ntsepe, Yoliswa; Bikitsha, Nwabisa; Khan, Gadija; Sewpaul, Ronel; Moyo, Sizulu; Rehle, Thomas

    2016-03-18

    South Africa is one of the 22 high tuberculosis burden countries that contribute 80% of the global tuberculosis cases. Tuberculosis is infectious and due to its rapid and easy transmission route poses a threat to population health. Considering the importance of social and psychological factors in influencing health outcomes, appraising knowledge and awareness of tuberculosis, remain vital for effective tuberculosis control. The main aim of this study was to investigate the factors that predict knowledge about tuberculosis among 18-64 year old adults in South Africa. A cross-sectional survey method was used. Multi-stage disproportionate, stratified cluster sampling was used to select households within enumeration areas stratified by province and locality type. Based on the Human Sciences Research Council 2007 master sample, 500 Enumerator Areas representative of the socio-demographic profile of South Africa were identified and a random sample of 20 households was randomly selected from each Enumerator Area, yielding an overall sample of 10,000 households. The tuberculosis module contained in the South African National Health And Nutrition Examination Survey I was the only module that examined the social determinants of an infectious disease. This module was questionnaire-based with no biomarkers obtained to screen for the presence of tuberculosis disease among the participants. Data was collected by administering a researcher developed individual level questionnaire. Simple and multiple linear regression was used to determine the independent variables associated with tuberculosis knowledge. Half the sample (52.6%) was female and the majority of the respondents were black African (76.5%). More than two thirds (68.0%) resided in urban areas, 56.9% did not complete high school and half were not in formal employment. Significant predictors of tuberculosis knowledge were race, sex, completion of high school, being in employment, having a diagnosis of the disease in ones' life-time and learning about tuberculosis from television, brochures, health workers, and teachers. To reduce the burden of tuberculosis in South Africa, media campaigns targeting both rural and urban communities should include conveying accurate information about the disease. Policy makers should also address structural barriers that vulnerable communities face.

  20. Household Food Waste: Multivariate Regression and Principal Components Analyses of Awareness and Attitudes among U.S. Consumers

    PubMed Central

    2016-01-01

    We estimate models of consumer food waste awareness and attitudes using responses from a national survey of U.S. residents. Our models are interpreted through the lens of several theories that describe how pro-social behaviors relate to awareness, attitudes and opinions. Our analysis of patterns among respondents’ food waste attitudes yields a model with three principal components: one that represents perceived practical benefits households may lose if food waste were reduced, one that represents the guilt associated with food waste, and one that represents whether households feel they could be doing more to reduce food waste. We find our respondents express significant agreement that some perceived practical benefits are ascribed to throwing away uneaten food, e.g., nearly 70% of respondents agree that throwing away food after the package date has passed reduces the odds of foodborne illness, while nearly 60% agree that some food waste is necessary to ensure meals taste fresh. We identify that these attitudinal responses significantly load onto a single principal component that may represent a key attitudinal construct useful for policy guidance. Further, multivariate regression analysis reveals a significant positive association between the strength of this component and household income, suggesting that higher income households most strongly agree with statements that link throwing away uneaten food to perceived private benefits. PMID:27441687

  1. General Household Emergency Preparedness: A Comparison Between Veterans and Nonveterans

    PubMed Central

    Der-Martirosian, Claudia; Strine, Tara; Atia, Mangwi; Chu, Karen; Mitchell, Michael N.; Dobalian, Aram

    2015-01-01

    Background Despite federal and local efforts to educate the public to prepare for major emergencies, many US households remain unprepared for such occurrences. United States Armed Forces veterans are at particular risk during public health emergencies as they are more likely than the general population to have multiple health conditions. Methods This study compares general levels of household emergency preparedness between veterans and nonveterans by focusing on seven surrogate measures of household emergency preparedness (a 3-day supply of food, water, and prescription medications, a battery-operated radio and flashlight, a written evacuation plan, and an expressed willingness to leave the community during a mandatory evacuation). This study used data from the 2006 through 2010 Behavioral Risk Factor Surveillance System (BRFSS), a state representative, random sample of adults aged 18 and older living in 14 states. Results The majority of veteran and nonveteran households had a 3-day supply of food (88% vs 82%, respectively) and prescription medications (95% vs 89%, respectively), access to a working, battery-operated radio (82% vs 77%, respectively) and flashlight (97% vs 95%, respectively), and were willing to leave the community during a mandatory evacuation (91% vs 96%, respectively). These populations were far less likely to have a 3-day supply of water (61% vs 52%, respectively) and a written evacuation plan (24% vs 21%, respectively). After adjusting for various sociodemographic covariates, general health status, and disability status, households with veterans were significantly more likely than households without veterans to have 3-day supplies of food, water, and prescription medications, and a written evacuation plan; less likely to indicate that they would leave their community during a mandatory evacuation; and equally likely to have a working, battery-operated radio and fiashlight. Conclusion These findings suggest that veteran households appear to be better prepared for emergencies than do nonveteran households, although the lower expressed likelihood of veterans households to evacuate when ordered to do so may place them at a somewhat greater risk of harm during such events. Further research should examine household preparedness among other vulnerable groups including subgroups of veteran populations and the reasons why their preparedness may differ from the general population. PMID:24642181

  2. General household emergency preparedness: a comparison between veterans and nonveterans.

    PubMed

    Der-Martirosian, Claudia; Strine, Tara; Atia, Mangwi; Chu, Karen; Mitchell, Michael N; Dobalian, Aram

    2014-04-01

    Despite federal and local efforts to educate the public to prepare for major emergencies, many US households remain unprepared for such occurrences. United States Armed Forces veterans are at particular risk during public health emergencies as they are more likely than the general population to have multiple health conditions. This study compares general levels of household emergency preparedness between veterans and nonveterans by focusing on seven surrogate measures of household emergency preparedness (a 3-day supply of food, water, and prescription medications, a battery-operated radio and flashlight, a written evacuation plan, and an expressed willingness to leave the community during a mandatory evacuation). This study used data from the 2006 through 2010 Behavioral Risk Factor Surveillance System (BRFSS), a state representative, random sample of adults aged 18 and older living in 14 states. The majority of veteran and nonveteran households had a 3-day supply of food (88% vs 82%, respectively) and prescription medications (95% vs 89%, respectively), access to a working, battery-operated radio (82% vs 77%, respectively) and flashlight (97% vs 95%, respectively), and were willing to leave the community during a mandatory evacuation (91% vs 96%, respectively). These populations were far less likely to have a 3-day supply of water (61% vs 52%, respectively) and a written evacuation plan (24% vs 21%, respectively). After adjusting for various sociodemographic covariates, general health status, and disability status, households with veterans were significantly more likely than households without veterans to have 3-day supplies of food, water, and prescription medications, and a written evacuation plan; less likely to indicate that they would leave their community during a mandatory evacuation; and equally likely to have a working, battery-operated radio and flashlight. These findings suggest that veteran households appear to be better prepared for emergencies than do nonveteran households, although the lower expressed likelihood of veterans households to evacuate when ordered to do so may place them at a somewhat greater risk of harm during such events. Further research should examine household preparedness among other vulnerable groups including subgroups of veteran populations and the reasons why their preparedness may differ from the general population.

  3. [Classical and molecular methods for identification and quantification of domestic moulds].

    PubMed

    Fréalle, E; Bex, V; Reboux, G; Roussel, S; Bretagne, S

    2017-12-01

    To study the impact of the constant and inevitable inhalation of moulds, it is necessary to sample, identify and count the spores. Environmental sampling methods can be separated into three categories: surface sampling is easy to perform but non quantitative, air sampling is easy to calibrate but provides time limited information, and dust sampling which is more representative of long term exposure to moulds. The sampling strategy depends on the objectives (evaluation of the risk of exposure for individuals; quantification of the household contamination; evaluation of the efficacy of remediation). The mould colonies obtained in culture are identified using microscopy, Maldi-TOF, and/or DNA sequencing. Electrostatic dust collectors are an alternative to older methods for identifying and quantifying household mould spores. They are easy to use and relatively cheap. Colony counting should be progressively replaced by quantitative real-time PCR, which is already validated, while waiting for more standardised high throughput sequencing methods for assessment of mould contamination without technical bias. Despite some technical recommendations for obtaining reliable and comparable results, the huge diversity of environmental moulds, the variable quantity of spores inhaled and the association with other allergens (mites, plants) make the evaluation of their impact on human health difficult. Hence there is a need for reliable and generally applicable quantitative methods. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  4. Fecal indicators and zoonotic pathogens in household drinking water taps fed from rainwater tanks in Southeast Queensland, Australia.

    PubMed

    Ahmed, W; Hodgers, L; Sidhu, J P S; Toze, S

    2012-01-01

    In this study, the microbiological quality of household tap water samples fed from rainwater tanks was assessed by monitoring the numbers of Escherichia coli bacteria and enterococci from 24 households in Southeast Queensland (SEQ), Australia. Quantitative PCR (qPCR) was also used for the quantitative detection of zoonotic pathogens in water samples from rainwater tanks and connected household taps. The numbers of zoonotic pathogens were also estimated in fecal samples from possums and various species of birds by using qPCR, as possums and birds are considered to be the potential sources of fecal contamination in roof-harvested rainwater (RHRW). Among the 24 households, 63% of rainwater tank and 58% of connected household tap water (CHTW) samples contained E. coli and exceeded Australian drinking water guidelines of <1 CFU E. coli per 100 ml water. Similarly, 92% of rainwater tanks and 83% of CHTW samples also contained enterococci. In all, 21%, 4%, and 13% of rainwater tank samples contained Campylobacter spp., Salmonella spp., and Giardia lamblia, respectively. Similarly, 21% of rainwater tank and 13% of CHTW samples contained Campylobacter spp. and G. lamblia, respectively. The number of E. coli (P = 0.78), Enterococcus (P = 0.64), Campylobacter (P = 0.44), and G. lamblia (P = 0.50) cells in rainwater tanks did not differ significantly from the numbers observed in the CHTW samples. Among the 40 possum fecal samples tested, Campylobacter spp., Cryptosporidium parvum, and G. lamblia were detected in 60%, 13%, and 30% of samples, respectively. Among the 38 bird fecal samples tested, Campylobacter spp., Salmonella spp., C. parvum, and G. lamblia were detected in 24%, 11%, 5%, and 13% of the samples, respectively. Household tap water samples fed from rainwater tanks tested in the study appeared to be highly variable. Regular cleaning of roofs and gutters, along with pruning of overhanging tree branches, might also prove effective in reducing animal fecal contamination of rainwater tanks.

  5. Fecal Indicators and Zoonotic Pathogens in Household Drinking Water Taps Fed from Rainwater Tanks in Southeast Queensland, Australia

    PubMed Central

    Hodgers, L.; Sidhu, J. P. S.; Toze, S.

    2012-01-01

    In this study, the microbiological quality of household tap water samples fed from rainwater tanks was assessed by monitoring the numbers of Escherichia coli bacteria and enterococci from 24 households in Southeast Queensland (SEQ), Australia. Quantitative PCR (qPCR) was also used for the quantitative detection of zoonotic pathogens in water samples from rainwater tanks and connected household taps. The numbers of zoonotic pathogens were also estimated in fecal samples from possums and various species of birds by using qPCR, as possums and birds are considered to be the potential sources of fecal contamination in roof-harvested rainwater (RHRW). Among the 24 households, 63% of rainwater tank and 58% of connected household tap water (CHTW) samples contained E. coli and exceeded Australian drinking water guidelines of <1 CFU E. coli per 100 ml water. Similarly, 92% of rainwater tanks and 83% of CHTW samples also contained enterococci. In all, 21%, 4%, and 13% of rainwater tank samples contained Campylobacter spp., Salmonella spp., and Giardia lamblia, respectively. Similarly, 21% of rainwater tank and 13% of CHTW samples contained Campylobacter spp. and G. lamblia, respectively. The number of E. coli (P = 0.78), Enterococcus (P = 0.64), Campylobacter (P = 0.44), and G. lamblia (P = 0.50) cells in rainwater tanks did not differ significantly from the numbers observed in the CHTW samples. Among the 40 possum fecal samples tested, Campylobacter spp., Cryptosporidium parvum, and G. lamblia were detected in 60%, 13%, and 30% of samples, respectively. Among the 38 bird fecal samples tested, Campylobacter spp., Salmonella spp., C. parvum, and G. lamblia were detected in 24%, 11%, 5%, and 13% of the samples, respectively. Household tap water samples fed from rainwater tanks tested in the study appeared to be highly variable. Regular cleaning of roofs and gutters, along with pruning of overhanging tree branches, might also prove effective in reducing animal fecal contamination of rainwater tanks. PMID:22020514

  6. Maternal and familial correlates of anthropometric typologies in the nutrition transition of Colombia, 2000-2010.

    PubMed

    Parra, Diana C; Gomez, Luis F; Iannotti, Lora; Haire-Joshu, Debra; Sebert Kuhlmann, Anne K; Brownson, Ross C

    2018-06-01

    We aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010. We classified children 2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight (<18·5 kg/m2) and overweight/obesity (≥25·0 kg/m2). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies. National and sub-regional (urban and rural) representative samples from Colombia, South America. Drawing on data from three waves of Colombia's Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18-49 years) and their children (birth-5 years). Higher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children <5 years, being an indigenous household, food purchase decisions by the mother and food security classification were also associated with the four anthropometric typologies. Results suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes.

  7. Geographic distribution and socio-economic determinants of women's nutritional status in Mali households.

    PubMed

    Gewa, Constance A; Leslie, Timothy F; Pawloski, Lisa R

    2013-09-01

    Mali is one of the poorest countries in Africa, with 72% of its population surviving on less than $US 1.00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women’s anthropometric status and use of adequately iodized salt among households in Mali. Demographic and Health Survey data, multistage-stratified cluster sampling methodology. Rural and urban areas of Mali. Non-pregnant women (n 6015) between the ages of 19 and 44 years. Nineteen per cent of the women were overweight or obese while 11% were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women’s BMI or households’ use of adequately iodized salt. The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.

  8. 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.

  9. The influence of parents, older siblings, and non-parental care on infant development at nine months of age.

    PubMed

    Cruise, Sharon; O'Reilly, Dermot

    2014-11-01

    The majority of research examining the influence of social environment on early child development suggests benefits to two-parent households, but contradictory evidence for the effects of siblings. The aims of the present study were to examine the influence of the child's proximal social environment, and the effects of interactions between socioeconomic status and social environment on developmental outcomes. Primary caregivers of a representative sample of 10,748 nine-month-old infants in Ireland completed the Ages and Stages Questionnaire and provided information on social environment. Adjustment was made for infant and maternal characteristics, household income, and area where the child was living at the time of the study. Further analyses tested for interactions between social environment and household income. Binary logistic regressions indicated no effects for number of parents in the household. However, the presence of siblings in the household was a consistent predictor of failing to reach milestones in communication, gross motor, problem-solving, and personal-social development. Furthermore, there was a gradient of increasing likelihood of failing in gross motor, problem-solving, and personal-social development with increasing numbers of siblings. Care by a grandparent decreased the likelihood of failing in communication and personal-social development. These findings do not support the majority of research that finds positive benefits for two-parent households. Similarly, the findings suggest limited effects for non-parental care. However, the observed negative effects of siblings support both the confluence and resource dilution models of sibling effect. Examination of follow-up data may elucidate current findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. How Does EIA Estimate Energy Consumption and End Uses in U.S. Homes?

    EIA Publications

    2011-01-01

    The Energy Information Administration (EIA) administers the Residential Energy Consumption Survey (RECS) to a nationally representative sample of housing units. Specially trained interviewers collect energy characteristics on the housing unit, usage patterns, and household demographics. This information is combined with data from energy suppliers to these homes to estimate energy costs and usage for heating, cooling, appliances and other end uses information critical to meeting future energy demand and improving efficiency and building design.

  11. Socioeconomic differences in attitudes and beliefs about healthy lifestyles.

    PubMed

    Wardle, J; Steptoe, A

    2003-06-01

    s: The factors underlying socioeconomic status differences in smoking, leisure time physical activity, and dietary choice are poorly understood. This study investigated attitudes and beliefs that might underlie behavioural choices, including health locus of control, future salience, subjective life expectancy, and health consciousness, in a nationally representative sample. Data were collected as part of the monthly Omnibus survey of the Office of National Statistics in Britain. A stratified, probability sample of 2728 households was selected by random sampling of addresses. One adult from each household was interviewed. Higher SES respondents were less likely to smoke and more likely to exercise and eat fruit and vegetables daily. Lower SES was associated with less health consciousness (thinking about things to do to keep healthy), stronger beliefs in the influence of chance on health, less thinking about the future, and lower life expectancies. These attitudinal factors were in turn associated with unhealthy behavioural choices, independently of age, sex, and self rated health. Socioeconomic differences in healthy lifestyles are associated with differences in attitudes to health that may themselves arise through variations in life opportunities and exposure to material hardship and ill health over the life course.

  12. Household solvent products: a shelf survey with laboratory analysis. Final report, October 1984-July 1987

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

    Maklan, D.M.; Steele, D.H.; Dietz, S.K.

    1987-07-01

    This study was conducted to provide information on the incidence and concentration of six chlorocarbons in common household products. The objectives of the study were to: (1) determine which categories of consumer products contain the chemical methylene chloride and/or five potential substitute solvents (1,1,1-trichloroethane, trichloroethylene, tetrachloroethylene, carbon tetrachloride, and 1,1,2-trichlorotrifluoroethane); and (2) analyze brands representing each product category to determine the concentration of these chemicals in household products. A national sample of household products was selected and laboratory tested to determine the incidence and concentration of the six target chlorocarbons. The following are some of the major findings. Fifty-eight percentmore » of the 67 product categories had at least one brand test positive for one or more of the target analytes. Thirty-four percent of the 1026 brands tested positive for at least one of the six target chlorocarbons. Thirty-four percent of the brands tested positive for methylene chloride, 14% tested positive for 1,1,1-trichloroethane, and less than 4% of the brands were positive on any of the remaining four chlorocarbons. The concentration of analyte varied considerably between brands of the same product category. Only 56% of the brands with chlorocarbons were so labeled.« less

  13. The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993.

    PubMed Central

    Peña, R; Wall, S; Persson, L A

    2000-01-01

    OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality. PMID:10630139

  14. Measuring the impact of Hurricane Katrina on access to a personal healthcare provider: the use of the National Survey of Children's Health for an external comparison group.

    PubMed

    Stehling-Ariza, Tasha; Park, Yoon Soo; Sury, Jonathan J; Abramson, David

    2012-04-01

    This paper examined the effect of Hurricane Katrina on children's access to personal healthcare providers and evaluated the use of propensity score methods to compare a nationally representative sample of children, as a proxy for an unexposed group, with a smaller exposed sample. 2007 data from the Gulf Coast Child and Family Health (G-CAFH) Study, a longitudinal cohort of households displaced or greatly impacted by Hurricane Katrina, were matched with 2007 National Survey of Children's Health (NSCH) data using propensity score techniques. Propensity scores were created using poverty level, household educational attainment, and race/ethnicity, with and without the addition of child age and gender. The outcome was defined as having a personal healthcare provider. Additional confounders (household structure, neighborhood safety, health and insurance status) were also examined. All covariates except gender differed significantly between the exposed (G-CAFH) and unexposed (NSCH) samples. Fewer G-CAFH children had a personal healthcare provider (65 %) compared to those from NSCH (90 %). Adjusting for all covariates, the propensity score analysis showed exposed children were 20 % less likely to have a personal healthcare provider compared to unexposed children in the US (OR = 0.80, 95 % CI 0.76, 0.84), whereas the logistic regression analysis estimated a stronger effect (OR = 0.28, 95 % CI 0.21, 0.39). Two years after Hurricane Katrina, children exposed to the storm had significantly lower odds of having a personal health care provider compared to unexposed children. Propensity score matching techniques may be useful for combining separate data samples when no clear unexposed group exists.

  15. Illicit drug use by persons with disabilities: insights from the National Household Survey on Drug Abuse.

    PubMed Central

    Gilson, S F; Chilcoat, H D; Stapleton, J M

    1996-01-01

    OBJECTIVES: This study sought to evaluate the association of drug use with disability in a representative sample of the US household population. METHODS: The use of illicit drugs and alcohol reported by respondents in the 1991 National Household Survey on Drug Abuse who identified themselves as "disabled, unable to work" was compared with respondents without disabilities. RESULTS: Among younger adults (18-24 years), persons with disabilities were more likely than those without disabilities to report that they had used heroin (adjusted odds ratio [OR] = 6.89; 95% confidence interval [CI] = 1.35, 35.1) or crack cocaine (OR = 6.38; 95% CI = 1.05, 38.6). Among older adults (35 years and older), persons with disabilities were more likely to report the use of sedatives (OR = 2.46; 95% CI = 1.21, 4.94) or tranquilizers (OR = 2.18: 95% CI = 1.08; 4.42) not medically prescribed. CONCLUSIONS: These results suggest that use of illicit drugs is a potentially serious problem among persons with disabilities and requires both research and clinical attention. PMID:8916529

  16. Financial management skills are associated with food insecurity in a sample of households with children in the United States.

    PubMed

    Gundersen, Craig G; Garasky, Steven B

    2012-10-01

    Food insecurity is one of the leading public health challenges facing children in the United States today. Reducing food insecurity and its attendant consequences requires an understanding of the determinants of food insecurity. Although previous work has greatly advanced our understanding of these determinants, the role of one of the oft-speculated important determinants of food insecurity, household financial management skills, has not been considered. To address this research lacuna, we use a recently conducted survey, the Survey of Household Finances and Childhood Obesity, that has information on specific financial management practices, impressions of financial management skills, and households' food insecurity. The sample included 904 households with children. Within this sample, 19.3% were food insecure and, for our central financial management skill variable, the mean value was 3.55 on a 5-point scale. Probit regression models estimated the probability of a household being food insecure as conditional on financial management skills and other covariates. We found a large and significant inverse relationship between a respondent's use of specific financial management practices and food insecurity and between a respondent's confidence in his or her financial management skills and food insecurity. That is, households with greater financial management abilities are less likely to be food insecure. This finding also holds when the sample is restricted to households with incomes <200% of the poverty line. These results suggest that improving households' financial management skills has the potential to reduce food insecurity in the United States.

  17. Validation of drinking water disinfection by-product exposure assessment for rural areas in the National Children's Study.

    PubMed

    Binkley, Teresa L; Thiex, Natalie W; Specker, Bonny L

    2015-05-01

    The objective of this study was to provide evidence to evaluate the proposed National Children's Study (NCS) protocol for household water sampling in rural study areas. Day-to-day variability in total trihalomethane (TTHM) concentrations in community water supplies (CWS) in rural areas was determined, and the correlation between TTHM concentrations from household taps and CWS monitoring reports was evaluated. Daily water samples were collected from 7 households serviced by 7 different CWS for 15 days. Coefficients of variation for TTHM concentration over 15 days ranged from 8% to 20% depending on the household. Correlations were tested between TTHM household concentrations and the closest date- and location-matched CWS monitoring reports for the 15-day mean (R=0.85, P<0.01). To simulate the NCS-proposed protocol, correlations were tested for 30 additional NCS household samples (polynomial fit: R=0.74, P=0.04). CWS reported TTHM concentrations >50 μg/l corresponded to measured NCS household concentrations ranging from 2 to 60 μg/l. TTHM concentrations were higher in CWS than NCS samples (11.2±3.2 μg/l, mean difference±SE, P<0.01). These results show that in rural areas there is high variability within households and poor correlation at higher concentrations, suggesting that TTHM concentrations from CWS monitoring reports are not an accurate measure of exposure in the household.

  18. The relationship between female genital cutting and women's autonomy in Eritrea.

    PubMed

    Besera, Ghenet; Roess, Amira

    2014-09-01

    To investigate the relationship between women's autonomy and attitudes toward female genital cutting (FGC) and having a daughter with FGC in Eritrea. Data from a nationally representative sample of 8754 women aged between 15 and 49 years from the 2002 Eritrea Demographic and Health Survey were analyzed. Multivariate logistic regression was used to determine significant predictors of the practice of and attitudes toward FGC, including women's autonomy. Sixty-three percent (n = 3168) of women sampled had at least one daughter who had undergone FGC and 50.1% (n = 4848) of women believed FGC should continue. When controlling for sociodemographic characteristics, the odds of supporting the continuation of FGC were greater among women who justified wife beating (adjusted odds ratio [aOR] 1.43; 95% confidence interval [CI] 1.23-1.66). Among women who participated in household decisions, the odds of them supporting the continuation of FGC were less than among women who did not participate in household decisions (aOR 0.87; 95% CI, 0.75-0.99). Interventions addressing women's autonomy, specifically attitudes toward gender norms and increasing women's involvement in household decisions that carry a greater responsibility, may be a useful approach to reduce the support for and practice of FGC. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Differences in the social patterning of active travel between urban and rural populations: findings from a large UK household survey.

    PubMed

    Hutchinson, Jayne; White, Piran C L; Graham, Hilary

    2014-12-01

    To determine the social patterning of active travel of short journeys for urban and rural residents in a large UK representative sample. Associations between frequently walking or cycling short journeys and socio-demographic factors in the UK Household Longitudinal Study were determined using logistic regression. Urban residents were 64 % more likely to frequently engage in active travel than rural residents (95 % CI 1.52, 1.77). Being younger, male, without full-time employment and having a lower income independently predicted greater active travel for both urban and rural residents. Degree level education and not having children were independent predictors for urban, but not rural residents. Actively travelling short journeys is less common and independently associated with fewer socio-demographic factors in rural than in urban populations.

  20. Child Schooling in Ethiopia: The Role of Maternal Autonomy.

    PubMed

    Gebremedhin, Tesfaye Alemayehu; Mohanty, Itismita

    2016-01-01

    This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population.

  1. Livestock and livelihoods of smallholder cattle-owning households in Cambodia: the contribution of on-farm and off-farm activities to income and food security.

    PubMed

    Ashley, Katherine; Harrison, Holly; Chan, Phalleap Hok; Sothoeun, Suon; Young, James Robert; Windsor, Peter Andrew; Bush, Russell David

    2018-05-23

    The majority of smallholder farming households in Cambodia are rurally based and rely on agriculture to support their livelihoods. However, in recent years, growth in the agriculture sector has stagnated with farmers facing several challenges including declining prices for traditional crops and irregular rainfall patterns. This has led to a need for farmers to diversify income sources with livestock promoted as a more viable livelihood activity, particularly the raising of cattle and poultry. However, uncertain profitability of livestock activities is a common perception by smallholders, especially where animals have not been traditionally viewed as a primary income source. To address this, information is required which compares the income and expenses associated with livestock raising to other on-farm activities and off-farm sources. This study reports on a survey of livelihood survey of 17 male and 21 female representatives of 20 households owning cattle in Cambodia, comparing the associated income and expenses of the various livelihood activities in the 12-month period from January to December 2016. Combined total household income from both on-farm and off-farm sources ranged from USD875 to 17730 with an average of USD6779, representing 51% and 49% from on-farm and off-farm activities, respectively. Cattle raising was the most common source of on-farm income (85%), contributing USD1064 and representing 22% of total household income. General household expenses, such as food and transportation (including expenses associated with off-farm employment), represented the majority of total household expenses (79%). Gross profit calculations indicated higher values for pig raising (USD1841.79), cattle (USD950.80) and non-rice crops (USD884) whilst the highest gross margin value was recorded for cattle (89.33%) followed by vegetables (85.27%) and non-rice crops (83.08%). Whilst wet season and dry season rice returned a negative gross profit value of USD197.27 and USD90.60 on average per household, respectively, both were ranked as most important for household consumption, followed by poultry, providing the main source of energy (rice) and protein (chicken meat) and sustaining household food requirements. The study concludes that although smallholder cattle-owning households in Cambodia undertake a diverse range of on-farm activities, as cattle raising provides a superior income source due to higher returns and lower variable costs, it could be promoted as a preferred livelihood activity by agencies conducting rural extension activities. Although consideration of available labour and monetary funds to invest in cattle raising is required, it was observed that income from off-farm sources may prove beneficial in providing the additional monetary funds to support cattle-raising activities and assist in providing generally poor smallholder households with enhanced economic resilience.

  2. 2017 National Household Travel Survey - California Add-On |

    Science.gov Websites

    Transportation Secure Data Center | NREL 7 National Household Travel Survey - California Add-On 2017 National Household Travel Survey - California Add-On The California add-on survey supplements the 2017 National Household Travel Survey (NHTS) with additional household samples and detailed travel

  3. Household water treatment and the nutritional status of primary-aged children in India: findings from the India human development survey.

    PubMed

    Li, Wei; Liu, Echu; BeLue, Rhonda

    2018-04-17

    Poor water quality, one of the leading causes of diarrhea, is an issue for most developing countries. Although the health burden of poor-quality water has been studied extensively, there is a paucity of research regarding the impact of household water treatment (HWT) on children's nutritional status using data from large-scale surveys. In this research, we study the effect of HWT on the nutritional status of primary-aged children in India using a secondary data set consisting of 20,315 children between the ages of 6 and 14 (10,523 males and 9,792 females) in 12,839 households from the second wave of the India Human Development Survey (IHDS-II). The IHDS-II is a nationally representative, household-based, comprehensive, and face-to-face survey. Households were selected using stratified random sampling, and a team consisting of one male and one female interviewer visited each household between November 2011 and October 2012. A knowledgeable member, typically the male head of household, was interviewed about the socioeconomic condition of the household. An ever-married woman between the ages of 15 and 49, typically the wife of the male head of household, answered questions related to education and health. The height and weight of all eligible household members were measured by interviewers. Correlation between HWT and nutritional status was computed first, and the estimation of a generalized simultaneous equation model, in which a binary indicator of HWT and other covariates was included, was carried out afterward. Bivariate analysis shows a negative association between the nutritional status of children and HWT. Additionally, findings from the generalized simultaneous equation model demonstrate that HWT increases the probability of producing normal-weighted primary-aged children by 1.7 %, while it decreases the probability of primary-aged children being thin by 2.5% and being severely thin by 1.7% in India. This study indicates that HWT has the potential to advance the nutritional status of primary school-aged children in India.

  4. Factors associated with women's and children's body mass indices by income status.

    PubMed

    Lin, B H; Huang, C L; French, S A

    2004-04-01

    To describe associations between eating behaviors, dietary intake, physical activity, attitudes toward diet and health, sociodemographic variables and body mass index (BMI) among women and children, and differences by household income. Data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS) were examined using multivariate regression to estimate the associations between BMI and behavioral and environmental variables among women and children. CSFII 1994-1996 is representative of the US population. DHKS surveyed CSFII respondents 20 y of age and over. Our samples consisted of 2419 adult women and 1651 school-age children. CSFII respondents reported 24 h recalls of all food intakes on 2 nonconsecutive days and their personal and household characteristics, including self-reported height and weight. DHKS collected data on knowledge and attitudes toward dietary guidance and health from CSFII adult respondents. Significant correlations between women's BMI and age, race, dietary patterns, TV watching, and smoking was observed among women from both low- and high-income households. Beverage consumption, eating out, the importance of maintaining healthy weight, and exercise were correlated with BMI only among women from high-income households. Among children, age, race, income, and mother's BMI were significantly correlated with child BMI. Among women, the associations between some behavioral and environmental factors and BMI differ by household income. Intervention programs need to target specific eating and physical activity behaviors to promote a healthy body weight.

  5. Household financial contribution to the health System in Shiraz, Iran in 2012.

    PubMed

    Kavosi, Zahra; Keshtkaran, Ali; Hayati, Ramin; Ravangard, Ramin; Khammarnia, Mohammad

    2014-10-01

    One common challenge to social systems is achieving equity in financial contributions and preventing financial loss. Because of the large and unpredictable nature of some costs, achieving this goal in the health system presents important and unique problems. The present study investigated the Household Financial Contributions (HFCs) to the health system. The study investigated 800 households in Shiraz. The study sample size was selected using stratified sampling and cluster sampling in the urban and rural regions, respectively. The data was collected using the household section of the World Health Survey (WHS) questionnaire. Catastrophic health expenditures were calculated based on the ability of the household to pay and the reasons for the catastrophic health expenditures by a household were specified using logistic regression. The results showed that the fairness financial contribution index was 0.6 and that 14.2% of households were faced with catastrophic health expenditures. Logistic regression analysis revealed that household economic status, the basic and supplementary insurance status of the head of the household, existence of individuals in the household who require chronic medical care, use of dental and hospital care, rural location of residences, frequency of use of outpatient services, and Out-of-Pocket (OOP) payment for physician visits were effective factors for determining the likelihood of experiencing catastrophic health expenditure. It appears that the current method of health financing in Iran does not adequately protect households against catastrophic health expenditure. Consequently, it is essential to reform healthcare financing.

  6. Malaria prevalence metrics in low- and middle-income countries: an assessment of precision in nationally-representative surveys.

    PubMed

    Alegana, Victor A; Wright, Jim; Bosco, Claudio; Okiro, Emelda A; Atkinson, Peter M; Snow, Robert W; Tatem, Andrew J; Noor, Abdisalan M

    2017-11-21

    One pillar to monitoring progress towards the Sustainable Development Goals is the investment in high quality data to strengthen the scientific basis for decision-making. At present, nationally-representative surveys are the main source of data for establishing a scientific evidence base, monitoring, and evaluation of health metrics. However, little is known about the optimal precisions of various population-level health and development indicators that remains unquantified in nationally-representative household surveys. Here, a retrospective analysis of the precision of prevalence from these surveys was conducted. Using malaria indicators, data were assembled in nine sub-Saharan African countries with at least two nationally-representative surveys. A Bayesian statistical model was used to estimate between- and within-cluster variability for fever and malaria prevalence, and insecticide-treated bed nets (ITNs) use in children under the age of 5 years. The intra-class correlation coefficient was estimated along with the optimal sample size for each indicator with associated uncertainty. Results suggest that the estimated sample sizes for the current nationally-representative surveys increases with declining malaria prevalence. Comparison between the actual sample size and the modelled estimate showed a requirement to increase the sample size for parasite prevalence by up to 77.7% (95% Bayesian credible intervals 74.7-79.4) for the 2015 Kenya MIS (estimated sample size of children 0-4 years 7218 [7099-7288]), and 54.1% [50.1-56.5] for the 2014-2015 Rwanda DHS (12,220 [11,950-12,410]). This study highlights the importance of defining indicator-relevant sample sizes to achieve the required precision in the current national surveys. While expanding the current surveys would need additional investment, the study highlights the need for improved approaches to cost effective sampling.

  7. 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.

  8. Associations between maternal employment and time spent in nutrition-related behaviours among German children and mothers.

    PubMed

    Möser, Anke; Chen, Susan E; Jilcott, Stephanie B; Nayga, Rodolfo M

    2012-07-01

    To examine associations between maternal employment and time spent engaging in nutrition-related behaviours among mothers and children using a nationally representative sample of households in West and East Germany. A cross-sectional analysis was performed using time-use data for a sample of mother-child dyads. Associations between maternal employment and time spent in nutrition-related activities such as eating at home, eating away from home and food preparation were estimated using a double-hurdle model. German Time Budget Survey 2001/02. The overall sample included 1071 households with a child between 10 and 17 years of age. The time-use data were collected for a 3 d period of observation (two weekdays and one weekend day). Maternal employment was associated with the time children spent on nutrition-related behaviours. In households with employed mothers, children spent more time eating alone at home and less time eating meals with their mothers. Moreover, employed mothers spent less time on meal preparation compared with non-employed mothers. There were regional differences in time spent on nutrition-related behaviours, such that East German children were more likely to eat at home alone than West German children. Maternal employment was associated with less time spent eating with children and preparing food, which may be related to the increasing childhood obesity rates in Germany. Future national surveys that collect both time-use data and health outcomes could yield further insight into mechanisms by which maternal time use might be associated with health outcomes among children.

  9. Out-of-pocket expenditure and its determinants in the context of private healthcare sector expansion in sub-Saharan Africa urban cities: evidence from household survey in Ouagadougou, Burkina Faso.

    PubMed

    Beogo, Idrissa; Huang, Nicole; Gagnon, Marie-Pierre; Amendah, Djesika D

    2016-01-21

    Conventional wisdom suggests that out-of-pocket (OOP) expenditure reduces healthcare utilization. However, little is known about the expenditure borne in urban settings with the current development of the private health sector in sub-Saharan Africa. In an effort to update knowledge on medical expenditure, this study investigated the level and determinants of OOP among individuals reporting illness or injury in Ouagadougou, Burkina Faso and who either self-treated or received healthcare in either a private or public facility. A cross-sectional study was conducted with a representative sample of 1017 households (5638 individuals) between August and November 2011. Descriptive statistics and multivariate techniques including generalized estimating equations were used to analyze the data. Among the surveyed sample, 29.6% (n = 1666) persons reported a sickness or injury. Public providers were the single most important providers of care (36.3%), whereas private and informal providers (i.e.: self-treatment, traditional healers) accounted for 29.8 and 34.0%, respectively. Almost universally (96%), households paid directly for care OOP. The average expenditure per episode of illness was 8404XOF (17.4USD) (median 3750XOF (7.8USD). The total expenditure was higher for those receiving care in private facilities compared to public ones [14,613.3XOF (30.3USD) vs. 8544.1XOF (17.7USD); p < 0.001], and the insured patients' bill almost tripled uninsured (p < 0.001). Finally, medication was the most expensive component of expenditure in both public and private facilities with a mean of 8022.1XOF (16.7USD) and 12,270.5 (25.5USD), respectively. OOP was the principal payment mechanism of households. A significant difference in OOP was found between public and private provider users. Considering the importance of private healthcare in Burkina Faso, regulatory oversight is necessary. Furthermore, an extensive protection policy to shield households from catastrophic health expenditure is required.

  10. Optimal design of studies of influenza transmission in households. II: comparison between cohort and case-ascertained studies.

    PubMed

    Klick, B; Nishiura, H; Leung, G M; Cowling, B J

    2014-04-01

    Both case-ascertained household studies, in which households are recruited after an 'index case' is identified, and household cohort studies, where a household is enrolled before the start of the epidemic, may be used to test and estimate the protective effect of interventions used to prevent influenza transmission. A simulation approach parameterized with empirical data from household studies was used to evaluate and compare the statistical power of four study designs: a cohort study with routine virological testing of household contacts of infected index case, a cohort study where only household contacts with acute respiratory illness (ARI) are sampled for virological testing, a case-ascertained study with routine virological testing of household contacts, and a case-ascertained study where only household contacts with ARI are sampled for virological testing. We found that a case-ascertained study with ARI-triggered testing would be the most powerful design while a cohort design only testing household contacts with ARI was the least powerful. Sensitivity analysis demonstrated that these conclusions varied by model parameters including the serial interval and the risk of influenza virus infection from outside the household.

  11. Health and human rights in eastern Myanmar after the political transition: a population-based assessment using multistaged household cluster sampling.

    PubMed

    Parmar, Parveen Kaur; Barina, Charlene C; Low, Sharon; Tun, Kyaw Thura; Otterness, Conrad; Mhote, Pue P; Htoo, Saw Nay; Kyaw, Saw Win; Lwin, Nai Aye; Maung, Cynthia; Moo, Naw Merry; Oo, Eh Kalu Shwe; Reh, Daniel; Mon, Nai Chay; Singh, Nakul; Goyal, Ravi; Richards, Adam K

    2015-01-01

    Myanmar transitioned to a nominally civilian parliamentary government in March 2011. Qualitative reports suggest that exposure to violence and displacement has declined while international assistance for health services has increased. An assessment of the impact of these changes on the health and human rights situation has not been published. Five community-based organizations conducted household surveys using two-stage cluster sampling in five states in eastern Myanmar from July 2013-September 2013. Data was collected from 6, 178 households on demographics, mortality, health outcomes, water and sanitation, food security and nutrition, malaria, and human rights violations (HRV). Among children aged 6-59 months screened, the prevalence of global acute malnutrition (representing moderate or severe malnutrition) was 11.3% (8.0-14.7). A total of 250 deaths occurred during the year prior to the survey. Infant deaths accounted for 64 of these (IMR 94.2; 95% CI 66.5-133.5) and there were 94 child deaths (U5MR 141.9; 95% CI 94.8-189.0). 10.7% of households (95% CI 7.0-14.5) experienced at least one HRV in the past year, while four percent reported 2 or more HRVs. Household exposure to one or more HRVs was associated with moderate-severe malnutrition among children (14.9 vs. 6.8%; prevalence ratio 2.2, 95% CI 1.2-4.2). Household exposure to HRVs was associated with self-reported fair or poor health status among respondents (PR 1.3; 95% CI 1.1-1.5). This large survey of health and human rights demonstrates that two years after political transition, vulnerable populations of eastern Myanmar are less likely to experience human rights violations compared to previous surveys. However, access to health services remains constrained, and risk of disease and death remains higher than the country as a whole. Efforts to address these poor health indicators should prioritize support for populations that remain outside the scope of most formal government and donor programs.

  12. Health and Human Rights in Eastern Myanmar after the Political Transition: A Population-Based Assessment Using Multistaged Household Cluster Sampling

    PubMed Central

    Parmar, Parveen Kaur; Barina, Charlene C.; Low, Sharon; Tun, Kyaw Thura; Otterness, Conrad; Mhote, Pue P.; Htoo, Saw Nay; Kyaw, Saw Win; Lwin, Nai Aye; Maung, Cynthia; Moo, Naw Merry; Oo, Eh Kalu Shwe; Reh, Daniel; Mon, Nai Chay; Singh, Nakul; Goyal, Ravi; Richards, Adam K.

    2015-01-01

    Background Myanmar transitioned to a nominally civilian parliamentary government in March 2011. Qualitative reports suggest that exposure to violence and displacement has declined while international assistance for health services has increased. An assessment of the impact of these changes on the health and human rights situation has not been published. Methods and Findings Five community-based organizations conducted household surveys using two-stage cluster sampling in five states in eastern Myanmar from July 2013-September 2013. Data was collected from 6, 178 households on demographics, mortality, health outcomes, water and sanitation, food security and nutrition, malaria, and human rights violations (HRV). Among children aged 6-59 months screened, the prevalence of global acute malnutrition (representing moderate or severe malnutrition) was 11.3% (8.0 – 14.7). A total of 250 deaths occurred during the year prior to the survey. Infant deaths accounted for 64 of these (IMR 94.2; 95% CI 66.5-133.5) and there were 94 child deaths (U5MR 141.9; 95% CI 94.8-189.0). 10.7% of households (95% CI 7.0-14.5) experienced at least one HRV in the past year, while four percent reported 2 or more HRVs. Household exposure to one or more HRVs was associated with moderate-severe malnutrition among children (14.9 vs. 6.8%; prevalence ratio 2.2, 95% CI 1.2-4.2). Household exposure to HRVs was associated with self-reported fair or poor health status among respondents (PR 1.3; 95% CI 1.1 – 1.5). Conclusion This large survey of health and human rights demonstrates that two years after political transition, vulnerable populations of eastern Myanmar are less likely to experience human rights violations compared to previous surveys. However, access to health services remains constrained, and risk of disease and death remains higher than the country as a whole. Efforts to address these poor health indicators should prioritize support for populations that remain outside the scope of most formal government and donor programs. PMID:25970445

  13. Information content of household-stratified epidemics.

    PubMed

    Kinyanjui, T M; Pellis, L; House, T

    2016-09-01

    Household structure is a key driver of many infectious diseases, as well as a natural target for interventions such as vaccination programs. Many theoretical and conceptual advances on household-stratified epidemic models are relatively recent, but have successfully managed to increase the applicability of such models to practical problems. To be of maximum realism and hence benefit, they require parameterisation from epidemiological data, and while household-stratified final size data has been the traditional source, increasingly time-series infection data from households are becoming available. This paper is concerned with the design of studies aimed at collecting time-series epidemic data in order to maximize the amount of information available to calibrate household models. A design decision involves a trade-off between the number of households to enrol and the sampling frequency. Two commonly used epidemiological study designs are considered: cross-sectional, where different households are sampled at every time point, and cohort, where the same households are followed over the course of the study period. The search for an optimal design uses Bayesian computationally intensive methods to explore the joint parameter-design space combined with the Shannon entropy of the posteriors to estimate the amount of information in each design. For the cross-sectional design, the amount of information increases with the sampling intensity, i.e., the designs with the highest number of time points have the most information. On the other hand, the cohort design often exhibits a trade-off between the number of households sampled and the intensity of follow-up. Our results broadly support the choices made in existing epidemiological data collection studies. Prospective problem-specific use of our computational methods can bring significant benefits in guiding future study designs. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  14. A Household-Based Distribution-Sensitive Human Development Index: An Empirical Application to Mexico, Nicaragua and Peru

    ERIC Educational Resources Information Center

    Lopez-Calva, Luis F.; Ortiz-Juarez, Eduardo

    2012-01-01

    In measuring human development, one of the main concerns relates to the inclusion of a measure that penalizes inequalities in the distribution of achievements across the population. Using indicators from nationally representative household surveys and census data, this paper proposes a straightforward methodology to estimate a household-based…

  15. NHEXAS PHASE I MARYLAND STUDY--PESTICIDES IN DERMAL WIPES ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticides in Dermal Wipe Samples data set contains analytical results for measurements of up to 8 pesticides in 40 dermal wipe samples over 40 households. Each sample was collected from the primary respondent within each household. The sampling period occurred on the last ...

  16. NHEXAS PHASE I MARYLAND STUDY--PESTICIDES IN BLOOD ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticides in Blood Serum data set contains analytical results for measurements of up to 17 pesticides in 358 blood samples over 79 households. Each sample was collected via a venous sample from the primary respondent within each household by a phlebotomist. Samples were ge...

  17. NHEXAS PHASE I MARYLAND STUDY--METALS IN DERMAL WIPES ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Dermal Wipe Samples data set contains analytical results for measurements of up to 4 metals in 343 dermal wipe samples over 80 households. Each sample was collected from the primary respondent within each household. The sampling period occurred on the first day of...

  18. NHEXAS PHASE I ARIZONA STUDY--METALS IN BLOOD ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Blood data set contains analytical results for measurements of up to 2 metals in 165 blood samples over 165 households. Each sample was collected as a venous sample from the primary respondent within each household during Stage III of the NHEXAS study. The samples...

  19. NHEXAS PHASE I MARYLAND STUDY--METALS IN BLOOD ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Blood data set contains analytical results for measurements of up to 2 metals in 374 blood samples over 80 households. Each sample was collected via a venous sample from the primary respondent within each household by a phlebotomist. Samples were generally drawn o...

  20. Poverty, food insecurity, and the behavior for childhood internalizing and externalizing disorders.

    PubMed

    Slopen, Natalie; Fitzmaurice, Garrett; Williams, David R; Gilman, Stephen E

    2010-05-01

    This study investigated the associations of poverty and food insecurity over a 2-year period with internalizing and externalizing problems in a large, community-based sample. A total of 2,810 children were interviewed between ages 4 and 14 years at baseline, and between ages 5 and 16 years at follow-up. Primary caregivers reported on household income, food insecurity, and were administered the Child Behavior Checklist, from which we derived indicators of clinically significant internalizing and externalizing problems. Prevalence ratios for the associations of poverty and food insecurity with behavior problems were estimated. At baseline, internalizing and externalizing problems were significantly more prevalent among children who lived in poor households than in nonpoor households, and among children who lived in food insecure households than in food-secure households. In adjusted analyses, children from homes that were persistently food insecure were 1.47 (95% CI = 1.12 to 1.94) times more likely to have internalizing problems and 2.01 (95% CI = 1.21 to 3.35) times more likely to have externalizing problems compared with children from households that were never food insecure. Children from homes that moved from food secure to insecure were 1.78 (95% CI = 1.07 to 2.94) times more likely to have externalizing problems at follow-up. Persistent food insecurity is associated with internalizing and externalizing problems, even after adjusting for sustained poverty and other potential confounders. These results implicate food insecurity as a novel risk factor for child mental well-being; if causal, this represents an important factor in the etiology of child psychopathology, and potentially a new avenue for prevention.

  1. Potential for pet animals to harbor methicillin-resistant Staphylococcus aureus (MRSA) when residing with human MRSA patients

    PubMed Central

    Morris, Daniel O.; Lautenbach, Ebbing; Zaoutis, Theoklis; Leckerman, Kateri; Edelstein, Paul H.; Rankin, Shelley C.

    2011-01-01

    Summary Colonization by methicillin-resistant Staphylococcus aureus (MRSA) may be persistent in people, and is horizontally transmissible. The scientific literature suggests that domestic pets may also participate in cross-transmission of MRSA within households. The objectives of this study were to evaluate the prevalence of and risk factors for MRSA carriage by pets residing in households with an MRSA-infected person. From 66 households in which an MRSA infected patient resided, we screened 47 dogs and 52 cats using a swab protocol. Isolates from pets and humans were genotyped using two techniques, and compared for concordance. Human participants completed a 22-question survey of demographic and epidemiologic data relevant to staphylococcal transmission. Eleven of 99 pets (11.5%) representing 9 (13.6%) of households were MRSA-positive, but in only 6 of these households were the human and animal-source strains genetically concordant. Human infection by strain USA 100 was significantly associated with pet carriage [OR = 11.4 (95% C.I. 1.7, 76.9); p=0.013]. Yet, for each day of delay in sampling the pet after the person’s MRSA diagnosis, the odds of isolating any type of MRSA from the pet decreased by 13.9% [(95% C.I. 2.6%, 23.8%); p=0.017)]. It may be concluded that pets can harbor pandemic strains of MRSA while residing in a household with an infected person. However, the source of MRSA to the pet cannot always be attributed to the human patient. Moreover, the rapid attrition of the odds of obtaining a positive culture from pets over time suggests that MRSA carriage may be fleeting. PMID:22233337

  2. Non-farmed fish contribute to greater micronutrient intakes than farmed fish: results from an intra-household survey in rural Bangladesh.

    PubMed

    Bogard, Jessica R; Marks, Geoffrey C; Mamun, Abdullah; Thilsted, Shakuntala H

    2017-03-01

    Fish is the most important animal-source food (ASF) in Bangladesh, produced from capture fisheries (non-farmed) and aquaculture (farmed) sub-sectors. Large differences in micronutrient content of fish species from these sub-sectors exist. The importance of fish in diets of vulnerable groups compared with other ASF; contribution from non-farmed and farmed species to nutrient intakes; and differences in fish consumption among age, gender, wealth groups and geographic regions were analysed, using quantitative intra-household fish consumption data, focusing on the first 1000 d of life. Two-stage stratified sample. Nationally representative of rural Bangladesh. Households (n 5503) and individuals (n 24 198). Fish consumption in poor households was almost half that in wealthiest households; and lower in females than males in all groups, except the wealthiest, and for those aged ≥15 years (P<0·01). In infants of complementary feeding age, 56 % did not consume ASF on the survey day, despite 78 % of mothers knowing this was recommended. Non-farmed fish made a larger contribution to Fe, Zn, Ca, vitamin A and vitamin B12 intakes than farmed fish (P<0·0001). Policies and programmes aimed to increase fish consumption as a means to improve nutrition in rural Bangladesh should focus on women and young children, and on the poorest households. Aquaculture plays an important role in increasing availability and affordability of fish; however, non-farmed fish species are better placed to contribute to greater micronutrient intakes. This presents an opportunity for aquaculture to contribute to improved nutrition, utilising diverse production technologies and fish species, including small fish.

  3. Risk of child obesity from parental obesity: analysis of repeat national cross-sectional surveys.

    PubMed

    McLoone, Philip; Morrison, David S

    2014-04-01

    To estimate the potential to reduce childhood obesity through targeted interventions of overweight households. Cross-sectional nationally representative samples of the Scottish population. Households in Scotland during 2008 and 2009. A total of 1651 households with parents and children aged 2-15 years. The WHO cut-off points for adult body mass index (BMI): overweight (25 to <30 kg/m2) and obese (≥30 kg/m2). Overweight and obesity in childhood respectively defined as a BMI 85th to <95th percentile and ≥95th percentile based on 1990 reference centiles. Thirty-two percent (600/1849) of children and 75% (966/1290) of adults were overweight or obese. Seventy-five percent (1606/2128) of all children lived with a parent who was overweight or obese. Among obese children, 58% (185/318) lived with an obese parent. The population attributable risk percentage of child obesity associated with parental obesity was 32.5%. Targeting obese households would require substantial falls in adult weight and need to reach 38% of all children; it might achieve a reduction in the prevalence of childhood obesity of 14% in these households (from 26% to 12%). Targeting parents with BMI ≥ 40 might reduce the overall prevalence of child obesity by 9%. Such an intervention would require large weight loss, consistent with approaches used for morbidly obese adults; it would involve 4% of all children and lead to a reduction in the prevalence of obesity in these households from 57% to 16%. Family-based interventions for obesity would be most efficiently targeted at obese children whose parents are morbidly obese.

  4. Polycyclic Aromatic Hydrocarbons in Residential Dust: Sources of Variability

    PubMed Central

    Metayer, Catherine; Petreas, Myrto; Does, Monique; Buffler, Patricia A.; Rappaport, Stephen M.

    2013-01-01

    Background: There is interest in using residential dust to estimate human exposure to environmental contaminants. Objectives: We aimed to characterize the sources of variability for polycyclic aromatic hydrocarbons (PAHs) in residential dust and provide guidance for investigators who plan to use residential dust to assess exposure to PAHs. Methods: We collected repeat dust samples from 293 households in the Northern California Childhood Leukemia Study during two sampling rounds (from 2001 through 2007 and during 2010) using household vacuum cleaners, and measured 12 PAHs using gas chromatography–mass spectrometry. We used a random- and a mixed-effects model for each PAH to apportion observed variance into four components and to identify sources of variability. Results: Median concentrations for individual PAHs ranged from 10 to 190 ng/g of dust. For each PAH, total variance was apportioned into regional variability (1–9%), intraregional between-household variability (24–48%), within-household variability over time (41–57%), and within-sample analytical variability (2–33%). Regional differences in PAH dust levels were associated with estimated ambient air concentrations of PAH. Intraregional differences between households were associated with the residential construction date and the smoking habits of residents. For some PAHs, a decreasing time trend explained a modest fraction of the within-household variability; however, most of the within-household variability was unaccounted for by our mixed-effects models. Within-household differences between sampling rounds were largest when the interval between dust sample collections was at least 6 years in duration. Conclusions: Our findings indicate that it may be feasible to use residential dust for retrospective assessment of PAH exposures in studies of health effects. PMID:23461863

  5. Occurrence of potentially pathogenic nontuberculous mycobacteria in Mexican household potable water: a pilot study.

    PubMed

    Perez-Martinez, Iza; Aguilar-Ayala, Diana A; Fernandez-Rendon, Elizabeth; Carrillo-Sanchez, Alma K; Helguera-Repetto, Addy C; Rivera-Gutierrez, Sandra; Estrada-Garcia, Teresa; Cerna-Cortes, Jorge F; Gonzalez-Y-Merchand, Jorge A

    2013-12-11

    Nontuberculous mycobacteria (NTM) are environmental opportunistic pathogens found in natural and human-engineered waters, including drinking water distribution systems and household plumbing. This pilot study examined the frequency of occurrence of NTM in household potable water samples in Mexico City. Potable water samples were collected from the "main house faucet" and kitchen faucet. The presence of aerobic-mesophilic bacteria (AMB), total coliforms (TC), fecal coliforms (FC) and NTM species were determined. Mycobacteria species were identified by PCR restriction enzyme pattern analysis (PRA) of the 65-kDa heat shock protein gene (hsp65) and sequencing of the hypervariable region 2 (V2) of the 16S rRNA gene and of the rpoB gene. AMB (<100 CFU/ml) were present in 118 out of 120 samples; only two samples were outside guidelines ranges (>100 CFU/ml). TC and FC were detected in four and one samples, respectively. NTM species were recovered from 16% samples (19/120) and included M. mucogenicum (nine), M. porcinum (three), M. avium (three), M. gordonae (one), M. cosmeticum (one), M. fortuitum (one), and Mycobacterium sp (one). All household water samples that contained NTM complied with the standards required to grade the water as "good quality" potable water. Household potable water may be a potential source of NTM infection in Mexico City.

  6. Have Socioeconomic Inequalities in Tobacco Use in India Increased Over Time? Trends From the National Sample Surveys (2000–2012)

    PubMed Central

    Karan, Anup; Srivastava, Swati; Selvaraj, Sakthivel; Subramanian, S. V.; Millett, Christopher

    2016-01-01

    Introduction: India has experienced marked sociocultural change, economic growth and industry promotion of tobacco products over the past decade. Little is known about the influence of these factors on socioeconomic patterning of tobacco use. This study examines trends in tobacco use by socioeconomic status (SES) in India between 2000 and 2012. Methods: We analyzed data in 2014 from nationally-representative repeated cross-sectional National Sample Surveys (NSS) in India for 1999–2000, 2004–2005 and 2011–2012 (n = 346 612 households). Prevalence and volume trends in cigarette, “bidi” and smokeless tobacco use were examined by household expenditure, educational attainment and caste/tribe status using Two-part model. Results: Prevalence of any tobacco use remained consistent in the poorest households (61.5% to 62.7%) and declined among the richest (43.8% to 36.8%) between 2000–2012. Bidi use declined across all groups (poorest: 26.3% to 16.8%, richest: 19.8% to 10.7%) while cigarette use increased (poorest: 1.2% to 1.3%, richest: 6.5% to 7.0%). Relative to educated and general caste households, between 2000 and 2012 cigarette use in illiterate households increased by 38% and among Scheduled Tribe households increased by 32%. Smokeless tobacco use increased for all households (poorest: 26.2% to 33.9%, richest: 11.4% to 13.5%, Scheduled Tribe: 31.1% to 34.8%, general caste: 13.6% to 18.5%), with greater increases among richer, more educated and general caste households. Conclusion: Marked SES patterning of tobacco use has persisted in India. Improving enforcement of tobacco control policies and monitoring comprehensive smoke-free legislations are needed to address this growing burden. Implications: We found “resilient” tobacco patterns in the last decade despite prevention interventions. SES continues to be inversely associated with tobacco products, with the exception of cigarettes. The declines in bidi use may be getting replaced by increase in cigarette use trends, especially among lower SES groups. The use of smokeless tobacco products has increased across all SES groups and the volume of smokeless tobacco use is not been declining despite a number of policies on tobacco use. This may be attributed to inadequate attention to chewed forms of tobacco in current policies, particularly to implementing pictoral warnings and regulating surrogate advertising. Evaluating the implementation of anti-tobacco policies and ensuring equity dimensions in interventions is urgently needed to address tobacco use inequalities. PMID:27048274

  7. Have Socioeconomic Inequalities in Tobacco Use in India Increased Over Time? Trends From the National Sample Surveys (2000-2012).

    PubMed

    Bhan, Nandita; Karan, Anup; Srivastava, Swati; Selvaraj, Sakthivel; Subramanian, S V; Millett, Christopher

    2016-08-01

    India has experienced marked sociocultural change, economic growth and industry promotion of tobacco products over the past decade. Little is known about the influence of these factors on socioeconomic patterning of tobacco use. This study examines trends in tobacco use by socioeconomic status (SES) in India between 2000 and 2012. We analyzed data in 2014 from nationally-representative repeated cross-sectional National Sample Surveys (NSS) in India for 1999-2000, 2004-2005 and 2011-2012 (n = 346 612 households). Prevalence and volume trends in cigarette, "bidi" and smokeless tobacco use were examined by household expenditure, educational attainment and caste/tribe status using Two-part model. Prevalence of any tobacco use remained consistent in the poorest households (61.5% to 62.7%) and declined among the richest (43.8% to 36.8%) between 2000-2012. Bidi use declined across all groups (poorest: 26.3% to 16.8%, richest: 19.8% to 10.7%) while cigarette use increased (poorest: 1.2% to 1.3%, richest: 6.5% to 7.0%). Relative to educated and general caste households, between 2000 and 2012 cigarette use in illiterate households increased by 38% and among Scheduled Tribe households increased by 32%. Smokeless tobacco use increased for all households (poorest: 26.2% to 33.9%, richest: 11.4% to 13.5%, Scheduled Tribe: 31.1% to 34.8%, general caste: 13.6% to 18.5%), with greater increases among richer, more educated and general caste households. Marked SES patterning of tobacco use has persisted in India. Improving enforcement of tobacco control policies and monitoring comprehensive smoke-free legislations are needed to address this growing burden. We found "resilient" tobacco patterns in the last decade despite prevention interventions. SES continues to be inversely associated with tobacco products, with the exception of cigarettes. The declines in bidi use may be getting replaced by increase in cigarette use trends, especially among lower SES groups. The use of smokeless tobacco products has increased across all SES groups and the volume of smokeless tobacco use is not been declining despite a number of policies on tobacco use. This may be attributed to inadequate attention to chewed forms of tobacco in current policies, particularly to implementing pictoral warnings and regulating surrogate advertising. Evaluating the implementation of anti-tobacco policies and ensuring equity dimensions in interventions is urgently needed to address tobacco use inequalities. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

  8. Analyzing the mobile "digital divide": changing determinants of household phone ownership over time in rural bangladesh.

    PubMed

    Tran, Michael Clifton; Labrique, Alain Bernard; Mehra, Sucheta; Ali, Hasmot; Shaikh, Saijuddin; Mitra, Maithilee; Christian, Parul; West, Keith

    2015-02-25

    We had a unique opportunity to examine demographic determinants of household mobile phone ownership in rural Bangladesh using socioeconomic data collected as part of a multiyear longitudinal cohort study of married women of reproductive age. This paper explores how the demographics of household mobile phone owners have changed over time in a representative population of rural Bangladesh. We present data collected between 2008 and 2011 on household mobile phone ownership and related characteristics including age, literacy, education, employment, electricity access, and household wealth among 35,306 individuals. Respondents were enrolled when found to be newly pregnant and contributed socioeconomic information once over the course of the time period serving as a "sample" of families within the population at that time. Univariate and multiple logistic regressions analyses were performed to identify the socioeconomic determinants of household phone ownership. Across 3 fiscal years, we found that reported household ownership of at least 1 working mobile phone grew from 29.85% in the first fiscal year to 56.07% in the third fiscal year. Illiteracy, unavailability of electricity, and low quartiles of wealth were identified as overall demographic constraints to mobile phone ownership. However, over time, these barriers became less evident and equity gaps among demographic status began to dissipate as access to mobile technology became more democratized. We saw a high growth rate in ownership among households in lower economic standing (illiterate, without electricity, low and lowest wealth index), likely a result of competitive pricing and innovative service packages that improve access to mobile phones as the mobile phone market matures. In contrast, as market saturation is rapidly attained in the most privileged demographics (literate, secondary schooling, electricity, high wealth index), members of the lower wealth quartiles seem to be following suit, with more of an exponential growth. Upward trends in household mobile phone ownership in vulnerable populations over time underline the potential to leverage this increasingly ubiquitous infrastructure to extend health and finance services across social and economic strata.

  9. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--METALS IN BLOOD ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Blood data set contains analytical results for measurements of up to 2 metals in 86 blood samples over 86 households. Each sample was collected as a venous sample from the primary respondent within each household. The samples consisted of two 3-mL tubes. The prim...

  10. Determinants of long-lasting insecticidal net use in Burkina Faso after a mass distribution in the Diébougou health district.

    PubMed

    Tinoaga Ouédraogo, L; Ouédraogo, I; Yaméogo, A; Ouédraogo, V

    2013-04-01

    In 2009, a mass distribution of long-lasting insecticidal nets (LLINs) was conducted in an experimental site of the Diébougou health district. Carried out 1year after the distribution, this study aimed to determine the presence of LLINs in households, to determine the LLIN use rate, and thirdly, to identify key factors associated with LLIN use in households. We conducted a cross-sectional descriptive and analytical study, which covered the entire Diébougou health district. The study population consisted of households in the district. The statistical unit was the household head, or if absent his designated representative. For the selection of households to be studied, we considered the health centers and their geographic accessibility. We thus defined three zones: an area within 5 km of health centers, the area between 5 and 10 km away, and the area beyond 10 km. In each area, we randomly selected 20 households, totaling 60 households in the area of each health center, giving a sample of 840 households to be surveyed. We selected 60 households per health center in accordance with the time and financial resources allocated to data collection. The data were analyzed using the Epi Info 3.5.1 software package. The Chi square test was used to investigate the association between the dependent and independent variables with statistical significance set at P<0.05. When an association was demonstrated, the relative risk (RR) was calculated with the 95% confidence interval. A total of 822 households (97.8%) were surveyed, households inhabited by 6379 people including 1175 (11.4%) children under 5 years of age and 158 (2.5%) pregnant women. The overall use of LLINs was 76.5%. This rate was 81.7% in children under 5 years and 57.6% among pregnant women. Factors influencing the use of LLINs were the implementation of a communication plan by health actors (RR=2.42 [2.03-2.83]), the social position of the household head (RR=1.62 [1.43-1.83]), the marital status of the household head (RR=1.41 [1.33-1.49]), the number of persons per room (RR=1.39 [1.08-1.78]), the religion of household head (RR=1.21 [1.15-1.27]), the level of education of the household head (RR=1.15 [1.06-1.24]), and the number of IECs (information, education, communication) sessions followed by the household (RR=1.14 [1.08-1.20]). The results of this study provide guidance on measures to ensure the success of the mass distribution of LLINs to the entire country. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. What you don't know can hurt you: household products and events.

    PubMed

    Leonard, S D; Wogalter, M S

    2000-05-01

    Product safety is affected by product design and by the knowledge of the user, either through the user's own background or through instructions and warnings presented with the product. Given adequate knowledge, warnings can serve primarily to remind individuals of the hazards and precautions that can be taken. This study examined people in the USA (represented by two diverse samples) to evaluate their knowledge about the hazards associated with common household products and situations using both multiple choice and open-ended surveys. The results indicated that the respondents were aware of a substantial number of hazards, but their knowledge often did not extend to the specific circumstances that could produce personal injury and property damage. Further, comparisons of cued and non-cued responses suggested some hazards are not well recognized without the cue. The results indicate warnings are needed both as reminders and to provide safety information.

  12. Child Schooling in Ethiopia: The Role of Maternal Autonomy

    PubMed Central

    Mohanty, Itismita

    2016-01-01

    This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population. PMID:27942039

  13. Economic analysis of the link between diet quality and health: Evidence from Kosovo.

    PubMed

    Braha, Kushtrim; Cupák, Andrej; Pokrivčák, Ján; Qineti, Artan; Rizov, Marian

    2017-11-01

    We analyse the link between diet diversity, (which is a proxy of diet quality) and health outcomes measured by body-mass index (BMI) in a representative sample of Kosovar adults using household expenditure micro-data. Building on a household model of health production we devise a two-stage empirical strategy to estimate the determinants of diet diversity and its effect on BMI. Economic factors and demographic characteristics play an important role in the choice of balanced diets. Results from the BMI analysis support the hypothesis that diet diversity is associated with optimal BMI. One standard deviation increase in diet diversity leads to 2.3% increase in BMI of the underweight individuals and to 1.5% reduction in BMI of the obese individuals. The findings have important implications for food security policies aiming at enhancing the public health in Kosovo. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Communicating actionable risk for terrorism and other hazards.

    PubMed

    Wood, Michele M; Mileti, Dennis S; Kano, Megumi; Kelley, Melissa M; Regan, Rotrease; Bourque, Linda B

    2012-04-01

    We propose a shift in emphasis when communicating to people when the objective is to motivate household disaster preparedness actions. This shift is to emphasize the communication of preparedness actions (what to do about risk) rather than risk itself. We have called this perspective "communicating actionable risk," and it is grounded in diffusion of innovations and communication theories. A representative sample of households in the nation was analyzed using a path analytic framework. Preparedness information variables (including content, density, and observation), preparedness mediating variables (knowledge, perceived effectiveness, and milling), and preparedness actions taken were modeled. Clear results emerged that provide a strong basis for communicating actionable risk, and for the conclusion both that information observed (seeing preparedness actions that other have taken) and information received (receiving recommendations about what preparedness actions to take) play key, although different, roles in motivating preparedness actions among the people in our nation. © 2011 Society for Risk Analysis.

  15. The nutrient content of US household food purchases by store types

    PubMed Central

    Stern, Dalia; Ng, Shu Wen; Popkin, Barry M

    2015-01-01

    Introduction Little is known about where households shop for packaged foods, what foods and beverages they purchase, and the nutrient content of these purchases. The objectives are to describe volume trends and nutrient content (food groups and nutrient profiles) of household packaged foods purchases (PFP) by store-type. Methods Cross-sectional analysis of US households’ food purchases (Nielsen Homescan) from 2000 to 2012 (n=652,023 household-year observations) with survey weights used for national representativeness. Household PFP trends (% volume) by store-type, household purchases of key food and beverage groups based on caloric contribution by store-type, and mean caloric and nutrient densities (sugars, saturated fat and sodium) of household PFP by store-type are analyzed. Data were collected from 2000–2012. Analyses were conducted in 2014–2015. Results The proportion of total volume of household PFP significantly increased from 2000 to 2012 for mass-merchandisers (13.1 to 23.9%), convenience-stores (3.6 to 5.9%) and warehouse-club (6.2 to 9.8%), and significantly decreased for grocery-chains (58.5 to 46.3%) and non-chain grocerys (10.3 to 5.2%). Top common sources of calories (%) from household PFP by food/beverage group include: savory snacks, grain-based desserts and regular soft-drinks. The energy, total sugar, sodium and saturated fat densities of household PFP from mass-merchandisers, warehouse-club and convenience-stores were higher, compared to grocery-stores. Conclusions PFP from stores with poorer nutrient density (more energy, total sugar, sodium and saturated fat-dense), such as warehouse-club, mass-merchandisers and convenience-stores are growing, representing a potential US public health concern. PMID:26437868

  16. So many, yet few: Human resources for health in India.

    PubMed

    Rao, Krishna D; Bhatnagar, Aarushi; Berman, Peter

    2012-08-13

    In many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable. This prevents effective workforce planning and management. This paper aims to address this deficit by producing a more complete picture of India's health workforce. Both the Census of India and nationally representative household surveys collect data on self-reported occupations. A representative sample drawn from the 2001 census was used to estimate key workforce indicators. Nationally representative household survey data and official estimates were used to compare and supplement census results. India faces a substantial overall deficit of health workers; the density of doctors, nurses and midwifes is a quarter of the 2.3/1000 population World Health Organization benchmark. Importantly, a substantial portion of the doctors (37%), particularly in rural areas (63%) appears to be unqualified. The workforce is composed of at least as many doctors as nurses making for an inefficient skill-mix. Women comprise only one-third of the workforce. Most workers are located in urban areas and in the private sector. States with poorer health and service use outcomes have a lower health worker density. Among the important human resources challenges that India faces is increasing the presence of qualified health workers in underserved areas and a more efficient skill mix. An important first step is to ensure the availability of reliable and comprehensive workforce information through live workforce registers.

  17. Socio-environmental factors associated with self-rated oral health in South Africa: a multilevel effects model.

    PubMed

    Olutola, Bukola G; Ayo-Yusuf, Olalekan A

    2012-10-02

    This study examined the influence of the social context in which people live on self-ratings of their oral health. This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South African Social Attitude Survey (SASAS). We used the 2005 General Household Survey (n = 107,987 persons from 28,129 households) to obtain living environment characteristics of SASAS participants, including sources of water and energy, and household cell-phone ownership (a proxy measure for the social network available to them). Information obtained from SASAS included socio-demographic data, respondents' level of trust in people, oral health behaviors and self-rated oral health. Of the respondents, 76.3% self-rated their oral health as good. Social context influenced women's self-rated oral health differently from that of men. Good self-rated oral health was significantly higher among non-smokers, employed respondents and women living in areas with higher household cell-phone ownership. Furthermore, trust and higher social position were associated with good self-rated oral health among men and women respectively. Overall, 55.1% and 18.3% of the variance in self-rated oral health were explained by factors operating at the individual and community levels respectively. The findings highlight the potential role of social capital in improving the population's oral health.

  18. Ethnomedical syndromes and treatment-seeking behavior among Mayan refugees in Chiapas, Mexico.

    PubMed

    Smith, Bryce D; Sabin, Miriam; Berlin, Elois Ann; Nackerud, Larry

    2009-09-01

    This survey investigated the prevalence of ethnomedical syndromes and examined treatments and treatment-seeking in Mayan Guatemalans living in United Nations High Commissioner for Refugee (UNHCR) camps in Chiapas, Mexico. Methods included a rapid ethnographic assessment to refine survey methods and inform the cross-sectional survey, which also examined mental health outcomes; 183 households were approached for interview, representing an estimated 1,546 residents in five refugee camps and 93% of all households. One adult per household (N = 170) was interviewed regarding his or her health; an additional 9 adults in three surveyed households participated and were included in this analysis; of the 179 participants, 95 primary child-care providers also answered a children's health questionnaire for their children. Results indicated that ethnomedical syndromes were common in this sample, with 59% of adults and 48.4% of children having experienced susto (fright condition) and 34.1% of adults reporting ataques de nervios (nervous attacks); both conditions were significantly associated with symptoms consistent with posttraumatic stress disorder, anxiety and depression and are mental health conditions recognized by the American Psychiatric Association. Combining healthcare provider and indigenous treatments such as physician prescribed medication (65%), medicinal plants (65.7%), and limpias (spiritual cleansings) (40.6%) was reported. Most participants (86%) sought routine medical treatment from UNHCR trained health promoters in their camp. Assessing ethnomedical health is important for informing mental health programs among this population.

  19. Household Microbial Water Quality Testing in a Peruvian Demographic and Health Survey: Evaluation of the Compartment Bag Test for Escherichia coli.

    PubMed

    Wang, Alice; McMahan, Lanakila; Rutstein, Shea; Stauber, Christine; Reyes, Jorge; Sobsey, Mark D

    2017-04-01

    AbstractThe Joint Monitoring Program relies on household surveys to classify access to improved water sources instead of measuring microbiological quality. The aim of this research was to pilot a novel test for Escherichia coli quantification of household drinking water in the 2011 Demographic and Health Survey (DHS) in Peru. In the Compartment Bag Test (CBT), a 100-mL water sample is supplemented with chromogenic medium to support the growth of E. coli , poured into a bag with compartments, and incubated. A color change indicates E. coli growth, and the concentration of E. coli /100 mL is estimated as a most probable number. Triplicate water samples from 704 households were collected; one sample was analyzed in the field using the CBT, another replicate sample using the CBT was analyzed by reference laboratories, and one sample using membrane filtration (MF) was analyzed by reference laboratories. There were no statistically significant differences in E. coli concentrations between the field and laboratory CBT results, or when compared with MF results. These results suggest that the CBT for E. coli is an effective method to quantify fecal bacteria in household drinking water. The CBT can be incorporated into DHS and other national household surveys as a direct measure of drinking water safety based on microbial quality to better document access to safe drinking water.

  20. Household Microbial Water Quality Testing in a Peruvian Demographic and Health Survey: Evaluation of the Compartment Bag Test for Escherichia coli

    PubMed Central

    Wang, Alice; McMahan, Lanakila; Rutstein, Shea; Stauber, Christine; Reyes, Jorge; Sobsey, Mark D.

    2017-01-01

    The Joint Monitoring Program relies on household surveys to classify access to improved water sources instead of measuring microbiological quality. The aim of this research was to pilot a novel test for Escherichia coli quantification of household drinking water in the 2011 Demographic and Health Survey (DHS) in Peru. In the Compartment Bag Test (CBT), a 100-mL water sample is supplemented with chromogenic medium to support the growth of E. coli, poured into a bag with compartments, and incubated. A color change indicates E. coli growth, and the concentration of E. coli/100 mL is estimated as a most probable number. Triplicate water samples from 704 households were collected; one sample was analyzed in the field using the CBT, another replicate sample using the CBT was analyzed by reference laboratories, and one sample using membrane filtration (MF) was analyzed by reference laboratories. There were no statistically significant differences in E. coli concentrations between the field and laboratory CBT results, or when compared with MF results. These results suggest that the CBT for E. coli is an effective method to quantify fecal bacteria in household drinking water. The CBT can be incorporated into DHS and other national household surveys as a direct measure of drinking water safety based on microbial quality to better document access to safe drinking water. PMID:28500818

  1. NHEXAS PHASE I ARIZONA STUDY--METALS IN AIR ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Air data set contains analytical results for measurements of up to 11 metals in 369 air samples over 175 households. Samples were taken by pumping standardized air volumes through filters at indoor and outdoor sites around each household being sampled. The primary...

  2. War and disaster in Sri Lanka: Depression, family adjustment and health among women heading households.

    PubMed

    Banford Witting, Alyssa; Lambert, Jessica; Wickrama, Thulitha; Thanigaseelan, Sivaguru; Merten, Michael

    2016-08-01

    The civil war, lasting from 1983 to 2009, and the tsunami that struck Southeastern Asia in 2004 were major stressors that changed the demographic landscape of the northern province of Sri Lanka. The composition of families changed dramatically, with an increase in female-headed households, largely due to casualties. The conservation of resources (COR) model was applied in this study to examine relationships between risk and resiliency factors among women heading households, including women widowed by war or disaster. This study represents an investigation of the association between predictive risk and resiliency factors (i.e. war damage and loss, social support, economic status, religious participation and discrimination) and outcomes representing well-being (depressive symptoms, family adjustment and a rating of physical health). Data from 514 women heading households living in the Kilinochchi district of Sri Lanka were collected through face-to-face interviews in 2013, and associations among the data were estimated using path analysis. Results suggest that resiliency factors that are representative of greater resources generally predicted lower levels of distress and vice versa. Further study informing intervention development with women heading households in Sri Lanka is warranted to better understand which individual, family and community resources are most important to mobilize for sustainable recovery efforts to be successful in the decades following war and natural disaster. © The Author(s) 2016.

  3. Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.

    PubMed

    Goulet-Stock, Sybil; Rueda, Sergio; Vafaei, Afshin; Ialomiteanu, Anca; Manthey, Jakob; Rehm, Jürgen; Fischer, Benedikt

    2017-01-01

    While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems. © 2017 S. Karger AG, Basel.

  4. 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.

  5. Behavior of urban residents toward the discarding of waste electrical and electronic equipment: a case study in Baoding, China.

    PubMed

    Li, Jinhui; Liu, Lili; Ren, Junshu; Duan, Huabo; Zheng, Lixia

    2012-11-01

    The volume of waste electrical and electronic equipment (WEEE) is growing rapidly worldwide, making its management difficult; therefore, this should be improved as a matter of urgency. WEEE includes both essential household appliances [including televisions, refrigerators, and washing machines; but not air conditioners, where the consumption mode is more like information, communication and technology (ICT)] ICT equipment (also called high-tech household appliances). In the present study, Baoding, a medium-sized, prefecture-level city in north central China with a population of 11 million, including 1.1 million urban residents, was selected as a representative city for an investigation of recycling behaviors. A valid sample size of 346 households in Baoding was investigated, and categorized into various income and educational levels. The results showed that the major reason for discarding WEEE was malfunction of the appliance, accounting for 52% of disposals. Surveyed households with either high income or good education were more likely to consume high-tech household appliances, attracted by advanced technology, versatile functions or flexibility of use. Personal computer ownership rates were highest in households with a high income and good education-1.2 and 0.9 per home respectively. WEEE was most often sold to peddlers or hawkers from where the WEEE flowed into the second-hand market to be refurbished or repaired, and then re-sold. However, 56.3% of residents in the college community were in support of charging consumers for disposal and 61.7% were in support of including a disposal surcharge in the purchase price of new products-a percentage approximately three times that for high-income residents. Thus, high educational level appears to be currently the most important factor in raising the potential of a household's willingness to pay for WEEE treatment cost. The findings of this study can be used to develop sound recycling systems for WEEE in mainland China.

  6. The association between socioeconomic deprivation and secondary school students' health: findings from a latent class analysis of a national adolescent health survey.

    PubMed

    Denny, Simon; Lewycka, Sonia; Utter, Jennifer; Fleming, Theresa; Peiris-John, Roshini; Sheridan, Janie; Rossen, Fiona; Wynd, Donna; Teevale, Tasileta; Bullen, Pat; Clark, Terryann

    2016-07-16

    The aims of this study were to examine indicators of socioeconomic deprivation among secondary school students and to determine associations between household poverty, neighbourhood deprivation and health indicators. Data were from a nationally representative sample of 8500 secondary school students in New Zealand who participated in a health survey in 2012. Latent class analyses were used to group students by household poverty based on nine indicators of household socioeconomic deprivation: no car; no phone; no computer; their parent/s worry about not having enough money for food; more than two people sharing a bedroom; no holidays with their families; moving home more than twice that year; garages or living rooms used as bedrooms; and, no parent at home with employment. Multilevel generalized linear models were used to estimate the cross-level interaction between household poverty and neighbourhood deprivation with depressive symptoms, cigarette smoking and overweight/ obesity. Three groups of students were identified: 80 % of students had low levels of household poverty across all indicators; 15 % experienced moderate poverty; and 5 % experienced high levels of poverty. Depressive symptoms and cigarette smoking were 2-3 times higher in the poverty groups compared to student's not experiencing poverty. There were also higher rates of overweight/ obesity among students in the poverty groups compared to students not experiencing poverty, but once covariates were accounted for the relationship was less clear. Of note, students experiencing poverty and living in affluent neighbourhoods reported higher levels of depressive symptoms and higher rates of cigarette smoking than students experiencing poverty and living in low socioeconomic neighbourhoods. This cross-level interaction was not seen for overweight/ obesity. Measures of household socioeconomic deprivation among young people should not be combined with neighbourhood measures of socioeconomic deprivation due to non-linear relationships with health and behaviour indicators. Policies are needed that address household poverty alongside efforts to reduce socioeconomic inequalities in neighbourhoods.

  7. 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…

  8. The socioeconomic within-gender gap in informal caregiving among middle-aged women: Evidence from a Japanese nationwide survey.

    PubMed

    Tokunaga, Mutsumi; Hashimoto, Hideki

    2017-01-01

    Caregiving to older people with needs has been mainly dependent on informal care provision by female caregivers. Compared with the care burden gender gap, the within-gender gap in women's socioeconomic status (SES) has attracted less policy attention. We investigated the association between middle-aged women's SES and the likelihood of being a primary caregiver for elderly informal care, focusing on household income, women's marital status, work status, and educational background under the universal and public system of formal long-term care provision in Japan. We used repeated cross-sectional data from nationally representative household surveys conducted between 2010 and 2013 to obtain a sample of 2399 women aged between 40 and 60 years living in the same household as a care recipient. We conducted multiple logistic regression analysis to obtain odds ratios of being a primary caregiver in the household regressed on women's SES variables, adjusting for the characteristics of care recipients and household composition. The results showed that single women with lower education were likely to be primary caregivers when the care recipients had severe levels of care needs, whereas the association was null in the case of care recipients with milder conditions. The results indicated that women's low education and non-married status were related to a higher likelihood of becoming a primary caregiver of severely disabled elderly for reasons other than lower economic power. To emancipate socioeconomically vulnerable women from the care burden, a broader set of social, economic, and welfare policies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. User fee exemptions are not enough: out-of-pocket payments for 'free' delivery services in rural Tanzania.

    PubMed

    Kruk, Margaret E; Mbaruku, Godfrey; Rockers, Peter C; Galea, Sandro

    2008-12-01

    To identify the main drivers of costs of facility delivery and the financial consequences for households among rural women in Tanzania, a country with a policy of delivery fee exemptions. We selected a representative sample of households in a rural district in western Tanzania. Women who given birth within 5 years were asked about payments for doctor's/nurse's fees, drugs, non-medical supplies, medical tests, maternity waiting home, transport and other expenses. Wealth was assessed using a household asset index. We estimated the proportion of women who cut down on spending or borrowed money/sold household items to pay for delivery in each wealth group. In all, 73.3% of women with facility delivery reported having made out-of-pocket payments for delivery-related costs. The average cost was 6272 Tanzanian shillings (TZS), [95% Confidence Interval (CI): 4916, 7628] or 5.0 United States dollars. Transport costs (53.6%) and provider fees (26.6%) were the largest cost components in government facilities. Deliveries in mission facilities were twice as expensive as those in government facilities. Nearly half (48.3%) of women reported cutting down on spending or borrowing money/selling household assets to pay for delivery, with the poor reporting this most frequently. Out-of-pocket payments for facility delivery were substantial and were driven by high transport costs, unofficial provider payments, and preference for mission facilities, which levy user charges. Novel approaches to financing maternal health services, such as subsidies for transport and care from private providers, are required to reduce the cost barriers to attended delivery.

  10. Household Food Insecurity Is Associated with Nutritional Status among Iranian Children.

    PubMed

    Shahraki, Soudabeh Hamedi; Amirkhizi, Farshad; Amirkhizi, Behzad; Hamedi, Sousan

    2016-01-01

    This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7-11 years was selected by a multistage cluster random sampling method during December 2013-May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother's and father's education level (p = .005 and p = .042, respectively), father's occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.

  11. A nationwide population-based study on incidence and cost of non-fatal injuries in Iran.

    PubMed

    Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Motevalian, Abbas; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Radgoodarzi, Reza; Hefazi, Mitra; Eslami, Vahid; Saadat, Soheil; Rahimi-Movaghar, Vafa

    2014-10-01

    Elucidating the epidemiological status of injuries is a critical component of preventive strategies in countries with high incidence of injuries, like Iran. Population-based surveys are able to estimate all types of non-fatal injuries. This study protocol is the core unit in describing Iran's national cost and epidemiology of non-fatal injuries, and also as a guide for other studies. In a cross-sectional study, 1525 primary sampling units are randomly selected with probability proportional to size regarding the number of households in each enumeration area based on Iran's 2006 national census. Six of the households are randomly selected. One member of each household is chosen using Kish Grid tables. In all, 9150 subjects are selected. Data on demographics are collected. For each injury during the past three months, activity, place, mechanism, site, type and the place of treatment are coded to match the International Classification of Diseases, 10th revision 2012 (ICD10-2012) classifications. Subjects are contacted via telephone to obtain data on cost of injury. Finally, sampling weights are calculated so that data for each respondent can be inflated to represent other individuals in Iran. Quality control and quality assurance issues are discussed. Our objectives will describe the present impact and the future priorities of injury prevention in Iran. 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.

  12. The Canadian Human Activity Pattern Survey: report of methods and population surveyed.

    PubMed

    Leech, J A; Wilby, K; McMullen, E; Laporte, K

    1996-01-01

    The assessment of health risk due to environmental contaminants depends upon accurate estimates of the distribution of population exposures. Exposure assessment, in turn, requires information on the time people spend in micro-environments and their activities during periods of exposure. This paper describes preliminary results including study methodology and population sampled in a large Canadian survey of time-activity patterns. A 24-hour diary recall survey was performed in 2381 households (representing a 65% response rate) to describe in detail the timing, location and activity pattern of one household member (the adult or child with the next birthday). Four cities (Toronto, Vancouver, Edmonton and Saint John, NB) and their suburbs were sampled by random-digit dialling over a nine-month period in 1994/1995. Supplemental questionnaires inquiring about sociodemographic information, house and household characteristics and potential exposure to toxins in the air and water were also administered. In general, the results show that respondents spend the majority of their time indoors (88.6%) with smaller proportions of time outdoors (6.1%) and in vehicles (5.3%). Children under the age of 12 spend more time both indoors and outdoors and less time in transit than do adults. The data from this study will be used to define more accurately the exposure of Canadians to a variety of toxins in exposure assessment models and to improve upon the accuracy of risk assessment for a variety of acute and chronic health effects known or suspected to be related to environmental exposures.

  13. Equity in out-of-pocket payments for hospital care: evidence from India.

    PubMed

    Roy, Kakoli; Howard, David Hill

    2007-02-01

    The lack of formal health insurance and inadequate social safety nets cause families in most low-income countries to finance health spending through out-of-pocket (OOP) payments, leaving poor families unable to insure their consumption during periods of major illnesses. To examine how well the Indian healthcare system protects households of differing living standards against the financial consequences of unanticipated health shocks. The data are drawn from the 52nd round of National Sample Survey, a nationally representative socioeconomic and health survey conducted in 1995-1996. The sample comprises 24,379 (3.84%) households where a member was hospitalized during the 1-year reference period. We estimate, using ordinary least squares, the relationship between household consumption (proxy for ability to pay) and OOP payments for hospitalization. We also estimate the relationship between consumption and OOP share in consumption. Our results indicate that both utilization (payments) and the consequent financial burden (payment share) increases with increasing ability to pay (ATP). While this relationship is retained across the different subgroups (e.g., gender, social code, region, etc.), comparisons across groups indicate horizontal inequities including differences in both degrees of progressivity and the redistributive effect. The finding that OOP payments do not decline with ATP could be an indication of: (1) the lack of insurance which implies that the better-off must pay from OOP to secure quality health care and (2) the absence of risk-pooling or prepayments mechanisms which poses financial impediments to the consumption of health care by the poor.

  14. The National Children's Study: Recruitment Outcomes Using an Enhanced Household-Based Approach.

    PubMed

    Blaisdell, Laura L; Zellner, Jennifer A; King, Alison A; Faustman, Elaine; Wilhelm, Mari; Hudak, Mark L; Annett, Robert D

    2016-06-01

    Ten National Children's Study (NCS) study locations with diverse demographic characteristics used an enhanced household-based recruitment (EHBR) approach to enroll preconceptional and pregnant women. Study centers used different types and dosages of community outreach and engagement (COE) activities and supplemental strategies. The goal of the study was to determine whether variability in enumeration and recruitment outcomes correlated with study location characteristics or types and dosages of COE activities (number of COE events, number of advance household mailings, total media expenditures, and total COE expenditures). Each of the sites provided data on COE activities, protocol implementation, supplemental recruitment activities, location demographic characteristics, and enumeration/recruitment outcomes. COE activities varied across sites in breadth and scope. Numerous strategies were used, including media advertising, social media, participation in community-wide events, presentations to stakeholders, and creation of advisory boards. Some sites included supplemental recruitment efforts. EHBR sites enrolled 1404 women at the initial pregnancy screening. No significant relationships were found between study location demographic characteristics or between the types and dosages of COE activities and recruitment outcomes. Probability sampling for a long-term study requires a positive image with stakeholders and within communities; this requirement may be especially true for door-to-door recruitment. EHBR sites successfully recruited a representative sample of preconceptional and pregnant women. Sites reported implementing similar COE activities but with varying dosage and cost; however, analyses did not support a benefit of COE strategies on study recruitment. Copyright © 2016 by the American Academy of Pediatrics.

  15. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY-PESTICIDES AND POLYCHLORINATED BIPHENYLS (PCBS) IN BLOOD ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticides and PCBs in Blood data set contains analytical results for measurements of up to 11 pesticides and up to 36 PCBs in 86 blood samples over 86 households. Each sample was collected as a venous sample from the primary respondent within each household. The samples co...

  16. Evaluation of four sampling methods for determining exposure of children to lead-contaminated household dust

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

    Sterling, D.A.; Roegner, K.C.; Lewis, R.D.

    Childhood exposure to lead has been demonstrated to result in health effects and lead-contaminated household dust is a primary exposure source. There is a need to establish reliable methods for sampling surfaces to determine levels of lead contamination. Three vacuums (HVS3, GS80, and MVM) and one wipe method were evaluated for the collection of household floor dust under field sampling conditions within a Superfund site and demographically similar control area. Side-by-side floor samples were taken from three locations within 41 randomly selected households between August and September 1995: a child's bedroom, primary play area, and primary entrance. Analysis was performedmore » to assess the relative collection performance of each sampler, spatial distribution of lead within a household, and correlation of lead loading with observed blood lead level, and to determine if discrete or composites samples were more predictive of blood lead levels. Approximately 90% of the floor surfaces were carpeted. The rank order of sampling methods from greatest to lowest collection efficiency was HVS3 > G80 > wipe > MVM. The HVS3 had the highest level of precision (CV = 0.05), with the GS80 and wipe precisions 0.48 and 0.053, respectively.« less

  17. Under-five mortality among mothers employed in agriculture: findings from a nationally representative sample.

    PubMed

    Singh, Rajvir; Tripathi, Vrijesh

    2015-01-01

    Background. India accounts for 24% to all under-five mortality in the world. Residence in rural area, poverty and low levels of mother's education are known confounders of under-five mortality. Since two-thirds of India's population lives in rural areas, mothers employed in agriculture present a particularly vulnerable population in the Indian context and it is imperative that concerns of this sizeable population are addressed in order to achieve MDG4 targets of reducing U5MR to fewer than 41 per 1,000 by 2015. This study was conducted to examine factors associated with under-five mortality among mothers employed in agriculture. Methods. Data was retrieved from National Family Household Survey-3 in India (2008). The study population is comprised of a national representative sample of single children aged 0 to 59 months and born to mothers aged 15 to 49 years employed in agriculture from all 29 states of India. Univariate and Multivariate Cox PH regression analysis was used to analyse the Hazard Rates of mortality. The predictive power of child mortality among mothers employed in agriculture was assessed by calculating the area under the receiver operating characteristic (ROC) curve. Results. An increase in mothers' ages corresponds with a decrease in child mortality. Breastfeeding reduces child mortality by 70% (HR 0.30, 0.25-0.35, p = 0.001). Standard of Living reduces child mortality by 32% with high standard of living (HR 0.68, 0.52-0.89, 0.001) in comparison to low standard of living. Prenatal care (HR 0.40, 0.34-0.48, p = 0.001) and breastfeeding health nutrition education (HR 0.45, 0.31-0.66, p = 0.001) are associated significant factors for child mortality. Birth Order five is a risk factor for mortality (HR 1.49, 1.05-2.10, p = 0.04) in comparison to Birth Order one among women engaged in agriculture while the household size (6-10 members and ≥ 11 members) is significant in reducing child mortality in comparison to ≤5 members in the house. Under-five mortality among mothers employed in agriculture in India discriminated well between death and survival (Area Under ROC was 0.75, 95% CI [0.73-0.77]) indicating that the model is good for appropriate prediction of child mortality. Conclusion. In a nationally representative sample of households in India, mother's age, breastfeeding, standard of living, prenatal care and breastfeeding health nutrition education are associated with reduction in child mortality.

  18. Household Food Insecurity, Underweight Status, and Associated Characteristics among Women of Reproductive Age Group in Assayita District, Afar Regional State, Ethiopia.

    PubMed

    Abdu, Jemal; Kahssay, Molla; Gebremedhin, Merhawi

    2018-01-01

    Poor nutritional status of women has been a serious problem in Ethiopia. Rural women are more likely to be undernourished than urban women. Afar region is the most likely to be undernourished (43.5%). Despite the humanitarian and food aid, food insecurity and maternal underweight are very high in the region. Household food insecurity is not adequately studied in Afar region. The aim of this study was to assess the prevalence of household food insecurity and underweight status and its association among reproductive age women. The study was conducted in Assayita district in June 2015. Community-based cross-sectional study design was used among nonpregnant women. Household data was collected using structured questionnaire. Multistage cluster sampling procedure was applied. Two pastoral and two agropastoral Kebeles have been selected by simple random sampling. Systematic random sampling was used to select respondents. The total sample size was 549 households. Household Food Insecurity Access Scale (HFIAS) and anthropometric data were used to determine food insecurity and underweight, respectively. Multivariate regression models were used to measure associations. Prevalence of HFIAS was 70.4 with a mean of 7.0 (3.6 ± SD); 26.1%, 30.20%, and 14.1% were mild, moderate, and severe food insecurity, respectively. Underweight prevalence (BMI < 18.5) was 41.1% with prevalence of mild, moderate, and severe underweight being 34.5%, 3.9%, and 2.7%, respectively. Age, parity, and having >2 children below five years of age were statistically associated with household food insecurity and maternal underweight. Household food insecurity and maternal underweight were very high. Age, parity, and having ≥2 children below five years of age were associated with household food insecurity. Maternal underweight was associated with maternal age, marital status, parity, number of children below 5 years, household food insecurity, and vocation of the respondents.

  19. Household safe water management in Kisii County, Kenya.

    PubMed

    Misati, A G

    2016-11-01

    Contaminated drinking water can lead to the risk of intestinal and other infectious diseases that lead to high morbidity. Therefore, determining household safe water management practices will benefit billions of people by ensuring there is no recontamination. A cross-sectional study design was used and a sample of 346 households was selected through systematic random sampling. A questionnaire was then used which was based on the core questions on drinking water and sanitation for household surveys and descriptive analyses were performed for the collected data using SPSS. Springs were predominantly used as the main source of water (97 %). Approximately, over half (58 %) of the sampled households never treated their drinking water to ensure that it was safe for drinking. Mostly (56 %), the households used jerricans for the storage of water with a majority of the households (95 %) covering their containers which were elevated from the reach of children in 52 % of the households. The risks included lack of water treatment, not covering the water container, risk of permitting dipping for those containers, lacking narrow neck and the risk of container being accessible to children. Basic treatment of the water at the household level by use of chemicals, filtration and boiling may have a great impact on the drinking water quality and health of the inhabitants of Kisii County. Also, creation of awareness on the possibilities of spring water being contaminated should be carried because of the assumption that spring water is safe and does not need to be treated.

  20. Profile of mental disorders among the elderly United Arab Emirates population: sociodemographic correlates.

    PubMed

    Ghubash, Rafia; El-Rufaie, Omer; Zoubeidi, Taoufik; Al-Shboul, Qasim M; Sabri, Sufyan M

    2004-04-01

    To investigate the prevalence, nature and sociodemographic correlates of mental disorders among the elderly United Arab Emirates (UAE) population. STUDY SUBJECTS AND SAMPLE: UAE nationals aged 60 years or more, were recruited from within a random sample of households representing the UAE national population, irrespective of the age of individuals in each household. RESEARCH INSTRUMENTS: (i) Geriatric Mental State Interview (GMS-A3): an Arabic version, using the AGECAT for analysis; (ii) A short questionnaire for relevant sociodemographic data. Purposely trained, Arabic speaking interviewers visited the targeted sample households to interview study subjects at their homes. The total number of screened subjects was 610: 166 (27.2%) in Al-Ain; 286 (46.9%) in Dubai and 158 (25.9%) in Ras Al-Khaimah. There were 347 (56.9%) male subjects and 263 (43.1%) female subjects. The mean age of the interviewed subjects was 68.6 (SD 8.3). The commonest diagnostic entities at the AGECAT syndrome case level were depression (20.2%), anxiety (5.6%), hypochondriasis (4.4%) and organic, mostly cognitive impairment with or without dementia (3.6%). Organic syndrome caseness, as an independent entity, showed significant correlation only to older age, while the rest of the mental disorders showed significant correlation with female gender, insufficient income and being single, separated, divorced or widowed. The GMS-AGECAT package proved to be a useful tool for psychiatric assessment among the elderly in this Arabian culture. The prevalence rates of mental disorders among the elderly UAE population were, more or less, within the same range reported by other comparable worldwide studies. Copyright 2004 John Wiley & Sons, Ltd.

  1. The role of gallery forests in maintaining Phlebotominae populations: potential Leishmania spp. vectors in the Brazilian savanna.

    PubMed

    Machado, Tâmara Dias Oliveira; Minuzzi-Souza, Thaís Tâmara Castro; Ferreira, Tauana de Sousa; Freire, Luciana Pereira; Timbó, Renata Velôzo; Vital, Tamires Emanuele; Nitz, Nadjar; Silva, Mariana Neiva; Santos, Alcinei de Souza; Sales, Nathyla Morgana Cunha; Obara, Marcos Takashi; Andrade, Andrey José de; Gurgel-Gonçalves, Rodrigo

    2017-10-01

    Knowledge on synanthropic phlebotomines and their natural infection by Leishmania is necessary for the identification of potential areas for leishmaniasis occurrence. To analyse the occurrence of Phlebotominae in gallery forests and household units (HUs) in the city of Palmas and to determine the rate of natural infection by trypanosomatids. Gallery forests and adjacent household areas were sampled on July (dry season) and November (rainy season) in 2014. The total sampling effort was 960 HP light traps and eight Shannon traps. Trypanosomatids were detected in Phlebotominae females through the amplification of the SSU rDNA region, and the positive samples were used in ITS1-PCR. Trypanosomatid species were identified using sequencing. A total of 1,527 sand flies representing 30 species were captured in which 949 (28 spp.) and 578 (22 spp.) were registered in July and November, respectively. In July, more specimens were captured in the gallery forests than in the HUs, and Nyssomyia whitmani was particularly frequent. In November, most of the specimens were found in the HUs, and again, Ny. whitmani was the predominant species. Lutzomyia longipalpis was commonly found in domestic areas, while Bichromomyia flaviscutellata was most frequent in gallery forests. Molecular analysis of 154 pools of females (752 specimens) identified Leishmania amazonensis, L. infantum, and Crithidia fasciculata in Ny. whitmani, as well as L. amazonensis in Lu. longipalpis, Trypanosoma sp. and L. amazonensis in Pintomyia christenseni, and L. amazonensis in both Psathyromyia hermanlenti and Evandromyia walkeri. These results show the importance of gallery forests in maintaining Phlebotominae populations in the dry month, as well as their frequent occurrence in household units in the rainy month. This is the first study to identify Leishmania, Trypanosoma, and Crithidia species in Phlebotominae collected in Palmas, Tocantins, Brazil.

  2. Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study.

    PubMed

    Petroze, Robin T; Joharifard, Shahrzad; Groen, Reinou S; Niyonkuru, Francine; Ntaganda, Edmond; Kushner, Adam L; Guterbock, Thomas M; Kyamanywa, Patrick; Calland, J Forrest

    2015-01-01

    Disparities in access to quality injury care are a growing concern worldwide, with over 90 % of global injury-related morbidity and mortality occurring in low-income countries. We describe the use of a survey tool that evaluates the prevalence of surgical conditions at the population level, with a focus on the burden of traumatic injuries, subsequent disabilities, and barriers to injury care in Rwanda. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool is a cross-sectional, cluster-based population survey designed to measure conditions that may necessitate surgical consultation or intervention. Questions are structured anatomically and designed around a representative spectrum of surgical conditions. Households in Rwanda were sampled using two-stage cluster sampling, and interviews were conducted over a one-month period in 52 villages nationwide, with representation of all 30 administrative districts. Injury-related results were descriptively analyzed and population-weighted by age and gender. A total of 1,627 households (3,175 individuals) were sampled; 1,185 lifetime injury-related surgical conditions were reported, with 38 % resulting in some form of perceived disability. Of the population, 27.4 % had ever had a serious injury-related condition, with 2.8 % having an injury-related condition at the time of interview. Over 30 % of household deaths in the previous year may have been surgically treatable, but only 4 % were injury-related. Determining accurate injury and disability burden is crucial to health system planning in low-income countries. SOSAS is a useful survey for determining injury epidemiology at the community level, which can in turn help to plan prevention efforts and optimize provision of care.

  3. Why do households invest in sanitation in rural Benin: Health, wealth, or prestige?

    NASA Astrophysics Data System (ADS)

    Gross, Elena; Günther, Isabel

    2014-10-01

    Seventy percent of the rural population in sub-Saharan Africa does not use adequate sanitation facilities. In rural Benin, as much as 95% of the population does not use improved sanitation. By analyzing a representative sample of 2000 rural households, this paper explores why households remain without latrines. Our results show that wealth and latrine prices play the most decisive role for sanitation demand and ownership. At current income levels, sanitation coverage will only increase to 50% if costs for construction are reduced from currently 190 USD to 50 USD per latrine. Our analysis also suggests that previous sanitation campaigns, which were based on prestige and the allure of a modern lifestyle as motives for latrine construction, have had no success in increasing sanitation coverage. Moreover, improved public health, which is the objective of public policies promoting sanitation, will not be effective at low sanitation coverage rates. Fear at night, especially of animals, and personal harassment, are stated as the most important motivational factors for latrine ownership and the intention to build one. We therefore suggest changing the message of sanitation projects and introduce new low-cost technologies into rural markets; otherwise, marketing strategies will continue to fail in increasing sanitation demand.

  4. Food security among young adults with disabilities in the United States: Findings from the National Health Interview Survey.

    PubMed

    Brucker, Debra L

    2016-04-01

    Prior research has suggested that young adults with disabilities face economic, health and social disadvantage. Food security, an area of disadvantage that can influence overall health, has not been fully explored for this population. To examine levels of food security between young adults with and without disabilities, controlling for individual characteristics. Logistic regression analysis of a nationally representative sample of young adults (age 18-25) (n = 32,795) with and without disabilities, using pooled data form the 2011-2013 National Health Interview Survey. Young adults with disabilities have significantly higher odds (OR: 2.58, p < 0.001) of living in a household that is food insecure than young adults without disabilities, even when controlling for individual characteristics. Odds of living in a household that is food insecure are particularly high (OR: 5.35, p < 0.001) among young adults with high levels of psychological distress, controlling for other factors. Young adults with disabilities have increased odds of living in a household that is food insecure. This study has important policy and community program implications. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--METALS IN AIR ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Air data set contains analytical results for measurements of up to 11 metals in 344 air samples over 86 households. Samples were taken by pumping standardized air volumes through filters at indoor and outdoor sites around each household being sampled. The primary ...

  6. NHEXAS PHASE I ARIZONA STUDY--METALS IN DERMAL WIPES ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Dermal Wipes data set contains analytical results for measurements of up to 11 metals in 179 dermal wipe samples over 179 households. Each sample was collected from the primary respondent within each household during Stage III of the NHEXAS study. The sampling per...

  7. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--PESTICIDE METABOLITES IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticide Metabolites in Urine data set contains the analytical results for measurements of up to 8 pesticide metabolites in 86 samples over 86 households. Each sample was collected form the primary respondent within each household. The sample consists of the first morning ...

  8. NHEXAS PHASE I ARIZONA STUDY--METALS IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Urine data set contains analytical results for measurements of up to 6 metals in 176 urine samples over 176 households. Each sample was collected from the primary respondent within each household during Stage III of the NHEXAS study. The sample consists of the fir...

  9. Copper in household drinking water in the city of Zagreb, Croatia.

    PubMed

    Pizent, Alica; Butković, Sanja

    2010-09-01

    Copper concentration was estimated in tap water samples obtained from 70 households in Zagreb, serviced by a public water supply system. First-draw and flushed samples of tap water were collected in the morning and total copper concentration was determined by graphite furnace atomic absorption spectrometry with Zeeman-effect background correction. We also estimated the contribution of plumbing material to copper concentrations in tap water. In households with copper pipes, median and range copper values were 310 μg L-1 [(27 to 632) μg L-1] in first-draw samples and 16 μg L-1 [(5 to 52) μg L-1] in flushed samples. Corresponding values for households with galvanised pipes were 140 μg L-1 [(11 to 289) μg L-1] and 8 μg L-1 [(1 to 42) μg L-1], respectively. Copper concentrations in household tap water in Zagreb were far below the proposed safe limits set by the Croatian and WHO regulations and EPA standards, and drinking water in Zagreb is not a significant source of copper exposure.

  10. Male-female differences in households' resource allocation and decision to seek healthcare in south-eastern Nigeria: Results from a mixed methods study.

    PubMed

    Onah, Michael Nnachebe; Horton, Susan

    2018-05-01

    Ability to influence household decision-making has been shown to increase with improved social capital and power and is linked to better access to household financial resources and other services outside the household including healthcare. To examine the male-female differences in household custody of financial resources, decision-making, and type of healthcare utilised, we used a mixed methods approach of cross-sectional household surveys and focus-group discussions (FGDs). Data was collected between 10 January-28 February 2011. We analyzed a sample of 411 households and a sub-sample of 223 households with a currently married head. We conducted six single-sex FGDs in 3 communities (1 urban, 2 rural) among a random sub-sample of participants in the survey. We performed univariate, bivariate, and logistic regression analyses with a 95% confidence interval. For the qualitative data, we performed thematic analysis where broad themes relevant to the research objective were abstracted. In all households and in those with a married head, sick male members were less likely to forgo healthcare (aOR all 0.87, 95% CI 0.80-0.90; aOR married 0.52, 95% CI 0.18-0.83) and more likely to utilise formal healthcare relative to female sick members (aOR all 3.36, 95% CI 3.20-3.87; aOR married 19.50, 95% CI 9.62-39.52). Formal healthcare providers are medically trained while informal providers are untrained vendors that dispense medications for profit. There were more reports of sole custody of household resources among men within households with married heads. Joint decision-making on healthcare expenditure improved women's access to healthcare but is not reflective of unhindered access to household financial resources. Qualitatively, women spoke of seeking permission from male household head before expenditure was incurred, while male heads spoke of concealing household financial resources from their spouse. Gender constructs and male-female differences have important effects on household resource allocation and healthcare utilisation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  11. Occurrence of potentially pathogenic nontuberculous mycobacteria in Mexican household potable water: a pilot study

    PubMed Central

    2013-01-01

    Background Nontuberculous mycobacteria (NTM) are environmental opportunistic pathogens found in natural and human-engineered waters, including drinking water distribution systems and household plumbing. This pilot study examined the frequency of occurrence of NTM in household potable water samples in Mexico City. Potable water samples were collected from the “main house faucet” and kitchen faucet. The presence of aerobic-mesophilic bacteria (AMB), total coliforms (TC), fecal coliforms (FC) and NTM species were determined. Mycobacteria species were identified by PCR restriction enzyme pattern analysis (PRA) of the 65-kDa heat shock protein gene (hsp65) and sequencing of the hypervariable region 2 (V2) of the 16S rRNA gene and of the rpoB gene. Results AMB (<100 CFU/ml) were present in 118 out of 120 samples; only two samples were outside guidelines ranges (>100 CFU/ml). TC and FC were detected in four and one samples, respectively. NTM species were recovered from 16% samples (19/120) and included M. mucogenicum (nine), M. porcinum (three), M. avium (three), M. gordonae (one), M. cosmeticum (one), M. fortuitum (one), and Mycobacterium sp (one). All household water samples that contained NTM complied with the standards required to grade the water as “good quality” potable water. Conclusion Household potable water may be a potential source of NTM infection in Mexico City. PMID:24330835

  12. Surface discharge of raw wastewater among unsewered homes in central Alabama

    NASA Astrophysics Data System (ADS)

    Elliott, M.; Das, P.; Blackwell, A.; Aytekin, E.; Hu, Y.; White, K.; Jones, R.; Lu, Y.

    2017-12-01

    Discussions of future water and wastewater challenges in the US typically focus on crumbling infrastructure. However, another major challenge has been almost entirely neglected. A growing body of evidence indicates that household discharge of untreated wastewater to the surface (through so-called "straight pipes") is widespread in poor rural communities of Appalachia and the southeastern US. The US Census included water and wastewater questions until 1990. However, the census questions do not appear to differentiate clearly between legal onsite treatment and discharge of raw wastewater to the ground (EPA, 1999; US Census, 2015). Although straight pipes are illegal, many reports from the southern US and Appalachia indicate that the practice is still common in poor rural areas (e.g., EPA Region 4, 2002; du Albuquerque, 2011). A representative, county-scale report on straight pipes in Madison County, NC (Baldwin, 2000) found that 5.6% of unsewered rural households directly discharged raw wastewater and a 2005 study of Bibb County, AL, reported 15% straight pipe among households not connected to sewer (White and Jones, 2006). We focused on two Alabama counties (Hale and Wilcox) with high rates of rural poverty (26.6% and 39.2% of households in poverty, respectively) and soils unsuited for conventional septic systems. We used two main methods (1) site-by-site inspections of a random sample of unsewered rural homes and (2) water sample collection and analysis from impacted streams. We found high rates of straight pipe use and substantial impacts on water quality in local streams. For example, in Wilcox Co., 60% of unsewered households had a visible straight pipe; conservatively, these homes discharge 500,000 gallons of raw sewage to the ground in Wilcox Co. each day. Water sampling upstream and downstream of an unsewered town with many straight pipes indicated major impacts on surface water quality. Additionally, the literature reveals possible health impacts from onsite wastewater; the most recent survey of soil-transmitted helminths (worms) in Alabama was in Wilcox Co. and showed that 33% of children were positive for one or more helminths (Badham, 1993). We will also address possible solutions to onsite wastewater failures in rural Alabama and current evidence for how widespread these issues may be in the US.

  13. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2012 Income Guidelines

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 4,950 6,188 5,688 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 Contiguous States and the District ofColumbia Alaska Hawaii 1 $22...

  14. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2011 Income Guidelines *

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: 4,775 5,975 5,488 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 Contiguous States and the District ofColumbia Alaska Hawaii 1 $21...

  15. 45 CFR Appendix A to Part 1611 - Income Level for Individuals Eligible for Assistance

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: 5,075 6,350 5,838 * The figures in this table represent 125% of the poverty guidelines by household size as determined by DHHS. Reference Chart—200% of DHHS Federal Poverty Guidelines Size of household...

  16. Success of Senegal's first nationwide distribution of long-lasting insecticide-treated nets to children under five - contribution toward universal coverage

    PubMed Central

    2011-01-01

    Background In 2009, the first national long-lasting insecticide-treated net (LLIN) distribution campaign in Senegal resulted in the distribution of 2.2 million LLINs in two phases to children aged 6-59 months. Door-to-door teams visited all households to administer vitamin A and mebendazole, and to give a coupon to redeem later for an LLIN. Methods A nationwide community-based two-stage cluster survey was conducted, with clusters selected within regions by probability proportional to size sampling, followed by GPS-assisted mapping, simple random selection of households in each cluster, and administration of a questionnaire using personal digital assistants (PDAs). The questionnaire followed the Malaria Indicator Survey format, with rosters of household members and bed nets, and questions on campaign participation. Results There were 3,280 households in 112 clusters representing 33,993 people. Most (92.1%) guardians of eligible children had heard about the campaign, the primary sources being health workers (33.7%), neighbours (26.2%), and radio (22.0%). Of eligible children, 82.4% received mebendazole, 83.8% received vitamin A, and 75.4% received LLINs. Almost all (91.4%) LLINs received during the campaign remained in the household; of those not remaining, 74.4% had been given away and none were reported sold. At least one insecticide-treated net (ITN) was present in 82.3% of all households, 89.2% of households with a child < 5 years and 57.5% of households without a child < 5 years. Just over half (52.4%) of ITNs had been received during the campaign. Considering possible indicators of universal coverage, 39.8% of households owned at least one ITN per two people, 21.6% owned at least one ITN per sleeping space and 34.7% of the general population slept under an ITN the night before the survey. In addition, 45.6% of children < 5 years, and 49.2% of pregnant women had slept under an ITN. Conclusions The nationwide integrated LLIN distribution campaign allowed household ITN ownership of one or more ITNs to surpass the RBM target of 80% set for 2010, though additional distribution strategies are needed to reach populations missed by the targeted campaign and to reach the universal coverage targets of one ITN per sleeping space and 80% of the population using an ITN. PMID:21489278

  17. Risk factors associated with the practice of child marriage among Roma girls in Serbia.

    PubMed

    Hotchkiss, David R; Godha, Deepali; Gage, Anastasia J; Cappa, Claudia

    2016-02-01

    Relatively little research on the issue of child marriage has been conducted in European countries where the overall prevalence of child marriage is relatively low, but relatively high among marginalized ethnic sub-groups. The purpose of this study is to assess the risk factors associated with the practice of child marriage among females living in Roma settlements in Serbia and among the general population and to explore the inter-relationship between child marriage and school enrollment decisions. The study is based on data from a nationally representative household survey in Serbia conducted in 2010 - and a separate survey of households living in Roma settlements in the same year. For each survey, we estimated a bivariate probit model of risk factors associated with being currently married and currently enrolled in school based on girls 15 to 17 years of age in the nationally representative and Roma settlements samples. The practice of child marriage among the Roma was found to be most common among girls who lived in poorer households, who had less education, and who lived in rural locations. The results of the bivariate probit analysis suggest that, among girls in the general population, decisions about child marriage school attendance are inter-dependent in that common unobserved factors were found to influence both decisions. However, among girls living in Roma settlements, there is only weak evidence of simultaneous decision making. The study finds evidence of the interdependence between marriage and school enrollment decisions among the general population and, to a lesser extent, among the Roma. Further research is needed on child marriage among the Roma and other marginalized sub-groups in Europe, and should be based on panel data, combined with qualitative data, to assess the role of community-level factors and the characteristics of households where girls grow up on child marriage and education decisions.

  18. 2012-2013 Delaware Valley Household Travel Survey | Transportation Secure

    Science.gov Websites

    Data Center | NREL 12-2013 Delaware Valley Household Travel Survey 2012-2013 Delaware Valley Household Travel Survey The 2012-2013 Delaware Valley Household Travel Survey collected data for multiple ) sponsored the survey in collaboration with AbtSRBI. Methodology A sampling strategy was designed to recruit

  19. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--METALS IN DERMAL ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Dermal Wipes data set contains analytical results for measurements of up to 11 metals in 86 dermal wipe samples over 86 households. Each sample was collected from the primary respondent within each household. The sampling period occurred on the first day of the fi...

  20. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--METALS IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Metals in Urine data set contains analytical results for measurements of up to 7 metals in 86 urine samples over 86 households. Each sample was collected from the primary respondent within each household. The sample consists of the first morning void following the 24-hour d...

  1. Data Investigation of Bariatric Surgery Outcome and Economic Savings

    DTIC Science & Technology

    2010-12-15

    Age, squared Age as well as interactions for Sex/Age, Sex/BMI and BMI/Age. Data were from the NCHS National Health Interview Survey ( NHIS ...National Health and Nutrition Examination Survey NHIS – National Health Interview Survey OLS – Ordinary Least Squares ORYGB – Open Roux en Y Gastric...a household are reported by a single household member.76 The sampling frame is the National Household Interview Survey ( NHIS ). The NHIS sample

  2. 45 CFR Appendix A to Part 1611 - Income Level for Individuals Eligible for Assistance

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: 5,025 6,288 5,775 * The figures in this table represent 125% of the poverty guidelines by household... Poverty Guidelines Size of household 48 ContiguousStates and the District of Columbia Alaska Hawaii 1 22...

  3. Development of a Tool to Stage Households' Readiness to Change Dietary Behaviours in Kerala, India.

    PubMed

    Daivadanam, Meena; Ravindran, T K Sundari; Thankappan, K R; Sarma, P S; Wahlström, Rolf

    2016-01-01

    Dietary interventions and existing health behaviour theories are centred on individuals; therefore, none of the available tools are applicable to households for changing dietary behaviour. The objective of this pilot study was to develop a practical tool that could be administered by community volunteers to stage households in rural Kerala based on readiness to change dietary behaviour. Such a staging tool, comprising a questionnaire and its algorithm, focusing five dietary components (fruits, vegetables, salt, sugar and oil) and households (rather than individuals), was finalised through three consecutive pilot validation sessions, conducted over a four-month period. Each revised version was tested with a total of 80 households (n = 30, 35 and 15 respectively in the three sessions). The tool and its comparator, Motivational Interviewing (MI), assessed the stage-of-change for a household pertaining to their: 1) fruit and vegetable consumption behaviour; 2) salt, sugar and oil consumption behaviour; 3) overall readiness to change. The level of agreement between the two was tested using Kappa statistics to assess concurrent validity. A value of 0.7 or above was considered as good agreement. The final version was found to have good face and content validity, and also a high level of agreement with MI (87%; weighted kappa statistic: 0.85). Internal consistency testing was performed using Cronbach's Alpha, with a value between 0.80 and 0.90 considered to be good. The instrument had good correlation between the items in each section (Cronbach's Alpha: 0.84 (fruit and vegetables), 0.85 (salt, sugar and oil) and 0.83 (Overall)). Pre-contemplation was the most difficult stage to identify; for which efficacy and perceived cooperation at the household level were important. To the best of our knowledge, this is the first staging tool for households. This tool represents a new concept in community-based dietary interventions. The tool can be easily administered by lay community workers and can therefore be used in large population-based studies. A more robust validation process with a larger sample is needed before it can be widely used.

  4. Absence of Mycobacterium intracellulare and presence of Mycobacterium chimaera in household water and biofilm samples of patients in the United States with Mycobacterium avium complex respiratory disease.

    PubMed

    Wallace, Richard J; Iakhiaeva, Elena; Williams, Myra D; Brown-Elliott, Barbara A; Vasireddy, Sruthi; Vasireddy, Ravikiran; Lande, Leah; Peterson, Donald D; Sawicki, Janet; Kwait, Rebecca; Tichenor, Wellington S; Turenne, Christine; Falkinham, Joseph O

    2013-06-01

    Recent studies have shown that respiratory isolates from pulmonary disease patients and household water/biofilm isolates of Mycobacterium avium could be matched by DNA fingerprinting. To determine if this is true for Mycobacterium intracellulare, household water sources for 36 patients with Mycobacterium avium complex (MAC) lung disease were evaluated. MAC household water isolates from three published studies that included 37 additional MAC respiratory disease patients were also evaluated. Species identification was done initially using nonsequencing methods with confirmation by internal transcribed spacer (ITS) and/or partial 16S rRNA gene sequencing. M. intracellulare was identified by nonsequencing methods in 54 respiratory cultures and 41 household water/biofilm samples. By ITS sequencing, 49 (90.7%) respiratory isolates were M. intracellulare and 4 (7.4%) were Mycobacterium chimaera. In contrast, 30 (73%) household water samples were M. chimaera, 8 (20%) were other MAC X species (i.e., isolates positive with a MAC probe but negative with species-specific M. avium and M. intracellulare probes), and 3 (7%) were M. avium; none were M. intracellulare. In comparison, M. avium was recovered from 141 water/biofilm samples. These results indicate that M. intracellulare lung disease in the United States is acquired from environmental sources other than household water. Nonsequencing methods for identification of nontuberculous mycobacteria (including those of the MAC) might fail to distinguish closely related species (such as M. intracellulare and M. chimaera). This is the first report of M. chimaera recovery from household water. The study underscores the importance of taxonomy and distinguishing the many species and subspecies of the MAC.

  5. Sampling Design Influences the Observed Dominance of Culex tritaeniorhynchus: Considerations for Future Studies of Japanese Encephalitis Virus Transmission

    PubMed Central

    Lord, Jennifer S.; Al-Amin, Hasan Mohammad; Chakma, Sumit; Alam, Mohammad Shafiul; Gurley, Emily S.; Pulliam, Juliet R. C.

    2016-01-01

    Mosquito sampling during Japanese encephalitis virus (JEV)-associated studies, particularly in India, has usually been conducted via aspirators or light traps to catch mosquitoes around cattle, which are dead-end hosts for JEV. High numbers of Culex tritaeniorhynchus, relative to other species, have often been caught during these studies. Less frequently, studies have involved sampling outdoor resting mosquitoes. We aimed to compare the relative abundance of mosquito species between these two previously used mosquito sampling methods. From September to December 2013 entomological surveys were undertaken in eight villages in a Japanese encephalitis (JE) endemic area of Bangladesh. Light traps were used to collect active mosquitoes in households, and resting boxes and a Bina Pani Das hop cage were used near oviposition sites to collect resting mosquitoes. Numbers of humans and domestic animals present in households where light traps were set were recorded. In five villages Cx. tritaeniorhynchus was more likely to be selected from light trap samples near hosts than resting collection samples near oviposition sites, according to log odds ratio tests. The opposite was true for Cx. pseudovishnui and Armigeres subalbatus, which can also transmit JEV. Culex tritaeniorhynchus constituted 59% of the mosquitoes sampled from households with cattle, 28% from households without cattle and 17% in resting collections. In contrast Cx. pseudovishnui constituted 5.4% of the sample from households with cattle, 16% from households with no cattle and 27% from resting collections, while Ar. subalbatus constituted 0.15%, 0.38%, and 8.4% of these samples respectively. These observations may be due to differences in timing of biting activity, host preference and host-seeking strategy rather than differences in population density. We suggest that future studies aiming to implicate vector species in transmission of JEV should consider focusing catches around hosts able to transmit JEV. PMID:26726881

  6. Sampling Design Influences the Observed Dominance of Culex tritaeniorhynchus: Considerations for Future Studies of Japanese Encephalitis Virus Transmission.

    PubMed

    Lord, Jennifer S; Al-Amin, Hasan Mohammad; Chakma, Sumit; Alam, Mohammad Shafiul; Gurley, Emily S; Pulliam, Juliet R C

    2016-01-01

    Mosquito sampling during Japanese encephalitis virus (JEV)-associated studies, particularly in India, has usually been conducted via aspirators or light traps to catch mosquitoes around cattle, which are dead-end hosts for JEV. High numbers of Culex tritaeniorhynchus, relative to other species, have often been caught during these studies. Less frequently, studies have involved sampling outdoor resting mosquitoes. We aimed to compare the relative abundance of mosquito species between these two previously used mosquito sampling methods. From September to December 2013 entomological surveys were undertaken in eight villages in a Japanese encephalitis (JE) endemic area of Bangladesh. Light traps were used to collect active mosquitoes in households, and resting boxes and a Bina Pani Das hop cage were used near oviposition sites to collect resting mosquitoes. Numbers of humans and domestic animals present in households where light traps were set were recorded. In five villages Cx. tritaeniorhynchus was more likely to be selected from light trap samples near hosts than resting collection samples near oviposition sites, according to log odds ratio tests. The opposite was true for Cx. pseudovishnui and Armigeres subalbatus, which can also transmit JEV. Culex tritaeniorhynchus constituted 59% of the mosquitoes sampled from households with cattle, 28% from households without cattle and 17% in resting collections. In contrast Cx. pseudovishnui constituted 5.4% of the sample from households with cattle, 16% from households with no cattle and 27% from resting collections, while Ar. subalbatus constituted 0.15%, 0.38%, and 8.4% of these samples respectively. These observations may be due to differences in timing of biting activity, host preference and host-seeking strategy rather than differences in population density. We suggest that future studies aiming to implicate vector species in transmission of JEV should consider focusing catches around hosts able to transmit JEV.

  7. Effect of household-based drinking water chlorination on diarrhoea among children under five in Orissa, India: a double-blind randomised placebo-controlled trial.

    PubMed

    Boisson, Sophie; Stevenson, Matthew; Shapiro, Lily; Kumar, Vinod; Singh, Lakhwinder P; Ward, Dana; Clasen, Thomas

    2013-08-01

    Boiling, disinfecting, and filtering water within the home can improve the microbiological quality of drinking water among the hundreds of millions of people who rely on unsafe water supplies. However, the impact of these interventions on diarrhoea is unclear. Most studies using open trial designs have reported a protective effect on diarrhoea while blinded studies of household water treatment in low-income settings have found no such effect. However, none of those studies were powered to detect an impact among children under five and participants were followed-up over short periods of time. The aim of this study was to measure the effect of in-home water disinfection on diarrhoea among children under five. We conducted a double-blind randomised controlled trial between November 2010 and December 2011. The study included 2,163 households and 2,986 children under five in rural and urban communities of Orissa, India. The intervention consisted of an intensive promotion campaign and free distribution of sodium dichloroisocyanurate (NaDCC) tablets during bi-monthly households visits. An independent evaluation team visited households monthly for one year to collect health data and water samples. The primary outcome was the longitudinal prevalence of diarrhoea (3-day point prevalence) among children aged under five. Weight-for-age was also measured at each visit to assess its potential as a proxy marker for diarrhoea. Adherence was monitored each month through caregiver's reports and the presence of residual free chlorine in the child's drinking water at the time of visit. On 20% of the total household visits, children's drinking water was assayed for thermotolerant coliforms (TTC), an indicator of faecal contamination. The primary analysis was on an intention-to-treat basis. Binomial regression with a log link function and robust standard errors was used to compare prevalence of diarrhoea between arms. We used generalised estimating equations to account for clustering at the household level. The impact of the intervention on weight-for-age z scores (WAZ) was analysed using random effect linear regression. Over the follow-up period, 84,391 child-days of observations were recorded, representing 88% of total possible child-days of observation. The longitudinal prevalence of diarrhoea among intervention children was 1.69% compared to 1.74% among controls. After adjusting for clustering within household, the prevalence ratio of the intervention to control was 0.95 (95% CI 0.79-1.13). The mean WAZ was similar among children of the intervention and control groups (-1.586 versus -1.589, respectively). Among intervention households, 51% reported their child's drinking water to be treated with the tablets at the time of visit, though only 32% of water samples tested positive for residual chlorine. Faecal contamination of drinking water was lower among intervention households than controls (geometric mean TTC count of 50 [95% CI 44-57] per 100 ml compared to 122 [95% CI 107-139] per 100 ml among controls [p<0.001] [n = 4,546]). Our study was designed to overcome the shortcomings of previous double-blinded trials of household water treatment in low-income settings. The sample size was larger, the follow-up period longer, both urban and rural populations were included, and adherence and water quality were monitored extensively over time. These results provide no evidence that the intervention was protective against diarrhoea. Low compliance and modest reduction in water contamination may have contributed to the lack of effect. However, our findings are consistent with other blinded studies of similar interventions and raise additional questions about the actual health impact of household water treatment under these conditions. ClinicalTrials.govNCT01202383 Please see later in the article for the Editors' Summary.

  8. Effect of Household-Based Drinking Water Chlorination on Diarrhoea among Children under Five in Orissa, India: A Double-Blind Randomised Placebo-Controlled Trial

    PubMed Central

    Boisson, Sophie; Stevenson, Matthew; Shapiro, Lily; Kumar, Vinod; Singh, Lakhwinder P.; Ward, Dana; Clasen, Thomas

    2013-01-01

    Background Boiling, disinfecting, and filtering water within the home can improve the microbiological quality of drinking water among the hundreds of millions of people who rely on unsafe water supplies. However, the impact of these interventions on diarrhoea is unclear. Most studies using open trial designs have reported a protective effect on diarrhoea while blinded studies of household water treatment in low-income settings have found no such effect. However, none of those studies were powered to detect an impact among children under five and participants were followed-up over short periods of time. The aim of this study was to measure the effect of in-home water disinfection on diarrhoea among children under five. Methods and Findings We conducted a double-blind randomised controlled trial between November 2010 and December 2011. The study included 2,163 households and 2,986 children under five in rural and urban communities of Orissa, India. The intervention consisted of an intensive promotion campaign and free distribution of sodium dichloroisocyanurate (NaDCC) tablets during bi-monthly households visits. An independent evaluation team visited households monthly for one year to collect health data and water samples. The primary outcome was the longitudinal prevalence of diarrhoea (3-day point prevalence) among children aged under five. Weight-for-age was also measured at each visit to assess its potential as a proxy marker for diarrhoea. Adherence was monitored each month through caregiver's reports and the presence of residual free chlorine in the child's drinking water at the time of visit. On 20% of the total household visits, children's drinking water was assayed for thermotolerant coliforms (TTC), an indicator of faecal contamination. The primary analysis was on an intention-to-treat basis. Binomial regression with a log link function and robust standard errors was used to compare prevalence of diarrhoea between arms. We used generalised estimating equations to account for clustering at the household level. The impact of the intervention on weight-for-age z scores (WAZ) was analysed using random effect linear regression. Over the follow-up period, 84,391 child-days of observations were recorded, representing 88% of total possible child-days of observation. The longitudinal prevalence of diarrhoea among intervention children was 1.69% compared to 1.74% among controls. After adjusting for clustering within household, the prevalence ratio of the intervention to control was 0.95 (95% CI 0.79–1.13). The mean WAZ was similar among children of the intervention and control groups (−1.586 versus −1.589, respectively). Among intervention households, 51% reported their child's drinking water to be treated with the tablets at the time of visit, though only 32% of water samples tested positive for residual chlorine. Faecal contamination of drinking water was lower among intervention households than controls (geometric mean TTC count of 50 [95% CI 44–57] per 100 ml compared to 122 [95% CI 107–139] per 100 ml among controls [p<0.001] [n = 4,546]). Conclusions Our study was designed to overcome the shortcomings of previous double-blinded trials of household water treatment in low-income settings. The sample size was larger, the follow-up period longer, both urban and rural populations were included, and adherence and water quality were monitored extensively over time. These results provide no evidence that the intervention was protective against diarrhoea. Low compliance and modest reduction in water contamination may have contributed to the lack of effect. However, our findings are consistent with other blinded studies of similar interventions and raise additional questions about the actual health impact of household water treatment under these conditions. Trial Registration ClinicalTrials.gov NCT01202383 Please see later in the article for the Editors' Summary PMID:23976883

  9. The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36–59 Months in Honduras

    PubMed Central

    Urke, Helga Bjørnøy; Contreras, Mariela; Matanda, Dennis Juma

    2018-01-01

    Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD. PMID:29735895

  10. Australian health-related quality of life population norms derived from the SF-6D.

    PubMed

    Norman, Richard; Church, Jody; van den Berg, Bernard; Goodall, Stephen

    2013-02-01

    To investigate population health-related quality of life norms in an Australian general sample by age, gender, BMI, education and socioeconomic status. The SF-36 was included in the 2009/10 wave of the Household, Income and Labour Dynamics in Australia (HILDA) survey (n=17,630 individuals across 7,234 households), and converted into SF-6D utility scores. Trends across the various population subgroups were investigated employing population weights to ensure a balanced panel, and were all sub-stratified by gender. SF-6D scores decline with age beyond 40 years, with decreasing education and by higher levels of socioeconomic disadvantage. Scores were also lower at very low and very high BMI levels. Males reported higher SF-6D scores than females across most analyses. This study reports Australian population utility data measured using the SF-6D, based on a national representative sample. These results can be used in a range of policy settings such as cost-utility analysis or exploration of health-related inequality. In general, the patterns are similar to those reported using other multi-attribute utility instruments and in different countries. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  11. Family planning choice behaviour in urban slums of Bangladesh: an econometric approach.

    PubMed

    Barkat, A; Rahman, M U; Bose, M L

    1997-03-01

    Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

  12. Assets and Income: Disability-Based Disparities in the United States

    ERIC Educational Resources Information Center

    Parish, Susan L.; Grinstein-Weiss, Michal; Yeo, Yeong Hun; Rose, Roderick A.; Rimmerman, Arie

    2010-01-01

    The authors analyzed data from the 2001 Survey of Income and Program Participation (SIPP) to determine the extent of a disability-based net worth and income gap among U.S. households. The sample included 4,154 households with an adult with disabilities and 12,365 households without an adult with disabilities. Households with an adult with…

  13. Housing characteristics 1993

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

    NONE

    1995-06-01

    This report, Housing Characteristics 1993, presents statistics about the energy-related characteristics of US households. These data were collected in the 1993 Residential Energy Consumption Survey (RECS) -- the ninth in a series of nationwide energy consumption surveys conducted since 1978 by the Energy Information Administration of the US Department of Energy. Over 7 thousand households were surveyed, representing 97 million households nationwide. A second report, to be released in late 1995, will present statistics on residential energy consumption and expenditures.

  14. Passive Sampling for Indoor and Outdoor Exposures to Chlorpyrifos, Azinphos-Methyl, and Oxygen Analogs in a Rural Agricultural Community.

    PubMed

    Gibbs, Jenna L; Yost, Michael G; Negrete, Maria; Fenske, Richard A

    2017-03-01

    Recent studies have highlighted the increased potency of oxygen analogs of organophosphorus pesticides. These pesticides and oxygen analogs have previously been identified in the atmosphere following spray applications in the states of California and Washington. We used two passive sampling methods to measure levels of the ollowing organophosphorus pesticides: chlorpyrifos, azinphos-methyl, and their oxygen analogs at 14 farmworker and 9 non-farmworker households in an agricultural region of central Washington State in 2011. The passive methods included polyurethane foam passive air samplers deployed outdoors and indoors and polypropylene deposition plates deployed indoors. We collected cumulative monthly samples during the pesticide application seasons and during the winter season as a control. Monthly outdoor air concentrations ranged from 9.2 to 199 ng/m 3 for chlorpyrifos, 0.03 to 20 ng/m 3 for chlorpyrifos-oxon, < LOD (limit of detection) to 7.3 ng/m 3 for azinphos-methyl, and < LOD to 0.8 ng/m 3 for azinphos-methyl-oxon. Samples from proximal households (≤ 250 m) had significantly higher outdoor air concentrations of chlorpyrifos, chlorpyrifos-oxon, and azinphos-methyl than did samples from nonproximal households ( p ≤ 0.02). Overall, indoor air concentrations were lower than outdoors. For example, all outdoor air samples for chlorpyrifos and 97% of samples for azinphos-methyl were > LOD. Indoors, only 78% of air samples for chlorpyrifos and 35% of samples for azinphos-methyl were > LOD. Samples from farmworker households had higher indoor air concentrations of both pesticides than did samples from non-farmworker households. Mean indoor and outdoor air concentration ratios for chlorpyrifos and azinphos-methyl were 0.17 and 0.44, respectively. We identified higher levels in air and on surfaces at both proximal and farmworker households. Our findings further confirm the presence of pesticides and their oxygen analogs in air and highlight their potential for infiltration of indoor living environments. Citation: Gibbs JL, Yost MG, Negrete M, Fenske RA. 2017. Passive sampling for indoor and outdoor exposures to chlorpyrifos, azinphos-methyl, and oxygen analogs in a rural agricultural community. Environ Health Perspect 125:333-341; http://dx.doi.org/10.1289/EHP425.

  15. Capability and Health Functioning in Ethiopian Households

    ERIC Educational Resources Information Center

    Mabsout, Ramzi

    2011-01-01

    From a recent Ethiopian representative household survey this paper empirically operationalizes concepts from the capability approach to shed light on the relationship between conversion factors, capability inputs and health functionings. The subjects of the study are women in partnership. The results suggest their health functionings are…

  16. Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey.

    PubMed

    Shrestha, Akina; Sharma, Subodh; Gerold, Jana; Erismann, Séverine; Sagar, Sanjay; Koju, Rajendra; Schindler, Christian; Odermatt, Peter; Utzinger, Jürg; Cissé, Guéladio

    2017-01-18

    This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8-7.6), free and total residual chlorine (0.1-0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren's homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08-2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities.

  17. Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey

    PubMed Central

    Shrestha, Akina; Sharma, Subodh; Gerold, Jana; Erismann, Séverine; Sagar, Sanjay; Koju, Rajendra; Schindler, Christian; Odermatt, Peter; Utzinger, Jürg; Cissé, Guéladio

    2017-01-01

    This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8–7.6), free and total residual chlorine (0.1–0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren’s homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08–2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities. PMID:28106779

  18. Fish consumption and its motives in households with versus without self-reported medical history of CVD: A consumer survey from five European countries

    PubMed Central

    Pieniak, Zuzanna; Verbeke, Wim; Perez-Cueto, Federico; Brunsø, Karen; De Henauw, Stefaan

    2008-01-01

    Background The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European countries. Methods A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household. Results Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusion Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made on communicating benefits especially from fatty fish consumption. PMID:18783593

  19. Household income and health problems during a period of labour-market change and widening income inequalities - a study among the Finnish population between 1987 and 2007.

    PubMed

    Aittomäki, Akseli; Martikainen, Pekka; Rahkonen, Ossi; Lahelma, Eero

    2014-01-01

    Income inequalities widened considerably from 1987 to 2007 in Finland. We compared the association between household income and health problems across three periods and in several different ways of modelling the dependence. Our aim was to find out whether the change in the distribution of income might have led to wider income-related inequalities in health problems. The data represent an 11-per-cent random sample of the Finnish population, and we restricted the analysed sample to those between 18 and 67 years of age and not in receipt of any pension in each of the three six-year periods examined (n between 280,106 and 291,198). The health outcome was sickness-allowance days compensated. Household-equivalent taxable income was applied with two different scale transformations: firstly, as real income adjusted for price level and secondly, as rank position on the income distribution. We used negative binomial regression models, with and without zero inflation, as well as decomposition analysis. We found that sickness-allowance days decreased with increasing income, while differences in the shape and magnitude of the association were found between the scales and the periods. During the study period the association strengthened considerably at both the lowest fifth and the top fifth of the rank scale, while the observed per-unit effect of real income changed less. Decomposition analysis suggested that slightly less than half of the observed increase in concentration of health problems at lower end of the rank scale could be accounted for by the change in real income distribution. The results indicate that widening differences in household consumption potential may have contributed to an intensified impact of household income on inequalities in health problems. Explaining the change only in terms of consumption potential, however, was problematic, and changes in the interdependence of labour-market advantage and health problems are likely to contribute as well. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal.

    PubMed

    Mulmi, Prajula; Masters, William A; Ghosh, Shibani; Namirembe, Grace; Rajbhandary, Ruchita; Manohar, Swetha; Shrestha, Binod; West, Keith P; Webb, Patrick

    2017-01-01

    Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions. This study investigates mediating effects of household wealth and child age on links between farm production and child diets, as measured by production and intake of nutrient-dense food groups. Two rounds (2013 and 2014) of nationally representative survey data (n = 5,978 observations) were used to measure production and children's dietary intake, as well as a household wealth index and control variables, including breastfeeding. Novel steps used include measuring production diversity in terms of both species grown and food groups grown, as well as testing for mediating effects of family wealth and age of child. We find significant associations between child dietary diversity and agricultural diversity in terms of diversity of food groups and of species grown, especially for older children in poorer households, and particularly for fruits and vegetables, dairy and eggs. With each additional food group produced, log-odds of meeting minimum dietary diversity score (≥4) increase by 0.25 (p = 0.01) for children aged 24-59 months. For younger children aged 18-23 months there is a similar effect size but only in the poorest two quintiles of household wealth, and for infants 6-18 months we find no correlation between production and intake in most models. Child dietary intake is associated with the composition of farm production, most evident among older preschool children and in poorer households. To improve the nutrition of infants, other interventions are needed; and for relatively wealthier households, own farm production may displace market purchases, which could attenuate the impact of household production on child diets.

  1. The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran.

    PubMed

    Khammarnia, M; Keshtkaran, A; Kavosi, Z; Hayati, R

    2014-08-01

    The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071 ± 0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p < 0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p < 0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.

  2. [Prevalence of geohelminth infections in children living in Kinshasa].

    PubMed

    Nundu Sabiti, S; Aloni, M-N; Linsuke, S-W-L; Ekila, M-B; Situakibanza, H-T; Polman, K; Lutumba, P-T

    2014-06-01

    Data on geohelminth infections in children in the Democratic Republic of Congo are sparse. The objective of this study was to document and compare the profile and prevalence in children living in Kinshasa. A prospective cohort study was conducted from May to October 2009 in children in the Biyela health area in Kinshasa, Democratic Republic of Congo. Stool samples were collected from representative members of these two populations and analyzed for geohelminths (GH) using the Kato-Katz technique. In this series, 438 school-age children were included. There were 235 children recruited in schools and 203 in households (77.8%). Overall prevalence of geohelminths was 66.9%. The specific prevalence was 69.4% in children recruited in schools and 64.0% in children recruited in households. The frequency of Ascaris lumbricoides, Trichuris trichiura, and Ancylostoma species were, respectively, 56.2%, 38.7%, and 1.7% in schools and 39.9%, 51.7%, and 1.0% in households. A. lumbricoides was significantly more prevalent in schools (56.2% vs 39.9%; OR=2.0; 95%CI: 1.3-3.0), T. trichiura was significantly less prevalent in schools (38.7% vs 51.7%; OR=0.6; 95% CI: 0.4-0.9). There were no significant differences in the prevalence of Ancylostoma between schools and households. GH is a health problem among Biyela children. Preventive measures and education of the population need to be emphasized in attempts to reduce the prevalence of geohelminths in these children. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Alcohol consumption patterns among Mexican American mothers and among children from single- and dual-headed households: findings from HHANES 1982-84.

    PubMed Central

    Stroup-Benham, C A; Treviño, F M; Treviño, D B

    1990-01-01

    Data from the southwestern United States sample of the Hispanic Health and Nutrition Examination Survey were employed to compare the patterns of alcohol use among Mexican American mothers and children in female-headed households with use patterns among mothers and children in couple-headed households. Single female heads of household drank more alcoholic beverages on more days than females from dual-headed households. As a whole, the children of single heads of household still living at home did not demonstrate significantly different drinking patterns from their dual-headed household counterparts. While male children of single-headed households drank more days and total drinks than their dual-headed household counterparts, female children of dual-headed households drank more days and total drinks than female children from single-headed households. PMID:9187580

  4. The temporal association of excessive health expenditure with suicidal ideation among primary income earners: a cross-sectional design using the Korean Welfare Panel Survey (KoWePS)

    PubMed Central

    Shin, Jaeyong; Choi, Jae Woo; Jang, Sung-in; Choi, Young; Lee, Sang Gyu; Ihm, Tae Hwan; Park, Eun-Cheol

    2015-01-01

    Objective Excessive health expenditure (EHE) is a global issue for households suffering from high-cost medical conditions, low incomes and limited insurance coverage. After the international financial crisis of 2008, EHE became a social problem in developed countries. Such economic crisis might induce severe mental stress, resulting in suicidal ideation. Methods We used the Korean Welfare Panel Study (KoWePS) from 2011 to 2013 and selected primary income earners, who were defined as practical and economic representatives of households; the total number of analysed samples was 4247 of 5717 households in the database. We only included households that had never experienced EHE before 2011. To examine the temporal relationship between EHE and suicidal ideation, we conducted a logistic regression analysis. Results Among 4247 participants, 146 (3.4%) experienced suicidal ideation, whereas 4101 (96.6%) did not. One scale of depression score (OR=1.28, CI 1.23 to 1.34, p<0.001) was associated with increased suicidal ideation. Such ideation was influenced to a greater extent by a recent EHE above 10% of disposable income (OR=1.91, CI 1.16 to 3.15, p=0.012) than by either a remote EHE (OR=1.29, CI 0.71 to 2.32) or one in 2011 and 2012 (OR=1.67, CI 1.01 to 2.78, p=0.048). Conclusions In this study, more recent EHE resulted in more suicidal ideation. In conclusion, we suggest that recent household EHE might be considered as an important factor to prevent suicidal ideation and to improve the mental health of individuals. PMID:26082463

  5. Household Food Insecurity, Mother's Feeding Practices, and the Early Childhood's Iron Status.

    PubMed

    Salarkia, Nahid; Neyestani, Tirang R; Omidvar, Nasrin; Zayeri, Farid

    2015-01-01

    Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6-24 months children. In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. We found no association between household food insecurity and the occurrence of anemia in the 6-24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children.

  6. Impact of wastewater-irrigation on in-household water contamination. A cohort study among urban farmers in Ahmedabad, India.

    PubMed

    Falkenberg, Timo; Saxena, Deepak; Kistemann, Thomas

    2018-10-15

    This cohort study explores the contribution of wastewater irrigation, in the context of WASH (Water, Sanitation, Hygiene), on in-household water contamination among urban farming households in Ahmedabad, India. Drinking water samples of 204 households in four peri-urban farming communities were collected from the point-of-source (PoS) and point-of-use (PoU) of each household four times over the 12-month follow-up period. Next to the quantification of E. coli, three household surveys (baseline, hygiene and farm) were conducted. Additionally, an observational spot-check was undertaken in bi-monthly intervals throughout the follow-up period. Significant positive differences in water quality between PoS and PoU samples were identified in 78% of households. During the monsoon, the peak of contamination, only 6% of households had access to safe drinking water at PoU. The Average Treatment Effect (ATE) of wastewater irrigation indicates an adverse effect on in-household water contamination, larger in effect size than the mitigation effect of access to sanitation or personal hygiene. To control transmission of fecal pathogens, effective barriers are required for wastewater irrigation similar to the necessity of ensuring access to sanitation and practicing adequate hygiene behavior. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Iraq, Women’s Empowerment, and Public Policy

    DTIC Science & Technology

    2006-12-01

    time, were considered fairly progressive. Polygamy . Under the previous Iraqi law, men had to obtain judicial permission for an additional marriage...argued that polygamous households represent only 2 to 11.5 percent of all households in the Middle East, yet there is evidence that polygamy has

  8. Bacterial contamination of drinking water and the economic burden of illnesses for the Nepalese households.

    PubMed

    Atreya, Kishor; Panthee, Santosh; Sharma, Prem

    2006-10-01

    A household survey was conducted to determine the number of working days lost and household medical expenditure (ME) due to six water-borne diseases in the Terai region of Nepal. Drinking water sources of each household were analysed for total coliforms (TC). The study found 61% of the household water sources were contaminated with TC at the time of sampling. Number of days lost due to water-borne diseases was 8 days for TC-negative households and 10 days for TC-positive households per year. The average annual household medical expenditure was NR 459 for TC-negative households, and NR 789 for TC-positive households (p = 0.02 at proportional to = 0.05). Regression result showed that the presence of TC in the drinking water sources, number of children in the household and income of the household significantly determined ME.

  9. Small area estimation (SAE) model: Case study of poverty in West Java Province

    NASA Astrophysics Data System (ADS)

    Suhartini, Titin; Sadik, Kusman; Indahwati

    2016-02-01

    This paper showed the comparative of direct estimation and indirect/Small Area Estimation (SAE) model. Model selection included resolve multicollinearity problem in auxiliary variable, such as choosing only variable non-multicollinearity and implemented principal component (PC). Concern parameters in this paper were the proportion of agricultural venture poor households and agricultural poor households area level in West Java Province. The approach for estimating these parameters could be performed based on direct estimation and SAE. The problem of direct estimation, three area even zero and could not be conducted by directly estimation, because small sample size. The proportion of agricultural venture poor households showed 19.22% and agricultural poor households showed 46.79%. The best model from agricultural venture poor households by choosing only variable non-multicollinearity and the best model from agricultural poor households by implemented PC. The best estimator showed SAE better then direct estimation both of the proportion of agricultural venture poor households and agricultural poor households area level in West Java Province. The solution overcame small sample size and obtained estimation for small area was implemented small area estimation method for evidence higher accuracy and better precision improved direct estimator.

  10. Household hazardous waste data for the UK by direct sampling.

    PubMed

    Slack, Rebecca J; Bonin, Michael; Gronow, Jan R; Van Santen, Anton; Voulvoulis, Nikolaos

    2007-04-01

    The amount of household hazardous waste (HHW) disposed of in the United Kingdom (UK) requires assessment. This paper describes a direct analysis study carried out in three areas in southeast England involving over 500 households. Each participating householder was provided with a special bin in which to place items corresponding to a list of HHW. The amount of waste collected was split into nine broad categories: batteries, home maintenance (DIY), vehicle upkeep, pesticides, pet care, pharmaceuticals, photographic chemicals, household cleaners, and printer cartridges. Over 1 T of waste was collected from the sample households over a 32-week period, which would correspond to an estimated 51,000 T if extrapolated to the UK population for the same period or over 7,000 T per month. Details of likely disposal routes adopted by householders were also sought, demonstrating the different pathways selected for different waste categories. Co-disposal with residual household waste dominated for waste batteries and veterinary medicines, hence avoiding classification as hazardous waste under new UK waste regulations. The information can be used to set a baseline for the management of HHW and provides information for an environmental risk assessment of the disposal of such wastes to landfill.

  11. School Progress Among Children of Same-Sex Couples.

    PubMed

    Watkins, Caleb S

    2018-06-01

    This study uses logit regressions on a pooled sample of children from the 2012, 2013, and 2014 American Community Survey to perform a nationally representative analysis of school progress for a large sample of 4,430 children who reside with same-sex couples. Odds ratios from regressions that compare children between different-sex married couples and same-sex couples fail to show significant differences in normal school progress between households across a variety of sample compositions. Likewise, marginal effects from regressions that compare children with similar family dynamics between different-sex married couples and same-sex couples fail to predict significantly higher probabilities of grade retention for children of same-sex couples. Significantly lower grade retention rates are sometimes predicted for children of same-sex couples than for different-sex married couples, but these differences are sensitive to sample exclusions and do not indicate causal benefits to same-sex parenting.

  12. Sociodemographic factors related to handgrip strength in children and adolescents in a middle income country: The SALUS study.

    PubMed

    Otero, Johanna; Cohen, Daniel Dylan; Herrera, Victor Mauricio; Camacho, Paul Anthony; Bernal, Oscar; López-Jaramillo, Patricio

    2017-01-01

    To determine sociodemographic factors associated with handgrip (HG) strength in a representative sample of children and adolescents from a middle income country. We evaluated youth between the ages of 8 and 17 from a representative sample of individuals from the Department of Santander, Colombia. Anthropometric measures, HG strength, and self-reported physical activity were assessed, and parents/guardians completed sociodemographic questionnairres. Multinomial logistic regression models were used to estimate the association between sociodemographic and anthropometric characteristics and tertiles of relative HG strength. We also produced centile data for raw HG strength using quantile regression. 1,691 young people were evaluated. HG strength increased with age, and was higher in males than females in all age groups. Lower HG strength was associated with indicators of higher socioeconomic status, such as living in an urban area, residence in higher social strata neighborhoods, parent/guardian with secondary education or higher, higher household income, and membership in health insurance schemes. In addition, low HG strength was associated with lower physical activity levels and higher waist-to-hip ratio. In a fully adjusted regression model, all factors remained significant except for health insurance, household income, and physical activity level. While age and gender specific HG strength values were substantially lower than contemporary data from high income countries, we found that within this middle income population indicators of higher socioeconomic status were associated with lower HG strength. This analysis also suggests that in countries undergoing rapid nutrition transition, improvements in socioeconomic conditions may be accompanied by reduction in muscle strength. © 2016 Wiley Periodicals, Inc.

  13. Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study

    PubMed Central

    Butts, Jessica; Ranaivoharimina, Harilala; Cotte, Annett H.; Ramarosandratana, Benjamin; Rabarijaona, Henintsoa; Tuseo, Luciano; Chang, Michelle; Vanden Eng, Jodi

    2017-01-01

    Background Madagascar conducted the first two phases of a national free mass distribution campaign of long-lasting insecticidal nets (LLINs) during a political crisis in 2009 aiming to achieve coverage of two LLINs per household as part of the National Malaria Control Strategy. The campaign targeted households in 19 out of 91 total health districts. Methods A community-based cross-sectional household survey using a three-stage cluster sample design was conducted four months post campaign to assess LLIN ownership, access and use. Multivariable logistic regression analysis was used to identify factors associated with household LLIN access and individual LLIN use. Results A total of 2211 households were surveyed representing 8867 people. At least one LLIN was present in 93.5% (95% confidence interval [CI], 91.6–95.5%) of households and 74.8% (95% CI, 71.0–78.6%) owned at least two LLINs. Access measured as the proportion of the population that could potentially be covered by household-owned LLINs was 77.2% (77.2% (95% CI, 72.9–81.3%) and LLIN use by all individuals was 84.2% (95% CI, 81.2–87.2%). LLIN use was associated with knowledge of insecticide treated net use to prevent malaria (OR = 3.58, 95% CI, 1.85–6.94), household ownership of more LLINs (OR 2.82, 95% CI 1.85–4.3), presence of children under five (OR = 2.05, 95% CI, 1.67–2.51), having traveled to the distribution point and receiving information about hanging a bednet (OR = 1.56, 95% CI, 1.41–1.74), and having received a post-campaign visit by a community mobilizer (OR = 1.75, 95% CI, 1.26–2.43). Lower LLIN use was associated with increasing household size (OR = 0.81 95% CI 0.77–0.85) and number of sleeping spaces (OR = 0.55, 95% CI, 0.44–0.68). Conclusions A large scale free mass LLIN distribution campaign was feasible and effective at achieving high LLIN access and use in Madagascar. Campaign process indicators highlighted potential areas for strengthening implementation to optimize access and equity. PMID:28850631

  14. Impact of the Bolsa Família program on food availability of low-income Brazilian families: a quasi experimental study.

    PubMed

    Martins, Ana Paula Bortoletto; Monteiro, Carlos Augusto

    2016-08-19

    The Bolsa Família Program was created in Brazil in 2003, by the joint of different social programs aimed at poor or very poor families with focus on income transfer to promote immediate poverty relief, conditionalities and complementary programs. Given the contributions of conditional cash transfer programs to poverty alleviation and their potential effects on nutrition and health, the objective of this study was to assess the impact of the Bolsa Família Program on food purchases of low-income households in Brazil. Representative data from the Household Budget Survey conducted in 2008-2009 were studied, with probabilistic sample of 55,970 households. 11,282 households were eligible for this study and 48.5 % were beneficiaries of the BFP. Food availability indicators were compared among paired blocks of households (n = 100), beneficiaries or non-beneficiaries of the Bolsa Família Program, with monthly per capita income up to R$ 210.00. Blocks of households were created based on the propensity score of each household to have beneficiaries and were homogeneous regarding potential confounding variables. The food availability indicators were weekly per capita expenditure and daily energy consumption, both calculated considering all food items and four food groups based on the extent and purpose of the industrial food processing. The comparisons between the beneficiaries and non-beneficiaries blocks of households were conducted through paired 't' tests. Compared to non-beneficiaries, the beneficiaries households had 6 % higher food expenditure (p = 0.015) and 9.4 % higher total energy availability (p = 0.010). It was found a 7.3 % higher expenditure on in natura or minimally processed foods and 10.4 % higher expenditure on culinary ingredients among the Bolsa Família Program families. No statistically significant differences were found regarding the expenditure and the availability of processed and ultra-processed food and drink products. In the in natura or minimally processed foods group, the expenditure and the availability of meat, tubers and vegetables were higher among the Bolsa Família Program beneficiaries. The Bolsa Família Program impact on food availability among low-income families was higher food expenditure, higher availability of fresh foods and culinary ingredients, including those foods that increase diet's quality and diversity.

  15. Household Food Insecurity and Its Association with Nutritional Status of Children 6-59 Months of Age in East Badawacho District, South Ethiopia.

    PubMed

    Betebo, Bealu; Ejajo, Tekle; Alemseged, Fissahaye; Massa, Desalegn

    2017-01-01

    Background . Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective . To assess household food insecurity and its association with the nutritional status of children 6-59 months of age in East Badawacho District, South Ethiopia. Methods . A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6-59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result . The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78-8.19) and stunting (AOR = 6.7; CI = 3.71-12.1) but not with wasting. Conclusion and Recommendation . Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.

  16. The longitudinal relation between peer violent victimization and delinquency: results from a national representative sample of u.s. Adolescents.

    PubMed

    Jackson, Corrie L; Hanson, Rochelle F; Amstadter, Ananda B; Saunders, Benjamin E; Kilpatrick, Dean G

    2013-05-01

    Using a nationally representative sample of adolescents from the United States aged 12 to 17 years (Wave 1, n = 3,614; Wave 2, n = 2,511), this study examined (a) demographic and descriptive information about peer violent victimization (PVV); and (b) the longitudinal relation between a history of PVV and delinquency. Results indicated that 12.4% of adolescents reported lifetime exposure to PVV, and many of these adolescents with a previous history of PVV also reported exposure to other forms of interpersonal violence, with witnessing community/school violence being the most commonly endorsed exposure category. Males, older adolescents, African American adolescents, and adolescents from low-income households were significantly more likely to endorse PVV. Regardless of the victim's gender, the majority of the perpetrators were male. After controlling for exposure to other forms of interpersonal violence and a history of delinquency, PVV was related to subsequent delinquency. Implications for policy, practice, and future research are discussed.

  17. The Longitudinal Relation Between Peer Violent Victimization and Delinquency: Results From a National Representative Sample of U.S. Adolescents

    PubMed Central

    Jackson, Corrie L.; Hanson, Rochelle F.; Amstadter, Ananda B.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2014-01-01

    Using a nationally representative sample of adolescents from the United States aged 12 to 17 years (Wave 1, n = 3,614; Wave 2, n = 2,511), this study examined (a) demographic and descriptive information about peer violent victimization (PVV); and (b) the longitudinal relation between a history of PVV and delinquency. Results indicated that 12.4% of adolescents reported lifetime exposure to PVV, and many of these adolescents with a previous history of PVV also reported exposure to other forms of interpersonal violence, with witnessing community/school violence being the most commonly endorsed exposure category. Males, older adolescents, African American adolescents, and adolescents from low-income households were significantly more likely to endorse PVV. Regardless of the victim's gender, the majority of the perpetrators were male. After controlling for exposure to other forms of interpersonal violence and a history of delinquency, PVV was related to subsequent delinquency. Implications for policy, practice, and future research are discussed. PMID:23266995

  18. Sample substitution can be an acceptable data-collection strategy: the case of the Belgian Health Interview Survey.

    PubMed

    Demarest, Stefaan; Molenberghs, Geert; Van der Heyden, Johan; Gisle, Lydia; Van Oyen, Herman; de Waleffe, Sandrine; Van Hal, Guido

    2017-11-01

    Substitution of non-participating households is used in the Belgian Health Interview Survey (BHIS) as a method to obtain the predefined net sample size. Yet, possible effects of applying substitution on response rates and health estimates remain uncertain. In this article, the process of substitution with its impact on response rates and health estimates is assessed. The response rates (RR)-both at household and individual level-according to the sampling criteria were calculated for each stage of the substitution process, together with the individual accrual rate (AR). Unweighted and weighted health estimates were calculated before and after applying substitution. Of the 10,468 members of 4878 initial households, 5904 members (RRind: 56.4%) of 2707 households (RRhh: 55.5%) participated. For the three successive (matched) substitutes, the RR dropped to 45%. The composition of the net sample resembles the one of the initial samples. Applying substitution did not produce any important distorting effects on the estimates. Applying substitution leads to an increase in non-participation, but does not impact the estimations.

  19. Humanitarian Needs Among Displaced and Female-Headed Households in Government-Controlled Areas of Syria.

    PubMed

    Doocy, Shannon; Lyles, Emily

    2017-06-01

    To identify unmet needs and assistance priorities of displaced and female-headed households in government-controlled areas of Syria. In mid-2016, we undertook a survey of accessible areas, largely urban and government-controlled, to identify unmet needs and assistance priorities. We used a cluster design with probability sampling to attain a final sample of 2405 households from 10 of 14 governorates; 31 of 65 (47.7%) districts were included that are home to 38.1% of people in need. Displaced and female-headed households were more vulnerable than nondisplaced and male-headed households in numerous sectors. Despite approximately half of surveyed households reporting receipt of humanitarian assistance in the preceding month and apparently effective targeting of assistance by vulnerability, unmet needs were nearly ubiquitous. The humanitarian situation in inaccessible areas of Syria is likely to be considerably worse; thus, findings presented here likely underestimate humanitarian needs. Efforts to expand support to Syria's most vulnerable households are desperately needed as are innovative targeting and modalities that enable more efficient and effective assistance.

  20. The influence of household pets on the composition and quantity of allergenic mite fauna within Irish homes: a preliminary investigation.

    PubMed

    Clarke, D; Dix, E; Liddy, S; Gormally, M; Byrne, M

    2016-03-01

    Allergenic mites are responsible for inducing hypersensitive reactions in genetically predisposed people worldwide. Mites in dust from 30 Irish homes with pets (dogs, n = 23; cats, n = 7) were compared with those in 30 homes without pets. House dust mites constituted 78% of all mites recorded, with Dermatophagoides pteronyssinus (Acariformes: Pyroglyphidae) representing 57-72% of mites in furniture and mattresses in both home types compared with only 22% of mites in pet beds. Although storage mites accounted for just 13% of all mites recorded, they represented 46% of mites recorded in pet beds. Median levels of the dust mite allergen Der p 1 (µg/g) in dust samples from mattresses in homes without pets were significantly greater than in mattresses from homes with pets, reflecting the greater densities of D. pteronyssinus found in the former home category. Mite species richness was greater in homes with pets (17 species) than in homes without pets (13 species). This suggests that although the presence of pets can result in a wider variety of epidemiologically important mite species within households, increased competition among mite species may result in a more balanced mite fauna in the home, inhibiting the dominance of any one species and hence lowering allergen-associated risks. © 2015 The Royal Entomological Society.

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

    Milovantseva, Natalia, E-mail: nmilovan@uci.edu; Saphores, Jean-Daniel, E-mail: saphores@uci.edu

    Highlights: ► US households are storing 84.1 million broken or obsolete (junk) TVs. ► They represent 2.12 million metric tons of scrap. ► The value of these materials is approximately $21 per TV. ► Our count models characterize US households who store junk TVs. ► Our results are useful for designing more effective TV recycling programs. - Abstract: Within the growing stockpile of electronic waste (e-waste), TVs are especially of concern in the US because of their number (which is known imprecisely), their low recycling rate, and their material content: cathode ray tube televisions contain lead, and both rear projectionmore » and flat panel displays contain mercury, in addition to other potentially toxic materials. Based on a unique dataset from a 2010 survey, our count models show that pro-environmental behavior, age, education, household size, marital status, gender of the head of household, dwelling type, and geographic location are statistically significant variables for explaining the number of broken or obsolete (junk) TVs stored by US households. We also estimate that they are storing approximately 84.1 million junk TVs, which represents 40 pounds of scrap per household. Materials in each of these junk TVs are worth $21 on average at January 2012 materials prices, which sets an upper bound on collecting and recycling costs. This information should be helpful for developing more effective recycling strategies for TVs in the e-waste stream.« less

  2. The Economic Burden of Visceral Leishmaniasis in Sudan: An Assessment of Provider and Household Costs

    PubMed Central

    Meheus, Filip; Abuzaid, Abuzaid A.; Baltussen, Rob; Younis, Brima M.; Balasegaram, Manica; Khalil, Eltahir A. G.; Boelaert, Marleen; Musa, Ahmed M.

    2013-01-01

    Visceral leishmaniasis (VL) is a neglected parasitic disease that is fatal if left untreated and is endemic in eastern Sudan. We estimated the direct and indirect costs of treatment of VL from the perspective of the provider and the household at three public hospitals in Gedaref State. The median total cost for one VL episode was estimated to be US$450. Despite the free provision of VL drugs at public hospitals, households bore 53% of the total cost of VL with one episode of VL representing 40% of the annual household income. More than 75% of households incurred catastrophic out-of-pocket expenditures. The length of treatment of 30 days led to important costs for both health providers and households. Alternative treatment regimens that reduce the duration of treatment are urgently needed. PMID:24189368

  3. Household waste behaviours among a community sample in Iran: an application of the theory of planned behaviour.

    PubMed

    Pakpour, Amir H; Zeidi, Isa Mohammadi; Emamjomeh, Mohammad Mahdi; Asefzadeh, Saeed; Pearson, Heidi

    2014-06-01

    Understanding the factors influencing recycling behaviour can lead to better and more effective recycling programs in a community. The goal of this study was to examine factors associated with household waste behaviours in the context of the theory of planned behaviour (TPB) among a community sample of Iranians that included data collection at time 1 and at follow-up one year later at time 2. Study participants were sampled from households under the coverage of eight urban health centers in the city of Qazvin. Of 2000 invited households, 1782 agreed to participate in the study. A self-reported questionnaire was used for assessing socio-demographic factors and the TPB constructs (i.e. attitude, subjective norms, perceived behavioural control, and intention). Furthermore, questions regarding moral obligation, self-identity, action planning, and past recycling behaviour were asked, creating an extended TPB. At time 2, participants were asked to complete a follow-up questionnaire on self-reported recycling behaviours. All TPB constructs had positive and significant correlations with each other. Recycling behaviour at time 1 (past behaviour) significantly related to household waste behaviour at time 2. The extended TPB explained 47% of the variance in household waste behaviour at time 2. Attitude, perceived behavioural control, intention, moral obligation, self-identity, action planning, and past recycling behaviour were significant predictors of household waste behaviour at time 2 in all models. The fact that the expanded TPB constructs significantly predicted household waste behaviours holds great promise for developing effective public campaigns and behaviour-changing interventions in a region where overall rates of household waste reduction behaviours are low. Our results indicate that educational materials which target moral obligation and action planning may be particularly effective. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Poor early childhood outcomes attributable to maternal depression in Mexican women.

    PubMed

    de Castro, Filipa; Place, Jean Marie; Villalobos, Aremis; Rojas, Rosalba; Barrientos, Tonatiuh; Frongillo, Edward A

    2017-08-01

    We aimed to estimate the population fraction of poor early child health and developmental outcomes attributable to maternal depressive symptoms (DS) contrasting it between low- and middle/high-income households. We used a nationally representative probabilistic sample of 4240 children younger than 5 years old and their mothers, derived from the Mexican National Health and Nutrition Survey Data (ENSANUT 2012). Complex survey design, sampling, and analytic weights were taken into account in analyses. DS was measured by CESD-7. Child outcomes were as follows: breastfeeding, attending well-child check-ups, respiratory disease, diarrhea and general health problems, immunization, accidents, growth, obesity, and food insecurity. Prevalence of DS among mothers was 21.36%. In low-SES households, DS was associated with higher risk of never being breastfed (RR = 1.77; p < .05), health problems (RR = 1.37; p < .05), acute respiratory disease (RR = 1.51; p < .05), accidents requiring child hospitalization (RR = 2.16; p < .01), and moderate or severe food insecurity (RR = 1.58; p < .001). In medium- or high-SES households, DS was associated with higher risk of never attending a developmental check-up (RR = 2.14; p < .05) and moderate or severe food insecurity (RR = 1.75; p < .01). Population risks attributable to DS ranged from 2.30 to 17.45%. Prevention of DS could lead to reduction of problematic early childhood outcomes in both low and medium/high SES.

  5. Socially optimal replacement of conventional with electric vehicles for the US household fleet

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

    Kontou, Eleftheria; Yin, Yafeng; Lin, Zhenhong

    In this study, a framework is proposed for minimizing the societal cost of replacing gas-powered household passenger cars with battery electric ones (BEVs). The societal cost consists of operational costs of heterogeneous driving patterns' cars, the government investments for charging deployment, and monetized environmental externalities. The optimization framework determines the timeframe needed for conventional vehicles to be replaced with BEVs. It also determines the BEVs driving range during the planning timeframe, as well as the density of public chargers deployed on a linear transportation network over time. We leverage datasets that represent U.S. household driving patterns, as well as themore » automobile and the energy markets, to apply the model. Results indicate that it takes 8 years for 80% of our conventional vehicle sample to be replaced with electric vehicles, under the base case scenario. The socially optimal all-electric driving range is 204 miles, with chargers placed every 172 miles on a linear corridor. All of the public chargers should be deployed at the beginning of the planning horizon to achieve greater savings over the years. Sensitivity analysis reveals that the timeframe for the socially optimal conversion of 80% of the sample varies from 6 to 12 years. The optimal decision variables are sensitive to battery pack and vehicle body cost, gasoline cost, the discount rate, and conventional vehicles' fuel economy. In conclusion, faster conventional vehicle replacement is achieved when the gasoline cost increases, electricity cost decreases, and battery packs become cheaper over the years.« less

  6. Socially optimal replacement of conventional with electric vehicles for the US household fleet

    DOE PAGES

    Kontou, Eleftheria; Yin, Yafeng; Lin, Zhenhong; ...

    2017-04-05

    In this study, a framework is proposed for minimizing the societal cost of replacing gas-powered household passenger cars with battery electric ones (BEVs). The societal cost consists of operational costs of heterogeneous driving patterns' cars, the government investments for charging deployment, and monetized environmental externalities. The optimization framework determines the timeframe needed for conventional vehicles to be replaced with BEVs. It also determines the BEVs driving range during the planning timeframe, as well as the density of public chargers deployed on a linear transportation network over time. We leverage datasets that represent U.S. household driving patterns, as well as themore » automobile and the energy markets, to apply the model. Results indicate that it takes 8 years for 80% of our conventional vehicle sample to be replaced with electric vehicles, under the base case scenario. The socially optimal all-electric driving range is 204 miles, with chargers placed every 172 miles on a linear corridor. All of the public chargers should be deployed at the beginning of the planning horizon to achieve greater savings over the years. Sensitivity analysis reveals that the timeframe for the socially optimal conversion of 80% of the sample varies from 6 to 12 years. The optimal decision variables are sensitive to battery pack and vehicle body cost, gasoline cost, the discount rate, and conventional vehicles' fuel economy. In conclusion, faster conventional vehicle replacement is achieved when the gasoline cost increases, electricity cost decreases, and battery packs become cheaper over the years.« less

  7. Effects of alcohol advertising exposure on drinking among youth.

    PubMed

    Snyder, Leslie B; Milici, Frances Fleming; Slater, Michael; Sun, Helen; Strizhakova, Yuliya

    2006-01-01

    To test whether alcohol advertising expenditures and the degree of exposure to alcohol advertisements affect alcohol consumption by youth. Longitudinal panel using telephone surveys. Households in 24 US media markets, April 1999 to February 2001. Individuals aged 15 to 26 years were randomly sampled within households and households within media markets. Markets were systematically selected from the top 75 media markets, representing 79% of the US population. The baseline refusal rate was 24%. Sample sizes per wave were 1872, 1173, 787, and 588. Data on alcohol advertising expenditures on television, radio, billboards, and newspapers were collected. Market alcohol advertising expenditures per capita and self-reported alcohol advertising exposure in the prior month. Self-reported number of alcoholic drinks consumed in the prior month. Youth who saw more alcohol advertisements on average drank more (each additional advertisement seen increased the number of drinks consumed by 1% [event rate ratio, 1.01; 95% confidence interval, 1.01-1.02]). Youth in markets with greater alcohol advertising expenditures drank more (each additional dollar spent per capita raised the number of drinks consumed by 3% [event rate ratio, 1.03; 95% confidence interval, 1.01-1.05]). Examining only youth younger than the legal drinking age of 21 years, alcohol advertisement exposure and expenditures still related to drinking. Youth in markets with more alcohol advertisements showed increases in drinking levels into their late 20s, but drinking plateaued in the early 20s for youth in markets with fewer advertisements. Control variables included age, gender, ethnicity, high school or college enrollment, and alcohol sales. Alcohol advertising contributes to increased drinking among youth.

  8. Household Implementation of Smoke-Free Rules in Homes and Cars: A Focus on Adolescent Smoking Behavior and Secondhand Smoke Exposure.

    PubMed

    Parks, Michael J; Kingsbury, John H; Boyle, Raymond G; Evered, Sharrilyn

    2018-01-01

    This study addresses the dearth of population-based research on how comprehensive household smoke-free rules (ie, in the home and car) relate to tobacco use and secondhand smoke (SHS) exposure among adolescents. Analysis of 2014 Minnesota Youth Tobacco Survey. Representative sample of Minnesota youth. A total of 1287 youth who lived with a smoker. Measures included household smoke-free rules (no rules, partial rules-home or car, but not both-and comprehensive rules), lifetime and 30-day cigarette use, 30-day cigarette and other product use, and SHS exposure in past 7 days in home and car. Weighted multivariate logistic, zero-inflated Poisson, and zero-inflated negative binomial regressions were used. Compared to comprehensive rules, partial and no smoke-free rules were significantly and positively related to lifetime cigarette use (respectively, adjusted odds ratio [AOR] = 1.80, 95% confidence interval [CI] = 1.24-2.61; AOR = 2.87, 95% CI = 1.93-4.25), and a similar significant pattern was found for 30-day cigarette use (respectively, AOR = 2.20, 95% CI = 1.21-4.02; AOR = 2.45, 95% CI = 1.34-4.50). No smoke-free rules significantly predicted using cigarettes and other tobacco products compared to comprehensive rules. In both descriptive and regression analyses, we found SHS exposure rates in both the home and car were significantly lower among youth whose household implemented comprehensive smoke-free rules. Comprehensive smoke-free rules protect youth from the harms of caregiver tobacco use. Relative to both partial and no smoke-free rules, comprehensive smoke-free rules have a marked impact on tobacco use and SHS exposure among youth who live with a smoker. Health promotion efforts should promote comprehensive smoke-free rules among all households and particularly households with children and adolescents.

  9. Health Insurance Benefit Design and Healthcare Utilization in Northern Rural China

    PubMed Central

    Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

    2012-01-01

    Background Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. Methods and Findings We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. Conclusion The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance may not benefit those who are most in need of financial protection from health services expenses. PMID:23185616

  10. Health insurance benefit design and healthcare utilization in northern rural China.

    PubMed

    Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

    2012-01-01

    Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance may not benefit those who are most in need of financial protection from health services expenses.

  11. Consumer preferences for household water treatment products in Andhra Pradesh, India.

    PubMed

    Poulos, Christine; Yang, Jui-Chen; Patil, Sumeet R; Pattanayak, Subhrendu; Wood, Siri; Goodyear, Lorelei; Gonzalez, Juan Marcos

    2012-08-01

    Over 5 billion people worldwide are exposed to unsafe water. Given the obstacles to ensuring sustainable improvements in water supply infrastructure and the unhygienic handling of water after collection, household water treatment and storage (HWTS) products have been viewed as important mechanisms for increasing access to safe water. Although studies have shown that HWTS technologies can reduce the likelihood of diarrheal illness by about 30%, levels of adoption and continued use remain low. An understanding of household preferences for HWTS products can be used to create demand through effective product positioning and social marketing, and ultimately improve and ensure commercial sustainability and scalability of these products. However, there has been little systematic research on consumer preferences for HWTS products. This paper reports the results of the first state-of-the-art conjoint analysis study of HWTS products. In 2008, we conducted a conjoint analysis survey of a representative sample of households in Andhra Pradesh (AP), India to elicit and quantify household preferences for commercial HWTS products. Controlling for attribute non-attendance in an error components mixed logit model, the study results indicate that the most important features to respondents, in terms of the effect on utility, were the type of product, followed by the extent to which the product removes pathogens, the retail outlet and, the time required to treat 10 L. Holding all other product attributes constant, filters were preferred to combination products and chemical additives. Department stores and weekly markets were the most favorable sales outlets, followed by mobile salespeople. In general, households do not prefer to purchase HWTS products at local shops. Our results can inform the types of products and sales outlets that are likely to be successful in commercial HWTS markets in AP, as well as the influence of different pricing and financing strategies on product demand and uptake. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake.

    PubMed

    Kun, P; Tong, X; Liu, Y; Pei, X; Luo, H

    2013-07-01

    To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China. Cross-sectional multicluster sample surveys with data collected from four counties. Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD. The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas. Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. Multidimensional poverty in rural Mozambique: a new metric for evaluating public health interventions.

    PubMed

    Victor, Bart; Blevins, Meridith; Green, Ann F; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F; Vergara, Alfredo E; Vermund, Sten H; Olupona, Omo; Moon, Troy D

    2014-01-01

    Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as "poor" if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program implementers to focus resources and critically explore linkages between poverty and its social determinants, thus deriving useful findings for evidence-based planning.

  14. Multidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions

    PubMed Central

    Victor, Bart; Blevins, Meridith; Green, Ann F.; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F.; Vergara, Alfredo E.; Vermund, Sten H.; Olupona, Omo; Moon, Troy D.

    2014-01-01

    Background Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Methods Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as “poor” if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. Results In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Conclusions Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program implementers to focus resources and critically explore linkages between poverty and its social determinants, thus deriving useful findings for evidence-based planning. PMID:25268951

  15. mHealth Series: Measuring maternal newborn and child health coverage by text messaging – a county–level model for China

    PubMed Central

    Zhang, Yanfeng; Chen, Li; van Velthoven, Michelle H. M. M. T.; Wang, Wei; Liu, Li; Du, Xiaozhen; Wu, Qiong; Li, Ye; Car, Josip

    2013-01-01

    Background Effective interventions in maternal, newborn and child health (MNCH), if achieving high level of population coverage, could prevent most of deaths in children under five years of age. High–quality measurements of MNCH coverage are essential for tracking progress and making evidence–based decisions. Methods MNCH coverage data are mainly collected through fieldworkers’ interview with preselected households in standard programs of Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS) in most low– and middle–income countries. Household surveys will continue to be the major data source for MNCH coverage in the foreseeable future. However, face–to–face data collection broadly used in household surveys is labor–intensive, time–consuming and expensive. Mobile phones are drawing more and more interest in medical research with the rapid increase in usage and text messaging could be an innovative way of data collection, that is, we could collect DHS data through mHealth method. We refer to it as “mDHS”. Finding We propose in this paper a conceptual model for measuring MNCH coverage by text messaging in China. In developing this model, we considered resource constraints, sample representativeness, sample size and survey bias. The components of the model are text messaging platform, routine health information system, health facilities, communities and households. Conclusions Measuring MNCH interventions coverage by text messaging could be advantageous in many ways and establish a much larger evidence–base for MNCH health policies in China. Before mDHS could indeed be launched, research priorities would include a systematic assessment of routine health information systems and exploring feasibility to collect name lists, mobile phone numbers and general demographic and socio–economic data; qualitative interviews with health workers and caregivers; assessment of data validity of all indicators to be collected by text messaging; and exploring approaches to increase participation rate. PMID:24363920

  16. [Economic impact of informal care after the establishment of the law of dependence in Spain].

    PubMed

    del Pozo Rubio, Raúl; Escribano Sotos, Francisco

    2012-01-01

    The Law of Dependence keeps the informal caregiver´s role, incorporating a specific economic benefit. The aims of this work are 1) to analyze the effect of the Law on informal care existence, and 2) to value the economic impact in the Law, disaggregated by financier. A cross-section study has been conducted from a representative sample of the dependent population in Cuenca (Spain) in February, 2009. We have obtained information for people with level II and III of dependence. A care service delivery simulation is used to quantify the economic impact of informal care to Cuenca (sample), Castilla-La Mancha and Spain. Informal care delivery is assigned in 81,74% of dependency benefits. Total costs of care service delivery is reduced between 36,51% and 80,53% if informal care exits, disaggregated into savings of 122,97-251,04% for user and 23,30-54,47% for public administration. Average estimated copayment for user is 13,25% for real sample, and it rises to 25,77% when it is supposed informal care extinguishes. Informal care is widespread in the Law, and it implies an important household and public resources saving: for household due to the assumption a smaller copayment that theoretical established, which is assumed by Autonomous Communities; in turn, for public administration, because of the fact economic deliveries require fewer resources.

  17. NHEXAS PHASE I ARIZONA STUDY--PESTICIDE METABOLITES IN URINE ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticide Metabolites in Urine data set contains analytical results for measurements of up to 4 pesticide metabolites in 176 urine samples over 176 households. Each sample was collected from the primary respondent within each household during Stage III of the NHEXAS study. ...

  18. Evidence of hepatitis A virus person-to-person transmission in household outbreaks.

    PubMed

    Lima, Lyana Rodrigues; De Almeida, Adilson José; Tourinho, Renata dos Santos; Hasselmann, Bárbara; Ximenez, Lia Laura Lewis; De Paula, Vanessa Salete

    2014-01-01

    The person-to-person transmission of the hepatitis A virus primarily occurs in enclosed spaces, particularly in the presence of inadequate hygiene conditions and a high proportion of susceptible individuals. Thus, intimate family contact stands out as a risk factor for HAV infection dissemination. The present study aimed to evaluate the occurrence of household HAV transmission. Blood samples were collected from patients with hepatitis A (index cases) and their family members (contacts) that were referred to an ambulatory care clinic specializing in viral hepatitis. A total of 97 samples were collected from 30 families with a confirmed hepatitis A case (index case). Serological and molecular techniques for the diagnosis of hepatitis A were conducted on all samples. HAV infection (anti-HAV IgM + and/or HAV RNA +) was detected in 34.3% (23/67) of the contacts; 34.3% (23/67) of the contacts were immune to HAV, and 31.4% (21/67) were susceptible. In the household contacts, HAV immunity was significantly associated with older age; susceptibility to infection and HAV infection were associated with younger age. Household outbreaks were detected in 16/30 families studied. Co-circulation of subgenotypes IA and IB was found in the household outbreaks, and person-to-person transmission was evidenced in six of the household outbreaks, with 100% homology between the index case and contact strains. The results demonstrated the relevance of HAV household transmission, reaffirming the need for hepatitis A vaccine administration in susceptible contacts and effective infection control procedures to prevent the extension of household outbreaks.

  19. Social analysis of sex imbalance in India: before and after the implementation of the Pre-Natal Diagnostic Techniques (PNDT) Act.

    PubMed

    Subramanian, S V; Selvaraj, S

    2009-03-01

    While the issue of sex imbalance in South Asia is well recognised, less is known about its social patterning. Social patterning in the proportion of sexes was investigated among infants in India before and after the implementation of the Pre-Natal Diagnostic Techniques (PNDT) Act in 1996. The act regulates the misuse of technologies for sex determination of fetuses and subsequent selective abortion. Multivariable regression analysis was performed on time series data from a nationally representative sample of households with infants. The outcome was log odds of having a male infant. Household income, parental education, social caste, a variable representing periods before and after the implementation of the PNDT Act and state of residence were the main predictors of interest. The odds of having a male infant increased with income quartiles. Heads of household with post-secondary education had a higher odds ratio of having a male infant than those with no formal education. The odds of having a male infant did not differ between high and low caste groups, and was not associated with the educational attainment of the spouse. Punjab had a higher odds ratio of having a male infant compared with Kerala. Kerala, meanwhile, was not particularly different from the remaining Indian states. The odds of having a male infant were similar in the pre- and post-PNDT periods. In the post-PNDT period, the income gradient in the odds of having a male infant was substantially weakened. Social analysis of the distribution of sexes among infants in India suggests that neither improvements in socioeconomic circumstances nor introducing policies that are not aligned with societal norms and preferences are likely to normalise the sex imbalance in India.

  20. Prevalence and risk factors of helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the 13C-Urea breath test

    PubMed Central

    2013-01-01

    Background Helicobacter pylori is an important global pathogen infecting approximately 50% of the world’s population. This study was undertaken in order to estimate the prevalence rate of Helicobacter pylori infections among adults living in Turkey and to investigate the associated risk factors. Method This study was a nationally representative cross sectional survey, using weighted multistage stratified cluster sampling. All individuals aged ≥18 years in the selected households were invited to participate in the survey. Ninety two percent (n = 2382) of the households in 55 cities participated; 4622 individuals from these households were tested with the 13C-Urea breath test. Helicobacter pylori prevalence and associated factors were analysed by the t test, chi square and multiple logistic regression with SPSS11.0. Results The weighted overall prevalence was 82.5% (95% CI: 81.0-84.2) and was higher in men. It was lowest in the South which has the major fruit growing areas of the country. The factors included in the final model were sex, age, education, marital status, type of insurance (social security), residential region, alcohol use, smoking, drinking water source. While education was the only significant factor for women, residential region, housing tenure, smoking and alcohol use were significant for men in models by sex. Conclusion In Turkey, Helicobacter pylori prevalence was found to be very high. Individuals who were women, elderly adults, single, had a high educational level, were living in the fruit growing region, had social security from Emekli Sandigi, were drinking bottled water, non smokers and regular alcohol consumers, were under less risk of Helicobacter pylori infection than others. PMID:24359515

  1. Dengue seroprevalence and force of primary infection in a representative population of urban dwelling Indonesian children.

    PubMed

    Prayitno, Ari; Taurel, Anne-Frieda; Nealon, Joshua; Satari, Hindra Irawan; Karyanti, Mulya Rahma; Sekartini, Rini; Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Medise, Bernie Endyarni; Sasmono, R Tedjo; Simmerman, James Mark; Bouckenooghe, Alain; Hadinegoro, Sri Rezeki

    2017-06-01

    Indonesia reports the second highest dengue disease burden in the world; these data are from passive surveillance reports and are likely to be significant underestimates. Age-stratified seroprevalence data are relatively unbiased indicators of past exposure and allow understanding of transmission dynamics. To better understand dengue infection history and associated risk factors in Indonesia, a representative population-based cross-sectional dengue seroprevalence study was conducted in 1-18-year-old urban children. From October to November 2014, 3,210 children were enrolled from 30 geographically dispersed clusters. Serum samples were tested for anti-dengue IgG antibodies by indirect ELISA. A questionnaire investigated associations between dengue serologic status and household socio-demographic and behavioural factors. Overall, 3,194 samples were tested, giving an adjusted national seroprevalence in this urban population of 69.4% [95% CI: 64.4-74.3] (33.8% [95% CI: 26.4-41.2] in the 1-4-year-olds, 65.4% [95% CI: 69.1-71.7] in the 5-9-year-olds, 83.1% [95% CI: 77.1-89.0] in the 10-14-year-olds, and 89.0% [95% CI: 83.9-94.1] in the 15-18-year-olds). The median age of seroconversion estimated through a linear model was 4.8 years. Using a catalytic model and considering a constant force of infection we estimated 13.1% of children experience a primary infection per year. Through a hierarchical logistic multivariate model, the subject's age group (1-4 vs 5-9 OR = 4.25; 1-4 vs. 10-14 OR = 12.60; and 1-4 vs 15-18 OR = 21.87; p<0.0001) and the number of cases diagnosed in the household since the subject was born (p = 0.0004) remained associated with dengue serological status. This is the first dengue seroprevalence study in Indonesia that is targeting a representative sample of the urban paediatric population. This study revealed that more than 80% of children aged 10 years or over have experienced dengue infection at least once. Prospective incidence studies would likely reveal dengue burdens far in excess of reported incidence rates.

  2. Trends in added sugars from packaged beverages available and purchased by US households, 2007-2012.

    PubMed

    Ng, Shu Wen; Ostrowski, Jessica D; Li, Kuo-Ping

    2017-07-01

    Background: The US Food and Drug Administration's updated nutrition labeling requirements will include added sugars starting in July 2018, but no measure currently exists to identify the added sugar content of products and what it represents among purchases. Beverages are one of the first targets for reducing added sugar consumption, and hence are the focus here. Objective: Our goal was to estimate trends in added sugars in nonalcoholic packaged beverage products available in the United States and to estimate amounts of added sugars obtained from these beverages given the purchases of US households overall and by subpopulations. Design: On the basis of nutrition label data from multiple sources, we used a stepwise approach to derive the added sugar content of 160,713 beverage products recorded as purchased by US households in 2007-2012 (345,193 observations from 110,539 unique households). We estimated the amounts of added sugars obtained from packaged beverages US households reported buying in 2007-2008, 2009-2010, and 2011-2012, overall and by subpopulations based on household composition, race/ethnicity, and income. The key outcomes are added sugars in terms of per capita grams per day and the percentage of calories from packaged beverages. Results: Packaged beverages alone account for per capita consumption of 12 g/d of added sugars purchased by US households in 2007-2012, representing 32-48% of calories from packaged beverages. Whereas the absolute amount of added sugars from beverages has not changed meaningfully over time, the relative contribution of added sugars to calories from beverages has increased. Non-Hispanic black households and low-income households obtain both higher absolute and relative amounts of added sugars from beverages than non-Hispanic white households and high-income households (all P < 0.01). Conclusions: These results provide measures of added sugars from packaged beverages at both the product level and the population level in the United States and can be used for comparisons after the revised nutrition labels are implemented and for future monitoring. © 2017 American Society for Nutrition.

  3. A state-wide information campaign during a pertussis epidemic in New South Wales, 2010.

    PubMed

    Spokes, Paula J; Rosewell, Alexander E; Stephens, Alex S; McAnulty, Jeremy M

    2014-09-30

    Pertussis notifications increased dramatically in New South Wales in 2008, exceeding the rates in previous epidemic years. A state-wide, multi-faceted campaign was launched in March 2009 to provide information about pertussis prevention. A population-based survey was conducted using a Computer Assisted Telephone Interviewing facility to assess the effectiveness of sending letters to households with young infants. A representative sample of 1,200 adults across all 8 area health services was interviewed between July 2009 and September 2010, with responses weighted against the state population. Many respondents (39.7%) reported receiving the letter, while fewer (29.6%) reported receiving an adult pertussis booster in the last year, mostly in response to General Practitioner advice (40.4%). Letter receipt was associated with the uptake of an adult pertussis booster in the past 12 months by respondents (OR 5.8; 95%CI 4.1, 8.2) and other adults in the household (OR 5.1; 95%CI 3.5, 7.5), as well as knowledge about pertussis prevention. Health providers remain crucial for vaccination decision making; however letters may have contributed to an increased uptake of pertussis booster vaccination and knowledge. Health authorities may consider mailing households in future pertussis epidemics as a component of a wider communication strategy.

  4. Household water use and conservation models using Monte Carlo techniques

    NASA Astrophysics Data System (ADS)

    Cahill, R.; Lund, J. R.; DeOreo, B.; Medellín-Azuara, J.

    2013-10-01

    The increased availability of end use measurement studies allows for mechanistic and detailed approaches to estimating household water demand and conservation potential. This study simulates water use in a single-family residential neighborhood using end-water-use parameter probability distributions generated from Monte Carlo sampling. This model represents existing water use conditions in 2010 and is calibrated to 2006-2011 metered data. A two-stage mixed integer optimization model is then developed to estimate the least-cost combination of long- and short-term conservation actions for each household. This least-cost conservation model provides an estimate of the upper bound of reasonable conservation potential for varying pricing and rebate conditions. The models were adapted from previous work in Jordan and are applied to a neighborhood in San Ramon, California in the eastern San Francisco Bay Area. The existing conditions model produces seasonal use results very close to the metered data. The least-cost conservation model suggests clothes washer rebates are among most cost-effective rebate programs for indoor uses. Retrofit of faucets and toilets is also cost-effective and holds the highest potential for water savings from indoor uses. This mechanistic modeling approach can improve understanding of water demand and estimate cost-effectiveness of water conservation programs.

  5. Household water use and conservation models using Monte Carlo techniques

    NASA Astrophysics Data System (ADS)

    Cahill, R.; Lund, J. R.; DeOreo, B.; Medellín-Azuara, J.

    2013-04-01

    The increased availability of water end use measurement studies allows for more mechanistic and detailed approaches to estimating household water demand and conservation potential. This study uses, probability distributions for parameters affecting water use estimated from end use studies and randomly sampled in Monte Carlo iterations to simulate water use in a single-family residential neighborhood. This model represents existing conditions and is calibrated to metered data. A two-stage mixed integer optimization model is then developed to estimate the least-cost combination of long- and short-term conservation actions for each household. This least-cost conservation model provides an estimate of the upper bound of reasonable conservation potential for varying pricing and rebate conditions. The models were adapted from previous work in Jordan and are applied to a neighborhood in San Ramon, California in eastern San Francisco Bay Area. The existing conditions model produces seasonal use results very close to the metered data. The least-cost conservation model suggests clothes washer rebates are among most cost-effective rebate programs for indoor uses. Retrofit of faucets and toilets is also cost effective and holds the highest potential for water savings from indoor uses. This mechanistic modeling approach can improve understanding of water demand and estimate cost-effectiveness of water conservation programs.

  6. What Effect Does International Migration Have on the Nutritional Status and Child Care Practices of Children Left Behind?

    PubMed

    Jayatissa, Renuka; Wickramage, Kolitha

    2016-02-15

    Despite an increasing trend in labour migration and economic dependence on foreign migrant workers in Sri Lanka, very little is known about the child care and nutritional status of "children left behind". The aim of this study was to examine the factors influencing the nutritional status and care practices of children left behind. A sample of 321 children, 6-59 months old of international migrant workers from a cross-sectional nationally represented study were included. Care practices were assessed using ten caregiving behaviours on personal hygiene, feeding, and use of health services. Results revealed the prevalence of stunting, wasting and underweight to be 11.6, 18.2 and 24.0 percent, respectively. Father being a migrant worker has a positive effect on childcare practices and birthweight of the child. This study indicates that undernutrition remains a major concern, particularly in the poorest households where the mother is a migrant worker, also each additional 100 g increase in the birthweight of a child in a migrant household, decreases the probability of being wasted, stunted and underweight by 6%, 8% and 23% respectively. In depth study is needed to understand how labour migration affects household level outcomes related to child nutrition and childcare in order to build skills and capacities of migrant families.

  7. Faecal contamination of drinking water in a Brazilian shanty town: importance of household storage and new human faecal marker testing.

    PubMed

    Copeland, Curtis C; Beers, Benjamin B; Thompson, Meghan R; Fitzgerald, Relana P; Barrett, Leah J; Sevilleja, Jesus E; Alencar, Sayonara; Lima, Aldo A M; Guerrant, Richard L

    2009-06-01

    Worldwide, contaminated drinking water poses a major health threat, particularly to child development. Diarrhoea represents a large part of the water-related disease burden and enteric infections have been linked to nutritional and growth shortfalls as well as long-term physical and cognitive impairment in children. Previous studies detailed the frequency of infection and the consequences for child health in a shanty town in north-east Brazil. To determine the frequency of contaminated water, we measured faecal contamination in primary drinking water samples from 231 randomly selected households. Risk for contamination was compared across source and storage types. Nearly a third of the study households (70/231: 30.3%) had contaminated drinking water; the source with the highest frequency of contamination was well water (23/24: 95.8%). For tap water, the type of storage had a significant effect on the susceptibility to contamination (chi(2) = 12.090; p = 0.007). The observed pattern of contamination demonstrated the relative potential contributions of both source and storage. With evidence that supports the inclusion of source and storage in water quality surveys, this study, like others, suggests that contaminated drinking water in storage vessels may be an important factor for the documented diarrhoea disease burden in the Brazilian shanty town.

  8. Depression amongst carers of AIDS-orphaned and other-orphaned children in Umlazi Township, South Africa

    PubMed Central

    Kuo, Caroline; Operario, Don; Cluver, Lucie

    2011-01-01

    South Africa faces the challenge of supporting the well-being of adults caring for growing numbers of AIDS-orphaned children. These adults play a critical role in responses to the epidemic but little information exists in regards to their mental health needs. This paper reports on findings from n=1599 adults, recruited through representative household sampling, who serve as primary carers for children in Umlazi Township, a HIV endemic community. Overall, 22% of participants were carers of AIDS-orphaned children, 11% were carers of other-orphaned children, and 67% were carers of non-orphaned children. Prevalence of depression was 30.3%. Orphan carers, regardless of whether they cared for AIDS-orphaned and other-orphaned children, were significantly more likely than carers of non-orphaned children to meet the clinical threshold for depression (35.2% versus 27.9%, p<.01). In multivariate logistic regressions, food insecurity and being a female carer were identified as additional risk factors for greater depression. In contrast, households with access to running water and households dependent on salaries as the main source of income were identified as protective factors for disparities in depression. Mental health interventions are urgently needed to address an increased risk for depression amongst all orphan carers, not just those caring for AIDS-orphaned children. PMID:22081931

  9. Deterioration in the nutritional status of young children and their mothers in Brazzaville, Congo, following the 1994 devaluation of the CFA franc.

    PubMed Central

    Martin-Prével, Y.; Delpeuch, F.; Traissac, P.; Massamba, J. P.; Adoua-Oyila, G.; Coudert, K.; Trèche, S.

    2000-01-01

    The effects of the January 1994 devaluation of the African Financial Community (CFA) franc on the nutritional situation of the populations concerned has been little documented. We report in this article on two nutritional cross-sectional surveys that were conducted before and after this devaluation (1993 and 1996) in two districts of Brazzaville, Congo. The surveys involved a representative sample of 4206 households with a child aged 4-23 months. Complementary feeding practices and the anthropometric indices of the children and their mothers were compared, adjusting for changes in household socioeconomic characteristics. The results show a decline in the quality of the first complementary foods offered to the infants, i.e. less frequent use of special transitional foods and imported complementary flours (of higher nutritional quality), and preparation of less nutritious local gruels. Overall, the nutritional situation had deteriorated, with greater levels of stunting and wasting among children, mothers with lower body mass index, and infants with reduced birth weights. Increased food prices would appear to be the direct cause of the decreased quality in complementary feeding, but factors other than the devaluation have also had an impact on household welfare. The influence of these factors on nutritional-status is discussed. PMID:10686745

  10. Household food insecurity and symptoms of neurologic disorder in Ethiopia: an observational analysis.

    PubMed

    El-Sayed, Abdulrahman M; Hadley, Craig; Tessema, Fasil; Tegegn, Ayelew; Cowan, John A; Galea, Sandro

    2010-12-31

    Food insecurity (FI) has been shown to be associated with poor health both in developing and developed countries. Little is known about the relation between FI and neurological disorder. We assessed the relation between FI and risk for neurologic symptoms in southwest Ethiopia. Data about food security, gender, age, household assets, and self-reported neurologic symptoms were collected from a representative, community-based sample of adults (N = 900) in Jimma Zone, Ethiopia. We calculated univariate statistics and used bivariate chi-square tests and multivariate logistic regression models to assess the relation between FI and risk of neurologic symptoms including seizures, extremity weakness, extremity numbness, tremors/ataxia, aphasia, carpal tunnel syndrome, vision dysfunction, and spinal pain. In separate multivariate models by outcome and gender, adjusting for age and household socioeconomic status, severe FI was associated with higher odds of seizures, movement abnormalities, carpal tunnel, vision dysfunction, spinal pain, and comorbid disorders among women. Severe FI was associated with higher odds of seizures, extremity numbness, movement abnormalities, difficulty speaking, carpal tunnel, vision dysfunction, and comorbid disorders among men. We found that FI was associated with symptoms of neurologic disorder. Given the cross-sectional nature of our study, the directionality of these associations is unclear. Future research should assess causal mechanisms relating FI to neurologic symptoms in sub-Saharan Africa.

  11. Household pesticide usage in the United States.

    PubMed

    Savage, E P; Keefe, T J; Wheeler, H W; Mounce, L; Helwic, L; Applehans, F; Goes, E; Goes, T; Mihlan, G; Rench, J; Taylor, D K

    1981-01-01

    A total of 10,000 U.S. households in 25 standard metropolitan statistical areas and 25 counties were included in the United States. More than 8,200 households granted an interview. Nine of every ten households in the United States used some types of pesticide in their house, garden, or yard. Households in the southeastern United States used the most pesticides. Although more than 500 different pesticide formulations were used by the sampled households, 15 pesticides accounted for 65.5% of all pesticides reported in this study. Thirteen of these 15 pesticides were insecticides, one was a herbicide, and one was a rodenticide.

  12. Drivers of microbiological quality of household drinking water - a case study in rural Ethiopia.

    PubMed

    Usman, Muhammed A; Gerber, Nicolas; Pangaribowo, Evita H

    2018-04-01

    This study aims at assessing the determinants of microbiological contamination of household drinking water under multiple-use water systems in rural areas of Ethiopia. For this analysis, a random sample of 454 households was surveyed between February and March 2014, and water samples from community sources and household storage containers were collected and tested for fecal contamination. The number of Escherichia coli (E. coli) colony-forming units per 100 mL water was used as an indicator of fecal contamination. The microbiological tests demonstrated that 58% of household stored water samples and 38% of protected community water sources were contaminated with E. coli. Moreover, most improved water sources often considered to provide safe water showed the presence of E. coli. The result shows that households' stored water collected from unprotected wells/springs had higher levels of E. coli than stored water from alternative sources. Distance to water sources and water collection containers are also strongly associated with stored water quality. To ensure the quality of stored water, the study suggests that there is a need to promote water safety from the point-of-source to point-of-use, with due considerations for the linkages between water and agriculture to advance the Sustainable Development Goal 6 of ensuring access to clean water for everyone.

  13. The effect of major income sources on rural household food (in)security: Evidence from Swaziland and implications for policy.

    PubMed

    Mabuza, Majola L; Ortmann, Gerald F; Wale, Edilegnaw; Mutenje, Munyaradzi J

    2016-01-01

    The aim of this article was to investigate the food (in)security effect of household income generated from major economic activities in rural Swaziland. From a sample of 979 households, the results of a multinomial treatment regression model indicated that gender of household head, labor endowment, education, size of arable land, and location significantly influenced the households' choice of primary economic activity. Further results suggested that off-farm-income-dependent households were less likely to be food insecure when compared with on-farm-income-dependent households. However, on-farm-income-dependent households had a better food security status than their counterparts who depended on remittances and nonfarm economic activities.

  14. NHEXAS PHASE I ARIZONA STUDY--PESTICIDES IN DERMAL WIPES ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticides in Dermal Wipes data set contains analytical results for measurements of up to 3 pesticides in 177 dermal wipe samples over 177 households. Each sample was collected from the primary respondent within each household during Stage III of the NHEXAS study. The Derma...

  15. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--PESTICIDES IN DERMAL ANALYTICAL RESULTS

    EPA Science Inventory

    The Pesticides in Dermal Wipes data set contains analytical results for measurements of up to 8 pesticides in 86 dermal wipe samples over 86 households. Each sample was collected from the primary respondent within each household. The Dermal/Pesticide hand wipe was collected 7 d...

  16. Suicidality in a Sample of Arctic Households

    ERIC Educational Resources Information Center

    Haggarty, John M.; Cernovsky, Zack; Bedard, Michel; Merskey, Harold

    2008-01-01

    We investigated the association of suicidal ideation and behavior with depression, anxiety, and alcohol abuse in a Canadian Arctic Inuit community. Inuit (N = 111) from a random sample of households completed assessments of anxiety and depression, alcohol abuse, and suicidality. High rates of suicidal ideation within the past week (43.6%), and…

  17. Assessment of iodine concentration in dietary salt at household level in Morocco.

    PubMed

    Zahidi, Ahmed; Zahidi, Meriem; Taoufik, Jamal

    2016-05-20

    Following WHO recommendations, Morocco adopted in 1995 the universal salt iodization (USI) as a strategy to prevent and control iodine deficiency disorders. In 2009, the standard salt iodine concentration was adjusted to 15-40 mg/kg. The success of USI for the control of iodine deficiency disorders requires an evaluation of iodine concentration in salt prior to assessing the iodine nutritional status of a population. In our study we refer to the anterior studies that were made in Morocco in 1993 and 1998. 178 salt samples from households were tested for iodine using spot-testing kits. The iodometric titration method was used to analyze accurately the concentration of iodine in the 178 household salt samples. An empiric polling method was adopted, using a non-probability sampling method; across the different twelve regions in the country. The median and interquartile range iodine concentration in salt was 2.9 mg/kg (IQR: 2.4-3.7). The results show that only 25 % of households use iodized salt. The recommended iodine concentration in salt of 15-40 mg/kg was met only in 4.5 % of salt samples. The bulk salt is used by 8 % of households. All samples of this bulk salt were found in rural areas. According to nonparametric appropriate tests used, there is no significant difference in iodine concentrations between regions, between urban and rural areas and between packaged and bulk salt. Two decades since introducing legislation on Universal Salt Iodization, our survey shows that generalization of iodized salt is far from being reached. In 2015, only a quarter of Moroccan households use the iodized salt and only 4.5 % of salt is in conformity with regulations. The use of bulk salt by households in rural areas constitutes a major obstacle to the success of USI. The National Iodine Deficiency Disorders Control Program can only be achieved if an internal follow-up and a control of external quality of program is put in place.

  18. Development of a Tool to Stage Households’ Readiness to Change Dietary Behaviours in Kerala, India

    PubMed Central

    Daivadanam, Meena; Ravindran, T. K. Sundari; Thankappan, K. R.; Sarma, P. S.; Wahlström, Rolf

    2016-01-01

    Dietary interventions and existing health behaviour theories are centred on individuals; therefore, none of the available tools are applicable to households for changing dietary behaviour. The objective of this pilot study was to develop a practical tool that could be administered by community volunteers to stage households in rural Kerala based on readiness to change dietary behaviour. Such a staging tool, comprising a questionnaire and its algorithm, focusing five dietary components (fruits, vegetables, salt, sugar and oil) and households (rather than individuals), was finalised through three consecutive pilot validation sessions, conducted over a four-month period. Each revised version was tested with a total of 80 households (n = 30, 35 and 15 respectively in the three sessions). The tool and its comparator, Motivational Interviewing (MI), assessed the stage-of-change for a household pertaining to their: 1) fruit and vegetable consumption behaviour; 2) salt, sugar and oil consumption behaviour; 3) overall readiness to change. The level of agreement between the two was tested using Kappa statistics to assess concurrent validity. A value of 0.7 or above was considered as good agreement. The final version was found to have good face and content validity, and also a high level of agreement with MI (87%; weighted kappa statistic: 0.85). Internal consistency testing was performed using Cronbach’s Alpha, with a value between 0.80 and 0.90 considered to be good. The instrument had good correlation between the items in each section (Cronbach’s Alpha: 0.84 (fruit and vegetables), 0.85 (salt, sugar and oil) and 0.83 (Overall)). Pre-contemplation was the most difficult stage to identify; for which efficacy and perceived cooperation at the household level were important. To the best of our knowledge, this is the first staging tool for households. This tool represents a new concept in community-based dietary interventions. The tool can be easily administered by lay community workers and can therefore be used in large population-based studies. A more robust validation process with a larger sample is needed before it can be widely used. PMID:27861500

  19. A monitoring of environmental effects from household greywater reuse for garden irrigation.

    PubMed

    Mohamed, Radin Maya Saphira Radin; Kassim, Amir Hashim Mohd; Anda, Martin; Dallas, Stewart

    2013-10-01

    The option of reusing greywater is proving to be increasingly attractive to address the water shortage issue in many arid and semiarid countries. Greywater represents a constant resource, since an approximately constant amount of greywater is generated from kitchen, laundries, bathroom in every household daily, independent of the weather. However, the use of greywater for irrigation in particular for household gardening may pose major hazards that have not been studied thoroughly. In this study, a 1-year monitoring was conducted in four selected households in Perth, Western Australia. The aim of the monitoring works is to investigate the variability in the greywater flow and quality, and to understand its impact in the surrounding environments. Case studies were selected based on different family structure including number, ages of the occupants, and greywater system they used. Samples of greywater effluent (showers, laundries, bathtub, and sinks), leachate, soil, and plants at each case study were collected between October 2008 and December 2009 which covered the high (spring/summer) and low (autumn/winter) production of greywater. Physical and chemical tests were based on the literature and expected components of laundry and bathroom greywater particularly on greywater components likely to have detrimental impacts on soils, plants, and other water bodies. Monitoring results showed the greywater quality values for BOD, TSS, and pH which sometimes fell outside the range as stipulated in the guidelines. The soil analyses results showed that salinity, SAR, and the organic content of the soil increased as a function of time and affected the plant growth. Nutrient leaching or losses from soil irrigated with greywater shows the movement of nutrients and the sole impact from greywater in uncontrolled plots in case studies is difficult to predicted due to the influence of land dynamics and activities. Investigative and research monitoring was used to understand greywater irrigation in households. Greywater quality is very site specific and difficult to predetermine or control except for the use of some recommended household products when using greywater. Investigative and research monitoring was indicated that greywater quality is very site specific and difficult to predetermine or control except for the use of some recommended household products when using greywater.

  20. Food insecurity among Iraqi refugees living in Lebanon, 10 years after the invasion of Iraq: data from a household survey.

    PubMed

    Ghattas, Hala; Sassine, AnnieBelle J; Seyfert, Karin; Nord, Mark; Sahyoun, Nadine R

    2014-07-14

    Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1% (95% CI 17·3, 23·2) were found to be food secure, 35·5% (95% CI 32·0, 39·2) moderately food insecure and 44·4% (95% CI 40·8, 48·1) severely food insecure. Severe food insecurity was associated with the respondent's good self-reported health (OR 0·3, 95% CI 0·2, 0·5), length of stay as a refugee (OR 1·1, 95% CI 1·0, 1·2), very poor housing quality (OR 3·3, 95% CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95% CI 1·0, 1·4), and resulted in poor dietary diversity (P< 0·0001). Anaemia was found in 41% (95% CI 30·6, 51·9) of children below 5 years of age, but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.

  1. Discrepancies in households and other stakeholders viewpoints on the food security experience: a gap to address.

    PubMed

    Hamelin, Anne-Marie; Mercier, Céline; Bédard, Annie

    2010-06-01

    This paper reports results from a case study on household food insecurity needs and the interventions that address them. It aimed at comparing households' perceptions on food insecurity experience and vulnerability to those of other stakeholders: community workers, programme managers and representatives from donor agencies. Semi-structured interviews with 55 households and 59 other stakeholders were conducted. Content analysis was performed, using a framework encompassing food sufficiency, characterization of household food insecurity and vulnerability of households to food insecurity. Overall, the results draw attention to a gap between households and the other stakeholders, where the later do not seem always able to assess the realities of food-insecure households. Other areas of divergences include: characteristics of food insecurity, relative importance of various risk factors related to food insecurity and the effectiveness of the community assistance to enhance the households' ability to face food insecurity. These divergent perceptions may jeopardize the implementation of sustainable solutions to food insecurity. Training of stakeholders for a better assessment of households' experience and needs, and systematic evaluation of interventions, appear urgent and highly relevant for an adequate response to households' needs. Collaboration between all stakeholders should lead to knowledge sharing and advocacy for policies dedicated to poverty reduction.

  2. Population Muscle Strength Predicts Olympic Medal Tallies: Evidence from 20 Countries in the PURE Prospective Cohort Study

    PubMed Central

    Leong, Darryl P.; McKee, Martin; Yusuf, Salim

    2017-01-01

    Background National sporting achievement at the Olympic Games is important for national pride and prestige, and to promote participation in sport. Summer Olympic Games medal tallies have been associated with national wealth, and also social development and healthcare expenditure. It is uncertain however, how these socioeconomic factors translate into Olympic success. The objective of this study was therefore to examine the relationship between population muscle strength and Olympic medal tallies. Methods and Results This study of handgrip strength represents a cross-sectional analysis of the Prospective Urban Rural Epidemiology (PURE) study, which is an ongoing population cohort study of individuals from high-, middle-, and low-income countries. Within participating countries, households from both urban and rural communities were invited to participate using a sampling strategy intended to yield a sample that was representative of the community. Households were eligible if at least one member was aged 35–70 years and if they intended living at the same address for a further four years. A total of 152,610 participants from these households, located in 21 countries, were included in this analysis. Handgrip strength was measured using a Jamar dynanometer. Olympic medal tallies were made over the five most recent Summer Games. There was a significant positive association between national population grip strength (GS) and medal tally that persisted after adjustment for sex, age, height, average daily caloric intake and GDP (total and per capita). For every 1kg increase in population GS, the medal tally increased by 36% (95% CI 13–65%, p = 0.001) after adjustment. Among countries that won at least one medal over the four most recent Summer Olympic Games, there was a close linear relationship between adjusted GS and the natural logarithm of the per capita medal tally (adjusted r = 0.74, p = 0.002). Conclusions Population muscle strength may be an important determinant of Summer Olympic Games medal success. Further research is needed to understand whether population muscle strength is modifiable, and whether this can improve Olympic medal success. Extreme outcomes may reflect the average attributes of the population from which the individual experiencing the extreme outcome is drawn. PMID:28107362

  3. Poverty and blindness in Pakistan: results from the Pakistan national blindness and visual impairment survey.

    PubMed

    Gilbert, Clare E; Shah, S P; Jadoon, M Z; Bourne, R; Dineen, B; Khan, M A; Johnson, G J; Khan, M D

    2008-01-05

    To explore the association between blindness and deprivation in a nationally representative sample of adults in Pakistan. Cross sectional population based survey. 221 rural and urban clusters selected randomly throughout Pakistan. Nationally representative sample of 16 507 adults aged 30 or above (95.3% response rate). Associations between visual impairment and poverty assessed by a cluster level deprivation index and a household level poverty indicator; prevalence and causes of blindness; measures of the rate of uptake and quality of eye care services. 561 blind participants (<3/60 in the better eye) were identified during the survey. Clusters in urban Sindh province were the most affluent, whereas rural areas in Balochistan were the poorest. The prevalence of blindness in adults living in affluent clusters was 2.2%, compared with 3.7% in medium clusters and 3.9% in poor clusters (P<0.001 for affluent v poor). The highest prevalence of blindness was found in rural Balochistan (5.2%). The prevalence of total blindness (bilateral no light perception) was more than three times higher in poor clusters than in affluent clusters (0.24% v 0.07%, P<0.001). The prevalences of blindness caused by cataract, glaucoma, and corneal opacity were lower in affluent clusters and households. Reflecting access to eye care services, cataract surgical coverage was higher in affluent clusters (80.6%) than in medium (76.8%) and poor areas (75.1%). Intraocular lens implantation rates were significantly lower in participants from poorer households. 10.2% of adults living in affluent clusters presented to the examination station wearing spectacles, compared with 6.7% in medium clusters and 4.4% in poor cluster areas. Spectacle coverage in affluent areas was more than double that in poor clusters (23.5% v 11.1%, P<0.001). Blindness is associated with poverty in Pakistan; lower access to eye care services was one contributory factor. To reduce blindness, strategies targeting poor people will be needed. These interventions may have an impact on deprivation in Pakistan.

  4. Domestic use of dirty energy and its effects on human health: empirical evidence from Bhutan

    NASA Astrophysics Data System (ADS)

    Rahut, Dil Bahadur; Ali, Akhter; Behera, Bhagirath

    2017-11-01

    Use of dirty fuels such as fuelwood, charcoal, cow dung and kerosene is common in developing countries, which adversely affects the health of people living in the dwellings, especially children and women. Using the data from a comprehensive and nationally representative Bhutan Living Standard Survey 2012, the present study examines the effects of dirty fuels on human health and household health expenditure. The result from propensity score-matching approach indicate that households using dirty fuels have a higher incidence of respiratory disease by 2.5-3% compared to households using cleaner fuels. The chances of household contracting tuberculosis are higher for households using dirty fuel in the range of 5-6%. It is also observed that the incidence of eye diseases and health expenditures among households using dirty fuels is higher. Hence the policy should focus on providing access to clean sources of energy to wider population.

  5. Household Food Insecurity, Mother's Feeding Practices, and the Early Childhood's Iron Status

    PubMed Central

    Salarkia, Nahid; Neyestani, Tirang R.; Omidvar, Nasrin; Zayeri, Farid

    2015-01-01

    Background: Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6–24 months children. Methods: In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Results: Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. Conclusions: We found no association between household food insecurity and the occurrence of anemia in the 6–24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children. PMID:26445633

  6. Passive Sampling for Indoor and Outdoor Exposures to Chlorpyrifos, Azinphos-Methyl, and Oxygen Analogs in a Rural Agricultural Community

    PubMed Central

    Gibbs, Jenna L.; Yost, Michael G.; Negrete, Maria; Fenske, Richard A.

    2016-01-01

    Background: Recent studies have highlighted the increased potency of oxygen analogs of organophosphorus pesticides. These pesticides and oxygen analogs have previously been identified in the atmosphere following spray applications in the states of California and Washington. Objectives: We used two passive sampling methods to measure levels of the ollowing organophosphorus pesticides: chlorpyrifos, azinphos-methyl, and their oxygen analogs at 14 farmworker and 9 non-farmworker households in an agricultural region of central Washington State in 2011. Methods: The passive methods included polyurethane foam passive air samplers deployed outdoors and indoors and polypropylene deposition plates deployed indoors. We collected cumulative monthly samples during the pesticide application seasons and during the winter season as a control. Results: Monthly outdoor air concentrations ranged from 9.2 to 199 ng/m3 for chlorpyrifos, 0.03 to 20 ng/m3 for chlorpyrifos-oxon, < LOD (limit of detection) to 7.3 ng/m3 for azinphos-methyl, and < LOD to 0.8 ng/m3 for azinphos-methyl-oxon. Samples from proximal households (≤ 250 m) had significantly higher outdoor air concentrations of chlorpyrifos, chlorpyrifos-oxon, and azinphos-methyl than did samples from nonproximal households (p ≤ 0.02). Overall, indoor air concentrations were lower than outdoors. For example, all outdoor air samples for chlorpyrifos and 97% of samples for azinphos-methyl were > LOD. Indoors, only 78% of air samples for chlorpyrifos and 35% of samples for azinphos-methyl were > LOD. Samples from farmworker households had higher indoor air concentrations of both pesticides than did samples from non-farmworker households. Mean indoor and outdoor air concentration ratios for chlorpyrifos and azinphos-methyl were 0.17 and 0.44, respectively. Conclusions: We identified higher levels in air and on surfaces at both proximal and farmworker households. Our findings further confirm the presence of pesticides and their oxygen analogs in air and highlight their potential for infiltration of indoor living environments. Citation: Gibbs JL, Yost MG, Negrete M, Fenske RA. 2017. Passive sampling for indoor and outdoor exposures to chlorpyrifos, azinphos-methyl, and oxygen analogs in a rural agricultural community. Environ Health Perspect 125:333–341; http://dx.doi.org/10.1289/EHP425 PMID:27517732

  7. The socioeconomic impact of interpersonal violence on women.

    PubMed

    Byrne, C A; Resnick, H S; Kilpatrick, D G; Best, C L; Saunders, B E

    1999-06-01

    Prospective data from a nationally representative sample of women were used to examine 4 objective indexes of social adjustment following direct, interpersonal crime. Household income, marital status, employment, and education level were evaluated as risk factors for and outcomes of victimization. Data were collected in 3 waves at 1-year intervals, and 2,863 women completed all 3 waves. Results indicate that women experience increased risk for victimization when income is below poverty level and when newly divorced. Further, victimization appears to increase women's risk for unemployment, reduced income, and divorce. The cyclical nature of victimization is discussed.

  8. Safety of packaged water distribution limited by household recontamination in rural Cambodia.

    PubMed

    Holman, Emily J; Brown, Joe

    2014-06-01

    Packaged water treatment schemes represent a growing model for providing safer water in low-income settings, yet post-distribution recontamination of treated water may limit this approach. This study evaluates drinking water quality and household water handling practices in a floating village in Tonlé Sap Lake, Cambodia, through a pilot cross-sectional study of 108 households, approximately half of which used packaged water as the main household drinking water source. We hypothesized that households purchasing drinking water from local packaged water treatment plants would have microbiologically improved drinking water at the point of consumption. We found no meaningful difference in microbiological drinking water quality between households using packaged, treated water and those collecting water from other sources, including untreated surface water, however. Households' water storage and handling practices and home hygiene may have contributed to recontamination of drinking water. Further measures to protect water quality at the point-of-use may be required even if water is treated and packaged in narrow-mouthed containers.

  9. 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

  10. 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.

  11. Questioning the stability of sense of coherence--the impact of socio-economic status and working conditions in the Canadian population.

    PubMed

    Smith, Peter M; Breslin, F Curtis; Beaton, Dorcas E

    2003-09-01

    Much debate exists about the stability of the sense of coherence measure. This study examined changes in sense of coherence (SOC), and the variables associated with these changes, over a 4-year period, in a representative sample of the Canadian labour force (n=6,790). Two methods were used to assess change in SOC: (1) Change outside of that which could be considered as indistinguishable from measurement error, and (2) Change of more than 10%, which was originally proposed by Antonovksy, the scales designer. Over the study period, 35.4% of the population reported changes in SOC outside the range we consider possible due to measurement error, with 58% reporting change greater than 10%. Unskilled occupations were associated with declines in SOC, with household income demonstrating a curvilinear relationship with decline in SOC in the female population only. None of the variables used predicted increases in SOC. Given the degree of change in SOC, and the representativeness of the study sample, we suggest that SOC has a large state component. Given this lack of stability, we recommend caution if using the SOC to represent a stable global orientation within a causal context.

  12. Considering Context, Place, and Culture: The National Latino and Asian American Study

    PubMed Central

    Alegria, Margarita; Takeuchi, David; Canino, Glorisa; Duan, Naihua; Shrout, Patrick; Meng, Xiao-Li; Vega, William; Zane, Nolan; Vila, Doryliz; Woo, Meghan; Vera, Mildred; Guarnaccia, Peter; Aguilar-Gaxiola, Sergio; Sue, Stanley; Escobar, Javier; Lin, Keh-Ming; Gong, Fong

    2009-01-01

    This paper provides a rationale and overview of procedures used to develop the National Latino and Asian American Study (NLAAS). The NLAAS is nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service utilization of Latinos and Asian Americans in the United States. The central aims of the NLAAS are to: 1) describe the lifetime and 12-month prevalence of psychiatric disorders and the rates of mental health services use for Latino and Asian American populations using nationwide representative samples of Latinos and Asian Americans, 2) assess the associations among social position, environmental context, and psychosocial factors with the prevalence of psychiatric disorders and utilization rates of mental health services, and 3) compare the lifetime and 12-month prevalence of psychiatric disorders, and utilization of mental health services of Latinos and Asian Americans with national representative samples of non-Latino whites (from the National Comorbidity Study-Replication; NCS-R) and African Americans (from the National Survey of American Life; NSAL). This paper presents new concepts and methods utilized in the development of the NLAAS to capture and investigate ethnic, cultural and environmental considerations that are often ignored in mental health research. PMID:15719529

  13. Specifying the Links between Household Chaos and Preschool Children's Development

    ERIC Educational Resources Information Center

    Martin, Anne; Razza, Rachel A.; Brooks-Gunn, Jeanne

    2012-01-01

    Household chaos has been linked to poorer cognitive, behavioural, and self-regulatory outcomes in young children, but the mechanisms responsible remain largely unknown. Using a diverse sample of families in Chicago, the present study tests for the independent contributions made by five indicators of household chaos: noise, crowding, family…

  14. 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.…

  15. Household Food Insecurity and Its Association with Nutritional Status of Children 6–59 Months of Age in East Badawacho District, South Ethiopia

    PubMed Central

    Ejajo, Tekle; Alemseged, Fissahaye; Massa, Desalegn

    2017-01-01

    Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children. PMID:28408936

  16. Modeling Stochastic Energy and Water Consumption to Manage Residential Water Uses

    NASA Astrophysics Data System (ADS)

    Abdallah, A. M.; Rosenberg, D. E.; Water; Energy Conservation

    2011-12-01

    Water energy linkages have received growing attention from the water and energy utilities as utilities recognize that collaborative efforts can implement more effective conservation and efficiency improvement programs at lower cost with less effort. To date, limited energy-water household data has allowed only deterministic analysis for average, representative households and required coarse assumptions - like the water heater (the primary energy use in a home apart from heating and cooling) be a single end use. Here, we use recent available disaggregated hot and cold water household end-use data to estimate water and energy consumption for toilet, shower, faucet, dishwasher, laundry machine, leaks, and other household uses and savings from appliance retrofits. The disaggregated hot water and bulk water end-use data was previously collected by the USEPA for 96 single family households in Seattle WA and Oakland CA, and Tampa FL between the period from 2000 and 2003 for two weeks before and four weeks after each household was retrofitted with water efficient appliances. Using the disaggregated data, we developed a stochastic model that represents factors that influence water use for each appliance: behavioral (use frequency and duration), demographical (household size), and technological (use volume or flowrate). We also include stochastic factors that govern energy to heat hot water: hot water fraction (percentage of hot water volume to total water volume used in a certain end-use event), heater water intake and dispense temperatures, and energy source for the heater (gas, electric, etc). From the empirical household end-use data, we derive stochastic probability distributions for each water and energy factor where each distribution represents the range and likelihood of values that the factor may take. The uncertainty of the stochastic water and energy factors is propagated using Monte Carlo simulations to calculate the composite probability distribution for water and energy use, potential savings, and payback periods to install efficient water end-use appliances and fixtures. Stochastic model results show the distributions among households for (i) water end-use, (ii) energy consumed to use water, and (iii) financial payback periods. Compared to deterministic analysis, stochastic modeling results show that hot water fractions for appliances follow normal distributions with high standard deviation and reveal pronounced variations among households that significantly affect energy savings and payback period estimates. These distributions provide an important tool to select and size water conservation programs to simultaneously meet both water and energy conservation goals. They also provide a way to identify and target a small fraction of customers with potential to save large water volumes and energy from appliance retrofits. Future work will embed this household scale stochastic model in city-scale models to identify win-win water management opportunities where households save money by conserving water and energy while cities avoid costs, downsize, or delay infrastructure development.

  17. Ageing in India: Financial hardship from health expenditures.

    PubMed

    Lee, Ting-Hsuan J; Saran, Indrani; Rao, Krishna D

    2018-04-01

    India's rapidly ageing population raises concerns about the burden of health care payments among older individuals who may have both limited income and greater health care needs. Using a nationally representative household survey, we investigate the association between age and financial hardship due to health expenditures. We find that both the probability of experiencing health problems and mean total out-of-pocket health expenditures increase with age. Second, the probability of households experiencing catastrophic health expenditures increases with each additional member aged 60 and above-33% of households with one 60+ member and 38% of households with 2 or more 60+ members experienced catastrophic health expenditures, compared to only 20% in households with all members under the age of 60 years. Lastly, we show that individuals aged 60 and above had a much higher probability of becoming impoverished as a result of health expenditures-the probability of impoverishment for 60+ individuals was 3 percentage points higher than for individuals under the age of 60. Overall, around 4.8% of the older population, representing 4.1 million people, fell into poverty. The results suggest that there is an urgent need for public investments in financial protection programs for older people in India. Copyright © 2017 John Wiley & Sons, Ltd.

  18. 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

  19. Household energy consumption and expenditures 1993

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

    NONE

    1995-10-05

    This presents information about household end-use consumption of energy and expenditures for that energy. These data were collected in the 1993 Residential Energy Consumption Survey; more than 7,000 households were surveyed for information on their housing units, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information represents all households nationwide (97 million). Key findings: National residential energy consumption was 10.0 quadrillion Btu in 1993, a 9% increase over 1990. Weather has a significant effect on energy consumption. Consumption of electricity for appliances is increasing. Houses that use electricity for space heating have lower overall energy expendituresmore » than households that heat with other fuels. RECS collected data for the 4 most populous states: CA, FL, NY, TX.« less

  20. Welfare Use Across Generations: How Important Are the Ties That Bind?

    ERIC Educational Resources Information Center

    Rank, Mark R.; Cheng, Li-Chen

    1995-01-01

    Examined extent of intergenerational welfare use, strength of the association across generations, and reasons underlying such a dynamic, utilizing nationally representative data set of American households (n=13,017). Three-quarters of welfare recipients do not grow up in households that received welfare. Parent economic background, not welfare use…

  1. Living with a Grandparent and Parent in Early Childhood: Associations with School Readiness and Differences by Demographic Characteristics

    ERIC Educational Resources Information Center

    Pilkauskas, Natasha V.

    2014-01-01

    Despite the increasing prevalence of 3-generation family households (grandparent, parent, child), relatively little research has studied these households during early childhood. Using nationally representative data from the Early Childhood Longitudinal Study--Birth Cohort ("N" = ~6,550), this study investigated the associations between…

  2. Household Food Security Study Summaries. 2001 Edition.

    ERIC Educational Resources Information Center

    Seavey, Dorie; Sullivan, Ashley F.

    This report provides the most recent data on the food security of United States households. Based on studies using the Food Security Core Module (FSCM), a tool facilitating direct documentation of the extent of food insecurity and hunger caused by income limitations, this report summarizes 35 studies representing 20 states and Canada. The report…

  3. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2010 Poverty Guidelines *

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Legal Services Corporation 2010 Poverty Guidelines... Corporation 2010 Poverty Guidelines * Legal Services Corporation 2010 Income Guidelines * Size of household 48...: 4,675 5,850 5,375 * The figures in this table represent 125% of the poverty guidelines by household...

  4. Using direct observations on multiple occasions to measure household food availability among low-income Mexicano residents in Texas colonias

    PubMed Central

    2010-01-01

    Background It has been recognized that the availability of foods in the home are important to nutritional health, and may influence the dietary behavior of children, adolescents, and adults. It is therefore important to understand food choices in the context of the household setting. Considering their importance, the measurement of household food resources becomes critical. Because most studies use a single point of data collection to determine the types of foods that are present in the home, which can miss the change in availability within a month and when resources are not available, the primary objective of this pilot study was to examine the feasibility and value of conducting weekly in-home assessments of household food resources over the course of one month among low-income Mexicano families in Texas colonias. Methods We conducted five in-home household food inventories over a thirty-day period in a small convenience sample; determined the frequency that food items were present in the participating households; and compared a one-time measurement with multiple measurements. After the development and pre-testing of the 252-item culturally and linguistically- appropriate household food inventory instrument that used direct observation to determine the presence and amount of food and beverage items in the home (refrigerator, freezer, pantry, elsewhere), two trained promotoras recruited a convenience sample of 6 households; administered a baseline questionnaire (personal info, shopping habits, and food security); conducted 5 in-home assessments (7-day interval) over a 30-day period; and documented grocery shopping and other food-related activities within the previous week of each in-home assessment. All data were collected in Spanish. Descriptive statistics were calculated for mean and frequency of sample characteristics, food-related activities, food security, and the presence of individual food items. Due to the small sample size of the pilot data, the Friedman Test and Kendall's W were used to assess the consistency of household food supplies across multiple observations. Results Complete data were collected from all 6 Mexicano women (33.2y ± 3.3; 6.5 ± 1.5 adults/children in household (HH); 5 HH received weekly income; and all were food insecure. All households purchased groceries within a week of at least four of the five assessments. The weekly presence and amounts of fresh and processed fruits and vegetables, dairy, meats, breads, cereals, beverages, and oils and fats varied. Further, the results revealed the inadequacy of a one-time measurement of household food resources, compared with multiple measures. The first household food inventory as a one-time measure would have mistakenly identified at least one-half of the participant households without fresh fruit, canned vegetables, dairy, protein foods, grains, chips, and sugar-sweetened beverages. Conclusions This study highlights the value of documenting weekly household food supplies, especially in households where income resources may be more volatile. Clearly, the data show that a single HFI may miss the changes in availability - presence and amount - that occur among low-income Mexicano households who face challenges that require frequent purchase of foods and beverages. Use of multiple household food inventories can inform the development and implementation of nutrition-related policies and culturally sensitive nutrition education programs. PMID:20670423

  5. Towards sustainable solid waste management: Investigating household participation in solid waste management

    NASA Astrophysics Data System (ADS)

    Akil, A. M.; Ho, C. S.

    2014-02-01

    The aim of this paper is to assess the readiness of Iskandar Malaysia community to accept solid waste recycling. The research is based on quantitative research design and descriptive survey of the households at Iskandar Malaysia using the stratified sampling method for a sample of 670. The survey was conducted using a structured questionnaire that covered two basic principles; a) recycling knowledge; b) willingness to recycle. Data was analysed using the SPSS to carry out statistical analysis. The finding shows households' knowledge towards the solid waste recycling is good and positive. However, finding also shows that respondents have incomprehensive knowledge on the method of disposal as more than 50% of householders only recycle papers and textiles. Most of the households agreed to participate in the activities of the separation of waste if the facility will be made available at their kerbside. Therefore, it is recommended that government should provide more in-depth knowledge by intensifying the awareness of the households in the recycling programs. In term of urban planning and management, the location of recycling facility can be analysing by using GIS. This is important to understand the catchment area of each neighbourhood or precinct to ensure effective household participation.

  6. Household income differences in food sources and food items purchased.

    PubMed

    French, Simone A; Wall, Melanie; Mitchell, Nathan R

    2010-10-26

    The present study examined income-related household food purchases among a sample of 90 households from the community. Annotated food purchase receipts were collected for a four-week period by the primary household shopper. Receipt food source and foods items were classified into specific categories, and food quantities in ounces were recorded by research staff. For home sources, a limited number of food/beverage categories were recorded. For eating out sources, all food/beverage items were recorded. Median monthly per person dollars spent and per person ounces purchased were computed. Food sources and food categories were examined by household income tertile. A community-based sample of 90 households. Higher income households spent significantly more dollars per person per month from both home and eating out sources compared with lower income households ($163 versus $100, p < .001). Compared with lower income households, higher income households spent significantly more home source dollars on both fruits/vegetables (21.5 versus 10.2, p < .001) and sweets/snacks (17.3 versus 8.3, p < .001), but did not differ on home dollars spent on sugar sweetened beverages (2.0 versus 1.7, p < .46). The proportion of home beverages that were sugar sweetened beverages was significantly higher among lower income households (45% versus 26%, p < .01). Within eating out sources, lower income households spent a significantly greater percent of dollars per person at carry out places (54% versus 37%, p < .01). No income differences were observed for dollars spent at discount grocery stores, small grocery stores or convenience stores. Higher income households spent more money on both healthy and less healthy foods from a wide range of sources. Lower income households spent a larger proportion of their eating out dollars at carry out places, and a larger proportion of their home beverage purchases were sugar sweetened beverages.

  7. Hygiene intervention reduces contamination of weaning food in Bangladesh.

    PubMed

    Islam, Mohammad Sirajul; Mahmud, Zahid Hayat; Gope, Partha Sarathi; Zaman, Rokon Uz; Hossain, Zakir; Islam, Mohammad Shafiqul; Mondal, Dinesh; Sharker, Mohammad Abu Yushuf; Islam, Khairul; Jahan, Hasin; Bhuiya, Abbas; Endtz, Hubert P; Cravioto, Alejandro; Curtis, Valerie; Touré, Ousmane; Cairncross, Sandy

    2013-03-01

    This study was conducted to measure the impact of a hygiene intervention on the contamination of weaning food in Bangladesh. Sixty households were selected: 30 study and 30 control households. Samples of weaning food were collected from all the 60 households at baseline and examined for faecal coliforms (FC), faecal streptococci (FS) and Clostridium perfringens (CP) following standard procedures. After cooking, food samples were collected on three occasions before feeding. Following Hazard Analysis Critical Control Point (HACCP) procedures, critical control points were determined. The mothers in the 30 study households were then trained for 4 weeks in how to attain the control point conditions. Then, again the food samples were collected and analysed. At baseline, weaning foods from study and control households were heavily contaminated with FC and FS. The FC and FS counts were 1.84 log(10) and 1.92 log(10) colony-forming unit (cfu)/g, respectively, in the study households, and 0.86 log(10) and 1.33 log(10)  cfu/g, respectively, in the control households in the first feeding. After the intervention, the FC and FS counts in study households had dropped to 0.10 log(10) and 0.09 log(10)  cfu/g, respectively, a statistically significant reduction (P < 0.001). Monitoring the sustainability of the behaviour change after 3 months showed that the mothers were maintaining food hygiene. A hygiene intervention following the HACCP approach reduced the weaning food contamination significantly. Awareness building among mothers about weaning food hygiene could be an important intervention for preventing weaning food-related diarrhoea in Bangladesh. © 2012 Blackwell Publishing Ltd.

  8. The relationship between relative deprivation and self-rated health among Palestinian women in refugee camps in Lebanon.

    PubMed

    Salti, Nisreen; Abdulrahim, Sawsan

    2016-12-01

    Relative deprivation (RD) has been advanced as a theory to explain the relationship between income inequality and health in high-income countries. In this study, we tested the theory in a low-income protracted refugee setting in a middle-income country. Using data from the 2010 Socioeconomic Survey of Palestine Refugees in Lebanon, we examined the relationship between RD and health among a representative sample of Palestinian refugee women ( N =1047). Data were gathered utilizing a household questionnaire with information on socio-demographics and an individual-level questionnaire with information on the health of each respondent. We examined self-rated health (SRH) as the main health measure but also checked the sensitivity of our results using self-reported chronic conditions. We used two measures for absolute SES: total household monthly expenditures on non-food goods and services and total household monthly expenditures on non-health goods and services. With refugee camp as a reference group, we measured a household's RD as a household's rank of absolute SES within the reference group, multiplied by the distance between its absolute SES and the average absolute SES of all households ranked above it. We investigated the robustness of the RD-SRH relationship using these two alternative measures of absolute SES. Our findings show that, controlling for absolute SES and other possible confounders, women report significantly poorer health when they live in households with a higher score on our RD measure (because of either lower relative rank or lower relative SES compared to households better off in the reference group which we take to be the refugee camp). While RD is always significant as a determinant of SRH under a variety of specifications, absolute SES is not consistently significant. These findings persist when we use self-reported chronic conditions as our measure of health instead of SRH, suggesting that the relationship between health and RD may be operating through a psychosocial mechanism. Our findings underscore the importance of examining RD under conditions of poverty and in diverse socio-cultural contexts. They also highlight that public health approaches should be concerned with reducing social inequalities in low-income settings in addition to alleviating poverty.

  9. Surface Sampling Collection and Culture Methods for Escherichia coli in Household Environments with High Fecal Contamination

    PubMed Central

    Kosek, Margaret N.; Schwab, Kellogg J.

    2017-01-01

    Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal contamination in low-income settings. The dry cloth method presented in this manuscript improves upon the more commonly used swabbing technique that has been shown in the literature to have a low sampling efficiency. The recovery efficiency of a dry electrostatic cloth sampling method was evaluated using Escherichia coli and then applied to household surfaces in Iquitos, Peru, where there is high fecal contamination and enteric infection. Side-by-side measurements were taken from various floor locations within a household at the same time over a three-month period to compare for consistency of quantification of E. coli bacteria. The dry cloth sampling method in the laboratory setting showed 105% (95% Confidence Interval: 98%, 113%) E. coli recovery efficiency off of the cloths. The field application demonstrated strong agreement of side-by-side results (Pearson correlation coefficient for dirt surfaces was 0.83 (p < 0.0001) and 0.91 (p < 0.0001) for cement surfaces) and moderate agreement for results between entrance and kitchen samples (Pearson (0.53, p < 0.0001) and weighted Kappa statistic (0.54, p < 0.0001)). Our findings suggest that this method can be utilized in households with high bacterial loads using either continuous (quantitative) or categorical (semi-quantitative) data. The standardization of this low-cost, dry electrostatic cloth sampling method can be used to measure differences between households in intervention and non-intervention arms of randomized trials. PMID:28829392

  10. Surface Sampling Collection and Culture Methods for Escherichia coli in Household Environments with High Fecal Contamination.

    PubMed

    Exum, Natalie G; Kosek, Margaret N; Davis, Meghan F; Schwab, Kellogg J

    2017-08-22

    Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal contamination in low-income settings. The dry cloth method presented in this manuscript improves upon the more commonly used swabbing technique that has been shown in the literature to have a low sampling efficiency. The recovery efficiency of a dry electrostatic cloth sampling method was evaluated using Escherichia coli and then applied to household surfaces in Iquitos, Peru, where there is high fecal contamination and enteric infection. Side-by-side measurements were taken from various floor locations within a household at the same time over a three-month period to compare for consistency of quantification of E. coli bacteria. The dry cloth sampling method in the laboratory setting showed 105% (95% Confidence Interval: 98%, 113%) E. coli recovery efficiency off of the cloths. The field application demonstrated strong agreement of side-by-side results (Pearson correlation coefficient for dirt surfaces was 0.83 ( p < 0.0001) and 0.91 ( p < 0.0001) for cement surfaces) and moderate agreement for results between entrance and kitchen samples (Pearson (0.53, p < 0.0001) and weighted Kappa statistic (0.54, p < 0.0001)). Our findings suggest that this method can be utilized in households with high bacterial loads using either continuous (quantitative) or categorical (semi-quantitative) data. The standardization of this low-cost, dry electrostatic cloth sampling method can be used to measure differences between households in intervention and non-intervention arms of randomized trials.

  11. Survey data on household electricity consumption and living status in Northwestern China.

    PubMed

    Niu, Shuwen; Jia, Yanqin; Ye, Liqiong; Dai, Runqi; Li, Na

    2016-06-01

    Based on 1128 survey questionnaires, main information on urban and rural household electricity consumption was obtained. Original data included household income, the price of electricity, all kinds of electrical appliances, purchase price of main appliances, household size, electricity consumption, as well as power, daily use time of electrical appliances in this data article. These data fully reflected behavior, preferences and living pattern of sample households in electricity use and provided the basis for analyzing the relationship between household electricity consumption and the quality of life ("Does electricity consumption improve residential living status in less developed regions? An empirical analysis using the quantile regression approach" [1]).

  12. Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal

    PubMed Central

    Mulmi, Prajula; Ghosh, Shibani; Namirembe, Grace; Rajbhandary, Ruchita; Manohar, Swetha; Shrestha, Binod; West, Keith P.; Webb, Patrick

    2017-01-01

    Background Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions. Objective This study investigates mediating effects of household wealth and child age on links between farm production and child diets, as measured by production and intake of nutrient-dense food groups. Methods Two rounds (2013 and 2014) of nationally representative survey data (n = 5,978 observations) were used to measure production and children’s dietary intake, as well as a household wealth index and control variables, including breastfeeding. Novel steps used include measuring production diversity in terms of both species grown and food groups grown, as well as testing for mediating effects of family wealth and age of child. Results We find significant associations between child dietary diversity and agricultural diversity in terms of diversity of food groups and of species grown, especially for older children in poorer households, and particularly for fruits and vegetables, dairy and eggs. With each additional food group produced, log-odds of meeting minimum dietary diversity score (≥4) increase by 0.25 (p = 0.01) for children aged 24–59 months. For younger children aged 18–23 months there is a similar effect size but only in the poorest two quintiles of household wealth, and for infants 6–18 months we find no correlation between production and intake in most models. Conclusions Child dietary intake is associated with the composition of farm production, most evident among older preschool children and in poorer households. To improve the nutrition of infants, other interventions are needed; and for relatively wealthier households, own farm production may displace market purchases, which could attenuate the impact of household production on child diets. PMID:29145391

  13. Mediating pathways in the socio-economic gradient of child development

    PubMed Central

    Attanasio, Orazio; Grantham-McGregor, Sally

    2016-01-01

    Research has previously shown a gap of near 0.5 of a standard deviation (SD) in cognition and language development between the top and bottom household wealth quartile in children aged 6–42 months in a large representative sample of low- and middle-income families in Bogota, using the Bayley Scales of Infant and Toddler Development. The gaps in fine motor and socio-emotional development were about half that size. Developmental deficits increased with age. The current study explored the associations amongst child development, household socio-economic status (SES), and a set of potential mediating variables—parental characteristics, child biomedical factors, and the quality of the home environment—in this sample. We ran mediation tests to quantify the contribution of these variables to the SES gap, and explored the role of age as a moderator. Parental education, particularly maternal education, and the quality of the home environment mediated the SES gap in all outcomes examined. Height-for-age mediated a small amount of the deficit in language scales only. More educated mothers provided better home stimulation than less educated mothers and the home environment partly mediated the effect of maternal education. These results suggested that in interventions aimed at promoting child development, those focusing on the quality of the home environment should be effective. PMID:27885311

  14. Out-of-pocket healthcare expenditures of older Americans with depression.

    PubMed

    Harman, Jeffrey S; Kelleher, Kelly J; Reynolds, Charles F; Pincus, Harold Alan

    2004-05-01

    The objective of this study was to estimate mean annual out-of-pocket (OOP) healthcare expenditures of Americans aged 65 and older with self-reported depression and compare these expenditures with the OOP expenditures of older Americans with hypertension, heart disease, diabetes mellitus, and arthritis. Data from the 1999 Medical Expenditure Panel Survey, which employs a nationally representative stratified random sample of households in the United States, were used to estimate mean OOP expenditures for health care during 1999. The data were limited to observations on individuals aged 65 and older living in households in the United States included in the 1999 Medical Expenditure Panel Survey sample (N=2,730). Mean OOP expenditures for older Americans with depression were $1,835 in 1999. Most of the spending ($1,090) was for prescription drugs in this population. For patients with depression, only 8% of total OOP spending was for depression-specific services and treatments. Mean OOP spending was greater for persons with depression than it was for older Americans with hypertension ($1,181) and arthritis ($1,190), whereas OOP spending for depression was similar to spending of older Americans with heart disease ($1,412) and diabetes mellitus ($1,527). Older Americans with depression have high OOP expenditures, with most of this spending for health services and drugs to treat general medical conditions.

  15. The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36⁻59 Months in Honduras.

    PubMed

    Urke, Helga Bjørnøy; Contreras, Mariela; Matanda, Dennis Juma

    2018-05-07

    Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36⁻59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011⁻2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD.

  16. Fat Content and Composition in Retail Samples of Australian Beef Mince

    PubMed Central

    Fayet-Moore, Flavia; Cunningham, Judy; Stobaus, Tim; Droulez, Veronique

    2014-01-01

    Nutrient composition data, representative of the retail supply, is required to support labelling and dietetic practice. Because beef mince represents approximately 30% of all beef dishes prepared in Australian households, a national survey of the different types of mince available for purchase in representative retail outlets was conducted. Sixty-one samples of beef mince from 24 retail outlets in New South Wales, Queensland, Victoria and Western Australia were collected in 2010 and analysed for moisture, protein, total fat and fatty acid profile. A variety of 18 different descriptors were used at point of sale with “Premium” (n = 15) and “Regular” (n = 8) the most commonly used terms. The analysed fat content of “Premium” samples varied from 2.2 g/100 g to 8.0 g/100 g. Forty-eight percent (n = 29) of the samples were categorised as low fat (<5 g/100 g; mean 4.1 g/100 g), 21% as medium fat (5–10 g/100 g; mean 8.9 g/100 g) and 31% as high fat (>10 g/100 g; mean 10.4 g/100 g). There was no significant difference between the types of mince available for purchase in low versus high socio-economic suburbs (Chi-square, p > 0.05). In conclusion, the fat content of the majority of retail beef mince in Australia is <10 g/100 g and a variety of descriptors are used at point of sale, all of which do not necessarily reflect analysed fat content. PMID:24922174

  17. Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea.

    PubMed

    Kim, Younhee; Yang, Bongmin

    2011-05-01

    The compositions of health expenditures by households in South Korea with and without catastrophic health expenditures were compared. Also, relationships between catastrophic health expenditures and household incomes, and between such health expenditures and expenditure patterns were explored. Data from the 2006 South Korean Household Income & Expenditure Survey, a representative survey of 90,696 households were analyzed. We used a double-hurdle model to assess each income source and expenditure category. The independent variable was the presence of catastrophic health expenditure. After adjusting for household characteristics, the results showed that earned, business, and property incomes were significantly lower, but transfer and loan incomes were significantly higher in households with catastrophic health expenditures than in those without such health expenditures. All consumption categories, other than health expenditure, were significantly lower in households with catastrophic health expenditures than in those without catastrophic health expenditures. This suggests that households with catastrophic health expenditures faced challenges in offset by the potentially excessive health expenditure and may have been obliged to reduce consumption of other items. The expansion of insurance coverage and lowering of out-of-pocket rates in the South Korean Health Insurance benefits could be a necessary first step in protecting households from the occurrence of health related economic catastrophes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  18. Transmission of methicillin-resistant Staphylococcus pseudintermedius between infected dogs and cats and contact pets, humans and the environment in households and veterinary clinics.

    PubMed

    van Duijkeren, E; Kamphuis, M; van der Mije, I C; Laarhoven, L M; Duim, B; Wagenaar, J A; Houwers, D J

    2011-06-02

    The objective of this study was to investigate the prevalence of methicillin-resistant Staphylococcus pseudintermedius (MRSP) in people, pets and the environment in households with a pet with a clinical MRSP-infection within the past year. Personnel and the environment at veterinary clinics were also screened. Nasal swabs (humans), nasal and perineal swabs (pets) and environmental wipes were examined using selective culturing. Twenty households were enrolled; 10/20 index cases still had clinical signs of infection at the start of the study and all were MRSP-positive. Of the remaining 10 index cases five were MRSP-positive in nasal and/or perineal samples. Five of 14 (36%) contact dogs and four of 13 (31%) contact cats were found MRSP-positive. In the households with an index case with clinical signs of infection 6/7 (86%) contact animals were MRSP-positive. MRSP was cultured from 2/45 (4%) human nasal samples. Domestic contamination was widespread as positive samples were found in 70% of the households and 44% of all environmental samples were MRSP-positive. In all but one of these MRSP-positive households the index case was still MRSP positive. Among the personnel in veterinary clinics 4/141 (3%) were MRSP-positive. MRSP was cultured from 31/200 environmental samples in 7/13 clinics at the first sampling and in 3/6 clinics the environment remained MRSP-positive after cleaning and disinfection indicating that current cleaning procedures often were unable to eliminate MRSP. These results show that transmission of MRSP between infected or colonized dogs and cats and healthy people does occur but is relatively uncommon, while transmission to contact pets occurs frequently, especially when the index case still has clinical signs of MRSP-infection. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. 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)

  20. Household Risk and Child Sexual Abuse in a Low Income, Urban Sample of Women.

    ERIC Educational Resources Information Center

    Rowland, David L.; Zabin, Laurie S.; Emerson, Mark

    2000-01-01

    Explored the impact of household environment and childhood sexual abuse (CSA) on psychosocial development. Data on low-income, urban CSA victims, and non-CSA women indicated that household conditions indicative of parental dysfunction, antisocial behavior, and instability set the stage for CSA by interfering with parental protection. Victims'…

  1. Using a Calendar and Explanatory Instructions to Aid Within-Household Selection in Mail Surveys

    ERIC Educational Resources Information Center

    Stange, Mathew; Smyth, Jolene D.; Olson, Kristen

    2016-01-01

    Although researchers can easily select probability samples of addresses using the U.S. Postal Service's Delivery Sequence File, randomly selecting respondents within households for surveys remains challenging. Researchers often place within-household selection instructions, such as the next or last birthday methods, in survey cover letters to…

  2. 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…

  3. Low-Income Multigenerational Households: Variation in Family Functioning by Mothers' Age and Race/Ethnicity

    ERIC Educational Resources Information Center

    Pittman, Laura D.; Boswell, Michelle K.

    2008-01-01

    This article compares characteristics of families, mothers, and children on the basis of whether their household is multigenerational, using data from Welfare, Children, and Families: A Three-City Study, which samples low-income culturally diverse families. Few differences were found between multigenerational and nonmultigenerational households,…

  4. Modeling Cooperation in an Address-Register-Based Telephone/Face-to-Face Survey

    ERIC Educational Resources Information Center

    Lipps, Oliver

    2016-01-01

    I analyze the effects of household sociodemography, interviewer performance in the current survey, and fieldwork characteristics on cooperation in a central telephone survey, where households with no publicly listed landline number receive face-to-face visits. Using the 2013 refreshment sample of the Swiss Household Panel, I employ…

  5. Supplemental nutrition assistance program participation and child food security.

    PubMed

    Mabli, James; Worthington, Julie

    2014-04-01

    This article investigates the association between Supplemental Nutrition Assistance Program (SNAP) participation and child food security by using data from the largest national survey of the food security of SNAP participants to date. The analysis used a survey of nearly 3000 households with children and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 months. Next, by using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 months later. Multivariate logistic regression analysis was used to estimate associations between SNAP and child food security. SNAP participation was associated with an approximately one-third decrease in the odds of children being food insecure in both samples. In the cross-sectional analysis only, SNAP was also associated with a decrease in the odds of children experiencing severe food insecurity (designated very low food security). Findings were qualitatively robust to different empirical specifications. After controlling for other possible confounders, we found children in households that had participated in SNAP for 6 months experienced improvements in food security. On the basis of these findings, we conclude SNAP serves a vital role in improving the health and well-being of low-income children by increasing food security. Future research is needed to determine whether specific groups of children experience differential improvements in food security.

  6. Validating self-reported food expenditures against food store and eating-out receipts.

    PubMed

    Tang, W; Aggarwal, A; Liu, Z; Acheson, M; Rehm, C D; Moudon, A V; Drewnowski, A

    2016-03-01

    To compare objective food store and eating-out receipts with self-reported household food expenditures. The Seattle Obesity Study II was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007 to 2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared with receipts using paired t-tests, Bland-Altman plots and κ-statistics. Bias by sociodemographics was also examined. Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores or eating out. However, the highest-income strata showed weaker agreement. Bland-Altman plots confirmed no significant bias across both methods-mean difference: 6.4; agreement limits: -123.5 to 143.4 for total food expenditures, mean difference 5.7 for food stores and mean difference 1.7 for eating out. The κ-statistics showed good agreement for each (κ 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Self-reported food expenditures using NHANES questions, both for food stores and eating out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high-income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts.

  7. Is nutritional quality of food-at-home purchases improving? 1969-2010: 40 years of household consumption surveys in France.

    PubMed

    Caillavet, France; Darmon, Nicole; Létoile, Flavie; Nichèle, Véronique

    2018-02-01

    The rise of nutrition-related diseases in developed countries prompts investigation into the role played by changing food patterns. Our aim was to observe changes in food-at-home purchases by French households and their impacts on nutritional quality over the past 40 years (1969-2010). Time-series of food-at-home purchases from representative samples of French households were built based on two sources of data: the INSEE National Food Survey (1969-1991) and the Kantar Food Consumption Panel (1989-2010). Food-at-home purchases were converted into energy and nutrients using the French CIQUAL food composition table. The nutritional quality of food-at-home purchases was estimated using the mean adequacy ratio (MAR) for 15 key nutrients. MAR was expressed per 2000 kcal to assess the nutrient density of food-at-home purchases. Between 1969 and 2010, food-at-home purchases showed dramatic changes in many food groups, with increasing processed vs raw products. The purchase of calories increased (+6.7%) and nutrient density improved (MAR per 2000 kcal + 12.9 points). However, this overall trend harbors heterogeneous patterns: food-at-home calories decreased and nutrient density improved up to 2002, but then calories increased while nutrient density stabilized. The nutritional quality of French households' food-at-home purchases improved over the last 40 years, as shown by increasing nutrient density. However, during the last decade, nutrient density ceased to increase and the purchase of calories increased, advocating a need for public action to promote healthier food purchasing patterns.

  8. Solar-Powered Drip Irrigation Impacts on Crops Production Diversity and Dietary Diversity in Northern Benin.

    PubMed

    Alaofè, Halimatou; Burney, Jennifer; Naylor, Rosamond; Taren, Douglas

    2016-06-01

    Meeting the food needs of Africa's growing population will require innovative and appropriate technologies whose effectiveness needs to be assessed. To evaluate the impact of Solar Market Gardens (SMGs) on crops production diversity and dietary diversity in the Kalalé district of Northern Benin. In 2007, SMGs were installed in 2 villages for women's agricultural groups as a strategy for enhancing food and nutrition security. Data were collected through interviews at installation and 1 year later from all women's group households (30-35 women/group) and from a random representative sample of 30 households in each village, for both treatment and matched-pair comparison villages. Comparison of baseline and endline data indicated increases in the variety of fruits and vegetables produced and consumed by SMG women's groups compared to other groups. The proportion of SMG women's group households engaged in vegetable and fruit production significantly increased by 26% and 55%, respectively (P < .05). After controlling for baseline values, SMG women's groups were 3 times more likely to increase their fruit and vegetable consumption compared with comparison non-women's groups (P < .05). In addition, the percentage change in corn, sorghum, beans, oil, rice and fish purchased was significantly greater in the SMG women's groups compared to other groups. At endline, 57% of the women used their additional income on food, 54% on health care, and 25% on education. Solar Market Gardens have the potential to improve household nutritional status through direct consumption and increased income to make economic decisions. © The Author(s) 2016.

  9. Health Surveys Using Mobile Phones in Developing Countries: Automated Active Strata Monitoring and Other Statistical Considerations for Improving Precision and Reducing Biases

    PubMed Central

    Blynn, Emily; Ahmed, Saifuddin; Gibson, Dustin; Pariyo, George; Hyder, Adnan A

    2017-01-01

    In low- and middle-income countries (LMICs), historically, household surveys have been carried out by face-to-face interviews to collect survey data related to risk factors for noncommunicable diseases. The proliferation of mobile phone ownership and the access it provides in these countries offers a new opportunity to remotely conduct surveys with increased efficiency and reduced cost. However, the near-ubiquitous ownership of phones, high population mobility, and low cost require a re-examination of statistical recommendations for mobile phone surveys (MPS), especially when surveys are automated. As with landline surveys, random digit dialing remains the most appropriate approach to develop an ideal survey-sampling frame. Once the survey is complete, poststratification weights are generally applied to reduce estimate bias and to adjust for selectivity due to mobile ownership. Since weights increase design effects and reduce sampling efficiency, we introduce the concept of automated active strata monitoring to improve representativeness of the sample distribution to that of the source population. Although some statistical challenges remain, MPS represent a promising emerging means for population-level data collection in LMICs. PMID:28476726

  10. The role of gallery forests in maintaining Phlebotominae populations: potential Leishmania spp. vectors in the Brazilian savanna

    PubMed Central

    Machado, Tâmara Dias Oliveira; Minuzzi-Souza, Thaís Tâmara Castro; Ferreira, Tauana de Sousa; Freire, Luciana Pereira; Timbó, Renata Velôzo; Vital, Tamires Emanuele; Nitz, Nadjar; Silva, Mariana Neiva; Santos, Alcinei de Souza; Sales, Nathyla Morgana Cunha; Obara, Marcos Takashi; de Andrade, Andrey José; Gurgel-Gonçalves, Rodrigo

    2017-01-01

    BACKGROUND Knowledge on synanthropic phlebotomines and their natural infection by Leishmania is necessary for the identification of potential areas for leishmaniasis occurrence. OBJECTIVE To analyse the occurrence of Phlebotominae in gallery forests and household units (HUs) in the city of Palmas and to determine the rate of natural infection by trypanosomatids. METHODS Gallery forests and adjacent household areas were sampled on July (dry season) and November (rainy season) in 2014. The total sampling effort was 960 HP light traps and eight Shannon traps. Trypanosomatids were detected in Phlebotominae females through the amplification of the SSU rDNA region, and the positive samples were used in ITS1-PCR. Trypanosomatid species were identified using sequencing. FINDINGS A total of 1,527 sand flies representing 30 species were captured in which 949 (28 spp.) and 578 (22 spp.) were registered in July and November, respectively. In July, more specimens were captured in the gallery forests than in the HUs, and Nyssomyia whitmani was particularly frequent. In November, most of the specimens were found in the HUs, and again, Ny. whitmani was the predominant species. Lutzomyia longipalpis was commonly found in domestic areas, while Bichromomyia flaviscutellata was most frequent in gallery forests. Molecular analysis of 154 pools of females (752 specimens) identified Leishmania amazonensis, L. infantum, and Crithidia fasciculata in Ny. whitmani, as well as L. amazonensis in Lu. longipalpis, Trypanosoma sp. and L. amazonensis in Pintomyia christenseni, and L. amazonensis in both Psathyromyia hermanlenti and Evandromyia walkeri. MAIN CONCLUSIONS These results show the importance of gallery forests in maintaining Phlebotominae populations in the dry month, as well as their frequent occurrence in household units in the rainy month. This is the first study to identify Leishmania, Trypanosoma, and Crithidia species in Phlebotominae collected in Palmas, Tocantins, Brazil. PMID:28953996

  11. Microbiome sharing between children, livestock and household surfaces in western Kenya.

    PubMed

    Mosites, Emily; Sammons, Matt; Otiang, Elkanah; Eng, Alexander; Noecker, Cecilia; Manor, Ohad; Hilton, Sarah; Thumbi, Samuel M; Onyango, Clayton; Garland-Lewis, Gemina; Call, Douglas R; Njenga, M Kariuki; Wasserheit, Judith N; Zambriski, Jennifer A; Walson, Judd L; Palmer, Guy H; Montgomery, Joel; Borenstein, Elhanan; Omore, Richard; Rabinowitz, Peter M

    2017-01-01

    The gut microbiome community structure and development are associated with several health outcomes in young children. To determine the household influences of gut microbiome structure, we assessed microbial sharing within households in western Kenya by sequencing 16S rRNA libraries of fecal samples from children and cattle, cloacal swabs from chickens, and swabs of household surfaces. Among the 156 households studied, children within the same household significantly shared their gut microbiome with each other, although we did not find significant sharing of gut microbiome across host species or household surfaces. Higher gut microbiome diversity among children was associated with lower wealth status and involvement in livestock feeding chores. Although more research is necessary to identify further drivers of microbiota development, these results suggest that the household should be considered as a unit. Livestock activities, health and microbiome perturbations among an individual child may have implications for other children in the household.

  12. The REFANI-N study protocol: a cluster-randomised controlled trial of the effectiveness and cost-effectiveness of early initiation and longer duration of emergency/seasonal unconditional cash transfers for the prevention of acute malnutrition among children, 6-59 months, in Tahoua, Niger.

    PubMed

    Sibson, Victoria L; Grijalva-Eternod, Carlos S; Bourahla, Leila; Haghparast-Bidgoli, Hassan; Morrison, Joanna; Puett, Chloe; Trenouth, Lani; Seal, Andrew

    2015-12-23

    The global burden of acute malnutrition among children remains high, and prevalence rates are highest in humanitarian contexts such as Niger. Unconditional cash transfers are increasingly used to prevent acute malnutrition in emergencies but lack a strong evidence base. In Niger, non-governmental organisations give unconditional cash transfers to the poorest households from June to September; the 'hunger gap'. However, rising admissions to feeding programmes from March/April suggest the intervention may be late. This cluster-randomised controlled trial will compare two types of unconditional cash transfer for 'very poor' households in 'vulnerable' villages defined and identified by the implementing organisation. 3,500 children (6-59 months) and 2,500 women (15-49 years) will be recruited exhaustively from households targeted for cash and from a random sample of non-recipient households in 40 villages in Tahoua district. Clusters of villages with a common cash distribution point will be assigned to either a control group which will receive the standard intervention (n = 10), or a modified intervention group (n = 10). The standard intervention is 32,500 FCFA/month for 4 months, June to September, given cash-in-hand to female representatives of 'very poor' households. The modified intervention is 21,500 FCFA/month for 5 months, April, May, July, August, September, and 22,500 FCFA in June, providing the same total amount. In both arms the recipient women attend an education session, women and children are screened and referred for acute malnutrition treatment, and the households receive nutrition supplements for children 6-23 months and pregnant and lactating women. The trial will evaluate whether the modified unconditional cash transfer leads to a reduction in acute malnutrition among children 6-59 months old compared to the standard intervention. The sample size provides power to detect a 5 percentage point difference in prevalence of acute malnutrition between trial arms. Quantitative and qualitative process evaluation data will be prospectively collected and programme costs will be collected and cost-effectiveness ratios calculated. This randomised study design with a concurrent process evaluation will provide evidence on the effectiveness and cost-effectiveness of earlier initiation of seasonal unconditional cash transfer for the prevention of acute malnutrition, which will be generalisable to similar humanitarian situations. ISRCTN25360839, registered March 19, 2015.

  13. Isolation of sulfur reducing and oxidizing bacteria found in contaminated drywall.

    PubMed

    Hooper, Dennis G; Shane, John; Straus, David C; Kilburn, Kaye H; Bolton, Vincent; Sutton, John S; Guilford, Frederick T

    2010-02-05

    Drywall from China has been reported to release sulfur producing products which are corrosive to metals, result in noxious odors, and represent a significant health risk. It has been reported that these emissions produce medical symptoms such as respiratory or asthma type problems, sinusitis, gastrointestinal disorders, and vision problems in home owners and their household pets. We report here a method of identifying a causative agent for these emissions by sampling affected gypsum wallboard and subjecting those samples to Real Time Polymerase Chain Reaction [RT-PCR] studies. Specific DNA probes and primers have been designed and patented that detect a specific iron and sulfur reducing bacterium (i.e., Thiobacillus ferrooxidans). One hundred percent of affected drywall samples obtained from homes located in the southeastern United States tested positive for the presence of T. ferrooxidans. All negative controls consisting of unaffected wallboard and internal controls, Geotrichum sp., tested negative within our limits of detection.

  14. Isolation of Sulfur Reducing and Oxidizing Bacteria Found in Contaminated Drywall

    PubMed Central

    Hooper, Dennis G.; Shane, John; Straus, David C.; Kilburn, Kaye H.; Bolton, Vincent; Sutton, John S.; Guilford, Frederick T.

    2010-01-01

    Drywall from China has been reported to release sulfur producing products which are corrosive to metals, result in noxious odors, and represent a significant health risk. It has been reported that these emissions produce medical symptoms such as respiratory or asthma type problems, sinusitis, gastrointestinal disorders, and vision problems in home owners and their household pets. We report here a method of identifying a causative agent for these emissions by sampling affected gypsum wallboard and subjecting those samples to Real Time Polymerase Chain Reaction [RT-PCR] studies. Specific DNA probes and primers have been designed and patented that detect a specific iron and sulfur reducing bacterium (i.e., Thiobacillus ferrooxidans). One hundred percent of affected drywall samples obtained from homes located in the southeastern United States tested positive for the presence of T. ferrooxidans. All negative controls consisting of unaffected wallboard and internal controls, Geotrichum sp., tested negative within our limits of detection. PMID:20386658

  15. Demythologizing sex education in Oklahoma: an attitudinal study.

    PubMed

    Turner, N H

    1983-08-01

    A randomized study was conducted to determine the distribution of attitudes among Oklahomans of voting age toward sex education and to analyze the relationship of demographic, sociocultural, and attitudinal factors. The state was stratified into six regions. Forty-five percent of the sample lived in urban areas, and 55% in rural areas. Random digit dialing and random selection within households were utilized to ensure a representative sample of the population. Eighty percent of the sample was found to be favorable toward sex education in the public schools, while 20% was unfavorable. A majority of respondents in all religious groups including "fundamentalists" were favorable. Seventeen variables were found to be significant in the univariate analysis of the data; eight were not significant. In a multivariate analysis, three variables, age, Protestant denominational type and female employment, were shown to have predictive ability in determining favorability and unfavorability. Implications for building community support for sex education also are discussed.

  16. Grocery store beverage choices by participants in federal food assistance and nutrition programs.

    PubMed

    Andreyeva, Tatiana; Luedicke, Joerg; Henderson, Kathryn E; Tripp, Amanda S

    2012-10-01

    Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits. This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP. Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January-June 2011. The sample consisted of families with a history of WIC participation in 2009-2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012. Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores. Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe.

    PubMed

    Paredes-Solís, Sergio; Andersson, Neil; Ledogar, Robert J; Cockcroft, Anne

    2011-12-21

    Unofficial payments in health services around the world are widespread and as varied as the health systems in which they occur. We reviewed the main lessons from social audits of petty corruption in health services in South Asia (Bangladesh, Pakistan), Africa (Uganda and South Africa) and Europe (Baltic States). The social audits varied in purpose and scope. All covered representative sample communities and involved household interviews, focus group discussions, institutional reviews of health facilities, interviews with service providers and discussions with health authorities. Most audits questioned households about views on health services, perceived corruption in the services, and use of government and other health services. Questions to service users asked about making official and unofficial payments, amounts paid, service delivery indicators, and satisfaction with the service. Contextual differences between the countries affected the forms of petty corruption and factors related to it. Most households in all countries held negative views about government health services and many perceived these services as corrupt. There was little evidence that better off service users were more likely to make an unofficial payment, or that making such a payment was associated with better or quicker service; those who paid unofficially to health care workers were not more satisfied with the service. In South Asia, where we conducted repeated social audits, only a minority of households chose to use government health services and their use declined over time in favour of other providers. Focus groups indicated that reasons for avoiding government health services included the need to pay for supposedly free services and the non-availability of medicines in facilities, often perceived as due to diversion of the supplied medicines. Unofficial expenses for medical care represent a disproportionate cost for vulnerable families; the very people who need to make use of supposedly free government services, and are a barrier to the use of these services. Patient dissatisfaction due to petty corruption may contribute to abandonment of government health services. The social audits informed plans for tackling corruption in health services.

  18. Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe

    PubMed Central

    2011-01-01

    Background Unofficial payments in health services around the world are widespread and as varied as the health systems in which they occur. We reviewed the main lessons from social audits of petty corruption in health services in South Asia (Bangladesh, Pakistan), Africa (Uganda and South Africa) and Europe (Baltic States). Methods The social audits varied in purpose and scope. All covered representative sample communities and involved household interviews, focus group discussions, institutional reviews of health facilities, interviews with service providers and discussions with health authorities. Most audits questioned households about views on health services, perceived corruption in the services, and use of government and other health services. Questions to service users asked about making official and unofficial payments, amounts paid, service delivery indicators, and satisfaction with the service. Results Contextual differences between the countries affected the forms of petty corruption and factors related to it. Most households in all countries held negative views about government health services and many perceived these services as corrupt. There was little evidence that better off service users were more likely to make an unofficial payment, or that making such a payment was associated with better or quicker service; those who paid unofficially to health care workers were not more satisfied with the service. In South Asia, where we conducted repeated social audits, only a minority of households chose to use government health services and their use declined over time in favour of other providers. Focus groups indicated that reasons for avoiding government health services included the need to pay for supposedly free services and the non-availability of medicines in facilities, often perceived as due to diversion of the supplied medicines. Conclusions Unofficial expenses for medical care represent a disproportionate cost for vulnerable families; the very people who need to make use of supposedly free government services, and are a barrier to the use of these services. Patient dissatisfaction due to petty corruption may contribute to abandonment of government health services. The social audits informed plans for tackling corruption in health services. PMID:22376233

  19. Socioeconomic determinants of bullying in the workplace: a national representative sample in Japan.

    PubMed

    Tsuno, Kanami; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Odagiri, Yuko; Yoshikawa, Toru; Haratani, Takashi; Shimomitsu, Teruichi; Kawachi, Ichiro

    2015-01-01

    Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20-60 years. The questionnaire included questions about employment, occupation, company size, education, household income, and subjective social status (SSS). We inquired about both the witnessing and personal experience of workplace bullying during the past 30 days. Among 2,384 respondents, data were analyzed from 1,546 workers. Multiple logistic regression analyses were used to examine the social determinants of workplace bullying. Six percent and 15 percent of the total sample reported experiencing or witnessing workplace bullying, respectively. After adjusting for gender and age, temporary employees (Odds Ratio [OR]: 2.45 [95% Confidence Interval (CI) = 1.03-5.85]), junior high school graduates (OR: 2.62 [95%CI: 1.01-6.79]), workers with lowest household income (OR: 4.13 [95%CI:1.58-10.8]), and workers in the lowest SSS stratum (OR: 4.21 [95%CI:1.66-10.7]) were at increased risk of experiencing workplace bullying. When all variables were entered simultaneously in the model, a significant inverse association was observed between higher SSS and experiencing bullying (p = 0.002). Similarly in terms of witnessing bullying; SSS was significantly inversely associated (p = 0.017) while temporary employees reported a significantly higher risk of witnessing bullying compared to permanent workers (OR: 2.25 [95%CI:1.04 to 4.87]). The significant association between SSS and experiencing/witnessing workplace bullying supports the frustration hypothesis. The power distance hypothesis was also partly supported by the finding that temporary employees experienced a higher prevalence of workplace bullying.

  20. Socioeconomic Determinants of Bullying in the Workplace: A National Representative Sample in Japan

    PubMed Central

    Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Odagiri, Yuko; Yoshikawa, Toru; Haratani, Takashi; Shimomitsu, Teruichi

    2015-01-01

    Bullying in the workplace is an increasingly recognized threat to employee health. We sought to test three hypotheses related to the determinants of workplace bullying: power distance at work; safety climate; and frustration related to perceived social inequality. A questionnaire survey was administered to a nationally representative community-based sample of 5,000 residents in Japan aged 20–60 years. The questionnaire included questions about employment, occupation, company size, education, household income, and subjective social status (SSS). We inquired about both the witnessing and personal experience of workplace bullying during the past 30 days. Among 2,384 respondents, data were analyzed from 1,546 workers. Multiple logistic regression analyses were used to examine the social determinants of workplace bullying. Six percent and 15 percent of the total sample reported experiencing or witnessing workplace bullying, respectively. After adjusting for gender and age, temporary employees (Odds Ratio [OR]: 2.45 [95% Confidence Interval (CI) = 1.03–5.85]), junior high school graduates (OR: 2.62 [95%CI: 1.01–6.79]), workers with lowest household income (OR: 4.13 [95%CI:1.58–10.8]), and workers in the lowest SSS stratum (OR: 4.21 [95%CI:1.66–10.7]) were at increased risk of experiencing workplace bullying. When all variables were entered simultaneously in the model, a significant inverse association was observed between higher SSS and experiencing bullying (p = 0.002). Similarly in terms of witnessing bullying; SSS was significantly inversely associated (p = 0.017) while temporary employees reported a significantly higher risk of witnessing bullying compared to permanent workers (OR: 2.25 [95%CI:1.04 to 4.87]). The significant association between SSS and experiencing/witnessing workplace bullying supports the frustration hypothesis. The power distance hypothesis was also partly supported by the finding that temporary employees experienced a higher prevalence of workplace bullying. PMID:25751252

  1. Nutritional status and its correlates in Equatorial Guinean preschool children: results from a nationally representative survey.

    PubMed

    Custodio, Estefanía; Descalzo, Miguel Angel; Roche, Jesús; Sánchez, Ignacio; Molina, Laura; Lwanga, Magdalena; Bernis, Cristina; Villamor, Eduardo; Baylin, Ana

    2008-03-01

    In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. The overall prevalence of stunting (< -2 height-for-age z-scores [HAZ]) was 29.7% based on the NCHS reference and 35.2% based on WHO standards; the risk factors associated with stunting were age (p < .0001), low socioeconomic status (p = .01), and fishing by a member of the household (p = .003) The prevalence of mild anemia (hemoglobin < 110 g/L) was 69.3%, and that of moderate or severe anemia (hemoglobin < 80 g/L) was 8.3%. The only significant risk factor associated with moderate to severe anemia was low household socioeducational level (p = .01). Stunting and anemia are public health problems in Equatorial Guinea. Integrated strategies, including fighting poverty and improving maternal education, should be undertaken.

  2. Education Modifies the Association of Wealth with Obesity in Women in Middle-Income but Not Low-Income Countries: An Interaction Study Using Seven National Datasets, 2005-2010

    PubMed Central

    Aitsi-Selmi, Amina; Bell, Ruth; Shipley, Martin J.; Marmot, Michael G.

    2014-01-01

    Background Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). Methods The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15–49 years collected in the period 2005–2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented Results In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction <0.001). Among women with no/primary education the wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative). In the poorer countries (India, Nigeria, Benin), there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (P<0.001). Conclusions The findings suggest that education may protect against the obesogenic effects of increased household wealth as countries develop. Further research could examine the factors explaining the country differences in education effects. PMID:24608086

  3. The impact of comorbidity of mental and physical conditions on role disability in the US adult household population.

    PubMed

    Merikangas, Kathleen R; Ames, Minnie; Cui, Lihong; Stang, Paul E; Ustun, T Bedirhan; Von Korff, Michael; Kessler, Ronald C

    2007-10-01

    There is limited information that accounts for comorbidity on the impact of role disability associated with a wide range of mental and physical disorders in population-based samples. To estimate the comparative effects of common mental and physical conditions on role disability in the general population using a novel method that accounts for comorbidity. Direct interviews about physical and mental conditions during the past year. The National Comorbidity Survey Replication, a nationally representative series of face-to-face interviews. A nationally representative sample of adults living in households (N = 5962 respondents, 18 years and older). Disability in major life roles was assessed with the World Health Organization Disability Assessment Schedule. Simulations that allow for complex interactions among conditions were used to estimate the conditions' effects on disability days, when respondents were completely unable to carry out their usual daily activities because of problems with mental or physical health, in the past 12 months. An estimated 53.4% of US adults have 1 or more of the mental or physical conditions assessed in the survey. These respondents report an average 32.1 more role-disability days in the past year than demographically matched controls, equivalent to nearly 3.6 billion days of role disability in the population. Musculoskeletal disorders and major depression had the greatest effects on disability days. Mental conditions accounted for more than half as many disability days as all physical conditions at the population level. Associations of specific conditions with disability decreased substantially after controlling for comorbidity, suggesting that prior studies, which generally did not control for comorbidity, overestimated disease-specific effects. The staggering amount of health-related disability associated with mental and physical conditions should be considered in establishing priorities for the allocation of health care and research resources.

  4. Delayed/back up antibiotic prescriptions: what do the public think?

    PubMed Central

    McNulty, Cliodna A M; Lecky, Donna M; Hawking, Meredith K D; Quigley, Anna; Butler, Chris C

    2015-01-01

    Objective To describe the general public's understanding, acceptance and use of delayed antibiotics. Design Face to face computer-assisted survey using an Ipsos MORI Capibus survey. Setting Randomly selected households in England using multistage sampling. Respondents A representative sample of 1625 adults aged over 15 years and recruited from household visits in England, using age and gender quotas for each area. Data collection and analysis The survey was undertaken in January 2014. Weights based on gender, age, ethnicity, working status, social grade, housing tenure and Government Office Region corrected for selection biases, so that results are broadly representative of the population. Main outcomes measures Proportion of respondents; understanding the meaning of the term delayed antibiotic prescription and how the strategy is used in general practice; in favour of, or opposed to clinicians offering them a delayed antibiotic; reporting receipt, use and acceptability of delayed antibiotic prescriptions in the past year. Results 17% reported fully understanding the meaning of delayed antibiotic prescription and strategy use in general practice;72% were unaware of the term or strategy; 36–39% were in favour of, and 28–30% opposed to clinicians offering them a delayed antibiotic for throat, urine, ear or chest infections. Half of those who were fully aware of the term and practice were in favour of delayed antibiotics. Women, and older respondents, were more strongly opposed to delayed prescribing. Only 4% of all respondents, and 15% of those prescribed an antibiotic, reported being offered a delayed antibiotic in the last year. Conclusions Wider understanding and acceptance of delayed prescribing may facilitate increased uptake. Further research is needed to determine why groups are so strongly in favour or opposed to delayed prescribing. PMID:26614626

  5. Religiousness and headache: is there a relation? Results from a representative sample of adults living in a low-income community.

    PubMed

    Lucchetti, Giancarlo; Lucchetti, Alessandra L G; Peres, Mario F Prieto

    2015-03-01

    The use of religious behaviors to alleviate the consequences of stressful life circumstances is a frequent strategy employed by pain sufferers. Specifically in the field of headache research, to date, few studies have assessed spiritual and religious beliefs. The objective of this article is to investigate the relation between religiousness (organizational, non-organizational and intrinsic) and headache disorders in a representative sample of adults living in a low-income community. This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 439 people, aged more than 18 years, randomly selected from a low-income community in Brazil. Four regression models were created to explain the relationships between religious involvement and headache, controlling for demographics, depression/anxiety and alcohol use and smoking. Of the 439 households contacted, at least one member from 383 (87.2%) households participated. We interviewed more women (74.4%) and more subjects aged 18-39 years. The mean age was 41.7 (SD 8.5) years. Bivariate analysis shows that high religious attendance, non-organizational religiousness and intrinsic religiousness were associated with presence of headache and presence of migraine. After the logistic regression models, only high non-organizational religiousness remained associated with presence of headache (odds ratio (OR): 1.22 (1.01-1.49)). All other religious variables were unrelated to the presence of headache and its types. There is a modest relationship between high non-organizational religiousness and presence of headache. Headache sufferers may use coping strategies such as private religious behaviors to try to overcome suffering. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. In Romania, exposure to Toxoplasma gondii occurs twice as often in swine raised for familial consumption as in hunted wild boar, but occurs rarely, if ever, among fattening pigs raised in confinement.

    PubMed

    Paştiu, Anamaria Ioana; Györke, Adriana; Blaga, Radu; Mircean, Viorica; Rosenthal, Benjamin Martin; Cozma, Vasile

    2013-06-01

    A wide range of swine husbandry practices prevail in Romania: pork for human consumption is derived from hunting wild boar, from household rearing of small numbers of backyard pigs, and from indoor, industrial production of swine raised in confinement indoors. Romania thus represents an instructive place for evaluating the influence of animal management on the exposure risk of the zoonotic parasite, Toxoplasma gondii. The fact that many Romanians eat uncooked or undercooked pork, especially when raised for household consumption, elevates the public health imperative to understand these risks. The aim of the study, therefore, was to evaluate the seroprevalence of T. gondii in pigs and wild boars from Romania. During 2008-2010, we collected 3,595 serum samples from pigs (fattening pigs, sows, backyard pigs) and 150 serum samples from wild boars. The sera were assayed by immunofluorescence antibody test (cutoff, 1:32) for antibodies against T. gondii. The overall seroprevalence of T. gondii infection was 23.1 % (829/3,595) in pigs and 16 % (24/150) in wild boars. The seroprevalence was significantly higher (p < 0.001) in backyard pigs (30.5 %; 783/2,564) than in sows (12.4 %; 46/371) or fattening pigs (none of the sera was positive). The management system (indoor pigs versus backyard pigs) represented the most important factor in the epidemiology of T. gondii infection. The proximity of backyard pigs to the definitive host of this parasite (cats), as well as their access to contaminated meat products, elevated their exposure risk well above that of pigs raised in confinement, and even above that of wild boars inhabiting sylvatic environments.

  7. Some Population Trends Affecting Extension Education and Other Community Programs.

    ERIC Educational Resources Information Center

    Niederfrank, E. J.

    Population trends affecting extension education and other community programs reveal that there will be large increases in numbers of young adult and young middleaged households, beginning in the next five years. The number of households in the United States will rise to 84.4 million by July 1985, representing an increase of 26.3 million over the…

  8. An Assessment of the Needs of Alaska Residents Who Are Disabled.

    ERIC Educational Resources Information Center

    Hanna, Virgene; Kruse, Jack

    A telephone survey of 4,364 randomly selected households in Alaska aimed at assessing the needs of disabled persons who were not institutionalized. In households that where found to have a disabled member, 514 interviews were conducted with the disabled person or a representative. The survey provided information on: (1) an estimated 22,220 persons…

  9. Factors Affecting Wealth Accumulation in Hispanic Households: A Comparative Analysis of Stock and Home Asset Utilization

    ERIC Educational Resources Information Center

    Fontes, Angela; Kelly, Nicole

    2013-01-01

    This research addresses differences between Hispanic ("N" = 2,333) and White ("N" = 15,521) households in the ownership and allocation of two representative measures of wealth accumulation, stock and homeownership. Using data from the 2008 panel of the Survey of Income and Program Participation, this research estimates a…

  10. Analysis of Binary Multivariate Longitudinal Data via 2-Dimensional Orbits: An Application to the Agincourt Health and Socio-Demographic Surveillance System in South Africa

    PubMed Central

    Visaya, Maria Vivien; Sherwell, David; Sartorius, Benn; Cromieres, Fabien

    2015-01-01

    We analyse demographic longitudinal survey data of South African (SA) and Mozambican (MOZ) rural households from the Agincourt Health and Socio-Demographic Surveillance System in South Africa. In particular, we determine whether absolute poverty status (APS) is associated with selected household variables pertaining to socio-economic determination, namely household head age, household size, cumulative death, adults to minor ratio, and influx. For comparative purposes, households are classified according to household head nationality (SA or MOZ) and APS (rich or poor). The longitudinal data of each of the four subpopulations (SA rich, SA poor, MOZ rich, and MOZ poor) is a five-dimensional space defined by binary variables (questions), subjects, and time. We use the orbit method to represent binary multivariate longitudinal data (BMLD) of each household as a two-dimensional orbit and to visualise dynamics and behaviour of the population. At each time step, a point (x, y) from the orbit of a household corresponds to the observation of the household, where x is a binary sequence of responses and y is an ordering of variables. The ordering of variables is dynamically rearranged such that clusters and holes associated to least and frequently changing variables in the state space respectively, are exposed. Analysis of orbits reveals information of change at both individual- and population-level, change patterns in the data, capacity of states in the state space, and density of state transitions in the orbits. Analysis of household orbits of the four subpopulations show association between (i) households headed by older adults and rich households, (ii) large household size and poor households, and (iii) households with more minors than adults and poor households. Our results are compared to other methods of BMLD analysis. PMID:25919116

  11. Rural drinking water at supply and household levels: quality and management.

    PubMed

    Hoque, Bilqis A; Hallman, Kelly; Levy, Jason; Bouis, Howarth; Ali, Nahid; Khan, Feroze; Khanam, Sufia; Kabir, Mamun; Hossain, Sanower; Shah Alam, Mohammad

    2006-09-01

    Access to safe drinking water has been an important national goal in Bangladesh and other developing countries. While Bangladesh has almost achieved accepted bacteriological drinking water standards for water supply, high rates of diarrheal disease morbidity indicate that pathogen transmission continues through water supply chain (and other modes). This paper investigates the association between water quality and selected management practices by users at both the supply and household levels in rural Bangladesh. Two hundred and seventy tube-well water samples and 300 water samples from household storage containers were tested for fecal coliform (FC) concentrations over three surveys (during different seasons). The tube-well water samples were tested for arsenic concentration during the first survey. Overall, the FC was low (the median value ranged from 0 to 4 cfu/100ml) in water at the supply point (tube-well water samples) but significantly higher in water samples stored in households. At the supply point, 61% of tube-well water samples met the Bangladesh and WHO standards of FC; however, only 37% of stored water samples met the standards during the first survey. When arsenic contamination was also taken into account, only 52% of the samples met both the minimum microbiological and arsenic content standards of safety. The contamination rate for water samples from covered household storage containers was significantly lower than that of uncovered containers. The rate of water contamination in storage containers was highest during the February-May period. It is shown that safe drinking water was achieved by a combination of a protected and high quality source at the initial point and maintaining quality from the initial supply (source) point through to final consumption. It is recommended that the government and other relevant actors in Bangladesh establish a comprehensive drinking water system that integrates water supply, quality, handling and related educational programs in order to ensure the safety of drinking water supplies.

  12. The association between domestic animal presence and ownership and household drinking water contamination among peri-urban communities of Kisumu, Kenya.

    PubMed

    Barnes, Amber N; Anderson, John D; Mumma, Jane; Mahmud, Zahid Hayat; Cumming, Oliver

    2018-01-01

    Household drinking water can be contaminated by diarrheagenic enteropathogens at numerous points between the source and actual consumption. Interventions to prevent this contamination have focused on preventing exposure to human waste through interventions to improve drinking water, sanitation and hygiene (WASH). In many cases though, the infectious agent may be of zoonotic rather than human origin suggesting that unsafely managed animal waste may contribute to the contamination of household drinking water and the associated diarrheal disease burden. A cross-sectional household survey of 800 households was conducted across three informal peri-urban neighborhoods of Kisumu, Kenya, collecting stored drinking water samples, administering a household survey including water, sanitation and hygiene infrastructure and behaviors, and recording domestic animal presence and ownership. We used multivariate logistic regression to assess the association of traditional WASH factors and domestic animal presence and ownership on microbial contamination of household drinking water. The majority of households sampled had fecally contaminated drinking water (67%), defined by the presence of any colony forming units of the fecal indicator bacteria enterococci. After adjustment for potential confounders, including socio-economic status and water and sanitation access, both household animal ownership (aOR 1.31; CI 1.00-1.73, p = 0.05) and the presence of animal waste in the household compound (aOR 1.38; CI 1.01, 1.89, p = 0.04) were found to be significantly associated with household drinking water contamination. None of the conventional WASH variables were found to be significantly associated with household drinking water contamination in the study population. Water, sanitation, and hygiene strategies to reduce diarrheal disease should consider the promotion of safe animal contact alongside more traditional interventions focusing on the management of human waste. Future research on fecal contamination of unsafe household drinking water should utilize host-specific markers to determine whether the source is human or animal to prepare targeted public health messages.

  13. The association between domestic animal presence and ownership and household drinking water contamination among peri-urban communities of Kisumu, Kenya

    PubMed Central

    Mumma, Jane; Mahmud, Zahid Hayat

    2018-01-01

    Introduction Household drinking water can be contaminated by diarrheagenic enteropathogens at numerous points between the source and actual consumption. Interventions to prevent this contamination have focused on preventing exposure to human waste through interventions to improve drinking water, sanitation and hygiene (WASH). In many cases though, the infectious agent may be of zoonotic rather than human origin suggesting that unsafely managed animal waste may contribute to the contamination of household drinking water and the associated diarrheal disease burden. Methods A cross-sectional household survey of 800 households was conducted across three informal peri-urban neighborhoods of Kisumu, Kenya, collecting stored drinking water samples, administering a household survey including water, sanitation and hygiene infrastructure and behaviors, and recording domestic animal presence and ownership. We used multivariate logistic regression to assess the association of traditional WASH factors and domestic animal presence and ownership on microbial contamination of household drinking water. Results The majority of households sampled had fecally contaminated drinking water (67%), defined by the presence of any colony forming units of the fecal indicator bacteria enterococci. After adjustment for potential confounders, including socio-economic status and water and sanitation access, both household animal ownership (aOR 1.31; CI 1.00–1.73, p = 0.05) and the presence of animal waste in the household compound (aOR 1.38; CI 1.01, 1.89, p = 0.04) were found to be significantly associated with household drinking water contamination. None of the conventional WASH variables were found to be significantly associated with household drinking water contamination in the study population. Conclusions Water, sanitation, and hygiene strategies to reduce diarrheal disease should consider the promotion of safe animal contact alongside more traditional interventions focusing on the management of human waste. Future research on fecal contamination of unsafe household drinking water should utilize host-specific markers to determine whether the source is human or animal to prepare targeted public health messages. PMID:29874284

  14. Monetary and nonmonetary household consumption of health services and the role of insurance benefits: An analysis of the Mexico's National Household Income and Expenditure Survey.

    PubMed

    Serván-Mori, Edson; Wirtz, Veronika J

    2018-05-23

    To study the monetary and nonmonetary consumption of healthcare services at household level in Mexico and the magnitude of the contribution of public programs. By using the National Household Income and Expenditure Survey 2012, we performed a cross-sectional and observational analysis of actual household consumption of health services by insurance type (no insurance, social security, Seguro Popular (SP)). Household consumption was divided into 2 categories: consumption related to "monetary" expenditure in health care and "nonmonetary" consumption in health care by the household. Nonmonetary included self-consumption or gifts received from other households and institutional contributions such as government payments or private organization transfers. In SP households, monetary and nonmonetary consumption of health services represented the highest proportion of available household expenditure (11.2%) compared to uninsured (8.4%) and social security (5.9%) households. The prevalence of outpatient consultation and medicine use is the highest among the health service consumption categories regardless of insurance status. Distribution of nonmonetary versus monetary consumption of health services was pro-poor: The poorer the households, the larger the proportion of nonmonetary consumption. The higher probability of receiving nonmonetary resources as a component of health service consumption in SP households is likely to increase the affordability to health services and likely to reduce healthcare expenditures. Future research should focus on the type of nonmonetary consumption of health services at household level to better understand financial protection and access to health care in Mexico. Copyright © 2018 John Wiley & Sons, Ltd.

  15. Indoor determinants of dustborne allergens in Mexican homes

    PubMed Central

    Hernández-Cadena, Leticia; Zeldin, Darryl C.; Sever, Michelle L.; Sly, Peter D.; London, Stephanie J.; Escamilla-Nuñez, María Consuelo; Romieu, Isabelle

    2015-01-01

    Exposure to indoor allergens represents a significant risk factor for allergies and asthma in several parts of the world. In Mexico, few studies have evaluated indoor allergens, including cat, dog, and mouse allergens and the factors that predict their presence. This study evaluates the main environmental and household predictors of high prenatal allergen levels and multiple allergen exposures in a birth cohort from Mexico City. A cross-sectional study was conducted as part of a birth cohort study of 1094 infants recruited during pregnancy and followed until delivery. We collected dust samples in a subset of 264 homes and assessed environmental factors. Der p 1, Der f 1, dust mite group 2, Fel d 1, Can f 1, Rat n 1, Mus m 1, and Bla g 2 concentrations in dust samples were measured using immunoassays. To define detectable allergen levels, the lowest limits of detection for each allergen were taken as cutoff points. Overall allergen exposure was considered high when four or more allergens exceeded detectable levels in the same household. Logistic regression was used for predictive models. Eighty-five percent of homes had at least one allergen in dust over the detection limit, 52.1% had high exposure (four or more allergens above detectable limits), and 11.7% of homes had detectable levels for more than eight allergens. Der p 1, Der p 2, Mus m 1, and Fel d 1 were the most frequent allergens detected. Each allergen had both common and distinct predictors. The main predictors of a high multiple allergen index were the size of the home, pesticide use, mother's age, mother as homemaker, and season. Increased indoor environmental allergen exposure is mainly related to sociodemographic factors and household cleaning. PMID:25715241

  16. Work satisfaction, career preferences and unpaid household work among recently graduated health-care professionals--a gender perspective.

    PubMed

    Enberg, Birgit; Stenlund, Hans; Sundelin, Gunnevi; Ohman, Ann

    2007-06-01

    This study investigated perceptions of recently graduated health-care professionals towards healthcare work, preferences for future careers, work organisation and management. In addition, it scrutinised the impact of unpaid household work on work satisfaction using a gender theoretical analysis. A questionnaire was distributed to 1035 nurses, occupational therapists and physiotherapists who graduated in the semester of spring 1999 in Sweden. The response rate was 81% and the respondents represent 3338 graduates. When estimating proportions and means, sampling weights reflecting the sampling design were used. Among both men and women, there was a high satisfaction with work in general, but a great dissatisfaction with work management and organisation. Multiple logistic regression analyses revealed a significant association between dissatisfaction with the work organisation and age groups and type of employment among the women. Younger women were more dissatisfied than older, and public employees were more dissatisfied than private employees. The women in the study did more unpaid household work than the men did. The data suggest that this can be of importance for the dissatisfaction at work, although this was not statistically significant. Working conditions and career preferences differ between the three professions as well as among men and women in the same profession. Geriatrics was not a preferred area for future work, although it is an area with predicted increasing personnel needs in the future. The results are discussed in relation to future needs for health-care personnel, gender and organisation theory. Because of the predicted scarcity of health-care personnel in Sweden, it is of importance that healthcare organisations address the issues of work satisfaction as well as possible competence drain. Gender equality in terms of working conditions is another important aspect that needs to be highlighted.

  17. Predictors of the risk of malnutrition among children under the age of 5 years in Somalia.

    PubMed

    Kinyoki, Damaris K; Berkley, James A; Moloney, Grainne M; Kandala, Ngianga-Bakwin; Noor, Abdisalan M

    2015-12-01

    To investigate the predictors of wasting, stunting and low mid-upper arm circumference among children aged 6-59 months in Somalia using data from household cross-sectional surveys from 2007 to 2010 in order to help inform better targeting of nutritional interventions. Cross-sectional nutritional assessment surveys using structured interviews were conducted among communities in Somalia each year from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6-59 months from households across three livelihood zones (pastoral, agro-pastoral and riverine). Predictors of three anthropometric measures, weight-for-height (wasting), height-for-age (stunting) and mid-upper arm circumference, were analysed using Bayesian binomial regression, controlling for both spatial and temporal dependence in the data. The study was conducted in randomly sampled villages, representative of three livelihood zones in Somalia. Children between the ages of 6 and 59 months in Somalia. The estimated national prevalence of wasting, stunting and low mid-upper arm circumference in children aged 6-59 months was 21 %, 31 % and 36 %, respectively. Although fever, diarrhoea, sex and age of the child, household size and access to foods were significant predictors of malnutrition, the strongest association was observed between all three indicators of malnutrition and the enhanced vegetation index. A 1-unit increase in enhanced vegetation index was associated with a 38 %, 49 % and 59 % reduction in wasting, stunting and low mid-upper arm circumference, respectively. Infection and climatic variations are likely to be key drivers of malnutrition in Somalia. Better health data and close monitoring and forecasting of droughts may provide valuable information for nutritional intervention planning in Somalia.

  18. The effects of illness on quality of life: findings from a survey of households in Great Britain.

    PubMed Central

    Bowling, A

    1996-01-01

    STUDY OBJECTIVE: To obtain national population norms on pertinent domains of quality of life, and the relative importance of these domains to people with reported longstanding illness. DESIGN AND SETTING: The vehicle for the study was the Office of Population Censuses and Surveys omnibus survey in Great Britain. The sampling frame was the British postcode address file of "small users", stratified by region and socioeconomic factors. This file includes all private household addresses. The postal sectors are selected with probability proportional to size. Within each sector 30 addresses are selected randomly with an target size of 2000 adults. PARTICIPANTS: The total number of adults interviewed was 2033 (one per sampled household), resulting in 2031 usable questionnaires, and representing a response rate of 77%. MAIN RESULTS: Of those who reported a longstanding illness, the most common, freely mentioned, first most important effects of the longstanding illness on their lives were (in order of frequency) ability to get out and about/stand/walk/go out shopping, being able to work/find a job, and effects on social life/leisure activities. Analysis of the areas of life affected by longstanding illness, showed considerable variation in relation to the condition. For example, respondents with mental health disorders (mainly depression) were most likely to report as the first most important effect the availability of work/ability to work, followed by social life/leisure activities; respondents with digestive and endocrine (for example, diabetes) disorders were most likely to report dietary restrictions; while respondents with cardiovascular disease, respiratory, and musculoskeletal disorders were most likely to report ability to get out and about/stand/walk/go out shopping. CONCLUSIONS: These results support the current trend of developing disease specific health related quality of life questionnaires rather than using generic scales. PMID:8762379

  19. Height of nations: a socioeconomic analysis of cohort differences and patterns among women in 54 low- to middle-income countries.

    PubMed

    Subramanian, S V; Özaltin, Emre; Finlay, Jocelyn E

    2011-04-20

    Adult height is a useful biological measure of long term population health and well being. We examined the cohort differences and socioeconomic patterning in adult height in low- to middle-income countries. We analyzed cross-sectional, representative samples of 364,538 women aged 25-49 years drawn from 54 Demographic and Health Surveys (DHS) conducted between 1994 and 2008. Linear multilevel regression models included year of birth, household wealth, education, and area of residence, and accounted for clustering by primary sampling units and countries. Attained height was measured using an adjustable measuring board. A yearly change in birth cohorts starting with those born in 1945 was associated with a 0.0138 cm (95% CI 0.0107, 0.0169) increase in height. Increases in heights in more recent birth year cohorts were largely concentrated in women from the richer wealth quintiles. 35 of the 54 countries experienced a decline (14) or stagnation (21) in height. The decline in heights was largely concentrated among the poorest wealth quintiles. There was a strong positive association between height and household wealth; those in two richest quintiles of household wealth were 1.988 cm (95% CI 1.886, 2.090) and 1.018 cm (95% CI 0.916, 1.120) taller, compared to those in the poorest wealth quintile. The strength of the association between wealth and height was positive (0.05 to 1.16) in 96% (52/54) countries. Socioeconomic inequalities in height remain persistent. Height has stagnated or declined over the last decades in low- to middle-income countries, particularly in Africa, suggesting worsening nutritional and environmental circumstances during childhood.

  20. Nationally representative household survey of surgery and mortality in Sierra Leone.

    PubMed

    Kwon, Steve; Groen, Reinou S; Kamara, Thaim B; Cassidy, Laura D; Samai, Mohamed; Yambasu, Sahr E; Kushner, Adam L

    2013-08-01

    There is limited evidence to characterize the burden of unmet need of surgical diseases in low- and middle-income countries. The purpose of this study was to determine rate of deaths attributable to a surgical condition and reasons for not seeking surgical care in Sierra Leone. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a survey tool developed collaboratively to be used for cross-sectional data collection of the prevalence of surgical conditions in any country. A population-weighted cluster-sample household survey was conducted throughout Sierra Leone in 2012 using the SOSAS survey tool. Total of 1,840 households (11,870 individuals) were sampled, yielding a 98.3 % response rate. Overall, there were 709 total deaths reported (6.0 %). The mean age at death was 36.4 ± 30.1 years: 330 (46.6 %) were female. Most deaths occurred at home (58.1 % vs. 34.1 % in hospitals). Of the 709 deaths, 237 (33.4 %) were associated with conditions included in our predefined surgical disease category. Abdominal distension/pain was the most commonly associated surgical condition (13.9 %) followed by perinatal bleeding/illness (6.0 %). Among the 237 with surgical conditions, 51 (21.9 %) did not seek medical care, most commonly because of a lack of money (35.3 %) or inability to provide timely care (37.3 %). A large proportion of deaths in Sierra Leone was associated with surgical conditions, the majority of which did not undergo surgical intervention. Our results indicate that to remove barriers to effective surgical care in Sierra Leone policymakers should first focus on relieving financial burdens and increasing access to timely surgical care.

  1. Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon

    PubMed Central

    Roberton, Timothy; Weiss, William; Doocy, Shannon

    2017-01-01

    Ensuring the sustained immunization of displaced persons is a key objective in humanitarian emergencies. Typically, humanitarian actors measure coverage of single vaccines following an immunization campaign; few measure routine coverage of all vaccines. We undertook household surveys of Syrian refugees in Jordan and Lebanon, outside of camps, using a mix of random and respondent-driven sampling, to measure coverage of all vaccinations included in the host country’s vaccine schedule. We analyzed the results with a critical eye to data limitations and implications for similar studies. Among households with a child aged 12–23 months, 55.1% of respondents in Jordan and 46.6% in Lebanon were able to produce the child’s EPI card. Only 24.5% of Syrian refugee children in Jordan and 12.5% in Lebanon were fully immunized through routine vaccination services (having received from non-campaign sources: measles, polio 1–3, and DPT 1–3 in Jordan and Lebanon, and BCG in Jordan). Respondents in Jordan (33.5%) and Lebanon (40.1%) reported difficulties obtaining child vaccinations. Our estimated immunization rates were lower than expected and raise serious concerns about gaps in vaccine coverage among Syrian refugees. Although our estimates likely under-represent true coverage, given the additional benefit of campaigns (not captured in our surveys), there is a clear need to increase awareness, accessibility, and uptake of immunization services. Current methods to measure vaccine coverage in refugee and displaced populations have limitations. To better understand health needs in such groups, we need research on: validity of recall methods, links between campaigns and routine immunization programs, and improved sampling of hard-to-reach populations. PMID:28805672

  2. Using the Precaution Adoption Process Model to Describe a Disaster Preparedness Intervention among Low-Income Latinos

    ERIC Educational Resources Information Center

    Glik, Deborah C.; Eisenman, David P.; Zhou, Qiong; Tseng, Chi-Hong; Asch, Steven M.

    2014-01-01

    Only 40-50% of households in the United States are currently disaster prepared. In this intervention study, respondent-driven sampling was used to select a sample (n = 187) of low income, Latino residents of Los Angeles County, randomly assigned into two treatment conditions: (i) household preparedness education received through…

  3. Parental Influence, Youth Contra-Culture, and Rural Adolescent Attitudes Toward Minority Groups.

    ERIC Educational Resources Information Center

    Summers, Gene F.; And Others

    Parental heads of households and high school students in 2 rural Illinois counties were studied to determine their respective attitudes toward several minority groups using the Bogardus Social Distance Scale as the primary attitudinal measure. A parental sample of 1096 households and a sample of 738 students were independently drawn. The two…

  4. Empirical findings on socioeconomic determinants of fertility differentials in Costa Rica.

    PubMed

    Carvajal, M J; Geithman, D T

    1986-01-01

    "This paper seeks to (1) identify socioeconomic variables that are expected to generate fertility differentials; (2) hypothesize the direction and magnitude of the effect of each variable by reference to a demand-for-children model; and (3) test empirically the model using evidence from Costa Rica. The estimates are obtained from a ten-percent systematic random sample of all Costa Rican individual-family households. There are 15,924 families in the sample...." The authors specifically seek "to capture the effects of changing relative prices and available income and time constraints on parental preferences for children. Least-squares estimates show statistically significant relationships between household fertility and opportunity cost of time, parental education, occurrence of an extended family, medical care, household sanitation, economic sector of employment, and household stock of nonhuman capital." excerpt

  5. Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda.

    PubMed

    Kabunga, Nassul S; Ghosh, Shibani; Webb, Patrick

    2017-01-01

    The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.

  6. Consistency of Use and Effectiveness of Household Water Treatment among Indian Households Claiming to Treat Their Water.

    PubMed

    Rosa, Ghislaine; Clasen, Thomas

    2017-07-01

    Household water treatment (HWT) can improve drinking water quality and prevent disease if used correctly and consistently by populations at risk. Current international monitoring estimates by the Joint Monitoring Programme for water and sanitation suggest that at least 1.1 billion people practice HWT. These estimates, however, are based on surveys that may overstate the level of consistent use and do not address microbial effectiveness. We sought to assess how HWT is practiced among households identified as HWT users according to these monitoring standards. After a baseline survey (urban: 189 households, rural: 210 households) to identify HWT users, 83 urban and 90 rural households were followed up for 6 weeks. Consistency of reported HWT practices was high in both urban (100%) and rural (93.3%) settings, as was availability of treated water (based on self-report) in all three sampling points (urban: 98.8%, rural: 76.0%). Nevertheless, only 13.7% of urban and 25.8% of rural households identified at baseline as users of adequate HWT had water free of thermotolerant coliforms at all three water sampling points. Our findings raise questions about the value of the data gathered through the international monitoring of HWT as predictors of water quality in the home, as well as questioning the ability of HWT, as actually practiced by vulnerable populations, to reduce exposure to waterborne diseases.

  7. Floors and Toilets: Association of Floors and Sanitation Practices with Fecal Contamination in Peruvian Amazon Peri-Urban Households.

    PubMed

    Exum, Natalie G; Olórtegui, Maribel Paredes; Yori, Pablo Peñataro; Davis, Meghan F; Heaney, Christopher D; Kosek, Margaret; Schwab, Kellogg J

    2016-07-19

    Over two billion people worldwide lack access to an improved sanitation facility that adequately retains or treats feces. This results in the potential for fecal material containing enteric pathogens to contaminate the environment, including household floors. This study aimed to assess how floor type and sanitation practices impacted the concentration of fecal contamination on household floors. We sampled 189 floor surfaces within 63 households in a peri-urban community in Iquitos, Peru. All samples were analyzed for colony forming units (CFUs) of E. coli, and households were evaluated for their water, sanitation, and hygiene characteristics. Results of multivariate linear regression indicated that households with improved sanitation and cement floors in the kitchen area had reduced fecal contamination to those with unimproved sanitation and dirt floors (Beta: -1.18 log10 E. coli CFU/900 cm(2); 95% confidence interval [CI]: -1.77, -0.60). Households that did not versus did share their sanitation facility also had less contaminated kitchen floors (Beta: -0.65 log10 E. coli CFU/900 cm(2); 95% CI: -1.15, -0.16). These findings suggest that the sanitation facilities of a home may impact the microbial load found on floors, contributing to the potential for household floors to serve as an indirect route of fecal pathogen transmission to children.

  8. Does living density matter for nonfatal unintentional home injury in Asian urban settings? Evidence from Hong Kong.

    PubMed

    Chan, Emily Y Y; Kim, Jean H; Griffiths, Sian M; Lau, Joseph T F; Yu, Ignatius

    2009-11-01

    Injury is a major global disease burden for the twenty-first century. There are, however, few studies of unintentional household injury in Asian urban settings where living environments are characterized by extremely compact, high-living-density, multistory apartments. This study investigated the association between nonfatal unintentional household injuries with the resident's sociodemographic attributes and household characteristics in Hong Kong, the city with the world's highest population density. A cross-sectional retrospective recall study was conducted in May 2007 using a random telephone survey with a modified Chinese version of the World Health Organization Injury and Violence instrument. The study sample included 1,001 noninstitutionalized Cantonese-speaking Hong Kong residents of all ages, including foreign live-in domestic helpers. Multivariate regression was conducted to identify risk factors for nonfatal unintentional injuries in Hong Kong. Among a predominantly adult sample, household size and time spent at home were not associated with nonfatal unintentional household injuries in the general population in Hong Kong. The multivariate analyses indicated that female gender, owners of private homes, lower square footage of living space per person, and those with slip prevention devices in the bathroom were significantly associated with household injuries. Injured and noninjured groups were found to have adopted different injury prevention strategies toward household injuries. The results identified potential target groups for household injury prevention programs.

  9. 2014-2015 Puget Sound Regional Travel Study | Transportation Secure Data

    Science.gov Websites

    a college-population travel survey in fall 2014. In spring 2015, a second household data collection sample of longitudinal data from households that completed the 2014 survey. Survey Records Survey records include a total of 794 participants. More Information Learn more about the PSRC Household Travel Survey

  10. Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda.

    PubMed

    Wanzira, Humphrey; Yeka, Adoke; Kigozi, Ruth; Rubahika, Denis; Nasr, Sussann; Sserwanga, Asadu; Kamya, Moses; Filler, Scott; Dorsey, Grant; Steinhardt, Laura

    2014-05-19

    Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged

  11. Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda

    PubMed Central

    2014-01-01

    Background Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged

  12. The living arrangements of older immigrants from the former Soviet Union: a comparison of Israel and the United States.

    PubMed

    Burr, Jeffrey A; Lowenstein, Ariela; Tavares, Jane L; Coyle, Caitlin; Mutchler, Jan E; Katz, Ruth; Khatutsky, Galina

    2012-12-01

    With the unprecedented emigration from the former Soviet Union (FSU) during the 1990s as context, this study described the living arrangements of older FSU immigrants living in Israel and the US. Living arrangement choices represented an important strategy for coping with the migration process. Census data from Israel and the US were employed to examine the relationships among living arrangements (independent households, multigenerational households, and extended households) and personal characteristics, including duration of residence, Jewish identity, education, and home ownership. Results showed that the less time older immigrants lived in the host country, the more likely they lived in a multigenerational or extended household. The residency length and household relationship was stronger in Israel than in the US. Also, older FSU immigrants who owned their own home and who lived in a metropolitan area were more likely to live in a complex household than in an independent household. We discussed how the economic and social environments in each country contributed to the variability in living arrangement options among these older immigrants. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Distinct longitudinal patterns of absenteeism and their antecedents in full-time Australian employees.

    PubMed

    Magee, Christopher A; Caputi, Peter; Lee, Jeong Kyu

    2016-01-01

    This paper investigated distinct longitudinal trajectories of absenteeism over time, and underlying demographic, work, and health antecedents. Data from the Household, Income, and Labor Dynamics in Australia Survey were used; this is a panel study of a representative sample of Australian households. This paper focused on 2,481 full-time employees across a 5-year period. Information on annual sick leave and relevant sociodemographic, work, and health-related factors was collected through interviews and self-completed surveys. Growth mixture modeling indicated 4 distinct longitudinal patterns of absenteeism over time. The moderate absenteeism trajectory (34.8%) of the sample had 4-5 days of sick leave per year and was used as the reference group. The low absenteeism trajectory (33.5%) had 1-2 days of absenteeism per year, while the no absenteeism trajectory (23.6%) had very low rates of absenteeism (<1 day per year). Finally, a smaller trajectory accounting for 8.1% of the sample had high levels of absenteeism (>11 days per year). Compared with the moderate absenteeism trajectory, the high absenteeism trajectory was characterized by poor health; the no absenteeism and low absenteeism trajectories had better health but may also reflect processes relating to presenteeism. These results provide important insights into the nature of absenteeism in Australian employees, and suggest that different patterns of absenteeism over time could reflect a range of demographic, work, and health related factors. (c) 2016 APA, all rights reserved).

  14. The influence of crop production and socioeconomic factors on seasonal household dietary diversity in Burkina Faso.

    PubMed

    Somé, Jérôme W; Jones, Andrew D

    2018-01-01

    Households in low-income settings are vulnerable to seasonal changes in dietary diversity because of fluctuations in food availability and access. We assessed seasonal differences in household dietary diversity in Burkina Faso, and determined the extent to which household socioeconomic status and crop production diversity modify changes in dietary diversity across seasons, using data from the nationally representative 2014 Burkina Faso Continuous Multisectoral Survey (EMC). A household dietary diversity score based on nine food groups was created from household food consumption data collected during four rounds of the 2014 EMC. Plot-level crop production data, and data on household assets and education were used to create variables on crop diversity and household socioeconomic status, respectively. Analyses included data for 10,790 households for which food consumption data were available for at least one round. Accounting for repeated measurements and controlling for the complex survey design and confounding covariates using a weighted multi-level model, household dietary diversity was significantly higher during both lean seasons periods, and higher still during the harvest season as compared to the post-harvest season (mean: post-harvest: 4.76 (SE 0.04); beginning of lean: 5.13 (SE 0.05); end of lean: 5.21 (SE 0.05); harvest: 5.72 (SE 0.04)), but was not different between the beginning and the end of lean season. Seasonal differences in household dietary diversity were greater among households with higher food expenditures, greater crop production, and greater monetary value of crops sale (P<0.05). Seasonal changes in household dietary diversity in Burkina Faso may reflect nutritional differences among agricultural households, and may be modified both by households' socioeconomic status and agricultural characteristics.

  15. Alcohol Consumption Practices among Married Women of Reproductive Age in Nepal: A Population Based Household Survey

    PubMed Central

    Thapa, Narbada; Aryal, Krishna Kumar; Puri, Rupendra; Shrestha, Saraswoti; Shrestha, Sheela; Thapa, Pukar; Mehata, Suresh; Thapa, Pushpa; Banjara, Megha Raj; Stray-Pedersen, Babill

    2016-01-01

    Background Alcohol chemically known as ethanol, causes several health, economic and social consequences across the world. Literatures suggest potential harm of alcohol drinking by pregnant women especially to the fetus and the mother. Despite anumber of significant public health problems related to alcohol consumption, this area has been ignored in Nepal and information at the national level is limited. Thus this study aimed at finding the prevalence of alcohol consumption among married women of reproductive age. Methods A nationally representative household survey was carried out from April to August 2013 by taking 16 districts across all 15 eco administrative regions. From the selected districts, 86 village development committees and 14 municipalities were selected as primary sampling units using probability proportionate to size, followed by random selection of 3 wards from each primary sampling unit. Finally, 30 households within each ward were selected using systematic random sampling, and one married women of reproductive age from each household. A total of 9000 married women of reproductive age were interviewed using a semi-structured questionnaire, on alcohol consumption practices including environmental factors and socio demographic characteristics and were included in the analysis. Results National prevalence of alcohol consumption ever among married women of reproductive age was 24.7% (95% CI:21.7–28.0), last 12 months 17.9% (95% CI:15.3–20.7) and last 30 days (current drinking) 11.8% (95% CI:9.8–14.1). There was substantial variation among the districts ranging from 2% to 60%. Multivariable analysis suggests women with no education or within formal education, dalit and janajatis ethnicity, whose husbands drink alcohol, who brew alcohol at home and women from mountains were significantly at higher risk of consuming alcohol. Among the women who drank alcohol in last 12 months, a substantial proportion of them drank home brewed alcoholic beverages (95.9%, 95% CI:94.3–97.4). Conclusion Alcohol consumption was common practice among married women of reproductive age in Nepal with variation among the subgroups of population. Thus, further investigation and behavior change communication interventions to reduce alcohol consumption especially among the women with higher risk of drinking is essential. PMID:27035722

  16. Long-term acceptability, durability and bio-efficacy of ZeroVector® durable lining for vector control in Papua New Guinea.

    PubMed

    Kuadima, Joseph J; Timinao, Lincoln; Naidi, Laura; Tandrapah, Anthony; Hetzel, Manuel W; Czeher, Cyrille; Pulford, Justin

    2017-02-28

    This study examined the acceptability, durability and bio-efficacy of pyrethroid-impregnated durable lining (DL) over a three-year period post-installation in residential homes across Papua New Guinea (PNG). ZeroVector ® ITPS had previously been installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires, DL visual inspections and group interviews (GIs) were completed with household heads at 12- and 36-months post-installation. Three DL samples were collected from all households in which it remained 36-months post-installation to evaluate the bio-efficacy of DL on Anopheles mosquitoes. Bio-efficacy testing followed WHO guidelines for the evaluation of indoor residual spraying. The DL was still intact in 86 and 39% of study homes at the two time periods, respectively. In homes in which the DL was still intact, 92% of household heads considered the appearance at 12-months post installation to be the same as, or better than, that at installation compared to 59% at 36-months post-installation. GIs at both time points confirmed continuing high acceptance of DL, based in large part of the perceived attractiveness and functionality of the material. However, participants frequently asserted that they, or their family members, had ceased or reduced their use of mosquito nets as a result of the DL installation. A total of 16 houses were sampled for bio-efficacy testing across the 4 study sites at 36-months post-installation. Overall, combining all sites and samples, both knock-down at 30 min and mortality at 24 h were 100%. The ZeroVector ® DL installation remained highly acceptable at 36-months post-installation, the material and fixtures proved durable and the efficacy against malaria vectors did not decrease. However, the DL material had been removed from over 50% of the original study homes 3 years post-installation, largely due to deteriorating housing infrastructure. Furthermore, the presence of the DL installation appeared to reduce ITN use among many participating householders. The study findings suggest DL may not be an appropriate vector control method for large-scale use in the contemporary PNG malaria control programme.

  17. Exposure assessment in epidemiologic studies of adverse pregnancy outcomes and disinfection byproducts.

    PubMed

    King, Will D; Dodds, Linda; Armson, B Anthony; Allen, Alexander C; Fell, Deshayne B; Nimrod, Carl

    2004-11-01

    A major challenge in studies that examine the association between disinfection byproducts in drinking water and pregnancy outcomes is the accurate representation of a subject's exposure. We used household water samples and questionnaire information on water-use behavior to examine several aspects of exposure assessment: (i) the distribution and correlation of specific disinfection byproducts, (ii) spatial distribution system and temporal variation in byproduct levels, and (iii) the contribution of individual water-use behavior. The level of specific trihalomethanes (THMs) and haloacetic acids (HAAs) was determined for 360 household water samples in Eastern Ontario and Nova Scotia. Subjects were interviewed regarding tap water ingestion and showering and bathing practices. In both provinces, total THMs correlated highly with chloroform (correlation coefficient (r) >0.95) and less so with total HAAs (r = 0.74 in Nova Scotia and r = 0.52 in Ontario). The correlation between total THMs and bromodichloromethane was high in Nova Scotia (r = 0.63), but low in Ontario (r = 0.26). The correlation was between THM level in individual household samples, and the mean THM level during the same time period from several distribution system samples was 0.63, while a higher correlation in THM level was observed for samples taken at the same location 1 year apart (r = 0.87). A correlation of 0.73 was found between household THM level and a total exposure measure incorporating ingestion, showering, and bathing behaviors. These results point to the importance of: measurement of different classes of byproducts; household rather than distribution system sampling; and, incorporation of subject behaviors in exposure assessment in epidemiologic studies of disinfection byproducts and adverse pregnancy outcomes.

  18. Seroprevalence study of feline coronavirus in owned and feral cats in Sydney, Australia.

    PubMed

    Bell, E T; Toribio, J A L M L; White, J D; Malik, R; Norris, J M

    2006-03-01

    i) To establish the seroprevalence of Feline Coronavirus (FCoV) infection in two defined groups of cats in Sydney: owned and feral cats; ii) to identify factors associated with an increased risk of infection with FCoV; and iii) to establish the seroprevalence and FCoV antibody titres of owned cats with immunohistochemically confirmed feline infectious peritonitis (FIP). Prospective multi-institutional cross sectional study. Procedure Serum samples from owned cats presented to three inner city veterinary clinics in Sydney and feral cats from a colony in South Western Sydney over an 11-month period were tested for FCoV antibodies using the Immunocomb test kit. The relationship between serological score and six major factors (breed, age, gender, number of cats per household, living environment and health status) in the owned cat sample population was analysed and compared to cats with FIR RESULTS: The seroprevalence of FCoV infection in the sample population of owned and feral cats was 34% and 0%, respectively. The median Immunocomb scores of DSH, Persian, Siamese and Devon Rex cats were significantly lower than that of Burmese, BSH, Abyssinian, Birman, Ragdoll and Russian Blue. The median lmmunocomb score of pedigree cats less than 2 years-of-age was significantly higher than for pedigree cats greater than 2 years-of-age. This distinction was not evident in DSH cats in these age groups. The number of cats per household at the time of blood collection had a strong positive association with Immunocomb score. The median Immunocomb score of cats with immunohistochemically confirmed FIP was significantly higher than cats in the sample population of owned cats but there was sufficient overlap between these two groups to make definitive diagnosis of FIP by serology impossible. This represents the first seroprevalence study of FCoV in Australia. The major determinants of antibody score of owned cats identified in this study were breed, age and the number of cats per household. The significant relationship between the breed of the cat and the FCoV antibody titre further supports the notion, proposed previously by the authors, that breed related differences exist in the immunological response to FCoV infection.

  19. 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.

  20. Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households.

    PubMed

    Coffey, Diane; Spears, Dean; Vyas, Sangita

    2017-09-01

    Open defecation, which is still practiced by about a billion people worldwide, is one of the most compelling examples of how place influences health in developing countries. Efforts by governments and development organizations to address the world's remaining open defecation would be greatly supported by a better understanding of why some people adopt latrines and others do not. We analyze the 2005 and 2012 rounds of the India Human Development Survey (IHDS), a nationally representative panel of households in India, the country which is home to 60% of the people worldwide who defecate in the open. Among rural households that defecated in the open in 2005, we investigate what baseline properties and what changes over time are associated with switching to latrine use between 2005 and 2012. We find that households that are richer or better educated, that have certain demographic properties, or that improved their homes over this period were more likely to switch to using a latrine or toilet. However, each of these effect sizes is small; overall switching to latrine use from open defecation is low; and no ready household-level mechanisms are available for sanitation programs to widely influence these factors. Our research adds to a growing consensus in the literature that the social context should not be overlooked when trying to understand and bring about change in sanitation behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Top