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Sample records for encourage low-income pregnant

  1. Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

    Science.gov (United States)

    Legault, Anik; Marquis, Marie

    2014-01-01

    Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

  2. Breast-feeding intentions among low-income pregnant and lactating women.

    Science.gov (United States)

    Hill, Gina Jarman; Arnett, Dennis B; Mauk, Eileen

    2008-01-01

    Provide a better understanding of the process used by low-income pregnant/postpartum women when deciding whether to breast-feed or not. Pregnant/postpartum women admitted to an obstetrics floor completed a survey to determine breast-feeding intention (n=88). Subjects were primarily Hispanic and African American women. Beliefs and referent other were related positively to attitude and subjective norm, respectively. Subjective norm was related positively to intention to breast-feed. Breast-feeding knowledge was low. Others' opinions clearly influence feeding intentions among this population of low-income women. Inclusion of these significant others, family, and friends within the breast-feeding education process is warranted.

  3. The Mental Health Needs of Low-Income Pregnant Teens: A Nursing-Social Work Partnership in Care

    Science.gov (United States)

    Payne, Nancy A.; Anastas, Jeane W.

    2015-01-01

    While the rates of teen childbearing have declined in the United States, adolescents who become pregnant and decide to bear and rear their babies are often from low-income, highly stressed families and communities. This article will describe the psychosocial problems of pregnant urban teens and how exposure to interpersonal trauma and current…

  4. Stress, sleep, depression and dietary intakes among low-income overweight and obese pregnant women.

    Science.gov (United States)

    Chang, Mei-Wei; Brown, Roger; Nitzke, Susan; Smith, Barbara; Eghtedary, Kobra

    2015-05-01

    This study investigated the mediating roles of sleep and depression on the relationships between stress, fat intake, and fruit and vegetable intake among low-income overweight and obese pregnant women by trimesters. Participants (N = 213) completed a self-administered survey including stress (exogenous variable), depression, sleep (mediators), fat intake, and fruit and vegetable intake (endogenous variables). Path analysis was performed to compare mediation effects among pregnant women in each trimester. Consistently across three trimesters, stress was related to depression but not sleep duration, night time sleep disturbance, sleep quality, sleep latency or fat intake. Sleep duration was not associated with depression. Depending on trimester, night time sleep disturbance, sleep quality, and sleep latency were related to depression; night time sleep disturbance and depression affected fat intake; stress influenced fruit and vegetable intake. Sleep duration, sleep disturbance, sleep quality, sleep latency and depression did not mediate the relationships between stress, fat intake, and fruit and vegetable intake in the second and third trimesters. However, depression mediated the relationship between stress and fat intake in the first trimester. Stress management interventions may help low-income overweight and obese pregnant women decrease depressive symptoms and therefore contribute to overall nutritional health.

  5. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA.

    Science.gov (United States)

    Rojjanasrirat, Wilaiporn; Sousa, Valmi D

    2010-07-01

    To describe the perceptions of breastfeeding in low-income pregnant women to understand their needs better as they plan to return to work or school. Maternal employment has a negative impact on breastfeeding duration. Yet there is insufficient research on challenges and facilitators regarding breastfeeding and employment issue among low-income women in the USA. Knowing the perceptions of breastfeeding among low-income pregnant women and their plan to return to work or school may have implications for nurses and midwives in providing quality care. Qualitative study using focus group interviews. The research setting consisted of three Women, Infants and Children clinics (WIC) in a midwestern city of the USA. Seventeen pregnant women (aged 19-35) participated in focus group interviews. Data were coded and analysed for themes and patterns using the QSR software - NVivo 6. Eleven participants were single. Ten women were primigravida, and seven were multipara. The following five themes were identified: (1) perceived benefits of breastfeeding; (2) general perceptions of breastfeeding; (3) maternal concerns; (4) having the right support; and (5) anticipated challenges of combining breastfeeding and work. Conclusions.  Low-income women anticipated substantial barriers for breastfeeding when they planned to combine breastfeeding and work or school. The results of this study have many implications for public health practice, research and policy. Educating employers and the public at large about the health and economic benefits derived from long-term breastfeeding could help promote breastfeeding awareness. Strategies supporting breastfeeding among low-income working women must be provided at multiple levels to help overcome the barriers they concern. Health care providers should help women gain confidence by minimising their uncertainties and fears about breastfeeding to prepare them to continue breastfeeding successfully after returning to work. © 2010 Blackwell

  6. Perceptions of low-income African-American mothers about excessive gestational weight gain.

    Science.gov (United States)

    Herring, Sharon J; Henry, Tasmia Q; Klotz, Alicia A; Foster, Gary D; Whitaker, Robert C

    2012-12-01

    A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to "eat for two" to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control.

  7. Adaptation of the U.S. Food Security Survey Module for Low-Income Pregnant Latinas: Qualitative Phase

    OpenAIRE

    Hromi-Fiedler, Amber; Bermúdez-Millán, Angela; Segura-Pérez, Sofia; Damio, Grace; Pérez-Escamilla, Rafael

    2009-01-01

    The objectives of this study were to: 1) assessed the face validity of the 18-items US Household Food Security Scale Module (US HFSSM) among low-income pregnant Latinas and 2) adapt the US HFSSM to the target population. This study was conducted in the United States in Hartford, Connecticut where 40% of residents are of Latina descent. Three focus groups (N=14total) were held with pregnant and postpartum Latinas from April – June 2004 to assess the understanding and applicability (face validi...

  8. An Exploratory Mixed Method Assessment of Low Income, Pregnant Hispanic Women's Understanding of Gestational Diabetes and Dietary Change

    Science.gov (United States)

    Rhoads-Baeza, Maria Elena; Reis, Janet

    2012-01-01

    Objective: To describe and assess low income, healthy, pregnant Hispanic women's understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center's prenatal clinic. Method:…

  9. Exclusive breastfeeding plan of pregnant Southeast Asian women: what encourages them?

    Science.gov (United States)

    Idris, Nikmah Salamia; Sastroasmoro, Sudigdo; Hidayati, Fatimah; Sapriani, Irma; Suradi, Rulina; Grobbee, Diederick E; Uiterwaal, Cuno S P M

    2013-06-01

    This study investigated factors involved in breastfeeding planning of pregnant Asian women. A cross-sectional study was conducted on 207 pregnant women visiting the Budi Kemuliaan Hospital, Jakarta, Indonesia, between June and August 2011. The planned breastfeeding duration and determinants were sought using a standardized self-reported questionnaire. Most subjects had low income (84.1%) and education (79.7%). Women who had been informed about breastfeeding had a higher likelihood to plan longer (≥6 months) breastfeeding (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.04-3.75; p=0.04), whereas women who had breastfed previous children over a shorter period had a lower likelihood (OR 0.26; 95% CI 0.11-0.59; p=0.001). Age, low education level, first pregnancy, and low income had no association with breastfeeding plans. Working mothers who had to return to work before 6 months and worked for >8 hours/day were less likely to plan longer breastfeeding (OR 0.14; 95% CI 0.02-0.83; p=0.03 vs. OR 0.53; 95% CI 0.17-1.63; p=0.27), whereas those intending to express their milk were more likely to breastfeed longer (OR 16.85; 95% CI 4.21-67.48; pwork, who had previously breastfed for a short period, and who are not well informed about breastfeeding tend to plan shorter breastfeeding. Among mothers who work, it is the length of maternal leave and required working hours that determine the plans.

  10. Intention to breastfeed in low-income pregnant women: the role of social support and previous experience.

    Science.gov (United States)

    Humphreys, A S; Thompson, N J; Miner, K R

    1998-09-01

    The purpose of this study was to describe the relationship between breastfeeding intention among socioeconomically disadvantaged pregnant women and maternal demographics, previous breastfeeding experience, and social support. A cross-sectional, convenience sampling strategy was employed for data collection. Low-income women (n = 1001) in a public hospital completed a six-page questionnaire about their infant feeding plans, demographics, and social support. Simple regression analyses were conducted to compare maternal breastfeeding intention with the hypothesized correlates. Breastfeeding intention was positively correlated with older maternal age, higher education, more breastfeeding experience, Hispanic ethnicity, and hearing about breastfeeding benefits from family members, the baby's father, and lactation consultants, but not from other health professionals. Health professionals' attitudes were less influential on women's infant feeding decisions than the attitudes and beliefs of members of women's social support networks. When controlling for breastfeeding experience (none vs any), some findings, varied, indicating a need for breastfeeding interventions tailored to women's level of experience. Use of peer counselors and lactation consultants, inclusion of a woman's family members in breastfeeding educational contacts, and creation of breastfeeding classes tailored to influential members of women's social support networks may improve breastfeeding rates among low-income women, especially those with no breastfeeding experience, more effectively than breastfeeding education to pregnant women that is solely conducted by health professionals.

  11. Adaptation of the U.S. Food Security Survey Module for Low-Income Pregnant Latinas: Qualitative Phase.

    Science.gov (United States)

    Hromi-Fiedler, Amber; Bermúdez-Millán, Angela; Segura-Pérez, Sofia; Damio, Grace; Pérez-Escamilla, Rafael

    2009-01-01

    The objectives of this study were to: 1) assessed the face validity of the 18-items US Household Food Security Scale Module (US HFSSM) among low-income pregnant Latinas and 2) adapt the US HFSSM to the target population. This study was conducted in the United States in Hartford, Connecticut where 40% of residents are of Latina descent. Three focus groups (N=14(total)) were held with pregnant and postpartum Latinas from April - June 2004 to assess the understanding and applicability (face validity) of the US HFSSM as well as adapt the US HFSSM based on their recommendations. This was followed by pre-testing (N=7) to make final adaptations to the US HFSSM. Overall, the items in the US HFSSM were clear and understandable to participants, but some questions sounded repetitive to them. Participants felt the questions were applicable to other pregnant Latinas in their community and shared food security related experiences and strategies. Participants recommendations led to key adaptations to the US HFSSM including reducing the scale to 15-items, wording statements as questions, including two time periods, replacing the term "balanced meals" with "healthy and varied", replacing the term "low cost foods" with "cheap foods" and including a definition of the term, and including a coping mechanism of avoiding running out of food. The adapted US HFSSM was found to have good face validity among pregnant Latinas and can be used to assess food insecurity among this vulnerable population.

  12. Low-income, pregnant, African American women's views on physical activity and diet.

    Science.gov (United States)

    Groth, Susan W; Morrison-Beedy, Dianne

    2013-01-01

    This research was conducted to gain insight into how low-income, pregnant, African American women viewed physical activity and approached nutrition during pregnancy. Three focus groups with a total of 26 women were conducted utilizing open-ended questions related to physical activity and diet during pregnancy. Content analysis was used to analyze the verbatim transcripts. Groups were compared and contrasted at the within-group and between-group levels to identify themes. Two themes that related to physical activity during pregnancy were identified: 1) fatigue and low energy dictate activity and 2) motivation to exercise is not there. Three themes were identified that related to diet: 1) despite best intentions, appetite, taste, and cravings drive eating behavior; 2) I'll decide for myself what to eat; and 3) eating out is a way of life. Women reported that being physically active and improving their diets was not easy. Women indicated that their levels of physical activity had decreased since becoming pregnant. Attempts at improving their diets were undermined by frequenting fast food restaurants and cravings for highly dense, palatable foods. Women ceded to the physical aspects of pregnancy, often choosing to ignore the advice of others. A combination of low levels of physical activity and calorie-dense diets increased the risk of excessive gestational weight gain in this sample of women, consequently increasing the risk for weight retention after pregnancy. Health care providers can promote healthy eating and physical activity by building on women's being "in tune with and listening to" their bodies. They can query women about their beliefs regarding physical activity and diet and offer information to ensure understanding of what contributes to healthy pregnancy outcomes. Intervention can focus on factors such as cravings and what tastes good, suggesting ways to manage pregnancy effects within a healthy diet. © 2013 by the American College of Nurse-Midwives.

  13. 42 CFR 436.229 - Optional targeted low-income children.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

  14. Material Hardship and Internal Locus of Control Over the Prevention of Child Obesity in Low-Income Hispanic Pregnant Women.

    Science.gov (United States)

    Gross, Rachel S; Mendelsohn, Alan L; Gross, Michelle B; Scheinmann, Roberta; Messito, Mary Jo

    2016-07-01

    To determine the relations between household material hardships and having a low internal locus of control over the prevention of child obesity in low-income Hispanic pregnant women. We performed a cross-sectional analysis of baseline data collected during a third trimester prenatal visit from women participating in the Starting Early Study, a randomized controlled trial to test the efficacy of a primary care-based family-centered early child obesity prevention intervention. Using multiple logistic regression analyses, we determined whether 4 domains of material hardship (food insecurity, difficulty paying bills, housing disrepair, neighborhood stress), considered individually and also cumulatively, were associated with having a low internal locus of control over the prevention of child obesity. The sample included 559 low-income Hispanic pregnant women, with 60% having experienced at least 1 hardship. Food insecurity was independently associated with a low internal locus of control over the prevention of child obesity (adjusted odds ratio, 2.38; 95% confidence interval, 1.50-3.77), controlling for other hardships and confounders. Experiencing a greater number of material hardships was associated in a dose-dependent relationship with an increased odds of having a low internal locus of control. Prenatal material hardships, in particular food insecurity, were associated with having a lower prenatal internal locus of control over the prevention of child obesity. Longitudinal follow-up of this cohort is needed to determine how relations between material hardships and having a low internal locus of control will ultimately affect infant feeding practices and child weight trajectories. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. Interrelationship between food security status, home availability of variety of fruits and vegetables and their dietary intake among low-income pregnant women.

    Science.gov (United States)

    Nunnery, Danielle L; Labban, Jeffrey D; Dharod, Jigna M

    2018-03-01

    To (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women. Design/Setting Participants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro. Low-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish. Low/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, -0·039 (-0·074, -0·013); fresh vegetables, -0·048 (-0·083, -0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake. The study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.

  16. Examining the feasibility of implementing behavioural economics strategies that encourage home dinner vegetable intake among low-income children.

    Science.gov (United States)

    Leak, Tashara M; Swenson, Alison; Rendahl, Aaron; Vickers, Zata; Mykerezi, Elton; Redden, Joseph P; Mann, Traci; Reicks, Marla

    2017-06-01

    To examine the feasibility of implementing nine behavioural economics-informed strategies, or 'nudges', that aimed to encourage home dinner vegetable intake among low-income children. Caregivers were assigned six of nine strategies and implemented one new strategy per week (i.e. 6 weeks) during three dinner meals. Caregivers recorded child dinner vegetable intake on the nights of strategy implementation and rated the level of difficulty for assigned strategies. Baseline data on home vegetable availability and child vegetable liking were collected to assess overall strategy feasibility. Participants' homes in a large Midwestern metropolitan area, USA. Low-income caregiver/child (aged 9-12 years) dyads (n 39). Pairwise comparisons showed that child dinner vegetable intake for the strategy 'Serve at least two vegetables with dinner meals' was greater than intake for each of two other strategies: 'Pair vegetables with other foods the child likes' and 'Eat dinner together with an adult(s) modelling vegetable consumption'. Overall, caregivers' mean rating of difficulty for implementing strategies was 2·6 (1='not difficult', 10='very difficult'). Households had a mean of ten different types of vegetables available. Children reported a rating ≥5 for seventeen types of vegetable on a labelled hedonic scale (1='hate it', 5-6='it's okay', 10='like it a lot'). Behavioural economics-informed strategies are feasible to implement during dinner meals, with some strategies differing by how much they influence vegetable intake among low-income children in the home.

  17. Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage.

    Science.gov (United States)

    Bradley, Cathy J; Neumark, David

    2017-08-01

    In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received $10 to complete a baseline survey during an interview and who were randomized to incentives of $50, $25, or $0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team. Subjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77 percent and 74 percent, respectively), compared to subjects in the $0 incentive group (68 percent). The effects of the intervention were about twice as large when we compared the proportions of subjects in the $50 and $25 incentive groups who visited their providers and the proportion in the nonincentivized group (61 percent). Cash incentive programs may steer newly covered low-income patients toward primary care, which could result in improved health outcomes and lower costs. Project HOPE—The People-to-People Health Foundation, Inc.

  18. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Stevens, Briony; Buettner, Petra; Watt, Kerrianne; Clough, Alan; Brimblecombe, Julie; Judd, Jenni

    2015-10-01

    The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to-date have included studies from high-, middle- and low-income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries on child growth. A systematic review of articles published in English (1970-2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer-reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full-text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer-term growth. Standardised mean differences were calculated using a random-effects meta-analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03-0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer-term physical growth due to limited evidence. Additional research is required in low- and middle-income countries to identify impacts on longer-term infant growth. © 2015 John Wiley & Sons Ltd.

  19. Interventions for domestic violence among pregnant women in low- and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Sapkota, Diksha; Baird, Kathleen; Saito, Amornrat; Anderson, Debra

    2017-12-12

    Violence during pregnancy is a global problem, associated with serious health risks for both the mother and baby. Evaluation of interventions targeted for reducing or controlling domestic violence (DV) is still in its infancy, and the majority of findings are primarily from high-income countries (HICs). Therefore, there is an urgent need for generating evidence of DV interventions among pregnant women in low- and middle-income countries (LMICs). Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be employed to structure the review. A comprehensive search will be carried out via electronic databases including MEDLINE, CINAHL, Scopus, Embase, Web of Science, PsycINFO, and The Cochrane library. Gray literature will also be scrutinized for potential articles. An optimal search strategy has been developed following consultations with subject-matter experts and librarians. This search strategy will be adapted to the different databases. Experimental studies evaluating DV interventions among pregnant women from LMICs will be included in the review. The review will only include literature written in English. Two reviewers will independently screen and assess studies for inclusion in the review. A third author will resolve any discrepancies between the reviewers. Risk of bias will be assessed based on the Cochrane risk of bias assessment tool, and overall quality of the evidence will be judged using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Findings will be presented with the narrative synthesis, and if applicable, they will be further quantified using random-effects meta-analysis. Effect size, risk ratio for dichotomous variables, and standardized mean differences for continuous variables will be calculated for each outcome using Review Manager 5.3. Systematic reviews to evaluate the efficacy of interventions to address DV within the perinatal context have been limited. Hence, no one

  20. Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study.

    Science.gov (United States)

    van Heyningen, Thandi; Honikman, Simone; Myer, Landon; Onah, Michael N; Field, Sally; Tomlinson, Mark

    2017-12-01

    Anxiety is highly prevalent in many populations; however, the burden of anxiety disorders amongst pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal anxiety disorders amongst low-income women living with psychosocial adversity. Pregnant women were recruited from an urban, primary level clinic in Cape Town, South Africa. The Mini-International Neuropsychiatric Interview diagnostic interview assessed prevalence of anxiety disorders. Four self-report questionnaires measured psychosocial characteristics. Logistic regression models explored demographic and socioeconomic characteristics, psychosocial risk factors and psychiatric comorbidity as predictors for anxiety disorders. Amongst 376 participants, the prevalence of any anxiety disorder was 23%. Although 11% of all women had post-traumatic stress disorder, 18% of the total sample was diagnosed with other anxiety disorders. Multivariable analysis revealed several predictors for anxiety including a history of mental health problems (adjusted odds ratio [AOR] 4.11; 95% confidence interval (CI) 2.03-8.32), Major depressive episode (MDE) diagnosis (AOR 3.83; CI 1.99-7.31), multigravidity (AOR 2.87; CI 1.17-7.07), food insecurity (AOR 2.57; CI 1.48-4.46), unplanned and unwanted pregnancy (AOR 2.14; CI 1.11-4.15), pregnancy loss (AOR 2.10; CI 1.19-3.75) and experience of threatening life events (AOR 1.30; CI 1.04-1.57). Increased perceived social support appeared to reduce the risk for antenatal anxiety (AOR 0.95; CI 0.91-0.99). A range of antenatal anxiety disorders are prevalent amongst pregnant women living in low-resource settings. Women who experience psychosocial adversity may be exposed to multiple risk factors, which render them vulnerable to developing antenatal anxiety disorders.

  1. Short Report: Acceptability and Feasibility of Rapid Chlamydial, Gonococcal, and Trichomonal Screening and Treatment in Pregnant Women in Six Low-to-Middle Income Countries.

    Science.gov (United States)

    Shannon, C L; Bristow, C C; Hoff, N A; Wynn, A; Nguyen, M; Medina-Marino, A; Cabeza, J; Rimoin, A W; Klausner, J D

    2018-03-09

    Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections during pregnancy are linked with adverse birth outcomes. However, few countries have prenatal CT, NG, or TV screening programs. In this study, we aimed to evaluate the acceptability and feasibility of CT, NG, and TV screening and treatment among pregnant women across six low-to-middle income countries. A total 1,817 pregnant women were screened for CT, NG, and TV in Botswana, the Democratic Republic of Congo (DRC), Haiti, South Africa, and Vietnam. An additional 640 pregnant women were screened for CT in Peru. Screening occurred between December 2012 and October 2017. Acceptability of screening was evaluated at each site as the proportion of eligible women who agreed to participate in screening. Feasibility of treatment was calculated as the proportion of women who tested positive that received treatment. Acceptability of screening and feasibility of treatment was high across all six sites. Acceptability of screening ranged from 85-99%, and feasibility of treatment ranged from 91-100%. The high acceptability of screening and treatment for CT, NG, and TV among pregnant women supports further research to evaluate the cost-effectiveness of prenatal CT, NG, and TV screening programs.

  2. Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations

    Directory of Open Access Journals (Sweden)

    K Michael Hambidge

    2017-07-01

    Full Text Available Abstract Background Maternal stature and body mass indices (BMI of non-pregnant women (NPW of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC. Methods Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m2 was calculated. Z-scores were determined using WHO reference data. Results A total of 7268 NPW participated in Equateur, DRC (n = 1741; Chimaltenango, Guatemala (n = 1695; North Karnataka, India (n = 1823; and Thatta, Sindh, Pakistan (n = 2009. Mean age was 23 y and mean parity 1.5. Median (P25-P75 height (cm ranged from 145.5 (142.2–148.9 in Guatemala to 156.0 (152.0–160.0 in DRC. Median weight (kg ranged from 44.7 (39.9–50.3 in India to 52.7 (46.9–59.8 in Guatemala. Median BMI ranged from 19.4 (17.6–21.9 in India to 24.9 (22.3–28.0 in Guatemala. Percent stunted (<−2SD height for age z-score ranged from 13.9% in DRC to 80.5% in Guatemala; % underweight (BMI <18.5 ranged from 1.2% in Guatemala to 37.1% in India; % overweight/obese (OW, BMI ≥25.0 ranged from 5.7% in DRC to 49.3% in Guatemala. For all sites, indicators for higher SES and higher age were associated with BMI. Lower SES women were underweight more frequently and higher SES women were OW more frequently at all sites. Younger women tended to be underweight, while older women tended to be OW. Conclusions Anthropometric data for NPW varied widely among low-income rural populations in four countries located on three different continents. Global comparisons of anthropometric measurements across sites using standard reference data serve to highlight major differences among populations of low-income rural NPW and assist in evaluating the rationale for and the design of optimal

  3. Reproductive tract infections (RTIs) among married non-pregnant women living in a low-income suburb of Beirut, Lebanon.

    Science.gov (United States)

    Ramia, Sami; Kobeissi, Loulou; El Kak, Faysal; Shamra, Sarah; Kreidieh, Khalil; Zurayk, Huda

    2012-09-17

    This study aimed to identify reproductive tract infections (RTIs) in married, non-pregnant women, aged 18 to 49 years, living in a low-income suburb of Beirut, and to investigate the relationship between demographic and socioeconomic factors and these infections. Among 1,015 women recruited for the study, 502 were found eligible and 441 were medically examined. Appropriate specimens were collected for Nisseria gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, candidiasis, and bacterial vaginosis. The results showed a relatively high prevalence of RTIs (28.2%). The prevalence rates of different agents were as follows: 22.9% of the women were positive for T. vaginalis, 8.8% for candidiasis, 4.5% for bacterial vaginosis, and 1% for N. gonorrhea; none of the women were positive for C. trachomatis. Regression analysis showed that women between the ages of 30 and 39 were twice more likely to have T. vaginalis as compared to younger women. Furthermore, women whose husbands were taxi drivers were at higher risk of acquiring T. vaginalis (OR = 2.2) as compared with women whose husbands occupation was listed as skilled/unskilled. This conclusion can be drawn for the odds of developing any RTI (OR = 2.15). Moreover, those participants with the lowest income were twice as likely to have any RTI compared to those with higher incomes. This study shows a relatively high prevalence of RTIs (T. vaginalis mainly). It urges further in-depth research on cultural practices and economic factors to understand the pattern of sexual behavior in this community.

  4. Preconception Health Behaviors of Low-Income Women.

    Science.gov (United States)

    Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L

    2016-01-01

    Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

  5. A review of low income energy assistance measures adopted in other jurisdictions

    International Nuclear Information System (INIS)

    2008-01-01

    Low-income energy assistance programs (LIEPs) have been established and implemented in many jurisdictions to help make electricity and natural gas more affordable. Low-income programs also serve many other public interest goals, such as safeguarding and protecting the public health and welfare of the citizens; augmenting incomes or standards of living for the lowest income energy customers; encouraging conservation and more efficient use of energy resources; reducing customer care costs for utilities; reducing uncollectible accounts and bad debt expense for utilities; and reducing carbon emissions and greenhouse gas levels. This report contained a summary of the policies, programs, and measures that have been implemented, mandated, or allowed by regulators in other jurisdictions to assist low-income energy consumers with electricity and natural gas costs. The report categorized the differing low income policies and programs that have been implemented and examined the effectiveness of those policies and programs as measured by the costs and benefits, as well the level of customer participation. These categories included rate discounts or waivers; modified rate designs; alternative billing methods; customer rebates; conservation and demand side management programs; budget or equal billing; payment plans for past due accounts; waivers of late payment charges; waivers or reductions of customer security deposits; limits on disconnections; and reduced or waived fees for reconnections. The report covered regulatory jurisdictions, including those in Canada, the United States, the United Kingdom, Australia, New Zealand, France, Spain, and Finland. The report also discussed the role of regulators, utilities, charitable organizations, and other interested parties in developing and implementing low-income energy assistance programs that were cost-effective and efficient. It was concluded that, in addition to rate discounts or waivers of the fixed monthly service charge, many

  6. The use of cell phones and radio communication systems to reduce delays in getting help for pregnant women in low- and middle-income countries: a scoping review.

    Science.gov (United States)

    Oyeyemi, Sunday O; Wynn, Rolf

    2015-01-01

    Delays in getting medical help are important factors in the deaths of many pregnant women and unborn children in the low- and middle-income countries (LMIC). Studies have suggested that the use of cell phones and radio communication systems might reduce such delays. We review the literature regarding the impact of cell phones and radio communication systems on delays in getting medical help by pregnant women in the LMIC. Cochrane Library, PubMed, Maternity and Infant care (Ovid), Web of Science (ISI), and Google Scholar were searched for studies relating to the use of cell phones for maternal and child health services, supplemented with hand searches. We included studies in LMIC and in English involving the simple use of cell phones (or radio communication) to either make calls or send text messages. Fifteen studies met the inclusion criteria. All the studies, while of various designs, demonstrated positive contributory effects of cell phones or radio communication systems in reducing delays experienced by pregnant women in getting medical help. While the results suggested that cell phones could contribute in reducing delays, more studies of a longer duration are needed to strengthen the finding.

  7. The use of cell phones and radio communication systems to reduce delays in getting help for pregnant women in low- and middle-income countries: a scoping review

    Directory of Open Access Journals (Sweden)

    Sunday O. Oyeyemi

    2015-09-01

    Full Text Available Background: Delays in getting medical help are important factors in the deaths of many pregnant women and unborn children in the low- and middle-income countries (LMIC. Studies have suggested that the use of cell phones and radio communication systems might reduce such delays. Objectives: We review the literature regarding the impact of cell phones and radio communication systems on delays in getting medical help by pregnant women in the LMIC. Design: Cochrane Library, PubMed, Maternity and Infant care (Ovid, Web of Science (ISI, and Google Scholar were searched for studies relating to the use of cell phones for maternal and child health services, supplemented with hand searches. We included studies in LMIC and in English involving the simple use of cell phones (or radio communication to either make calls or send text messages. Results: Fifteen studies met the inclusion criteria. All the studies, while of various designs, demonstrated positive contributory effects of cell phones or radio communication systems in reducing delays experienced by pregnant women in getting medical help. Conclusions: While the results suggested that cell phones could contribute in reducing delays, more studies of a longer duration are needed to strengthen the finding.

  8. Parenting perceptions of low-income mothers.

    Science.gov (United States)

    Webb, Jenny; Morris, Melanie Hall; Thomas, Sandra P; Combs-Orme, Terri

    2015-01-01

    The purpose of this descriptive qualitative study was to gain understanding of perceptions of low-income pregnant women and mothers about parenting. Participants were 65 low-income, primarily African American, women in their 20s and 30s who were recruited from a faith-based social service center in Memphis, Tennessee. Interviews were conducted by nursing, social work, and psychology students. The existential phenomenological method was used to analyze verbatim responses of participants to vignettes depicting parenting behaviors of hypothetical mothers. Five global themes were identified: (a) Focus on baby's development: "Because I'm the Mother, I'm the First Teacher"; (b) Focus on baby's safety/security: "The Baby Could Be Hurt"; (c) Focus on conveying love: "She Just Wants the Baby to Feel Her Love"; (d) Focus on learning the rules of good childcare: "It's Important to Know the Do's and Don'ts"; and (e) Focus on doing it differently (better) than parents did: "When You Know Better, You Do Better." Findings suggest that these mothers care deeply about providing a better life for their children than the life they have had. They desire to learn about being the best parents they can be. As nurses, we can help to provide educational opportunities for mothers through a variety of evidence-based interventions delivered across the childbearing years.

  9. Fast Food Intake in Relation to Employment Status, Stress, Depression, and Dietary Behaviors in Low-Income Overweight and Obese Pregnant Women.

    Science.gov (United States)

    Chang, Mei-Wei; Brown, Roger; Nitzke, Susan

    2016-07-01

    Objective This study explored fast food intake as a potential mediator of the relationships among employment status; stress; depression; and fruit, vegetable, and fat intakes by race (African American vs. Non-Hispanic White) and body mass index (BMI category: overweight vs. obesity). Methods Low-income overweight and obese pregnant women (N = 332) were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children in Michigan. Path analysis was performed to explore mediation effects by race and BMI category. Results Fast food intake mediated the relationship between employment status and fat intake (p = 0.02) in Non-Hispanic White women, but no mediation effect was detected in African American women. For overweight women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04) and the relationship between depression and vegetable intake (p = 0.01). Also, fast food intake partially mediated the relationship between depression and fat intake (p = 0.003). For obese women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04). Conclusion Fast food is an important topic for nutrition education for overweight and obese pregnant women. Future interventions may be more successful if they address issues associated with employment status (e.g., lack of time to plan and cook healthy meals) and depressive mood (e.g., inability to plan meals or shop for groceries when coping with negative emotions).

  10. Information and Communication Technology Use Among Low-Income Pregnant and Postpartum Women by Race and Ethnicity: A Cross-Sectional Study.

    Science.gov (United States)

    Chilukuri, Nymisha; West, Meredith; Henderson, Janice Lynn; Lawson, Shari; Ehsanipoor, Robert; Costigan, Kathleen; Polk, Sarah; Bennett, Wendy

    2015-07-03

    interventions to low-income, racially diverse pregnant and postpartum women, but disparities in Internet use and SMS text messaging exist. Interventions or programs requiring Web-based apps may have lower uptake unless alternatives are available, such as those adapted for limited English proficiency populations.

  11. Food sources and intake of n-6 and n-3 fatty acids in low-income countries with emphasis on infants, young children (6-24 months), and pregnant and lactating women.

    Science.gov (United States)

    Michaelsen, Kim F; Dewey, Kathryn G; Perez-Exposito, Ana B; Nurhasan, Mulia; Lauritzen, Lotte; Roos, Nanna

    2011-04-01

    With increasing interest in the potential effects of n-6 and n-3 fatty acids in early life, there is a need for data on the dietary intake of polyunsaturated fatty acids (PUFA) in low-income countries. This review compiles information on the content in breast milk and in foods that are important in the diets of low-income countries from the few studies available. We also estimate the availability of fat and fatty acids in 13 low-income and middle-income countries based on national food balance sheets from the United Nations' Food and Agriculture Organization Statistical Database (FOASTAT). Breast milk docosahexaenoic acid content is very low in populations living mainly on a plant-based diet, but higher in fish-eating countries. Per capita supply of fat and n-3 fatty acids increases markedly with increasing gross domestic product (GDP). In most of the 13 countries, 70-80% of the supply of PUFA comes from cereals and vegetable oils, some of which have very low α-linolenic acid (ALA) content. The total n-3 fatty acid supply is below or close to the lower end of the recommended intake range [0.4%E (percentage of energy supply)] for infants and young children, and below the minimum recommended level (0.5%E) for pregnant and lactating women in the nine countries with the lowest GDP. Fish is important as a source of long-chain n-3 fatty acids, but intake is low in many countries. The supply of n-3 fatty acids can be increased by using vegetable oils with higher ALA content (e.g. soybean or rapeseed oil) and by increasing fish production (e.g. through fish farming). © 2011 Blackwell Publishing Ltd.

  12. Income, income inequality and youth smoking in low- and middle-income countries.

    Science.gov (United States)

    Li, David X; Guindon, G Emmanuel

    2013-04-01

    To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  13. Income inequality and adolescent fertility in low-income countries.

    Science.gov (United States)

    Castro, Ruben; Fajnzylber, Eduardo

    2017-09-28

    : The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999). Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.

  14. 77 FR 65139 - Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income...

    Science.gov (United States)

    2012-10-25

    ...-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY... amend its low-income credit unions regulation by extending the time credit unions have to accept a low- income designation. Under the current rule, an FCU that has received notification from NCUA that it...

  15. 78 FR 4030 - Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income...

    Science.gov (United States)

    2013-01-18

    ...-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY... amending its low-income credit unions regulation by extending the time period in which a federal credit union (FCU) may accept a low-income designation. Under the current rule, an FCU that receives notice...

  16. Pregnancy planning, timing, happiness and depressive symptoms among low-income women living with and without HIV.

    Science.gov (United States)

    Polansky, Marcia; Singh, Hardeep; Gao, Yang; Aaron, Erika

    2018-03-21

    This study assessed associations of sociodemographic factors and pregnancy intent and wantedness with pregnancy happiness and prenatal depressive symptoms and the relationship between prenatal depressive symptoms and pregnancy happiness. Depression is the leading cause of disability world-wide and more so for women. Women are most likely to experience depression in their child bearing years, including during pregnancy. Untreated prenatal depression, associated with unwanted pregnancies endangers the health and wellbeing of the mother and her child. Research on the association of prenatal depression with pregnancy happiness among women with low incomes in the U.S.A. is limited. For women living with HIV, associations among family planning factors, pregnancy feelings and prenatal depression have been understudied. Sixty-four women living with HIV and 194 HIV-negative low-income pregnant women receiving care in a public university-based ob-gyn clinic with integrated HIV-care in Philadelphia between 2009 and 2012 participated in the study. The women completed a questionnaire on sociodemographic and pregnancy factors and the Center for Epidemiological Studies Depression Scale (CES-D). The independent associations of sociodemographic and pregnancy factors with pregnancy happiness and associations of these factors and pregnancy happiness with the CES-D were assessed using multivariable linear regressions. Women who felt the pregnancy was too soon were less happy being pregnant (p < 0.01). Prenatal depressive symptoms were inversely associated with happiness with being pregnant and completing high school (p < 0.001 for both). Health care professionals need to provide reproductive counselling and mental health for prenatal depression should explore feelings about being pregnant and being a mother.

  17. Income inequality and adolescent fertility in low-income countries

    Directory of Open Access Journals (Sweden)

    Ruben Castro

    2017-09-01

    Full Text Available Abstract: The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999. Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.

  18. Urinary tract infection among pregnant women at Bobo-Dioulasso ...

    African Journals Online (AJOL)

    Urinary tract infections are the first infections in pregnant women and can cause serious complications during pregnancy. In order to improve its management in low income country like Burkina Faso, we conducted a prospect cross-sectional study, to describe its epidemiological and biological aspects in pregnant women at ...

  19. Feeding practices of low-income mothers: how do they compare to current recommendations?

    Science.gov (United States)

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-03-07

    Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Many mothers spent considerable time encouraging eating--often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.

  20. Factors associated with maternal anaemia among pregnant women in Dhaka city.

    Science.gov (United States)

    Chowdhury, Hasina Akhter; Ahmed, Kazi Rumana; Jebunessa, Fatema; Akter, Jesmin; Hossain, Sharmin; Shahjahan, Md

    2015-09-22

    Maternal anaemia is a common problem in pregnancy, particularly in developing countries. The study was aimed at determining the factors associated with anaemia among a group of pregnant mothers who attended an antenatal clinic in Dhaka city. This cross-sectional study included 224 pregnant women, who visited the antenatal clinic of the Marie Stops, Dhaka. Demographic data and information on maternal age, gestational age, educational and income level, and socioeconomic status were collected from all the subjects. Haemoglobin status was measured to assess their anaemia. A qualified technician drew venous blood samples from them. The reference values of haemoglobin were categorized according to the World Health Organization (WHO) criteria as follows: normal (11 g/dL or higher), mild (10-10.9 g/dL), and moderate (7-9.9 g/dL). Mild and moderate levels of haemoglobin were defined as anaemic (haemoglobin levels of anaemia was significantly associated with age (p = 0.036), education (p = 0.002), income (p = 0.001), living area (p = 0.031). Results of binary logistic regression analysis showed that maternal anaemia was also significantly associated with age (p = 0.006), educational status (primary to 8th grade, p = 0.004; secondary and above, p = 0.002), living area (0.022), and income (0.021). A significant proportion of pregnant women were found anaemic. Most data showed education has animpact on awareness to use of health services and iron supplementation should be encouraged to improve the haemoglobin levels in pregnancy. The results indicate that anaemia is alarmingly high among pregnant women in Dhaka city. Maternal anaemia is associated with age, education level, income level, and living area. The results suggest that pregnant women and members of their families should be urgently educated to understand the importance of antenatal care.

  1. State Medicaid Expansions for Parents Led to Increased Coverage and Prenatal Care Utilization among Pregnant Mothers.

    Science.gov (United States)

    Wherry, Laura R

    2017-12-28

    To evaluate impacts of state Medicaid expansions for low-income parents on the health insurance coverage, pregnancy intention, and use of prenatal care among mothers who became pregnant. Person-level data for women with a live birth from the 1997-2012 Pregnancy Risk Assessment Monitoring System. The sample was restricted to women who were already parents using information on previous live births and combined with information on state Medicaid policies for low-income parents. I used a measure of expanded generosity of state Medicaid eligibility for low-income parents to estimate changes in health insurance, pregnancy intention, and prenatal care for pregnant mothers associated with Medicaid expansion. I found an increase in prepregnancy health insurance coverage and coverage during pregnancy among pregnant mothers, as well as earlier initiation of prenatal care, associated with the expansions. Among pregnant mothers with less education, I found an increase in the adequacy of prenatal care utilization. Expanded Medicaid coverage for low-income adults has the potential to increase a woman's health insurance coverage prior to pregnancy, as well as her insurance coverage and medical care receipt during pregnancy. © Health Research and Educational Trust.

  2. Entrepreneurship and Income Inequality in Southern Ethiopia

    OpenAIRE

    Kimhi, Ayal

    2009-01-01

    This paper uses inequality decomposition techniques in order to analyse the consequences of entrepreneurial activities to household income inequality in southern Ethiopia. A uniform increase in entrepreneurial income reduces per capita household income inequality. This implies that encouraging rural entrepreneurship may be favourable for both income growth and income distribution. Such policies could be particularly successful if directed at the low-income, low-wealth, and relatively uneducat...

  3. A Problem-Solving Therapy Intervention for Low-Income, Pregnant Women at Risk for Postpartum Depression

    Science.gov (United States)

    Sampson, McClain; Villarreal, Yolanda; Rubin, Allen

    2016-01-01

    Postpartum Depression (PPD) occurs at higher rates among impoverished mothers than the general population. Depression during pregnancy is one of the strongest predictors of developing PPD. Research indicates that non-pharmacological interventions are effective in reducing depressive symptoms but engaging and retaining low-income mothers remains a…

  4. Adherence to hysterosalpingogram appointments following hysteroscopic sterilization among low income women

    Science.gov (United States)

    Leyser-Whalen, Ophra; Berenson, Abbey B.

    2013-01-01

    Background The few studies on post-Essure hysterosalpingogram (HSG) adherence rates show inconsistent results. This study examined associations between sociodemographic variables not examined in prior studies and HSG adherence among low income women. Study Design Medical records of 286 women who underwent sterilization between August 31, 2005 and September 30, 2011 were reviewed. Chi-square and Mann-Whitney tests were used to determine variable associations with HSG adherence. Results The adherence rate for the first HSG was 85.0% (243/286). Variables associated with adherence were: lower education level (p=.01), not working outside the home (p=.04), being married (pEssure placement is feasible among low income populations. Furthermore, not speaking English or having to commute a far distance to the clinic do not appear to be barriers. This is encouraging considering the importance of this test to confirm tubal occlusion. PMID:24012097

  5. Prenatal and postnatal depression among low income Brazilian women

    Directory of Open Access Journals (Sweden)

    V.A. Da-Silva

    1998-06-01

    Full Text Available Postnatal depression is a significant problem affecting 10-15% of mothers in many countries and has been the subject of an increasing number of publications. Prenatal depression has been studied less. The aims of the present investigation were: 1 to obtain information on the prevalence of prenatal and postnatal depression in low income Brazilian women by using an instrument already employed in several countries, i.e., the Edinburgh Postnatal Depression Scale (EPDS; 2 to evaluate the risk factors involved in prenatal and postnatal depression in Brazil. The study groups included 33 pregnant women interviewed at home during the second and third trimesters of pregnancy, and once a month during the first six months after delivery. Questions on life events and the mother's relationship with the baby were posed during each visit. Depressed pregnant women received less support from their partners than non-depressed pregnant women (36.4 vs 72.2%, P<0.05; Fisher exact test. Black women predominated among pre- and postnatally depressed subjects. Postnatal depression was associated with lower parity (0.4 ± 0.5 vs 1.1 ± 1.0, P<0.05; Student t-test. Thus, the period of pregnancy may be susceptible to socio-environmental factors that induce depression, such as the lack of affective support from the partner. The prevalence rate of 12% observed for depression in the third month postpartum is comparable to that of studies from other countries.

  6. A randomized controlled design reveals barriers to citizenship for low-income immigrants.

    Science.gov (United States)

    Hainmueller, Jens; Lawrence, Duncan; Gest, Justin; Hotard, Michael; Koslowski, Rey; Laitin, David D

    2018-01-30

    Citizenship endows legal protections and is associated with economic and social gains for immigrants and their communities. In the United States, however, naturalization rates are relatively low. Yet we lack reliable knowledge as to what constrains immigrants from applying. Drawing on data from a public/private naturalization program in New York, this research provides a randomized controlled study of policy interventions that address these constraints. The study tested two programmatic interventions among low-income immigrants who are eligible for citizenship. The first randomly assigned a voucher that covers the naturalization application fee among immigrants who otherwise would have to pay the full cost of the fee. The second randomly assigned a set of behavioral nudges, similar to outreach efforts used by service providers, among immigrants whose incomes were low enough to qualify them for a federal waiver that eliminates the application fee. Offering the fee voucher increased naturalization application rates by about 41%, suggesting that application fees act as a barrier for low-income immigrants who want to become US citizens. The nudges to encourage the very poor to apply had no discernible effect, indicating the presence of nonfinancial barriers to naturalization. Copyright © 2018 the Author(s). Published by PNAS.

  7. Neighborhood perceptions and hypertension among low-income black women: a qualitative study

    Directory of Open Access Journals (Sweden)

    Maliyhah Al-Bayan

    2016-10-01

    Full Text Available Abstract Background The majority of studies examining the role of neighborhoods and hypertension-related outcomes have been quantitative in nature and very few studies have examined specific disadvantaged populations, including low-income housing residents. The objective of this study was to use qualitative interviews to explore low-income Black women’s perceptions of their neighborhoods and to understand how those perceptions may affect their health, especially as it relates to blood pressure. Methods Seventeen Black female participants, living in public housing communities in New York City, completed one semi-structured, audiotaped interview in July of 2014. All interviews were transcribed, coded, and analyzed for emerging themes using N’Vivo 10 software. Results Three major themes emerged: (1 social connectedness, (2 stress factors, and (3 availability of food options. For example, factors that caused stress varied throughout the study population. Sources of stress included family members, employment, and uncleanliness within the neighborhood. Many participants attributed their stress to personal issues, such as lack of employment and relationships. In addition, the general consensus among many participants was that there should be a greater density of healthy food options in their neighborhoods. Some believed that the pricing of fresh foods in the neighborhoods should better reflect the financial status of the residents in the community. Conclusions Various neighborhood influences, including neighborhood disorder and lack of healthy food options, are factors that appear to increase Black women’s risk of developing high blood pressure. Implications of this research include the need to develop interventions that promote good neighborhood infrastructure (e.g. healthy food stores to encourage good nutrition habits and well-lit walking paths to encourage daily exercise, in addition to interventions that increase hypertension awareness in

  8. 75 FR 80364 - Sample Income Data To Meet the Low-Income Definition

    Science.gov (United States)

    2010-12-22

    ... 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union... (FCUs) that do not qualify for a low-income designation using the geo-coding software the NCUA has developed for that purpose to submit an analysis of a statistically valid sample of their member income data...

  9. 76 FR 36976 - Sample Income Data To Meet the Low-Income Definition

    Science.gov (United States)

    2011-06-24

    ... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union Administration (NCUA). ACTION: Final rule. SUMMARY... low-income designation using the geo-coding software the agency has developed for that purpose to...

  10. HUD Low and Moderate Income Areas

    Data.gov (United States)

    Department of Housing and Urban Development — This dataset and map service provides information on the U.S. Housing and Urban Development's (HUD) low to moderate income areas. The term Low to Moderate Income,...

  11. Supporting and including children from low income families

    OpenAIRE

    Benoist, FD

    2017-01-01

    This chapter explores: • What we mean by low income and poverty and how poverty is defined • The families living on low income in the UK today and the impact of low income and poverty on children’s well-being, development and learning • Supporting children from low income families • The attainment gap between children from low income backgrounds and their peers • The pupil premium and how schools have used the extra funding to raise attainment • Key aspects of good practice and what schools c...

  12. Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial.

    Science.gov (United States)

    Stockwell, Melissa S; Westhoff, Carolyn; Kharbanda, Elyse Olshen; Vargas, Celibell Y; Camargo, Stewin; Vawdrey, David K; Castaño, Paula M

    2014-02-01

    We evaluated the impact of influenza vaccine text message reminders in a low-income obstetric population. We conducted a randomized controlled trial that enrolled 1187 obstetric patients from 5 community-based clinics in New York City. The intervention group received 5 weekly text messages regarding influenza vaccination starting mid-September 2011 and 2 text message appointment reminders. Both groups received standard automated telephone appointment reminders. The prespecified endpoints were receipt of either pre- or postpartum influenza vaccination calculated cumulatively at the end of each month (September-December 2011). After adjusting for gestational age and number of clinic visits, women who received the intervention were 30% more likely to be vaccinated as of December 2011 (adjusted odds ratio [AOR] = 1.30; 95% confidence interval [CI] = 1.003, 1.69 end of September: AOR = 1.34; 95% CI = 0.98, 1.85; October: AOR = 1.35; 95% CI = 1.05, 1.75; November: AOR = 1.27; 95% CI = 0.98, 1.65). The subgroup of women early in the third trimester at randomization showed the greatest intervention effect (December 31: 61.9% intervention vs 49.0% control; AOR = 1.88; 95% CI = 1.12, 3.15). In this low-income obstetric population, text messaging was associated with increased influenza vaccination, especially in those who received messages early in their third trimester.

  13. Financing the response to HIV in low-income and middle-income countries.

    Science.gov (United States)

    Izazola-Licea, José Antonio; Wiegelmann, Jan; Arán, Christian; Guthrie, Teresa; De Lay, Paul; Avila-Figueroa, Carlos

    2009-12-01

    To describe levels of national HIV spending and examine programmatic allocations according to the type of epidemic and country income. Cross-sectional analysis of HIV expenditures from 50 low-income and middle-income countries. Sources of information included country reports of domestic spending by programmatic activity and HIV services. These HIV spending categories were cross tabulated by source of financing, stratified by type of HIV epidemic and income level of the country and reported in international dollars (I$). Fifty low-income and middle-income countries spent US $ 2.6 billion (I$ 5.8 billion) on HIV in 2006; 87% of the funding among the 17 low-income countries came from international donors. Average per capita spending was I$ 2.1 and positively correlated with Gross National Income. Per capita spending was I$ 1.5 in 9 countries with low-level HIV epidemics, I$ 1.6 in 27 countries with concentrated HIV epidemics and I$ 9.5 in 14 countries with generalized HIV epidemics. On average, spending on care and treatment represented 50% of AIDS spending across all countries. The treatment-to-prevention spending ratio was 1.5:1, 3:1, and 2:1 in countries with low-level, concentrated and generalized epidemics, respectively. Spending on prevention represented 21% of total AIDS spending. However, expenditures addressing most-at-risk populations represented less than 1% in countries with generalized epidemics and 7% in those with low-level or concentrated epidemics. The most striking finding is the mismatch between the types of HIV epidemics and the allocation of resources. The current global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency. Mapping HIV expenditures provides crucial guidance for reallocation of resources and supports evidence-based decisions. Now more than ever, countries need to know and act on their epidemics and give priority to the most effective programmatic

  14. Digital Inequality and Developmental Trajectories of Low-income, Immigrant, and Minority Children.

    Science.gov (United States)

    Katz, Vikki S; Gonzalez, Carmen; Clark, Kevin

    2017-11-01

    Children growing up in the United States today are more ethnically and racially diverse than at any time in the nation's history. Because of rising income inequality, almost half of the 72 million children in the United States are also growing up in low-income families, with immigrant and children of color disproportionately likely to be within their ranks. Children in low-income households are more likely to face a number of social challenges, including constrained access to the Internet and devices that connect to it (ie, digital inequality), which can exacerbate other, more entrenched disparities between them and their more privileged counterparts. Although the American Academy of Pediatrics' new guidelines encourage clinicians to reduce children's overexposure to technology, we argue for a more nuanced approach that also considers how digital inequality can reduce low-income children's access to a range of social opportunities. We review previous research on how digital inequality affects children's learning and development and identify areas where more research is needed on how digital inequality relates to specific aspects of children's developmental trajectories, and to identify what interventions at the family, school, and community levels can mitigate the adverse effects of digital inequality as children move through their formal schooling. On the basis of the evidence to date, we conclude with guidelines for clinicians related to supporting digital connectivity and more equitable access to social opportunity for the increasingly diverse population of children growing up in the United States. Copyright © 2017 by the American Academy of Pediatrics.

  15. Legislated changes to federal pension income in Canada will adversely affect low income seniors' health.

    Science.gov (United States)

    Emery, J C Herbert; Fleisch, Valerie C; McIntyre, Lynn

    2013-12-01

    This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator. Food insecurity prevalence and income source were assessed for unattached low income (seniors aged 65-69 years (population weighted n=151,485) using public use data from the Canadian Community Health Survey Cycle 4.1 (2007-2008). Seniors' benefits through federal public pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65-69 years, in contrast to low income seniors aged 60-64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥65 years versus 22.8% for seniors seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship. © 2013.

  16. Associations Between Parent-Perceived Neighborhood Safety and Encouragement and Child Outdoor Physical Activity Among Low-Income Children.

    Science.gov (United States)

    Nicksic, Nicole E; Salahuddin, Meliha; Butte, Nancy F; Hoelscher, Deanna M

    2018-05-01

    A growing body of research has examined the relationship between perceived neighborhood safety and parental encouragement for child physical activity (PA), yet these potential predictors have not been studied together to predict child outdoor PA. The purpose of this study is to examine these predictors and parent- and child-reported child outdoor PA. The Texas Childhood Obesity Research Demonstration study collected data from fifth-grade students attending 31 elementary schools across Austin and Houston and their parents (N = 748 parent-child dyads). Mixed-effects linear and logistic regressions stratified by gender and adjusted for sociodemographic covariates assessed associations among parental-perceived neighborhood safety, parental encouragement for child's outdoor PA, and parent- and child-reported child's outdoor PA. Parental-perceived neighborhood safety was significantly associated with encouraging outdoor PA (P = .01) and child-reported child's outdoor PA in boys, but not in girls. Significant associations were found between parental encouragement and child-reported outdoor PA for girls (P < .05) and parent-reported outdoor PA (P < .01) for boys and girls. Parent encouragement of PA and neighborhood safety are potential predictors of child outdoor PA and could be targeted in youth PA interventions.

  17. Widening Income Inequalities: Higher Education's Role in Serving Low Income Students

    Science.gov (United States)

    Dalton, Jon C.; Crosby, Pamela C.

    2015-01-01

    Many scholars argue that America is becoming a dangerously divided nation because of increasing inequality, especially in income distribution. This article examines the problem of widening income inequality with particular focus on the role that colleges and universities and their student affairs organizations play in serving low income students…

  18. Assessing the Digital Divide Among Low-Income Perinatal Women: Opportunities for Provision of Health Information and Counseling.

    Science.gov (United States)

    Acquavita, Shauna P; Krummel, Debra A; Talks, Alexandra; Cobb, Alexandra; McClure, Erin

    2018-04-30

    Technology-based health interventions may provide a means to reach low-income perinatal women and improve outcomes for both mother and infant, yet little is known about technology access and interest among this population. This study explored interest, attitudes, and concerns regarding technology to deliver health information and interventions. Between May and October 2014, a cross-sectional study of 161 low-income pregnant and/or postpartum mothers (up to 1 year) was conducted, assessing attitudes and behaviors regarding the current use of devices and receptivity to interventions delivered through devices. Participants (ages 18-41) were pregnant or postpartum and able to read and comprehend English. Women were recruited from waiting areas at two urban clinics affiliated with the local health department in a Midwestern city in the United States. Surveys included 46 questions and were completed at the time of invitation. Descriptive statistics, independent sample t test, or chi-square for independence tests were completed using SPSS (version 23). Participants from this sample were mostly African American (60%) and had a mean age of 26 years. Most were postpartum (67%). The majority of the sample used mobile phones (most being smartphones), with less access and use of computers and tablets. A moderate level of interest in utilizing technology for health-related information and interventions was found, with concerns related to privacy and time.

  19. Immunization in pregnancy clinical research in low- and middle-income countries - Study design, regulatory and safety considerations.

    Science.gov (United States)

    Kochhar, Sonali; Bonhoeffer, Jan; Jones, Christine E; Muñoz, Flor M; Honrado, Angel; Bauwens, Jorgen; Sobanjo-Ter Meulen, Ajoke; Hirschfeld, Steven

    2017-12-04

    Immunization of pregnant women is a promising public health strategy to reduce morbidity and mortality among both the mothers and their infants. Establishing safety and efficacy of vaccines generally uses a hybrid design between a conventional interventional study and an observational study that requires enrolling thousands of study participants to detect an unknown number of uncommon events. Historically, enrollment of pregnant women in clinical research studies encountered many barriers based on risk aversion, lack of knowledge, and regulatory ambiguity. Conducting research enrolling pregnant women in low- and middle-income countries can have additional factors to address such as limited availability of baseline epidemiologic data on disease burden and maternal and neonatal outcomes during and after pregnancy; challenges in recruiting and retaining pregnant women in research studies, variability in applying and interpreting assessment methods, and variability in locally acceptable and available infrastructure. Some measures to address these challenges include adjustment of study design, tailoring recruitment, consent process, retention strategies, operational and logistical processes, and the use of definitions and data collection methods that will align with efforts globally. Copyright © 2017. Published by Elsevier Ltd.

  20. Women's empowerment and its differential impact on health in low income communities in Mumbai, India

    Science.gov (United States)

    Davis, Lwendo Moonzwe; Schensul, Stephen L.; Schensul, Jean J.; Verma, Ravi; Nastasi, Bonnie K.; Singh, Rajendra

    2015-01-01

    This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalized area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined. PMID:24766149

  1. Designing Low-Income Housing Using Local Architectural Concepts

    Science.gov (United States)

    Trumansyahjaya, K.; Tatura, L. S.

    2018-02-01

    The provision of houses for low-income people who do not have a home worthy of being one of the major problems in the city of Gorontalo, because the community in establishing the house only pay attention to their wants and needs in creating a healthy environment, the beauty of the city and the planning of the home environment in accordance with the culture of the people of Gorontalo. In relation to the condition, the focus of this research is the design of housing based on local architecture as residential house so that it can be reached by a group of low income people with house and environment form determined based on family development, social and economic development of society and environment which take into account the local culture. Stages of this research includes five (5) stages, including the identification phase characteristics Gorontalo people of low income, the characteristics of the identification phase house inhabited by low-income people, the stage of identification preference low-income households, the phase formation house prototype and the environment, as well as the stage of formation model home for low-income people. Analysis of the model homes for low-income people using descriptive analysis, Hierarchical Cluster Analysis, and discrimination analysis to produce a prototype of the house and its surroundings. The prototype is then reanalyzed to obtain the model home for low-income people in the city of Gorontalo. The shape of a model home can be used as a reference for developers of housing intended for low-income people so that housing is provided to achieve the goals and the desired target group.

  2. Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

    Directory of Open Access Journals (Sweden)

    Rhonda C. Boyd

    2011-01-01

    Full Text Available Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1 screening and referral, (2 facilitators to referral, (3 barriers to referral, (4 culture and language, (5 life events, and (6 support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

  3. Breastfeeding support - the importance of self-efficacy for low-income women.

    Science.gov (United States)

    Entwistle, Francesca; Kendall, Sally; Mead, Marianne

    2010-07-01

    Breastfeeding is a key determinant in promoting public health and reducing health inequality. Low-income women have a significantly lower level of breastfeeding. Midwives in the UK have been encouraged to implement the World Health Organization/United Nations Children's Fund's Ten Steps to Successful Breastfeeding, but to date, there has been no evaluation of the impact of the training initiative on the breastfeeding behaviours of low-income women. As part of a wider study, this qualitative component was designed to answer the question - what are the views and experiences of low-income women (defined by Jarman scores) in relation to their breastfeeding support received in the post-natal period? A sample of seven women was interviewed. The in-depth interviews were analysed using a qualitative, thematic approach based on the self-efficacy theory. The four themes that emerged from the data were the following: breastfeeding related to the woman's self-confidence, the social environment in which the woman lived, knowledge of breastfeeding and the influence of maternity services on breastfeeding outcomes. These themes were interpreted in relation to the self-efficacy theory. The findings suggest that the components that inform self-efficacy are consistent with the themes from the data, suggesting that midwives and other health professionals should take the psychosocial aspects of breastfeeding support into account. As this important feature of breastfeeding support is not explicitly part of the current Ten Steps to Successful Breastfeeding, we suggest that further research and debate could inform expansion of these minimum standards to include the psychosocial aspects.

  4. Mercury Levels in an Urban Pregnant Population in Durham County, North Carolina

    Science.gov (United States)

    Miranda, Marie Lynn; Edwards, Sharon; Maxson, Pamela J.

    2011-01-01

    The adverse effects of prenatal mercury exposure, most commonly resulting from maternal fish consumption, have been detected at very low exposure levels. The omega-3 fatty acids found in fish, however, have been shown to support fetal brain and vision development. Using data from a prospective, cohort study of pregnant women from an inland area in the US South, we sought to understand the fish consumption habits and associated mercury levels across subpopulations. Over 30% of women had at least 1 μg/L of mercury in their blood, and about 2% had blood mercury levels above the level of concern during pregnancy (≥3.5 μg/L). Mercury levels were higher among Asian/Pacific Islander, older, higher educated, and married women. Fish consumption from any source was reported by 2/3 of the women in our study, with older women more likely to consume fish. Despite eating more fish meals per week, lower income, lower educated women had lower blood mercury levels than higher income, higher educated women. This suggests the different demographic groups consume different types of fish. Encouraging increased fish consumption while minimizing mercury exposure requires careful crafting of a complex health message. PMID:21556174

  5. Factors associated with the prevalence of periodontal disease in low-risk pregnant women

    Science.gov (United States)

    2012-01-01

    Objective To evaluate the prevalence of periodontal disease (PD) among Brazilian low-risk pregnant women and its association with sociodemographic factors, habits and oral hygiene. Method This cross-sectional study included 334 low-risk pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. Independent variables were: age, race/color, schooling, marital status, parity, gestational age, smoking habit, alcohol and drugs consumption, use of medication, presence of any systemic diseases and BMI (body mass index). Statistical analyses provided prevalence ratios and their respective 95%CI and also a multivariate analysis. Results The prevalence of PD was 47% and significantly associated with higher gestational age (PR 1.40; 1.01 - 1.94 for 17-24 weeks and PR 1.52; 1.10 - 2.08 for 25-32 weeks), maternal age 25-29 years, obesity (PR 1.65; 1.02 - 2.68) and the presence of gingival bleeding on probing (ORadj 2.01, 95%CI 1.41 - 2.88). Poor oral hygiene was associated with PD by the mean values of plaque and bleeding on probing indexes significantly greater in PD group. Conclusions The prevalence of PD is high and associated with gingival bleeding on probing, more advanced gestational age and obesity. A program of oral health care should be included in prenatal care for early pregnancy, especially for low-income populations. PMID:22273008

  6. Factors associated with the prevalence of periodontal disease in low-risk pregnant women

    Directory of Open Access Journals (Sweden)

    Vogt Marianna

    2012-01-01

    Full Text Available Abstract Objective To evaluate the prevalence of periodontal disease (PD among Brazilian low-risk pregnant women and its association with sociodemographic factors, habits and oral hygiene. Method This cross-sectional study included 334 low-risk pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. Independent variables were: age, race/color, schooling, marital status, parity, gestational age, smoking habit, alcohol and drugs consumption, use of medication, presence of any systemic diseases and BMI (body mass index. Statistical analyses provided prevalence ratios and their respective 95%CI and also a multivariate analysis. Results The prevalence of PD was 47% and significantly associated with higher gestational age (PR 1.40; 1.01 - 1.94 for 17-24 weeks and PR 1.52; 1.10 - 2.08 for 25-32 weeks, maternal age 25-29 years, obesity (PR 1.65; 1.02 - 2.68 and the presence of gingival bleeding on probing (ORadj 2.01, 95%CI 1.41 - 2.88. Poor oral hygiene was associated with PD by the mean values of plaque and bleeding on probing indexes significantly greater in PD group. Conclusions The prevalence of PD is high and associated with gingival bleeding on probing, more advanced gestational age and obesity. A program of oral health care should be included in prenatal care for early pregnancy, especially for low-income populations.

  7. Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review.

    Science.gov (United States)

    Sondaal, Stephanie Felicie Victoria; Browne, Joyce Linda; Amoakoh-Coleman, Mary; Borgstein, Alexander; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Klipstein-Grobusch, Kerstin

    2016-01-01

    Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth and postnatal period in LMIC. The review was registered with Prospero (CRD42014010292). Six databases were searched from June 2014-April 2015, accompanied by grey literature search using pre-defined search terms linked to pregnant women in LMIC and mHealth. Quality of articles was assessed with an adapted Cochrane Risk of Bias Tool. Because of heterogeneity in outcomes, settings and study designs a narrative synthesis of quantitative results of intervention studies on maternal outcomes, neonatal outcomes, service utilization, and healthy pregnancy education was conducted. Qualitative and quantitative results were synthesized with a strengths, weaknesses, opportunities, and threats analysis. In total, 3777 articles were found, of which 27 studies were included: twelve intervention studies and fifteen descriptive studies. mHealth interventions targeted at pregnant women increased maternal and neonatal service utilization shown through increased antenatal care attendance, facility-service utilization, skilled attendance at birth, and vaccination rates. Few articles assessed the effect on maternal or neonatal health outcomes, with inconsistent results. mHealth interventions may be effective solutions to improve maternal and neonatal service utilization. Further studies assessing mHealth's impact on maternal and neonatal outcomes are recommended. The emerging trend of strong experimental research designs with randomized controlled trials, combined with feasibility research, government involvement

  8. Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Stephanie Felicie Victoria Sondaal

    Full Text Available Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC. Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth and postnatal period in LMIC.The review was registered with Prospero (CRD42014010292. Six databases were searched from June 2014-April 2015, accompanied by grey literature search using pre-defined search terms linked to pregnant women in LMIC and mHealth. Quality of articles was assessed with an adapted Cochrane Risk of Bias Tool. Because of heterogeneity in outcomes, settings and study designs a narrative synthesis of quantitative results of intervention studies on maternal outcomes, neonatal outcomes, service utilization, and healthy pregnancy education was conducted. Qualitative and quantitative results were synthesized with a strengths, weaknesses, opportunities, and threats analysis.In total, 3777 articles were found, of which 27 studies were included: twelve intervention studies and fifteen descriptive studies. mHealth interventions targeted at pregnant women increased maternal and neonatal service utilization shown through increased antenatal care attendance, facility-service utilization, skilled attendance at birth, and vaccination rates. Few articles assessed the effect on maternal or neonatal health outcomes, with inconsistent results.mHealth interventions may be effective solutions to improve maternal and neonatal service utilization. Further studies assessing mHealth's impact on maternal and neonatal outcomes are recommended. The emerging trend of strong experimental research designs with randomized controlled trials, combined with feasibility research

  9. Whole grain intake, determined by dietary records and plasma alkylresorcinol concentrations, is low among pregnant women in Singapore.

    Science.gov (United States)

    Ross, Alastair B; Colega, Marjorelee T; Lim, Ai Lin; Silva-Zolezzi, Irma; Macé, Katherine; Saw, Seang Mei; Kwek, Kenneth; Gluckman, Peter; Godfrey, Keith M; Chong, Yap-Seng; Chong, Mary F F

    2015-01-01

    To quantify whole grain intake in pregnant women in Singapore in order to provide the first detailed analysis of whole grain intake in an Asian country and in pregnant women. Analysis of 24-h diet recalls in a cross-sectional cohort study and analysis of a biomarker of whole grain intake (plasma alkylresorcinols) in a subset of subjects. The Growing Up in Singapore Towards healthy Outcomes-mother offspring cohort study based in Singapore. 998 pregnant mothers with complete 24-h recalls taken during their 26-28th week of gestation. Plasma samples from a randomly select subset of 100 subjects were analysed for plasma alkylresorcinols. Median (IQR) whole grain intake for the cohort and the 30% who reported eating whole grains were 0 (IQR 0, 9) and 23.6 (IQR 14.6, 44.2) g/day respectively. Plasma alkylresorcinol concentrations were very low [median (IQR)=9 (3, 15) nmol/L], suggesting low intake of whole grain wheat in this population. Plasma alkylresorcinols were correlated with whole grain wheat intake (Spearman's r=0.35; pSingapore was well below the 2-3 (60-95 g) servings of whole grains per day recommended by the Singapore Health Promotion Board. Efforts to increase whole grain intake should be supported to encourage people to choose whole grains over refined grains in their diet.

  10. Low Hemoglobin among Pregnant Women in Midwives Practice of Primary Health Care, Jatinangor, Indonesia: Iron Deficiency Anemia or β-Thalassemia Trait?

    Science.gov (United States)

    Susanti, Ari Indra; Winarno, Gatot; Sugianli, Adhi Kristianto; Susanto, Herman; Panigoro, Ramdan

    2017-01-01

    Low hemoglobin (Hb) or anemia is common among pregnant women in developing countries which may cause adverse pregnancy outcomes and maternal deaths. Our study aimed to assess Hb level measured by midwives in primary health care facility at rural area of Jatinangor, Indonesia, and to explore whether the anemia was due to iron deficiency (IDA) or β-thalassemia trait (β-TT). Pregnant women (n = 105) had finger prick test for Hb level during a regular antenatal care examination from October to November 2016. Hb level by finger prick test was compared with venous blood, measured by complete blood count (CBC). Indices including MCV and MCH and indices of Shine & Lal, Mentzer, Srivastava, Engels & Frase, Ehsani, and Sirdah were analyzed to differentiate anemia due to IDA and anemia due to suspect β-TT. HbA2 was measured to confirm β-TT. Anemic pregnant women were found in 86.7% by finger prick test compared to 21.9% (n = 23) by CBC. The prevalence of β-TT in our study was 5.7%. Hb measurement among pregnant women in low resource area is highly important; however, finger prick test in this study showed a high frequency of anemia which may lead to iron oversupplementation. A standard CBC is encouraged; MCV and MCH would help midwives to identify β-TT. PMID:28634546

  11. Gender Differences in Caregiver Emotion Socialization of Low-Income Toddlers

    Science.gov (United States)

    Chaplin, Tara M.; Casey, James; Sinha, Rajita; Mayes, Linda C.

    2010-01-01

    Low-income children are at elevated risk for emotion-related problems; however, little research has examined gender and emotion socialization in low-income families. The authors describe the ways in which emotion socialization may differ for low-income versus middle-income families. They also present empirical data on low-income caregivers'…

  12. Food purchasing selection among low-income, Spanish-speaking Latinos.

    Science.gov (United States)

    Cortés, Dharma E; Millán-Ferro, Andreina; Schneider, Karen; Vega, Rodolfo R; Caballero, A Enrique

    2013-03-01

    purchased from baseline to post-education (median total calories: baseline, 20,191; post-education, 15,991, p=0.008); median calories per dollar: baseline, 404; post-education, 320, p=0.008). The median grams of carbohydrates per dollar (baseline, 66, post-education, 45) and median calories from processed food (baseline, 11,000, post-education, 7845) were not reduced (p=0.06). This pilot study demonstrated that grocery shopping practices are an important factor to address in nutrition education among Spanish-speaking, low-income individuals, and that there may be ways to encourage low-income, Latino families to purchase healthier foods. Findings challenged arguments suggesting that such an approach is not possible because of the high cost of healthier foods. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Resource handbook for low-income residential retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Callaway, J.W.; Brenchley, D.L.; Davis, L.J.; Ivey, D.L.; Smith, S.A.; Westergard, E.J.

    1987-04-01

    The purpose of the handbook is to provide technical assistance to state grantees participating in the Partnerships in Low-Income Residential Retrofit (PILIRR) Program. PILIRR is a demonstration program aimed at identifying innovative, successful approaches to developing public and private support for weatherization of low-income households. The program reflects the basic concept that responsibility for financial support for conservation activities such as low-income residential retrofitting is likely to gradually shift from the DOE to the states and the private sector. In preparing the handbook, PNL staff surveyed over 50 programs that provide assistance to low-income residents. The survey provided information on factors that contribute to successful programs. PNL also studied the winning PILIRR proposals (from the states of Florida, Iowa, Kentucky, Oklahoma and Washington) and identified the approaches proposed and the type of information that would be most helpful in implementing these approaches.

  14. 42 CFR 457.310 - Targeted low-income child.

    Science.gov (United States)

    2010-10-01

    ... family income at or below 200 percent of the Federal poverty line for a family of the size involved; (ii... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

  15. 42 CFR 435.229 - Optional targeted low-income children.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 435.229... Coverage of Families and Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined in...

  16. Coping with low incomes and cold homes

    International Nuclear Information System (INIS)

    Anderson, Will; White, Vicki; Finney, Andrea

    2012-01-01

    This paper presents findings from a study of low-income households in Great Britain which explored households’ strategies for coping both with limited financial resources in the winter months, when demand for domestic energy increases, and, in some cases, with cold homes. The study combined a national survey of 699 households with an income below 60 per cent of national median income with in-depth interviews with a subsample of 50 households. The primary strategy adopted by low-income households to cope with financial constraint was to reduce spending, including spending on essentials such as food and fuel, and thereby keep up with core financial commitments. While spending on food was usually reduced by cutting the range and quality of food purchased, spending on energy was usually reduced by cutting consumption. Sixty-three per cent of low-income households had cut their energy consumption in the previous winter and 47 per cent had experienced cold homes. Improvements to the thermal performance of homes reduced but did not eliminate the risk of going cold as any heating cost could be a burden to households on the lowest incomes. Householders’ attitudes were central to their coping strategies, with most expressing a determination to ‘get by’ come what may.

  17. Effects of low income on infant health.

    Science.gov (United States)

    Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

    2003-06-10

    Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not

  18. Impact of a targeted direct marketing price promotion intervention (Buywell) on food-purchasing behaviour by low income consumers: a randomised controlled trial.

    Science.gov (United States)

    Stead, M; MacKintosh, A M; Findlay, A; Sparks, L; Anderson, A S; Barton, K; Eadie, D

    2017-08-01

    Price promotions are a promising intervention for encouraging healthier food purchasing. We aimed to assess the impact of a targeted direct marketing price promotion combined with healthy eating advice and recipe suggestions on the purchase of selected healthier foods by low income consumers. We conducted a randomised controlled trial (n = 53 367) of a direct marketing price promotion (Buywell) combined with healthy eating advice and recipe suggestions for low income consumers identified as 'less healthy' shoppers. Impact was assessed using electronic point of sale data for UK low income shoppers before, during and after the promotion. The proportion of customers buying promoted products in the intervention month increased by between 1.4% and 2.8% for four of the five products. There was significantly higher uptake in the promotion month (P marketing price promotions combined with healthy eating advice and recipe suggestions targeted at low income consumers are feasible and can have a modest impact on short-term food-purchasing behaviour, although further approaches are needed to help sustain these changes. © 2017 The British Dietetic Association Ltd.

  19. Pregnant at work: time for prenatal care providers to act.

    Science.gov (United States)

    Karkowsky, Chavi Eve; Morris, Liz

    2016-09-01

    Fifty years ago, when a woman became pregnant, she was expected to stop working. Today, however, most women who work are the primary, sole, or co-breadwinner for their families, and their earnings during pregnancy are often essential to their families' economic well-being. Medical data about working during pregnancy are sparse but generally show that both low-risk and high-risk women can tolerate work-related duties well, although some work accommodations (eg, providing a chair for sitting, allowing snacks, or modifying the work schedule) may be necessary. However, some employers refuse to accommodate pregnant women who need adjustments. This can result in a woman being forced to make the choice between working without accommodations and losing her income and health insurance or even her job. Prenatal care providers can play an important role by implementing changes in their own practice, shaping public policy, and conducting research to increase protections for pregnant women and to ensure that they receive medically recommended accommodations while continuing to earn income for their growing families. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Smart solutions for low-income buildings rehabilitation: international researches and experiences

    Directory of Open Access Journals (Sweden)

    Eugenio Arbizzani

    2015-11-01

    Full Text Available Smart City concept briefly refers to a sustainable city where innovative Smart strategies will be adopted to an efficient management of resources flows and social interoperability. Aligned with the most relevant European research experiences, the paper describes the relations between an on-going research from the PDTA Dept., centered on a knowledge platform tool for energy-efficient interactive buildings design, and the contribution of the ELIH-MED project on the use of industrialized solutions and smart devices during the rehabilitation process in Mediterranean low-income housings. A pilot project in the Spanish climate context reveals the important role of Smart Monitoring Devices to encourage energy savings and tackle recognized needs through a participative process where stakeholders and beneficiaries are actively involved.

  1. High prevalence of asymptomatic sexually transmitted infections among human immunodeficiency virus-infected pregnant women in a low-income South African community.

    Science.gov (United States)

    Mudau, Maanda; Peters, Remco P; De Vos, Lindsey; Olivier, Dawie H; J Davey, Dvora; Mkwanazi, Edwin S; McIntyre, James A; Klausner, Jeffrey D; Medina-Marino, Andrew

    2018-03-01

    There is a lack of evidence on the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among HIV-infected pregnant women in South Africa. We conducted a cross-sectional analysis of HIV-infected pregnant women in two healthcare facilities in a South African township to determine the prevalence of CT, NG and TV. HIV-infected pregnant women were recruited during the first antenatal care visit for their current pregnancy and requested to self-collect vulvovaginal swab specimens. Specimens were tested for CT, NG and TV using the Xpert® assay (Cepheid, Sunnyvale, CA). Of 247 tested for CT, NG and TV, 47.8% tested positive for at least one organism; CT = 36.8%, TV = 23.9%, NG = 6.9%. Forty three (17.4%) had multiple infections, of which 42 included CT as one of the infecting organisms. Of the 118 participants who tested positive for at least one sexually transmitted infection (STI), 23.7% reported STI-like symptoms. Among women who tested positive for CT, 29.7% reported symptoms while 47.1 and 27.1% of those who tested positive for NG and TV, respectively, reported symptoms. The high STI prevalence coupled with the low symptom prevalence among infected individuals justifies the use of diagnostic screening approaches rather than syndromic management of STIs in this setting.

  2. The association between food insecurity and depressive symptoms severity among pregnant women differs by social support category: a cross-sectional study.

    Science.gov (United States)

    Natamba, Barnabas K; Mehta, Saurabh; Achan, Jane; Stoltzfus, Rebecca J; Griffiths, Jeffrey K; Young, Sera L

    2017-07-01

    Common mental disorders, such as depression and anxiety, affect approximately 16% of pregnant women in low- and middle-income countries. Food insecurity (FI) has been shown to be associated with depressive symptoms. It has also been suggested that the association between FI and depressive symptoms is moderated by social support (SS); however, there is limited evidence of these associations among pregnant women living in low-income and middle-income countries. We studied the association between FI and depressive symptoms severity and assessed whether such an association varied among Ugandan pregnant women with low vs. high SS. Cross-sectional data were collected among 403 pregnant women in northern Uganda. SS was assessed using an eight-item version of the Duke-UNC functional SS scale. FI and depressive symptoms were assessed by, respectively, the individually focused FI scale and the Center for Epidemiologic Studies-Depression scale. Women were categorized into two SS groups, based on scoring category (adjusted beta (95%CI): 0.91 (0.55; 1.27)) than for women belonging to the high SS group (0.53 (0.28; 0.78)) (adjusted p value for interaction = 0.026). There is need for longitudinal or interventional studies among pregnant women living in northern Uganda or similar contexts to examine the temporal sequence of the associations among food insecurity, depressive symptoms severity and social support. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  3. Happiness and related factors in pregnant women.

    Science.gov (United States)

    Jayasvasti, Kanthika; Kanchanatawan, Buranee

    2005-09-01

    Pregnancy is a crisis in the human life cycle as an important turning point in aspects of anatomical, physiological and psychosocial changes. An unhappy pregnanus could influence the fetal growth and development and sense of maternal competence as well as bonding with the fetus which profoundly affect the nurture of the infant after delivery. The authors'purposes were to study happiness and related factors in pregnant women having antenatal care at King Chulalongkorn Memorial Hospital. Four hundred and thirty-eight pregnant women from the antenatal clinic at King Chulalongkorn Memorial Hospital were randomly selected to complete a set of questionnaires that consisted of personal information, pregnant information, The Oxford Happiness Questionnaire (OHQ), The Maudsley Personality Inventory (MPI) and The Marital Satisfaction Scale (MSS). Prevalence of happiness level was classified by descriptive analysis. Unpaired t-test, ANOVA and Pearson's Product Moment Correlation analyzed related factors to happiness in pregnant woman. Also Stepwise Multiple Regression Analysis was used to define predictive factors for happiness in pregnant women. The sample had a high level of happiness of 57.3%. Significant related factors to happiness were age between 31-35 years, high education level, high individual and family income, having saving deposition, no drug abuse, improved marital relationship, no conflict with relatives, extrovert and stable personality types and no concerns about post-partum body image. Four predictive factors for happiness in pregnant women were extrovert personality, stable personality, high family income and improved marital relationship. Level of happiness in pregnant women could be predicted by type of personality, family income and marital relationship.

  4. Management of severe acute malnutrition in low-income and middle-income countries

    Science.gov (United States)

    Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environm...

  5. Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review

    OpenAIRE

    Sondaal, Stephanie Felicie Victoria; Browne, Joyce Linda; Amoakoh-Coleman, Mary; Borgstein, Alexander; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Klipstein-Grobusch, Kerstin

    2016-01-01

    INTRODUCTION: Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth a...

  6. [Analysis of the status and influential factors for prenatal care and postpartum visit among pregnant women based on the First Health Service Survey in Hunan Province].

    Science.gov (United States)

    Zhang, Wei; Cheng, Xunjie; Zhang, Lin; Ning, Peishan; Li, Li; Deng, Xin; Deng, Jing; Hu, Guoqing

    2016-11-28

    To evaluate the status and influential factors for prenatal care and postpartum visit among pregnant women in Hunan Province from 2008 to 2013 based on the data from the First Health Service Survey in Hunan Province.
 Methods: Based on the data of prenatal care and postpartum visit among pregnant women from the First Health Service Survey of Hunan Province in 2013, proportion of pregnant women, who didn't meet the criteria for prenatal care and postpartum visit, were calculated (≥5 times for prenatal care and ≥2 times for postpartum visit, according to the National Basic Public Health Service program, 2009 Edition). Multivariable logistic regression models were used to identify the influencial factors.
 Results: A total of 1 035 eligible women were included in data analysis. The proportion of pregnant women who did not meet the criteria were 40.12% (95% CI 24.91%-55.33%) for prenatal care and 64.88% (95% CI 39.70%-90.06%) for postpartum visit. After adjusting other confounding factors, pregnant women with middle- and high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.41 and 0.39, respectively. Multiparae had higher proportion of not meeting the criteria than primiparas, with adjusted odds ratio of 1.54, and pregnant women with age 25-34 years and 35-64 years had lower proportions of not meeting the criteria than those with age 15-24 years. In term of postpartum visit, pregnant women with middle- to high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.50, 0.46 and 0.54, respectively; multiparae had higher proportion of not meeting the criteria than primiparas, with the adjusted odds ratio of 2.30.
 Conclusion: Proportions of pregnant women of not meeting the criteria are high in Hunan Province. Local government should strengthen the management to decrease the proportions of pregnant women who do not meet the standard in

  7. Siblings, Language, and False Belief in Low-Income Children

    Science.gov (United States)

    Tompkins, Virginia; Farrar, M. Jeffrey; Guo, Ying

    2013-01-01

    The authors examined the relationship between number of siblings and false belief understanding (FBU) in 94 low-income 4-5-year-olds. Previous research with middle-income children has shown a positive association between number of siblings and FBU. However, it is unclear whether having multiple siblings in low-income families is related to better…

  8. Energy-microfinance intervention for low income households in India

    Science.gov (United States)

    Rao, P. Sharath Chandra

    In India, limited energy access and energy inequity hamper the lives of low income households. Traditional fuels such as firewood and dung cake account for 84 percent and 32 percent of the rural and urban household cooking energy (NSSO, 2007). With 412 million people without access to electricity in 2005, India hosts the world's largest such population (IEA, 2007). But, low income households still spend 9 - 11.7 percent1 of their incomes on inefficient forms of energy while wealthy households spend less than 5 percent on better energy products (Saghir, 2005). Renewable energy technologies coupled with innovative financial products can address the energy access problem facing the low income households in India (MacLean & Siegel, 2007; REEEP, 2009). Nevertheless, the low income households continue to face low access to mainstream finance for purchasing renewable energy technology at terms that meet their monthly energy related expenditure (ESMAP, 2004a; SEEP, 2008a) and low or no access to energy services (Ailawadi & Bhattacharyya, 2006; Modi et. al., 2006). The lack of energy-finance options has left the marginalized population with little means to break the dependence on traditional fuels. This dissertation proposes an energy microfinance intervention to address the present situation. It designed a loan product dedicated to the purchase of renewable energy technologies while taking into account the low and irregular cash flows of the low income households. The arguments presented in this dissertation are based on a six-month pilot project using this product designed and developed by the author in conjunction with a microfinance institution and its low income clients and Energy Service Companies in the state of Karnataka. Finding the right stakeholders and establishing a joint agreement, obtaining grant money for conducting the technology dissemination workshops and forming a clear procedure for commissioning the project, are the key lessons learnt from this study

  9. Concept of innovation in low-income market

    Directory of Open Access Journals (Sweden)

    Vitor Koki da Costa Nogami

    2018-01-01

    Full Text Available Purpose – Investigate the concept and the adoption of innovation in the low-income market. Design/methodology/approach – Four different studies were conducted. First, a Delphi study with 126 Marketing and Innovation professors from graduate programs. Second, interviews with 13 professionals, technical assistance professionals and retail managers. Third, two focus groups with low-income consumers. Fourth, survey with 390 respondents. Findings – The results indicate that innovations in the low-income markets are mainly characterized by adaptations and adjustments in products, with emphasis on incremental innovations, not radical. In addition, the adoption of innovation in this context is characterized as late, not initial. Originality/value – In terms of theoretical contributions, the present study reveals how the concept of innovation is built in the low-income market. From a perspective collectively constructed with information from different market agents (industry, retail and consumers, research findings become robust to understanding a phenomenon. Moreover, in addition to different market agents, different methods of data collection and analysis were also used, further enriching the results. This collective contribution, based theoretically on a literature of social construction, interviewing different market agents and using different methodological approaches, synergistically potentiated the development of this paper

  10. A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries.

    Science.gov (United States)

    Koay, C L; Patel, D K; Tajunisah, I; Subrayan, V; Lansingh, V C

    2015-04-01

    To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

  11. Pesticide Poisonings in Low- and Middle-Income Countries

    DEFF Research Database (Denmark)

    Jørs, Erik; Neupane, Dinesh; London, Leslie

    2018-01-01

    Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'.......Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'....

  12. Low back pain in pregnant women attending antenatal clinic: The Aminu Kano teaching hospital experience.

    Science.gov (United States)

    Usman, Mustapha Ibrahim; Abubakar, Muhammad Kabir; Muhammad, Shamsuddeen; Rabiu, Ayyuba; Garba, Ibrahim

    2017-01-01

    The profound physiologic effects of pregnancy affect the musculoskeletal system. Pregnant women are at increased risks of low back/pelvic girdle pains. To determine the incidence of low back/pelvic girdle pains among pregnant women. This was a cross-sectional study conducted from May 1 to June 30, 2016, among consenting pregnant women at Aminu Kano Teaching Hospital. Ethical approval was obtained from the Hospital Ethics Committee. Information was obtained in a questionnaire on consecutive pregnant women. Data obtained were analyzed using SPSS version 18 (SPSS Inc., Chicago, Illinois, USA, 2012). Fisher's exact test was used for categorical data, and P ≤ 0.05 was considered statistically significant. A total of 309 pregnant women were recruited from May 1 to June 30, 2016. The mean age ± standard deviation was 28.4 ± 5.86 years. The incidence of low back pains (LBPs) and pelvic girdle pains among the pregnant women was 106 (34.3%) and 178 (57.6%), respectively. The pain was severe among 26 (9.2%) pregnant women, which warranted analgesic usage. Pain radiation was reported in> 50% of cases. There was an incidental finding of urinary incontinence in 36 (12.6%) cases. Low back/pelvic girdle pain was not associated with body mass index (BMI) (P = 0.390). The incidence of LBPs and pelvic girdle pains was high and found to be 34.3% and 57.6%, respectively. Analgesics were used especially among those with severe pains. There was an incidental finding of urinary incontinence among pregnant women with complaints of low back/pelvic girdle pains. There was no statistically significant association between LBPs and maternal BMI.

  13. Level and intensity of objectively assessed physical activity among pregnant women from urban Ethiopia

    Directory of Open Access Journals (Sweden)

    Hjorth Mads F

    2012-12-01

    Full Text Available Abstract Background Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physical activity performed. In this study we report objectively assessed levels of physical activity, cardiorespiratory fitness and muscular fitness among pregnant urban Ethiopian women, and their association with demographic characteristics and anthropometric measures. Methods Physical activity was measured for seven consecutive days in 304 women using a combined uniaxial accelerometer and heart rate sensor. Activity energy expenditure was determined using a group calibration in a branched equation model framework. Type and duration of activities were reported using a 24-hour physical activity recall and grip strength was assessed using a dynamometer. Results Median (interquartile-range, IQR activity energy expenditure was 31.1 (23.7-42.0 kJ/kg/day corresponding to a median (IQR physical activity level of 1.46 (1.39-1.58. Median (IQR time in sedentary, light, and moderate-to-vigorous intensity was 1100 (999–1175, 303 (223–374 and 40 (22–69 min/day, respectively. Mean (standard deviation sleeping heart rate was 73.6 (8.0 beats/min and grip strength was 21.6 (4.5 kg. Activity energy expenditure was 14% higher for every 10 cm2 difference in arm muscle area and 10% lower for every 10 cm2 difference in arm fat area and 10-week difference in gestational age. Conclusion The level and intensity of physical activity among pregnant women from urban Ethiopia is low compared to non-pregnant women from other low income countries as well as pregnant European women from high-income countries.

  14. Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study.

    Science.gov (United States)

    Abrahams, Zulfa; Lund, Crick; Field, Sally; Honikman, Simone

    2018-04-01

    Food insecurity has been linked with maternal depression in low-income settings. Few studies have looked at factors associated with both food insecurity and maternal depression as outcomes. This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women. We conducted a cross-sectional study at a Midwife Obstetric Unit in a low-income suburb in Cape Town. Pregnant women attending the clinic for their first antenatal visit were invited to participate. The shortened form of the US Household Food Security Survey Module was used to measure food insecurity. The Expanded Mini-International Neuropsychiatric Interview was used to diagnose depression, anxiety, alcohol and drug dependence, and assess for suicidal ideation and behaviour. Logistic regression modelling was conducted to explore factors associated with food insecurity and depression in separate models. We found that 42% of households were food insecure and that 21% of participants were depressed (N = 376). The odds of being food insecure were increased in women with suicidal behaviour (OR = 5.34; 95% CI 1.26-22.57), with depression (4.27; 1.43-12.70) and in those with three or more children (3.79; 1.25-11.55). The odds of depression was greater in women who were food insecure (5.30; 1.63-17.30), substance dependent (15.83; 1.31-191.48) or diagnosed with an anxiety disorder (5.04; 1.71-14.82). Food insecurity and depression are strongly associated in pregnant women. The relationship between food insecurity and depression is complex and requires further investigation. Interventions that improve both food security and mental health during the perinatal period are likely to benefit the physical and mental well-being of mothers and children.

  15. Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries.

    Science.gov (United States)

    Conklin, Annalijn I; Ponce, Ninez A; Frank, John; Nandi, Arijit; Heymann, Jody

    2016-01-01

    To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development. A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y) from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference. We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084]), and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]). The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042]) and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027]). This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

  16. Low-Income Community Solar: Utility Return Considerations for Electric Cooperatives

    Energy Technology Data Exchange (ETDEWEB)

    Aznar, Alexandra Y [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gagne, Douglas A [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-05

    The objective of this short report is to identify project structures that make low-income community solar projects more cost-effective, replicable, and scalable, for electric cooperative and municipal utilities. This report explores the tradeoffs between providing energy bill savings for low-income subscribers and utility project returns, as well as some of the key lessons learned from existing successful low-income community solar pilot projects.

  17. 24 CFR 1000.142 - What is the “useful life” during which low-income rental housing and low-income homebuyer housing...

    Science.gov (United States)

    2010-04-01

    ... Activities § 1000.142 What is the “useful life” during which low-income rental housing and low-income... recipient shall describe in its IHP its determination of the useful life of each assisted housing unit in... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is the âuseful lifeâ during...

  18. Pregnant Women Diet Quality and Its Sociodemographic Determinants in Southwestern Bangladesh.

    Science.gov (United States)

    Shamim, Abu Ahmed; Mashreky, Saidur Rahman; Ferdous, Tarana; Tegenfeldt, Kathrin; Roy, Sumitro; Rahman, A K M Fazlur; Rashid, Iftekhar; Haque, Raisul; Rahman, Zakia; Hossen, Kabir; Siddiquee, Saydur Rahman; Rahman, Mosiqure; Sanghvi, Tina G; Shaheen, Nazma

    2016-03-01

    Diet diversity of pregnant women is associated with nutrition sufficiency, micronutrient adequacy, and pregnancy outcomes. However, the sociodemographic determinants of diet diversity among pregnant women in low-income countries are not well studied. The analysis was undertaken to study the determinants of high dietary diversity and consumption of micronutrient-rich foods by pregnant women from rural Bangladesh. Pregnant women (508) were randomly selected from southwestern Bangladesh and interviewed to collect data about diet and sociodemographic characteristics. A 24-hour recall was used to collect information about diet. Diet diversity score was calculated for 9 major food groups. All analyses were conducted using STATA SE 12. The overall mean diet diversity score was low at 4.28 and was significantly high among pregnant women who have higher educational achievement, whose husbands' occupation was business, who live in households of 4 or more family members, and who were dwelling in a house with more than 1 room. Highest gap on knowledge and consumption was reported for 3 food groups including dairy foods, eggs, and dark green leafy vegetables. Consumption of dairy and eggs was lower among women from low socioeconomic status, but no significant association was found between sociodemographic characteristics and consumption of leafy vegetables. Our analysis has shown that diet quality of pregnant women was poor and intake of micronutrient-rich foods was low despite having knowledge about the importance of these foods, underscoring the need for promoting the diet quality in developing countries through behavior change communication programs. © The Author(s) 2016.

  19. A three year retrospective study on seroprevalence of syphilis among pregnant women at Gondar University Teaching Hospital, Ethiopia.

    Science.gov (United States)

    Assefa, Abate

    2014-03-01

    Sexually transmitted infections (STIs) are a serious public health problem in low income countries, including Ethiopia. Syphilis caused by Treponema pallidum remains a major cause of reproductive morbidity and poor pregnancy outcomes in low income countries. Stillbirth, perinatal death, serious neonatal infection and low-birth weight babies are common among seropositive mothers. To assess the seroprevalence of syphilis and risk factor correlates of this infection at Gondar University Teaching Hospital, Ethiopia. The study was done on 2385 pregnant women attending the antenatal care clinic (ANC) from January 2009 to December 2011. Data was abstracted from the antenatal care clinic medical database. Chi-square test was used, using SPSS version 16 and significance level was chosen at 0.05 level with a two-tailed test. Of the total, 69(2. 9%) of pregnant women were confirmed as seropositive for syphilis. Pregnant women with an age group of 21-25 years of old were the most seropositive (3.4%), followed by 26-30 years of old (3.1%). The prevalence of syphilis infection was 3.2% in urban and 2.2% in rural pregnant women. Relatively high prevalence of syphilis infection were identified among students (4.2%) followed by governmental employees (3.8%). The seroprevalence of syphilis among pregnant women attending ANC is declining. However, syphilis is more prevalent in the young and urban pregnant women. Emphasis on education to young people on STI risk behavioral change and partner follow up and notification for exposure to syphilis and treatment should be given.

  20. Pregnant adolescent women's perceptions of depression and psychiatric services in the United States.

    Science.gov (United States)

    Bledsoe, Sarah E; Rizo, Cynthia F; Wike, Traci L; Killian-Farrell, Candace; Wessel, Julia; Bellows, Anne-Marie O; Doernberg, Alison

    2017-10-01

    Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes. However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women. This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression. We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews. Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma. Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support. Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women's perceptions of depression and services. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. Effectiveness of motivational interviewing in influencing smoking cessation in pregnant and postpartum disadvantaged women.

    LENUS (Irish Health Repository)

    Hayes, Catherine B

    2013-05-01

    Systematic assessments of Motivational Interviewing (MI) in smoking behavior have been rare to date. This study aimed to determine whether an integrated approach, involving staff training in MI techniques, was sufficient to affect change in smoking status or intensity in low-income pregnant and postpartum women.

  2. Improving Strategies for Low-Income Family Children's Information Literacy

    Science.gov (United States)

    Zhang, Haiyan; Washington, Rodney; Yin, Jianjun

    2014-01-01

    This article discussed the significance of improving low-income family children's information literacy, which could improve educational quality, enhance children's self-esteem, adapt children to the future competitive world market, as well as the problems in improving low-income family children's information literacy, such as no home computer and…

  3. Does a low-income urban population practise healthy dietary habits?

    Science.gov (United States)

    Azizan, Nurul Ain; Thangiah, Nithiah; Su, Tin Tin; Majid, Hazreen Abdul

    2018-03-01

    The purpose of this study was to identify the unhealthy dietary habits and practices in a low-income community in an urban area and determine the associated factors. A cross-sectional survey was conducted in a low-income housing area in Kuala Lumpur, Malaysia. Data were collected using a questionnaire via face-to-face interviews by trained enumerators in order to obtain details on sociodemographic characteristics and dietary practices. Descriptive statistics showed that 86.7% of the respondents in the low-income community consumed fruit and vegetables less than five times per day, 11.7% consumed carbonated and sweetened drinks more than twice per day and about 25% consumed fast food more than four times per month. In total, 65.2% (n=945) did not have healthy dietary practices. Binary logistic regression showed that age, education and ethnicity were significant predictors of unhealthy dietary practices among the low-income community. Those in the 30-59 years age group had higher odds (odds ratio 1.65, p=0.04) of practising an unhealthy diet as compared with those older than 60 years of age. Unhealthy dietary practices were found to be common among the low-income group living in an urban area. Healthy lifestyle intervention should be highlighted so that it can be adopted in the low-income group.

  4. Association of spiritual/religious coping with depressive symptoms in high- and low-risk pregnant women.

    Science.gov (United States)

    Vitorino, Luciano M; Chiaradia, Raíssa; Low, Gail; Cruz, Jonas Preposi; Pargament, Kenneth I; Lucchetti, Alessandra L G; Lucchetti, Giancarlo

    2018-02-01

    To investigate the role of spiritual/religious coping (SRC) on depressive symptoms in high- and low-risk pregnant women. Spiritual/religious coping is associated with physical and mental health outcomes. However, only few studies investigated the role of these strategies during pregnancy and whether low- and high-risk pregnant women have different coping mechanisms. This study is a cross-sectional comparative study. This study included a total of 160 pregnant women, 80 with low-risk pregnancy and 80 with high-risk pregnancy. The Beck Depression Inventory, the brief SRC scale and a structured questionnaire on sociodemographic and obstetric aspects were used. General linear model regression analysis was used to identify the factors associated with positive and negative SRC strategies in both groups of pregnant women. Positive SRC use was high, whereas negative SRC use was low in both groups. Although we found no difference in SRC strategies between the two groups, negative SRC was associated with depression in women with high-risk pregnancy, but not in those with low-risk pregnancy. Furthermore, positive SRC was not associated with depressive symptoms in both groups. Results showed that only the negative SRC strategies of Brazilian women with high-risk pregnancies were associated with worsened mental health outcomes. Healthcare professionals, obstetricians and nurse midwives should focus on the use of negative SRC strategies in their pregnant patients. © 2017 John Wiley & Sons Ltd.

  5. Poject Managment Approach to Public Low Income Housing. | Ogbu ...

    African Journals Online (AJOL)

    This research assesses the impacts of project management (PM) variables on the socio-economic formation of public low-income housing (LIH) users in Abia and ... socio-economic impact of public low income housing (LIH) and the PM variables: project scope control (PS), project planning (PPC), project cost control (PC), ...

  6. Low Income Consumer Utility Issues: A National Perspective; TOPICAL

    International Nuclear Information System (INIS)

    Eisenberg, J

    2001-01-01

    This report provides a survey of assistance programs that public utility commissions have approved in most states to assist the low-income customers of utilities within their states. Surveys find that there is no single model of low-income assistance; rather, each state has adopted a program that meets its particular circumstances. However, while the details of programs vary considerably, they all fall within four broad categories: (1) Affordability programs, which provide direct assistance in paying energy bills; (2) Consumer protections, such as collection practices and installment billing requirements, which make it easier to pay energy bills on time; (3) Education programs, which teach consumers about prudent energy use and counsel them about budgeting; and (4) Efficiency and weatherization programs, which make investments to help consumers control their energy bills by reducing their need for energy. Programs usually include more than one of these components. All programs also include outreach and evaluation components. This report describes these options, the advantages and disadvantages of each, and the economic and other benefits of utility assistance programs for low-income customers. Low-income programs help participants by lowering the fraction of their incomes devoted to energy bills (the energy burden) from a very high level. In the United States, the median household devotes only 3.8 percent of its income to electricity while a family depending on a minimum-wage earner must devote 12.1 percent to energy while facing housing cost increases all over the nation. Low-income families unable to keep up with these pressures find themselves forced to go without power at times, to move, or to forgo other necessities such as food or medicine in order to pay their electricity bills

  7. National income inequality and ineffective health insurance in 35 low- and middle-income countries.

    Science.gov (United States)

    Alvarez, Francisco N; El-Sayed, Abdulrahman M

    2017-05-01

    Global health policy efforts to improve health and reduce financial burden of disease in low- and middle-income countries (LMIC) has fuelled interest in expanding access to health insurance coverage to all, a movement known as Universal Health Coverage (UHC). Ineffective insurance is a measure of failure to achieve the intended outcomes of health insurance among those who nominally have insurance. This study aimed to evaluate the relation between national-level income inequality and the prevalence of ineffective insurance. We used Standardized World Income Inequality Database (SWIID) Gini coefficients for 35 LMICs and World Health Survey (WHS) data about insurance from 2002 to 2004 to fit multivariable regression models of the prevalence of ineffective insurance on national Gini coefficients, adjusting for GDP per capita. Greater inequality predicted higher prevalence of ineffective insurance. When stratifying by individual-level covariates, higher inequality was associated with greater ineffective insurance among sub-groups traditionally considered more privileged: youth, men, higher education, urban residence and the wealthiest quintile. Stratifying by World Bank country income classification, higher inequality was associated with ineffective insurance among upper-middle income countries but not low- or lower-middle income countries. We hypothesize that these associations may be due to the imprint of underlying social inequalities as countries approach decreasing marginal returns on improved health insurance by income. Our findings suggest that beyond national income, income inequality may predict differences in the quality of insurance, with implications for efforts to achieve UHC. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries.

    Directory of Open Access Journals (Sweden)

    Annalijn I Conklin

    Full Text Available To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development.A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference.We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084], and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]. The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042] and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027].This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

  9. Cancer Outcomes in Low-Income Elders

    Data.gov (United States)

    U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...

  10. A qualitative study of motivators and barriers to healthy eating in pregnancy for low-income, overweight, African-American mothers.

    Science.gov (United States)

    Reyes, Naomi R; Klotz, Alicia A; Herring, Sharon J

    2013-09-01

    Poor diet quality is common among low-income, overweight, African-American mothers, placing them at high risk for adverse pregnancy outcomes. We sought to better understand the contextual factors that may influence low-income African-American mothers' diet quality during pregnancy. In 2011, we conducted semi-structured interviews with 21 overweight/obese, pregnant African Americans in Philadelphia, PA, all of whom received Medicaid and were eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children. Two readers independently coded the interview transcripts to identify recurrent themes. We identified 10 themes around motivators and barriers to healthy eating in pregnancy. Mothers believed that consuming healthy foods, like fruits and vegetables, would lead to healthy babies and limit the physical discomforts of pregnancy. However, more often than not, mothers chose foods that were high in fats and sugars because of taste, cost, and convenience. In addition, mothers had several misconceptions about the definition of healthy (eg, "juice is good for baby"), which led to overconsumption. Many mothers feared they might "starve" their babies if they did not get enough to eat, promoting persistent snacking and larger portions. Living in multigenerational households and sharing resources also limited the mothers' control over food choices and made consuming healthy foods especially difficult. Despite the good intentions of low-income African-American mothers to improve diet quality during pregnancy, multiple factors worked together as barriers to healthy eating. Interventions that emphasize tasty and affordable healthy food substitutes, address misconceptions, and counsel mothers about true energy needs in pregnancy may improve low-income, African-American, overweight/obese mothers' diet quality. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. Surviving spinal cord injury in low income countries

    Directory of Open Access Journals (Sweden)

    Tone Øderud

    2014-08-01

    Objectives: The aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual and the situation of persons living with SCI in low income settings. Method: Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals. Results: There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges. Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

  12. Influenza vaccines in low and middle income countries

    Science.gov (United States)

    Ott, Jördis J.; Klein Breteler, Janna; Tam, John S.; Hutubessy, Raymond C.W.; Jit, Mark; de Boer, Michiel R.

    2013-01-01

    Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. Methods: PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Results: Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and cost-saving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Conclusion: Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner. PMID:23732900

  13. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

    Science.gov (United States)

    Gelaye, Bizu; Rondon, Marta B; Araya, Ricardo; Williams, Michelle A

    2016-10-01

    Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Patients' Characteristics and Providers' Attitudes: Predictors of Screening Pregnant Women for Illicit Substance Use

    Science.gov (United States)

    Kerker, Bonnie D.; Horwitz, Sarah M.; Leventhal, John M.

    2004-01-01

    Objective: This study's aim was to determine how patients' and providers' characteristics affect hospital providers' decisions to screen pregnant and postpartum women for illicit substances. Methods: A retrospective design was used. Participants included all low-income women (N=1,100) who delivered at an urban teaching hospital over a 12-month…

  15. The Effects of Low Income Housing Tax Credit Developments on Neighborhoods.

    Science.gov (United States)

    Baum-Snow, Nathaniel; Marion, Justin

    2009-06-01

    This paper evaluates the impacts of new housing developments funded with the Low Income Housing Tax Credit (LIHTC), the largest federal project based housing program in the U.S., on the neighborhoods in which they are built. A discontinuity in the formula determining the magnitude of tax credits as a function of neighborhood characteristics generates pseudo-random assignment in the number of low income housing units built in similar sets of census tracts. Tracts where projects are awarded 30 percent higher tax credits receive approximately six more low income housing units on a base of seven units per tract. These additional new low income developments cause homeowner turnover to rise, raise property values in declining areas and reduce incomes in gentrifying areas in neighborhoods near the 30th percentile of the income distribution. LIHTC units significantly crowd out nearby new rental construction in gentrifying areas but do not displace new construction in stable or declining areas.

  16. Cigarette Design Features in Low-, Middle-, and High-Income Countries

    Directory of Open Access Journals (Sweden)

    Rosalie V. Caruso

    2012-01-01

    Full Text Available Previous studies have shown that country income grouping is correlated with cigarette engineering. Cigarettes (=111 brands were purchased during 2008–2010 from 11 low-, middle-, and high-income countries to assess physical dimensions and an array of cigarette design features. Mean ventilation varied significantly across low- (7.5%, middle- (15.3%, and high-income (26.2% countries (≤0.001. Differences across income groups were also seen in cigarette length (=0.001, length of the tipping paper (=0.01, filter weight (=0.017, number of vent rows (=0.003, per-cigarette tobacco weight (=0.04, and paper porosity (=0.008. Stepwise linear regression showed ventilation and tobacco length as major predictors of ISO tar yields in low-income countries (=0.909, 0.047, while tipping paper (<0.001, filter length (<0.001, number of vent rows (=0.014, and per-cigarette weight (=0.015 were predictors of tar yields in middle-income countries. Ventilation (<0.001, number of vent rows (=0.009, per-cigarette weight (<0.001, and filter diameter (=0.004 predicted tar yields in high-income countries. Health officials must be cognizant of cigarette design issues to provide effective regulation of tobacco products.

  17. Is ACOG guideline helpful for encouraging pregnant women to do exercise during pregnancy?

    Science.gov (United States)

    Davari Tanha, Fatemeh; Ghajarzadeh, Mahsa; Mohseni, Mona; Shariat, Mamak; Ranjbar, Maryam

    2014-01-01

    To evaluate physical activity of pregnant women before and after ACOG guideline study. Four hundred and eighty-five pregnant women enrolled in this before-after study. They were asked to study ACOG guideline. A structured questionnaire filled by women at first visit and the last visit in the prenatal clinic.Type, frequency, duration and anxiety about doing exercises during pregnancy period. Before education, 411 did exercises before pregnancy onset, among them, 346 were walking out and 65 did light exercises such as aerobics. After studying the protocol, 434 (89.4%) did walking during pregnancy period in comparison to 71% who did walking before pregnancy (Psport before, went for walking after the protocol reading, and nine continued not doing exercise. Among 74 participants who had not done exercise before the protocol reading, 16 (21%) were doing exercise three times a week and 11 (14%) changed their habit to daily exercise practice (Ppregnancy before guideline study, while 116 reported that after the protocol reading, they had no anxiety about doing exercises during pregnancy (Ppregnancy will help pregnant women to do exercise during pregnancy with convenience and less anxiety.

  18. Food Group Categories of Low-Income African American Women

    Science.gov (United States)

    Lynch, Elizabeth B.; Holmes, Shane

    2011-01-01

    Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups. Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups. Setting:…

  19. Developmental Trends in Self-Regulation among Low-Income Toddlers

    Science.gov (United States)

    Raikes, H. Abigail; Robinson, JoAnn L.; Bradley, Robert H.; Raikes, Helen H.; Ayoub, Catherine C.

    2007-01-01

    The attainment of self-regulatory skills during the toddler years is an understudied issue, especially among low-income children. The present study used growth modeling to examine the change over time and the final status in children's abilities to self-regulate, in a sample of 2,441 low-income children aged 14 to 36 months. Positive growth in…

  20. Nation's Capital to cover low-income women's abortions.

    Science.gov (United States)

    1994-04-15

    Sharon Pratt Kelly, the mayor of the District of Columbia, has announced that, effective May 1, 1994, the city will use its Medical Charities Fund to pay for "medically appropriate" abortions for women with annual incomes of US$13,200 who do not have health insurance that covers abortions. This income level represents 185% of the federal poverty level for single women. The determination as to whether an abortion is "appropriate" will be made by the woman's physician. From 1989-93, there was a ban on the use of District of Columbia tax monies to cover abortions for local women. In 1988, however, approximately 4000 District women received funding for their abortions. The US$1 million Medical Charities Fund was originally set up to cover emergency room bills for low-income District residents who did not qualify for Medicaid. $650,000 is expected to be added to the fund; in addition, the District's 1995 budget will allocate funding earmarked for abortion coverage for low-income women.

  1. How many low birthweight babies in low- and middle-income countries are preterm?

    Directory of Open Access Journals (Sweden)

    Fernando C Barros

    2011-06-01

    Full Text Available OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.

  2. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

    Science.gov (United States)

    Montagu, Dominic; Goodman, Catherine

    2016-08-06

    The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Electronic Payment Adoption in the Banking Sector of Low-Income Countries

    OpenAIRE

    Teshome Alemu; Tridib Bandyopadhyay; Solomon Negash

    2015-01-01

    Banks in low-income countries are launching e-banking services such as Internet banking, SMS banking, ATM banking, card banking, point of sales (PoS) and mobile banking. Among these planned services, ATM is the most matured service in many private and state owned banks in Ethiopia. ATM is a recent phenomenon in low-income countries (; ), and is still being introduced in financial sectors in low-income countries (Angeli, 2008; ) making investigation of factors of ICT technology adoption in low...

  4. Community-based distribution of iron-folic acid supplementation in low- and middle-income countries: a review of evidence and programme implications.

    Science.gov (United States)

    Kavle, Justine A; Landry, Megan

    2018-02-01

    The present literature review aimed to review the evidence for community-based distribution (CBD) of iron-folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries. The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases. Low- and middle-income countries. Non-pregnant women, pregnant women, and girls. CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to present late to antenatal care. CBD channels had greater consistency in terms of adequate supplies of IFA in comparison to clinics and vendors, who faced stock outages. Targeting women of reproductive age through school and community settings showed high compliance and demonstrated reductions in anaemia. CBD of IFA supplementation can be a valuable platform for improving knowledge about anaemia, addressing compliance and temporary side-effects of IFA supplements, and increasing access and coverage of IFA supplementation. Programmatic efforts focusing on community-based platforms should complement services and information provided at the health facility level. Provision of training and supportive supervision for CHW on how to counsel women on benefits, side-effects, and when, why, and how to take IFA supplements, as part of behaviour change communication, can be strengthened, alongside logistics and supply systems to ensure consistent supplies of IFA tablets at both the facility and community levels.

  5. 13 CFR 108.710 - Requirement to finance Low-Income Enterprises.

    Science.gov (United States)

    2010-01-01

    ... VENTURE CAPITAL (âNMVCâ) PROGRAM Financing of Small Businesses by NMVC Companies Determining the... of your Portfolio Concerns must be Low-Income Enterprises in which you have an Equity Capital... total dollars) in Equity Capital Investments in Low-Income Enterprises. (b) Non-compliance with this...

  6. Childhood asthma in low income countries

    DEFF Research Database (Denmark)

    Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K

    2012-01-01

    Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... of pneumonia and asthma/wheezing/bronchiolitis and examines whether asthma in under-5s may be confused with pneumonia. Over-diagnosing of bacterial pneumonia can be suspected from the limited association between clinical pneumonia and confirmatory test results such as chest x-ray and microbiological findings...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...

  7. Vaginal flora alterations and clinical symptoms in low-risk pregnant women.

    Science.gov (United States)

    Gondo, Fausto; da Silva, Márcia G; Polettini, Jossimara; Tristao, Andréa da R; Peracoli, José C; Witkin, Steven S; Rudge, Marilza V C

    2011-01-01

    To evaluate associations between alterations in vaginal flora and clinical symptoms in low-risk pregnant women. Vaginal specimens from 245 pregnant women were analyzed by microscopy for vaginal flora. Signs and symptoms of vaginal infection were determined by patient interviews and gynecologic examinations. Abnormal vaginal flora was identified in 45.7% of the subjects. The final clinical diagnoses were bacterial vaginosis (21.6%), vaginal candidosis (10.2%), intermediate vaginal flora (5.2%), aerobic vaginitis (2.9%), mixed flora (2.9%) and other abnormal findings (2.9%). The percentage of women with or without clinical signs or symptoms was not significantly different between these categories. The presence of vaginal odor or vaginal discharge characteristics was not diagnostic of any specific flora alteration; pruritus was highly associated with candidosis (p vaginal odor was associated with bacterial vaginosis (p = 0.0026). The prevalence of atypical vaginal flora is common in our low-risk pregnant population and is not always associated with pathology. The occurrence of specific signs or symptoms does not always discriminate between women with different types of atypical vaginal flora or between those with abnormal and normal vaginal flora. Copyright © 2010 S. Karger AG, Basel.

  8. Foreign Direct Investment Behaviour in Low and Middle Income ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Does FDI actually stimulate growth and development in low-income ... Does FDI help reduce poverty and inequality and if so, under what circumstances? ... countries that share key features such as income level or economic structure.

  9. Social Policy Trends- Housing Affordability for Families with Low Incomes Across Canada

    Directory of Open Access Journals (Sweden)

    Margarita (Gres Wilkins

    2017-06-01

    Full Text Available HOUSING AFFORDABILITY FOR FAMILIES WITH LOW INCOMES ACROSS CANADA Percentage of income devoted to paying lowest-priced rent in a city, by low-income family type, select years, 1990-2015 Much public attention has been directed towards the issue of a Canada-wide housing crisis. The focus has typically been on the cost of housing for an average income Canadian family. Less attention has been paid to families with incomes much lower than those of the average Canadian household, for which the housing crisis is far more severe. Households and individuals with particularly low incomes are at the highest risk of experiencing the worst effects of a lack of housing affordability, including homelessness.

  10. Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations

    Science.gov (United States)

    ... Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations Share: © Photodisc ... in minority and low-income populations with chronic low-back pain. Researchers from Boston University School of Medicine, Boston ...

  11. 75 FR 8392 - Low Income Housing Tax Credit Tenant Database

    Science.gov (United States)

    2010-02-24

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-11] Low Income Housing Tax Credit Tenant Database AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice. SUMMARY: The... Lists the Following Information Title Of Proposal: Low Income Housing Tax Credit Tenant Database. Omb...

  12. Exploring Attitudes, Perceived Norms, and Personal Agency: Insights Into Theory-Based Messages to Encourage Park-Based Physical Activity in Low-Income Urban Neighborhoods.

    Science.gov (United States)

    Groshong, Lisa; Stanis, Sonja A Wilhelm; Kaczynski, Andrew T; Hipp, J Aaron; Besenyi, Gina M

    2017-02-01

    Public parks hold promise for promoting population-level PA, but studies show a significant portion of park use is sedentary. Past research has documented the effectiveness of message-based strategies for influencing diverse behaviors in park settings and for increasing PA in nonpark contexts. Therefore, to inform message-based interventions (eg, point-ofdecision prompts) to increase park-based PA, the purpose of this study was to elicit insights about key attitudes, perceived norms, and personal agency that affect park use and park-based PA in low-income urban neighborhoods. This study used 6 focus groups with youth and adults (n = 41) from low-income urban areas in Kansas City, MO, to examine perceptions of key attitudinal outcomes and motivations, perceived norms, key referents, and personal agency facilitators and constraints that affect park use and park-based PA. Participant attitudes reflected the importance of parks for mental and physical health, with social interaction and solitude cited as key motivations. Of 10 themes regarding perceived norms, influential others reflected participants' ethnic makeup but little consensus emerged among groups. Social and safety themes were cited as both facilitators and constraints, along with park offerings and setting. Information about attitudes, perceived norms, and personal agency can increase understanding of theoretically derived factors that influence park-based PA and help park and health professionals create communication strategies to promote PA.

  13. Researching Entrepreneurship in Low-income Settlements

    DEFF Research Database (Denmark)

    Gough, Katherine V.; Langevang, Thilde; Namatovu, Rebecca

    2014-01-01

    of entrepreneurship conducted in a low-income settlement, which combined participatory quantitative and qualitative approaches, highlighting the strengths and challenges of using participatory methods. The paper demonstrates how drawing on a range of participatory methods can contribute to creating more engaging...

  14. Acquired heart disease in low-income and middle-income countries.

    Science.gov (United States)

    Curry, Chris; Zuhlke, Liesl; Mocumbi, Ana; Kennedy, Neil

    2018-01-01

    The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. A Portrait of Low-Income Migrants in Contemporary Qatar

    OpenAIRE

    GARDNER, ANDREW; GARDNER, ANDREW; PESSOA, SILVIA; DIOP, ABDOULAYE; AL-GHANIM, KALTHAM; LE TRUNG, KIEN; HARKNESS, LAURA

    2013-01-01

    Though transnational labor migration in the Gulf States has increasingly been of scholarly interest, that scholarship has to date relied largely on qualitative ethnographic methodologies or small non-representative sampling strategies. This paper presents the findings of a large representative sample of low-income migrant laborers in Qatar. The data describe the basic characteristics of the low-income migrant population in Qatar, the process by which migrants obtain employment, the frequency ...

  16. Low-income minority and homeless mothers' perceptions of their 9-13 year-old children's weight status, diet, and health.

    Science.gov (United States)

    Dammann, Kristen Wiig; Smith, Chery; Richards, Rickelle

    2011-01-01

    The purpose of this study was to examine low-income mothers' perceptions of their children's height and weight in relation to actual measures, and perceptions of dietary quality and health status. Demographic, anthropometric, and dietary quality/health status data were collected during a multi-phase nutrition research project with low-income Minnesotans, and a sub-set of non-pregnant mother-child dyads (mothers ages ≥ 18 years, children ages 9-13 years) were analyzed (n = 257). Participants were Caucasian, African American, American Indian, Hispanic, Asian, or Other/mixed race, and most were homeless. Relationships between maternal perceptions of their child's height and weight and the actual measures, and maternal perceptions of dietary quality and health status for the dyad, were examined using independent and paired samples t-tests, ANOVA, and paired samples correlations. Comparisons were also made by maternal and child body mass index (BMI) status and living situation. Mothers significantly underestimated their child's height and weight (-4.8 ± 13.9 cm, P = 0.000; -5.3 ± 8.5 kg, P = 0.000); greatest misperceptions of weight were among mothers of overweight/obese children (P = 0.000). Mothers not reporting estimates of their child's height and weight (n = 53) had higher BMIs (P = 0.029), and their children were younger (P = 0.000) and lighter (P = 0.021) compared to mothers who provided estimates. Inability to objectify children's weight status may contribute to the obesity epidemic affecting low-income minority populations. Underestimation of weight status may be influenced by cultural perceptions of body image and socioeconomic status.

  17. Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

    OpenAIRE

    Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

    2014-01-01

    : More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

  18. Pilot evaluation of HEAL – A natural experiment to promote obesity prevention behaviors among low-income pregnant women

    Directory of Open Access Journals (Sweden)

    Shreela V. Sharma

    2018-06-01

    Full Text Available Instituting interventions during the prenatal period is optimal for early obesity prevention in the child. Healthy Eating Active Living (HEAL is a six-week, multi-component program to promote breastfeeding, healthy dietary habits, cooking skills and physical activity among Medicaid-eligible pregnant-women in Texas. HEAL is integrated into the healthcare system and offered as a standard-of-care for eligible patients. Methods: Preliminary evaluation of this natural experiment conducted from March 2015 through October 2016 informs the initial feasibility, acceptability and effects of the program on participant diet, home nutrition environment, physical activity, and breastfeeding self-efficacy and intentions measured using self-report surveys. Analysis of covariance (ANCOVA was conducted to evaluate pre- and post-intervention changes, controlling for participants' ethnicity, age, and income level. Interaction effects of session attendance on the outcomes were further assessed. Results: Of the 329 women who enrolled in HEAL, 210 women completed the pre-post assessment (64% retention rate. Pre-to-post intervention, there were significant increases in availability and intake of fruits and vegetables, self-efficacy towards consuming more fruits and vegetables, and cooking frequency and skills (p < 0.05, and decreased frequency of eating heat and serve foods (p < 0.05. Significant improvements in physical activity, duration of breastfeeding, perceived benefits and intentions to breastfeed were also observed (p < 0.05. Higher attendance of HEAL sessions was associated with better outcomes. Process evaluation demonstrated 95% fidelity of program implementation. Conclusion: HEAL operationalizes clinic-community linkages and shows promise in improving behaviors during pregnancy. Future research warrants the use of a stringent study design with a control group to determine program efficacy. Keywords: Pregnancy, Obesity prevention, Nutrition

  19. Top-Down, Routinized Reform in Low-Income, Rural Schools

    Directory of Open Access Journals (Sweden)

    Robert Bickel

    2000-02-01

    Full Text Available Since 1991, the National Science Foundation has funded fifty-nine state, urban, and rural systemic initiatives. The purpose of the initiatives is to promote achievement in math, science, and technology among all students, and to encourage schools and communities to secure the resources needed to maintain such outcomes. The Appalachian Rural Systemic Initiative (ARSI is a six-state consortium which focuses these efforts on low-income, rural schools. The primary means of accomplishing ARSI's aims is a one-day-one-school site visit, called a Program Improvement Review, done by an ARSI math or science expert. The centrally important Program Improvement Reviews, however, seem to be premised on unsubstantiated assumptions as to the static, easy-to-understand, easy-to-evaluate nature of educational achievement in rural Appalachian schools. As a result, the Reviews resemble exercises in early-twentieth century scientific management, and are unlikely to enhance achievement in science or math. Consequently, even if there is merit to the commonsense human capital approach to economic growth and development on which systemic initiatives are tacitly premised, this first- person account makes a case that desired payoffs are unlikely to follow from the work of ARSI.

  20. Ambulatory Blood Pressure Monitoring: A Complementary Strategy for Hypertension Diagnosis and Management in Low-Income and Middle-Income Countries.

    Science.gov (United States)

    Abdalla, Marwah

    2017-02-01

    Ambulatory blood pressure monitoring (ABPM) can assess out-of-clinic blood pressure. ABPM is an underutilized resource in low-income and middle-income countries but should be considered a complementary strategy to clinic blood pressure measurement for the diagnosis and management of hypertension. Potential uses for ABPM in low-income and middle-income countries include screening of high-risk individuals who have concurrent communicable diseases, such as HIV, and in task-shifting health care strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Is ACOG guideline helpful for encouraging pregnant women to do exercise during pregnancy?

    Directory of Open Access Journals (Sweden)

    Fatemeh Davari Tanha

    2014-06-01

    Full Text Available To evaluate physical activity of pregnant women before and after ACOG guideline study. Four hundred and eighty-five pregnant women enrolled in this before-after study. They were asked to study ACOG guideline. A structured questionnaire filled by women at first visit and the last visit in the prenatal clinic.Type, frequency, duration and anxiety about doing exercises during pregnancy period. Before education, 411 did exercises before pregnancy onset, among them, 346 were walking out and 65 did light exercises such as aerobics. After studying the protocol, 434 (89.4% did walking during pregnancy period in comparison to 71% who did walking before pregnancy (P<0.001. Forty two (56.7% out of 74 who had not done sport before, went for walking after the protocol reading, and nine continued not doing exercise. Among 74 participants who had not done exercise before the protocol reading, 16 (21% were doing exercise three times a week and 11 (14% changed their habit to daily exercise practice (P<0.001. Forty percent (195 women were anxious about doing exercise during pregnancy before guideline study, while 116 reported that after the protocol reading, they had no anxiety about doing exercises during pregnancy (P<0.001. Guidelines providing information about physical activity during pregnancy will help pregnant women to do exercise during pregnancy with convenience and less anxiety.

  2. Successful schools and risky behaviors among low-income adolescents.

    Science.gov (United States)

    Wong, Mitchell D; Coller, Karen M; Dudovitz, Rebecca N; Kennedy, David P; Buddin, Richard; Shapiro, Martin F; Kataoka, Sheryl H; Brown, Arleen F; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J

    2014-08-01

    We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. Copyright © 2014 by the American Academy of Pediatrics.

  3. achieving improved financing for low-income producers

    African Journals Online (AJOL)

    KEY WORDS: Approaches, Improved Access, Finance, Low-income, Producers. INTRODUCTION .... either by setting up a dual-purpose financial institution, or by making ..... management information systems (Braverman and. Huppi, 1991).

  4. Pregnant womens' concerns when invited to a randomized trial: a qualitative case control study

    NARCIS (Netherlands)

    Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M.; Mol, Ben Willem

    2015-01-01

    Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific enrolment

  5. Pregnant womens' concerns when invited to a randomized trial : a qualitative case control study

    NARCIS (Netherlands)

    Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M; Mol, Ben Willem; Oude Rengerink, K

    2015-01-01

    BACKGROUND: Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific

  6. Low Income Consumer Utility Issues: A National Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Eisenberg, J

    2001-03-26

    This report has been prepared to provide low-income advocates and other stakeholders information on the energy burden faced by low-income customers and programs designed to alleviate that burden in various states. The report describes programs designed to lower payments, manage arrearages, weatherize and provide other energy efficiency measures, educate consumers, increase outreach to the target It discusses the costs and benefits of the population, and evaluate the programs. various options--to the degree this information is available--and describes attempts to quantify benefits that have heretofore not been quantified. The purpose of this report is to enable the low-income advocates and others to assess the options and design program most suitable for the citizens of their states or jurisdictions. It is not the authors' intent to recommend a particular course of action but, based on our broad experience in the field, to provide the information necessary for others to do so. We would be happy to answer any questions or provide further documentation on any of the material presented herein. The original edition of this report was prepared for the Utah Committee on Consumer Services, pursuant to a contract with the National Consumer Law Center (NCLC), to provide information to the Utah Low-Income Task Force established by the Utah Public Service, Commission. Attachment 1 is drawn from NCLC's 1998 Supplement to its Access to Utility Services; NCLC plans to update this list in 2001, and it will be available then from NCLC. This report has been updated by the authors for this edition.

  7. A systematic review of ethical issues in vaccine studies involving pregnant women.

    Science.gov (United States)

    Beeler, Jennifer A; Lambach, Philipp; Fulton, T Roice; Narayanan, Divya; Ortiz, Justin R; Omer, Saad B

    2016-08-02

    Immunization during pregnancy can provide protection for mother and child. However, there have been only a limited number of studies documenting the efficacy and safety of this strategy. To determine the extent and nature of subject matter related to ethics in maternal immunization by systematically documenting the spectrum of ethical issues in vaccine studies involving pregnant women. We conducted a systematic literature review of published works pertaining to vaccine and therapeutic studies involving pregnant women through searches of PubMed, EMBASE, Web of Science, the Cochrane Database, and ClinicalTrials.gov. We selected literature meeting the inclusion criteria published between 1988 and June 2014. We systematically abstracted subject matter pertaining to ethical issues in immunization studies during pregnancy. Immunization-specific ethical issues were matched and grouped into major categories and subcategories. Seventy-seven published articles met the inclusion criteria. Published articles reported findings on data that had been collected in 26 countries, the majority of which were classified as high-income or upper-middle-income nations according to World Bank criteria. Review of these publications produced 60 immunization-specific ethical issues, grouped into six major categories. Notably, many studies demonstrated limited acknowledgment of key ethical issues including the rights and welfare of participants. Additionally, there was no discussion pertaining to the ethics of program implementation, including integration of maternal immunization programs into existing routine immunization programs. This review of ethical issues in immunization studies of pregnant women can be used to help inform future vaccine trials in this important population. Consistent documentation of these ethical issues by investigators will facilitate a broader and more nuanced discussion of ethics in immunization of pregnant women - offering new and valuable insights for programs

  8. 44 CFR 13.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program income. 13.25 Section... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 13.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees...

  9. 36 CFR 1207.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program income. 1207.25... GOVERNMENTS Post-Award Requirements Financial Administration § 1207.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for...

  10. 38 CFR 43.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Program income. 43.25... Requirements Financial Administration § 43.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the...

  11. 32 CFR 33.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Program income. 33.25 Section 33.25 National... Post-Award Requirements Financial Administration § 33.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services...

  12. 7 CFR 3016.25 - Program income.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Program income. 3016.25 Section 3016.25 Agriculture... GOVERNMENTS Post-Award Requirements Financial Administration § 3016.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for...

  13. Pregnant teenagers' group: contributions to prenatal care.

    Science.gov (United States)

    Queiroz, Maria Veraci Oliveira; Menezes, Giselle Maria Duarte; Silva, Thaís Jormanna Pereira; Brasil, Eysler Gonçalves Maia; Silva, Raimunda Magalhães da

    2017-06-05

    To describe changes in nurses' care following the implementation of a group of pregnant teenagers in prenatal care based on the expectations and experiences of pregnant teenagers. Qualitative and descriptive study conducted from February to November 2013 at a Primary Care Unit in Fortaleza, Ceará, Brazil, through focus groups with 16 adolescents from the group of pregnant women in the second or third trimester of pregnancy. The analysis identified central ideas and units of meanings that formed the categories. The strategy of a group of pregnant teenagers, which provides a space for coexistence and the establishment of ties encourages these individuals to talk about their needs, re-signifying their ties. Educational strategies to promote self-care of pregnant teenagers and care for their babies involve the sharing of experiences, doubts and beliefs. Considerations and suggestions of the adolescents contributed to guide nurses' practice and provide a strategic space of care and support for pregnant adolescents in primary care.

  14. 45 CFR 1174.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program income. 1174.25 Section 1174.25 Public....25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or...

  15. 20 CFR 437.25 - Program income.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Program income. 437.25 Section 437.25....25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or...

  16. 49 CFR 18.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program income. 18.25 Section 18.25 Transportation... income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or personal property...

  17. 22 CFR 135.25 - Program income.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Program income. 135.25 Section 135.25 Foreign... income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or personal property...

  18. 45 CFR 2541.250 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program income. 2541.250 Section 2541.250 Public... Post-Award Requirements § 2541.250 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the...

  19. 40 CFR 31.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Program income. 31.25 Section 31.25... Requirements Financial Administration § 31.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the...

  20. 29 CFR 1470.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Program income. 1470.25 Section 1470.25 Labor Regulations... Financial Administration § 1470.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or...

  1. 29 CFR 97.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Program income. 97.25 Section 97.25 Labor Office of the... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 97.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees...

  2. 45 CFR 1183.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program income. 1183.25 Section 1183.25 Public....25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or...

  3. 24 CFR 85.25 - Program income.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Program income. 85.25 Section 85.25... TRIBAL GOVERNMENTS Post-Award Requirements Financial Administration § 85.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees...

  4. 10 CFR 600.225 - Program income.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Program income. 600.225 Section 600.225 Energy DEPARTMENT....225 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or...

  5. 45 CFR 1157.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program income. 1157.25 Section 1157.25 Public... income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or personal property...

  6. Water End-Uses in Low-Income Houses in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Ana Kelly Marinoski

    2014-07-01

    Full Text Available Knowing water consumption patterns in buildings is key information for water planning. This article aims to characterize the water consumption pattern and water end-uses in low-income houses in the region of Florianópolis, Southern Brazil. Data were collected by interviewing householders, as well as by measuring the flow rate of existing water fixtures and appliances. The results indicated that the shower was the fixture with the largest water consumption in households, i.e., about 30%–36% of total water consumption on average, followed by the toilet (18%–20%. The surveyed households consumed from 111 to 152 L/capita·day on average, based on different income ranges. No correlation was found between income and water consumption. The results of this study can be used to estimate the consumption of water for new buildings, as well as to develop integrated water management strategies in low-income developments, in Florianópolis, such as water-saving plumbing fixtures, rainwater harvesting, and greywater reuse. Likely, there would be a deferral of capital investments in new water assets for enhancing water and wastewater services by saving water in low-income houses.

  7. Food (In)Security in Rapidly Urbanising, Low-Income Contexts.

    Science.gov (United States)

    Tacoli, Cecilia

    2017-12-11

    Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

  8. Food (InSecurity in Rapidly Urbanising, Low-Income Contexts

    Directory of Open Access Journals (Sweden)

    Cecilia Tacoli

    2017-12-01

    Full Text Available Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

  9. Shopping Behaviors of Low-income Families during a 1-Month Period of Time

    Science.gov (United States)

    Darko, Janice; Eggett, Dennis L.; Richards, Rickelle

    2013-01-01

    Objective: To explore food shopping behaviors among low-income families over the course of the month. Design: Two researchers conducted 13 90-minute focus groups. Setting: Two community organizations serving low-income populations and a university campus. Participants: Low-income adults (n = 72) who were the primary household food shoppers and who…

  10. 28 CFR 66.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Program income. 66.25 Section 66.25... Administration § 66.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real...

  11. 34 CFR 80.25 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Program income. 80.25 Section 80.25 Education Office of... income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real or personal property...

  12. 21 CFR 1403.25 - Program income.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Program income. 1403.25 Section 1403.25 Food and....25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use of rental of real or...

  13. 14 CFR 1273.25 - Program income.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Program income. 1273.25 Section 1273.25... Administration § 1273.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real...

  14. 45 CFR 602.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program income. 602.25 Section 602.25 Public... Requirements § 602.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real...

  15. 43 CFR 12.65 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Program income. 12.65 Section 12.65 Public... to State and Local Governments Post-Award Requirements § 12.65 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for...

  16. Suicidal behavior-related hospitalizations among pregnant women in the USA, 2006-2012.

    Science.gov (United States)

    Zhong, Qiu-Yue; Gelaye, Bizu; Miller, Matthew; Fricchione, Gregory L; Cai, Tianxi; Johnson, Paula A; Henderson, David C; Williams, Michelle A

    2016-06-01

    Suicide is one of the leading causes of maternal mortality in many countries, but little is known about the epidemiology of suicide and suicidal behavior among pregnant women in the USA. We sought to examine trends and provide nationally representative estimates for suicidal behavior (including suicidal ideation and suicide and self-inflicted injury) among pregnant women from 2006 to 2012 in the USA. Pregnant women aged 12-55 years were identified through pregnancy- and delivery-related hospitalization records from the National (Nationwide) Inpatient Sample. Suicidal behavior was identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Annual, nationwide estimates and trends were determined using discharge and hospital weights. The prevalence of suicidal ideation more than doubled from 2006 to 2012 (47.5 to 115.0 per 100,000 pregnancy- and delivery-related hospitalizations), whereas the prevalence of suicide and self-inflicted injury remained stable. Nearly 10 % of suicidal behavior occurred in the 12-18-year group, showing the highest prevalence per 100,000 pregnancy- and delivery-related hospitalizations (158.8 in 2006 and 308.7 in 2012) over the study period. For suicidal ideation, blacks had higher prevalence than whites; women in the lowest income quartile had the highest prevalence. Although the prevalence of suicidal behavior was higher among hospitalizations with depression diagnoses, more than 30 % of hospitalizations were for suicidal behavior without depression diagnoses. Our findings highlight the increasing burden and racial differences in suicidal ideation among US pregnant women. Targeted suicide prevention efforts are needed for high-risk pregnant women including teens, blacks, and low-income women.

  17. Discrimination, acculturation and other predictors of depression among pregnant Hispanic women.

    Science.gov (United States)

    Walker, Janiece L; Ruiz, R Jeanne; Chinn, Juanita J; Marti, Nathan; Ricks, Tiffany N

    2012-01-01

    The purpose of our study was to examine the effects of socioeconomic status, acculturative stress, discrimination, and marginalization as predictors of depression in pregnant Hispanic women. A prospective observational design was used. Central and Gulf coast areas of Texas in obstetrical offices. A convenience sample of 515 pregnant, low income, low medical risk, and self-identified Hispanic women who were between 22-24 weeks gestation was used to collect data. The predictor variables were socioeconomic status, discrimination, acculturative stress, and marginalization. The outcome variable was depression. Education, frequency of discrimination, age, and Anglo marginality were significant predictors of depressive symptoms in a linear regression model, F (6, 458) = 8.36, Pdiscrimination was the strongest positive predictor of increased depressive symptoms. It is important that health care providers further understand the impact that age and experiences of discrimination throughout the life course have on depressive symptoms during pregnancy.

  18. The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

    Directory of Open Access Journals (Sweden)

    Ali Batouli

    2014-06-01

    Conclusions: The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries.

  19. Contraceptive use among low-income urban married women in India.

    Science.gov (United States)

    Kumar, Manisha; Meena, Jyoti; Sharma, Sumedha; Poddar, Anju; Dhalliwal, Vikas; Modi-Satish Chander Modi, S C; Singh, Kamlesh

    2011-02-01

    The reports of a rise in contraceptive practices have not been matched by a similar decrease in population, so there is a need to look into the causes of this discrepancy. To obtain information from low-income urban married women regarding their contraceptive knowledge, practices, and utilization of the services. Percentage of low-income urban married women using contraception, different types of contraception used, influence of education on choice of contraception. All nonpregnant married women between the ages of 18 and 45 years, belonging to low-income groups were selected for study. Statistical analysis was done using EPI Info ver-5.0. Chi square test was used to test the significance of data. Contraceptive use among these women was 52%; the most common method was tubal ligation. Educated women used spacing methods more often than uneducated women. Women had adequate awareness regarding type of contraceptives available but had no idea about the timing of starting contraception after delivery and about emergency contraception. The low-income urban population is aware of the importance of limiting the family size and has family planning facilities yet has less contraceptive usage because of low level of education, increased rate of discontinuation, and lack of proper knowledge of the use of contraception. © 2010 International Society for Sexual Medicine.

  20. RELATIONSHIP BETWEEN PERIODONTAL DISEASE INDEX AND LOW BIRTH WEIGHT BABIES IN PREGNANT WOMEN WITH PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Ira Komara

    2016-03-01

    Full Text Available Objective: To identify the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and low birth weight babies. Methods: A case-control study was conducted to determine the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and the low birth weight babies (LBW. The participants were mothers with periodontitis and non-periodontitis mothers aged 20–35 years who gave birth in the Department of Obstetrics and Gynecology-Dr. Hasan Sadikin General Hospital, Bandung in the period of December to January 2005. Results: Based on the chisquare test results a highly significant relationship between periodontitis and low birth weight (p=0.002 was found. The Odd’s ratio showed that the risk of low birth weight in pregnant women with periodontitis was 15.58 times higher compared to those who did not suffer from periodontitis. The periodontal disease index has an accuracy of 88.6% in predicting the incidence of LBW. It strongly influenced the incidence of LBW with a high Odd’s ratio of 28.0. Pregnant women who suffer from periodontitis with a PDI > 3.25, have 19.2 times higher risk for delivering babies with LBW compared to the non-periodontitis mothers. Conclusions: The loss of attachment affects the possibility of delivering LBW babies.

  1. 45 CFR 92.25 - Program income.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Program income. 92.25 Section 92.25 Public Welfare... Administration § 92.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real...

  2. 15 CFR 24.25 - Program income.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Program income. 24.25 Section 24.25... Administration § 24.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services performed, from the use or rental of real...

  3. Prevalence of Hypertension in Low- and Middle-Income Countries

    Science.gov (United States)

    Sarki, Ahmed M.; Nduka, Chidozie U.; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A.

    2015-01-01

    Abstract We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4–35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1–45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0–40.6) and lowest across low-income countries (23.1%, 95% CI 20.1–26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income

  4. Arts Enrichment and Preschool Emotions for Low-Income Children at Risk

    Science.gov (United States)

    Brown, Eleanor D.; Sax, Kacey L.

    2013-01-01

    No studies to date examine the impact of arts-integrated preschool programming on the emotional functioning of low-income children at risk for school problems. The present study examines observed emotion expression and teacher-rated emotion regulation for low-income children attending Settlement Music School's Kaleidoscope Preschool Arts…

  5. A pilot randomized controlled trial of cognitive behavioral therapy for perinatal depression adapted for women with low incomes.

    Science.gov (United States)

    O'Mahen, Heather; Himle, Joseph A; Fedock, Gina; Henshaw, Erin; Flynn, Heather

    2013-07-01

    Perinatal women with identified depression in prenatal care settings have low rates of engagement and adherence with depression-specific psychotherapy. We report the feasibility and symptom outcomes of Cognitive Behavioral Therapy (CBT) modified (mCBT) to address the needs of perinatal, low-income women with Major Depressive Disorder (MDD). Pregnant women (n = 1421) were screened for depressive symptoms in obstetrics clinics in conjunction with prenatal care visits. A total of 59 women met diagnostic criteria for MDD; 55 women were randomly assigned to mCBT or Treatment as Usual (TAU). The mCBT intervention included an initial engagement session, outreach, specific perinatal content and interpersonal components. Measures were gathered at pre-treatment, 16 week post-randomization, and 3-month follow-up. Most participants attended at least one CBT session and met study criteria for treatment adherence. Active research staff outreach promoted engagement and retention in the trial. Treatment satisfaction was rated as very good. In both observed and multiple imputation results, women who received mCBT demonstrated greater improvement in depressed mood than those in TAU at 16-week post-randomization and 3-month follow-up, Cohen's d = -0.71 (95% CI -4.93, -5.70). Modified CBT offers promise as a feasible and acceptable treatment for perinatal women with low-incomes in prenatal care settings. Targeted delivery and content modifications are needed to engage populations tailored to setting and psychosocial challenges specific to the perinatal period. © 2013 Wiley Periodicals, Inc.

  6. Physical violence against pregnant women by an intimate partner, and adverse pregnancy outcomes in Mazandaran Province, Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Abdollahi

    2015-01-01

    Full Text Available Background and Aim: Violence against women during pregnancy is linked to poor outcome of pregnancy, which is reported to have widespread in Iran. The aim of this study was to determine the prevalence of physical violence against women by an intimate partner during pregnancy, and to assess the impact of this physical violence on pregnancy outcomes. Materials and Methods: A prospective cohort study was conducted on the characteristics of pregnant women in urban areas and related violence. The modified standard World Health Organization Domestic Violence Questionnaire was used to classify pregnant women and domestic violence. A total of 1461 pregnant women were selected using cluster sampling. The association between sociodemographic with intimate partner violence (IPV and IPV with pregnancy outcomes was determined using logistic regression. Results: Of these, 206 (14.1% (confidence interval = 12.3-15.9 reported physical IPV during pregnancy. The adjusted odds ratio for IPV in illiterate women or those with primary level of education (0.001, secondary level education (0.003, and in low income households (0.0001 were significantly higher than in those women with university level education and in higher income households. After adjusting for suspected confounding factors, the women with a history of violence by partners had 1.9 fold risk of premature rupture of membranes, and a 2.9 fold risk of low birth weight compared to women who did not experience any violence from their partners. Conclusion: The results of this research indicated that the prevalence of IPV was high among pregnant women. Therefore, it is necessary to emphasize the screening of pregnant women at Primary Health Centers to prevent physical abuse.

  7. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.

    Science.gov (United States)

    Rice, Jayne R; Larrabure-Torrealva, Gloria T; Luque Fernandez, Miguel Angel; Grande, Mirtha; Motta, Vicky; Barrios, Yasmin V; Sanchez, Sixto; Gelaye, Bizu; Williams, Michelle A

    2015-09-02

    Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors. Compared with lean women (overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63). Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.

  8. Promoting food security of low income women in central Uganda

    DEFF Research Database (Denmark)

    Midtvåge, Runa; Hiranandani, Vanmala Sunder; Nambuanyi, Lekunze Ransom

    • Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014.......• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014....

  9. The consequences of high cigarette excise taxes for low-income smokers.

    Directory of Open Access Journals (Sweden)

    Matthew C Farrelly

    Full Text Available BACKGROUND: To illustrate the burden of high cigarette excise taxes on low-income smokers. METHODOLOGY/PRINCIPAL FINDINGS: Using data from the New York and national Adult Tobacco Surveys from 2010-2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000-$59,999; and more than $60,000. The 2010-2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1% than nationally (22.2% and is strongly associated with income in New York and nationally (P<.001. Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010-2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003-2004 and 14.2% nationally. Daily cigarette consumption is not related to income. CONCLUSIONS/SIGNIFICANCE: Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers.

  10. Uterotonic use at home births in low-income countries: a literature review.

    Science.gov (United States)

    Flandermeyer, Dawn; Stanton, Cynthia; Armbruster, Deborah

    2010-03-01

    This literature review compiles data on rates of use, indications, types of provider, mode of administration, and dose of uterotonics used for home births in low-income countries, and identifies gaps meriting further research. Published and unpublished English language articles from 1995 through 2008 pertaining to home use of uterotonics were identified via electronic searches of medical and social science databases. In addition, bibliographies of articles were examined for eligible studies. Data were abstracted and analyzed by the objectives outlined for this review. Twenty-three articles met the inclusion/exclusion criteria. Use rates of uterotonics at home births ranged widely from 1% to 69%, with the large majority of observations from South Asia. Descriptive studies suggest that home use of uterotonics before delivery of the baby are predominantly administered by nonprofessionals to accelerate labor, and are not perceived as unsafe. To achieve maximum benefit and minimal harm, programs that increase access to uterotonics for postpartum hemorrhage prevention must take into account existing practices among pregnant women. Further research regarding access to uterotonics and intervention studies for provider behavior change regarding uterotonic use is warranted.

  11. After-school programs for low-income children: promise and challenges.

    Science.gov (United States)

    Halpern, R

    1999-01-01

    Children's out-of-school time, long a low-level source of public concern, has recently emerged as a major social issue. This, in turn, has heightened interest in the heterogeneous field of after-school programs. This article provides a profile of after-school programs for low-income children, focusing on supply and demand, program emphases, and program sponsors and support organizations. It also discusses the major challenges facing the field in the areas of facilities, staffing, and financing. Details and examples are drawn from the ongoing evaluation of a specific after-school program initiative called MOST (Making the Most of Out-of-School Time), which seeks to strengthen after-school programs in Boston, Chicago, and Seattle. Looking ahead, the article highlights the pros and cons of options for increasing coverage to reach more low-income children, strengthening programs, expanding funding, and articulating an appropriate role for after-school programs to fill in the lives of low-income children.

  12. Federally Funded Education and Job Training Programs for Low-Income Youth

    Science.gov (United States)

    Dworsky, Amy

    2011-01-01

    With the growing demand for highly skilled workers and declining wages for those who are less skilled, low-income youth with limited education and no work experience have few opportunities for gainful employment. Since the Great Depression, the federal government has been funding programs that provide low-income, out-of-school, and unemployed…

  13. Association of low-protein supplemented diets with fetal growth in pregnant women with CKD.

    Science.gov (United States)

    Piccoli, Giorgina B; Leone, Filomena; Attini, Rossella; Parisi, Silvia; Fassio, Federica; Deagostini, Maria Chiara; Ferraresi, Martina; Clari, Roberta; Ghiotto, Sara; Biolcati, Marilisa; Giuffrida, Domenica; Rolfo, Alessandro; Todros, Tullia

    2014-05-01

    Women affected by CKD increasingly choose to get pregnant. Experience with low-protein diets is limited. The aim of this study was to review results obtained from pregnant women with CKD on supplemented vegan-vegetarian low-protein diets. This was a single-arm, open intervention study between 2000-2012 of a low-protein diet in pregnant patients with stages 3-5 CKD or severe proteinuria (>1 g/d in the first trimester or nephrotic at any time). Stages 3-5 CKD patients who were not on low-protein diets for clinical, psychologic, or logistic reasons served as controls. The setting was the Obstetrics-Nephrology Unit dedicated to kidney diseases in pregnancy. The treated group included 24 pregnancies--21 singleton deliveries, 1 twin pregnancy, 1 abortion, and 1 miscarriage. Additionally, there were 21 controls (16 singleton deliveries, 5 miscarriages). The diet was a vegan-vegetarian low-protein diet (0.6-0.8 g/kg per day) with keto-acid supplementation and 1-3 protein-unrestricted meals allowed per week. Treated patients and controls were comparable at baseline for median age (35 versus 34 years), referral week (7 versus 8), eGFR (59 versus 54 ml/min), and hypertension (43.5% versus 33.3%); median proteinuria was higher in patients on the low-protein diet (1.96 [0.1-6.3] versus 0.3 [0.1-2.0] g/d; Pdiet group. Incidence of small for gestational age babies was significantly lower in the diet group (3/21) versus controls (7/16; chi-squared test; P=0.05). Throughout follow-up (6 months to 10 years), hospitalization rates and prevalence of children below the third percentile were similar in both groups. Vegan-vegetarian supplemented low-protein diets in pregnant women with stages 3-5 CKD may reduce the likelihood of small for gestational age babies without detrimental effects on kidney function or proteinuria in the mother.

  14. Prevalence of Food Addiction Among Low-Income Reproductive-Aged Women.

    Science.gov (United States)

    Berenson, Abbey B; Laz, Tabassum H; Pohlmeier, Ali M; Rahman, Mahbubur; Cunningham, Kathryn A

    2015-09-01

    Hyperpalatable foods (i.e., high in salt, sugar, or fat) have been shown to have addictive properties that may contribute to overeating. Prior studies conducted on food addiction behaviors are mostly based on white and middle-aged women. Data are not available, however, on reproductive-aged women from other races/ethnicities or low-income women. The purpose of this study was to examine the prevalence and correlates of food addiction among multiethnic women of low socioeconomic status. We conducted a cross-sectional survey of health behaviors, including food addiction according to the Yale Food Addiction Scale (YFAS) between July 2010 and February 2011 among 18- to 40-year-old low-income women attending reproductive-health clinics (N = 1,067). Overall, 2.8% of women surveyed met the diagnosis of food addiction. The prevalence of food addiction did not differ by age group, race/ethnicity, education, income, or body mass index categories, tobacco and alcohol use, or physical activity. However, it did differ by level of depression (p addiction among low-income, reproductive-aged women. Racial differences were observed in the YFAS symptom count score, but not in the overall prevalence of food addition. Additionally, women with food addiction had higher levels of depression than women without food addiction.

  15. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women

    OpenAIRE

    Feitosa,Danielle Cristina Alves; Silva,Márcia Guimarães da; Parada,Cristina Maria Garcia de Lima

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to...

  16. Household expenditure for dental care in low and middle income countries.

    Directory of Open Access Journals (Sweden)

    Mohd Masood

    Full Text Available This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries who participated in the WHO World Health Survey (WHS were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.

  17. Level and intensity of objectively assessed physical activity among pregnant women from urban Ethiopia

    DEFF Research Database (Denmark)

    Hjorth, Mads Fiil; Kloster, Stine; Girma, Tsinuel

    2012-01-01

    Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physica...... activity performed. In this study we report objectively assessed levels of physical activity, cardiorespiratory fitness and muscular fitness among pregnant urban Ethiopian women, and their association with demographic characteristics and anthropometric measures.......Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physical...

  18. 41 CFR 105-71.125 - Program income.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program income. 105-71... GOVERNMENTS 71.12-Post-Award Requirements/Financial Administration § 105-71.125 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees...

  19. Is There a Link between Low Parental Income and Childhood Obesity?

    Science.gov (United States)

    Shackleton, Nichola

    2017-01-01

    The association between familial socioeconomic status and child obesity has created the expectation that low familial income increases the risk of child obesity. Yet, there is very little evidence in the United Kingdom to suggest that this is the case. This article focuses on whether low familial income and family poverty are associated with an…

  20. Using social media to communicate child health information to low-income parents.

    Science.gov (United States)

    Stroever, Stephanie J; Mackert, Michael S; McAlister, Alfred L; Hoelscher, Deanna M

    2011-11-01

    The objective of this study was to determine the value of using social media to communicate child health information to low-income parents. We evaluated qualitative data obtained through focus groups with low-income, predominantly Hispanic parents. Results were mixed; lack of time and credibility were the primary objections parents cited in using social media to obtain information about their children's health. Social media has value as part of an overall communication strategy, but more work is needed to determine the most effective way to use this channel in low-income populations.

  1. Hepatitis E among Pregnant Women in Urmia, Iran

    Directory of Open Access Journals (Sweden)

    Z Rostamzadeh Khameneh

    2014-04-01

    Full Text Available Introduction: Although the hepatitis E virus mostly causes a self-limited disease in general population, but the disease is more severe in pregnant women. Hepatitis E accounts for about 10% of pregnancy associated deaths in southern Asia. But the prevalence in Iran is almost unclear, so this study is aimed to investigate the seroprevalence of anti-HEV IgG among a population of pregnant women in West Azerbaijan of Iran.   Materials and Methods: 136 pregnant women who referred to an urban health centers of Urmia for pursuing pregnancy-related health services were selected randomly and enrolled in a descriptive, cross-sectional study. Each subject was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy.   Results: The mean age among 136 pregnant women was 25.12±4.91 years old (range of 14-39 years. Only five cases (3.6% among all 136 subjects were demonstrated to be seropositive for anti-HEV IgG using ELISA method. There was no significant difference between age (P=0.88, income level (P=0.19 of two seropositive and seronegative groups. All seropositive cases were from urban areas.   Conclusion: The seroprevalence of anti-HEV IgG is low in the population of pregnant women in Urmia, Iran. Because of limited sample size in this study, we recommend to perform further studies with larger sample size in other regions of Iran in order to be able to systematically generalize the findings of studies to the population of Iranian pregnant women.   Keywords: Pregnancy, Hepatitis E, women ELISA  

  2. Science for Agriculture and Rural Development in Low-Income Countries

    Science.gov (United States)

    Barros, Vicente

    2008-09-01

    During recent months, another sign of the global fragility to sustain the increasing human demand for resources has appeared with merciless cruelty. Increasing food prices, paradoxically driven to a large extent by the rapid economic growth of vast regions of the emerging world, are affecting hundreds of millions of the poorest people in Africa, Asia, and Latin America. As described in Science for Agriculture and Rural Development in Low-Income Countries, most of the poorest people in these low-income countries live in rural areas and are engaged in agriculture or related activities. Because many people in these areas are engaged in subsistence agriculture, they do not share in the added income derived from higher market prices for food.

  3. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care

    Directory of Open Access Journals (Sweden)

    Shirtcliff R Mike

    2010-02-01

    Full Text Available Abstract Background A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. Methods As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Results Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93. The mean (SD number of teeth with any decay was .75 (2.5 in the test population and 1.6 (2.5 in the comparison population (t = 2.08, p = .04. Conclusions The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  4. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care.

    Science.gov (United States)

    Milgrom, Peter; Sutherland, Marilynn; Shirtcliff, R Mike; Ludwig, Sharity; Smolen, Darlene

    2010-02-18

    A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid) in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93). The mean (SD) number of teeth with any decay was .75 (2.5) in the test population and 1.6 (2.5) in the comparison population (t = 2.08, p = .04). The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  5. Pregnant women's perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research.

    Science.gov (United States)

    Vanstone, Meredith; Kandasamy, Sujane; Giacomini, Mita; DeJean, Deirdre; McDonald, Sarah D

    2017-10-01

    Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy. We used the methodology of qualitative meta-synthesis to analyze 42 empirical qualitative research studies conducted in high-income countries and published between 2005 and 2015. With this synthesis, we provide an account of the underlying factors and circumstances (barriers, facilitators, and motivators) that pregnant women identify as important for appropriate weight gain. We also offer a description of the strategies identified by pregnant women as acceptable and appropriate ways to promote healthy weight gain. Through our integrative analysis, we identify women's common perception on the struggle to enact health behaviors and physical, social, and environmental factors outside of their control. Effective and sensitive interventions to encourage healthy weight gain in pregnancy must consider the social environment in which decisions about weight take place. © 2016 John Wiley & Sons Ltd.

  6. Serum oxidized low density lipoprotein levels in preeclamptic and normotensive pregnants.

    Science.gov (United States)

    Kozan, A; Yildirmak, S Turkmen; Mihmanli, V; Ayabakan, H; Cicek, Y G; Kalaslioglu, V; Doean, S; Cebeci, H Cerci

    2015-01-01

    BACKGROUNDS/AIM: The aim of the study was to determine serum lipids and oxidized low density lipoprotein (ox-LDL) levels in preeclamptic pregnants and compare with those of normotensives. Ox-LDL levels were determined by enzyme linked immunosorbent assay (ELISA); total cholesterol, hight density lipoprotein (HDL)-cholesterol and triglyceride levels were measured by enzymatic colorimetric assay in 26 normotensive and 27 preeclamptic pregnants. LDL and very low density lipoprotein (VLDL) cholesterol was calculated by Friedwald formula. Serum levels of Ox-LDL (U/L), total-cholesterol (mg/dL), HDL-cholesterol (mg/dL), LDL-cholesterol (mg/dL), triglyceride (mg/dL), and VLDL-cholesterol (mg/dL) in normotensive and preeclamptic pregnants were found as 130±60 and 133±69; 248±49 and 248±81; 67±14 and 61±16; 147±61 and 135±59; 207±76 and 256±87; 41±15 and 50±17, respectively. Mean values of Ox-LDL and other lipid parameters were higher than the upper limits of their reference ranges in both of groups. However no significant differences were found in Ox-LDL, total, HDL and LDL-cholesterol levels between two groups. However, the levels of triglyceride and VLDL-cholesterol were significantly higher in preeclampsia group. The present results suggest that the levels of serum Ox-LDL and other lipid parameters rise as a result of pregnancy rather than as a result of preeclampsia.

  7. Feeding practices of low-income mothers: how do they compare to current recommendations?

    OpenAIRE

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-01-01

    Background Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods Eighty low-income mothers and their preschool children were videotaped a...

  8. Low-Income Urban High School Students' Use of the Internet to Access Financial Aid

    Science.gov (United States)

    Venegas, Kristan M.

    2006-01-01

    This article focuses on the Web-based resources available to low-income students as they build their perceptions, make their decisions, and engage in financial aid activities. Data are gathered from the results of six focus groups with low-income high school students attending urban high schools. Findings suggest that low-income students do have…

  9. Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study.

    Science.gov (United States)

    Alemu, Yihun Mulugeta; Ambaw, Fentie; Wilder-Smith, Annelies

    2017-06-24

    HIV testing of women in child bearing age is an entry point for preventing mother-to-child transmission of HIV (MTCT). This study aims to identify the proportion of women tested for HIV and to determine factors associated with utilization of HIV testing services among pregnant mothers in primary care settings in northern Ethiopia. A cross sectional study was conducted in 416 pregnant women from four primary care centers between October 2, 2012 and May 31, 2013 in East Gojjam, Ethiopia. The proportion of mothers who tested for HIV was 277(67%). Among mothers who were not tested for HIV, lack of HIV risk perception (n = 68, 49%) was a major self-reported barrier for HIV testing. A multivariable logistic regression analysis showed that those pregnant women who had comprehensive knowledge about MTCT had an Adjusted Odd Ratio (AOR) of 3.73 (95% CI: 1.56, 8.94), having comprehensive knowledge on prevention of mother to child transmission (PMTCT) of HIV an AOR of 2.56 (95% CI: 1.26, 5.19), and a favorable attitude towards persons living with HIV an AOR of 2.42 (95%CI, 1.20, 4.86) were more likely to be tested for HIV. One third of pregnant women had never been tested for HIV until the time of the study. Efforts should be made to improve mother's knowledge about MTCT and PMTCT to increase uptake of HIV testing. Enhancing mother's HIV risk perception to scale up HIV testing in resource limited setting is highly recommended.

  10. Air Quality, Energy Budget, and Offset Policy in South Africa's Low-Income Settlements

    Science.gov (United States)

    Hersey, S. P.; Piketh, S.; Burger, R.

    2014-12-01

    Urban and exurban residential populations in South Africa reside primarily in low-income settlements, including many townships remaining from Apartheid. Over 3 million free government homes have been built in the last 20 years, but the number of people living in informal settlements is the same as at the end of Apartheid in 1994 - a consequence of rapid urbanization. Despite availability of electricity to the vast majority of South Africans, ~80% of electrified homes in low-income areas also burn coal and/or wood as supplementary fuels for cooking and heating. These domestic burning activities represent 70-85% of total PM10mass during winter in South Africa's low-income settlements. Here we analyze data from observations of human-atmosphere systems in: 1) 19 ground monitoring sites in Gauteng Province (Johannesburg and Pretoria), and 2) an intensive sampling campaign in a township in Mpumalanga Province (Industrial Highveld). From ground monitoring, we quantitatively describe seasonal and diurnal trends in PM10 and PM2.5 typical in low-income settlements as compared with industrial and developed suburban areas, and demonstrate the impact of low-income settlements on regional air quality. We also explore the implications of economic development in townships (increased household income, expanded commercialization and widespread electricity usage) on local and regional air quality. Data from the intensive township sampling study provides a seasonal energy budget for domestic burning in low-income settlements and suggests that indoor and ambient air quality are independent systems requiring unique interventions. We conclude with a preview of innovative strategies being developed by industry, government, and academic stakeholders for a not-like-for-like emissions offset policy in South Africa, focused on investments directly into low-income settlements that are aimed at reducing PM exposure.

  11. The support gap: New teachers' early experiences in high-income and low-income schools

    Directory of Open Access Journals (Sweden)

    Susan Moore Johnson

    2004-10-01

    Full Text Available In this article, the authors consider three sources of support for new teachers—hiring practices, relationships with colleagues, and curriculum—all found in earlier research to influence new teachers’ satisfaction with their work, their sense of success with students, and their eventual retention in their job. They find that a "support gap" exists: new teachers in low-income schools are less likely than their counterparts in high-income schools to experience timely and information-rich hiring, to benefit from mentoring and support by experienced colleagues, and to have a curriculum that is complete and aligned with state standards, yet flexible for use in the classroom. Such patterns of difference between high-income and lowincome schools warrant careful consideration because they reveal broad patterns of inequity, which can have severe consequences for low-income students. Survey data for this study were collected from random samples of teachers in five states. One survey, focusing on hiring practices and teachers’ relationships with colleagues, was administered to 374 first-year and secondyear teachers in Florida, Massachusetts, and Michigan. A second survey, focusing on curriculum, was administered to 295 second-year elementary school teachers in Massachusetts, North Carolina, and Washington. The inequitable patterns of support for teachers reported here have important implications for the work of state policymakers, school district administrators, and principals. The authors describe these and offer recommendations for policy and practice in the conclusion.

  12. Travel patterns and characteristics of low-income subpopulation in New York state

    Energy Technology Data Exchange (ETDEWEB)

    Reuscher, Tim [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lim, Hyeonsup [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-10-01

    Studies have shown that people residing in poverty face more mobility challenges in their daily travels as compared to those living in higher income households. In many cities, the lack of a public transportation systems and investments in low-income areas are making it difficult for those living in poverty to access jobs, goods, and services (schools, groceries, health cares, etc. In this study, Oak Ridge National Laboratory was tasked by the New York State (NYS) Department of Transportation to conduct a detailed examination of the travel behaviors and identify patterns and trends of the low-income residents within NYS. The 2009 National Household Travel Survey data was used as the primary information source to analyze subjects associated with poverty and mobility, as well as to address questions such as are there differences in traveler demographics between the low-income population and those of others who live in various NYS regions (e.g., New York City, other urban areas of NYS)? How do they compare with the population at large (e.g., rest of the country) or with findings from previous years (i.e., trend)? Are there any regional differences (e.g., urban versus rural)? Do any unique travel characteristics or patterns exist within the low-income group? Through this study, various key findings on low-income population sizes, household characteristics, travel patterns, and mobility limitations were identified and summarized in this report.

  13. An optimization algorithm for simulation-based planning of low-income housing projects

    Directory of Open Access Journals (Sweden)

    Mohamed M. Marzouk

    2010-10-01

    Full Text Available Construction of low-income housing projects is a replicated process and is associated with uncertainties that arise from the unavailability of resources. Government agencies and/or contractors have to select a construction system that meets low-income housing projects constraints including project conditions, technical, financial and time constraints. This research presents a framework, using computer simulation, which aids government authorities and contractors in the planning of low-income housing projects. The proposed framework estimates the time and cost required for the construction of low-income housing using pre-cast hollow core with hollow blocks bearing walls. Five main components constitute the proposed framework: a network builder module, a construction alternative selection module, a simulation module, an optimization module and a reporting module. An optimization module utilizing a genetic algorithm enables the defining of different options and ranges of parameters associated with low-income housing projects that influence the duration and total cost of the pre-cast hollow core with hollow blocks bearing walls method. A computer prototype, named LIHouse_Sim, was developed in MS Visual Basic 6.0 as proof of concept for the proposed framework. A numerical example is presented to demonstrate the use of the developed framework and to illustrate its essential features.

  14. Economic aspects of low labour-income farming

    NARCIS (Netherlands)

    Luning, H.A.

    1967-01-01

    Conflicting views on the relevance of economic theory, as developed in the West, to low-income peasant societies had been advanced ever since Boeke's time.

    Recent literature pointed out that available economic theories did not seem to fit the behavioral motivation, assumed in economic logic. The

  15. Cigarette smoking and food insecurity among low-income families in the United States, 2001.

    Science.gov (United States)

    Armour, Brian S; Pitts, M Melinda; Lee, Chung-Won

    2008-01-01

    To quantify the association between food insecurity and smoking among low-income families. A retrospective study using data from the 2001 Panel Study of Income Dynamics (PSID), a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Low-income families. Family income was linked with U.S. poverty thresholds to identify 2099 families living near or below 200% of the federal poverty level. Food insecurity (i.e., having insufficient funds to purchase enough food to maintain an active and healthy lifestyle) was calculated from the 18-core-item food security module of the U.S. Department of Agriculture. Current smoking status was determined. Smoking prevalence was higher among low-income families who were food insecure compared with low-income families who were food secure (43.6% vs. 31.9%; p < .01). Multivariate analysis revealed that smoking was associated with an increase in food insecurity of approximately six percentage points (p < .01). Given our finding that families near the federal poverty level spend a large share of their income on cigarettes, perhaps it would be prudent for food-assistance and tobacco-control programs to work together to help low-income people quit smoking.

  16. Low Molecular Weight Heparin Improves Endothelial Function in Pregnant Women at High Risk of Preeclampsia.

    Science.gov (United States)

    McLaughlin, Kelsey; Baczyk, Dora; Potts, Audrey; Hladunewich, Michelle; Parker, John D; Kingdom, John C P

    2017-01-01

    Low molecular weight heparin (LMWH) has been investigated for the prevention of severe preeclampsia, although the mechanisms of action are unknown. The objective of this study was to investigate the cardiovascular effects of LMWH in pregnant women at high risk of preeclampsia. Pregnant women at high risk of preeclampsia (n=25) and low-risk pregnant controls (n=20) at 22 to 26 weeks' gestation underwent baseline cardiovascular assessments. High-risk women were then randomized to LMWH or saline placebo (30 mg IV bolus and 1 mg/kg subcutaneous dose). Cardiovascular function was assessed 1 and 3 hours post randomization. The in vitro endothelial effects of patient serum and exogenous LMWH on human umbilical venous endothelial cells were determined. High-risk women demonstrated a reduced cardiac output, high resistance hemodynamic profile with impaired radial artery flow-mediated dilation compared with controls. LMWH increased flow-mediated dilation in high-risk women 3 hours after randomization compared with baseline and increased plasma levels of placental growth factor, soluble fms-like tyrosine kinase-1, and myeloperoxidase. Serum from high-risk women impaired endothelial cell angiogenesis and increased PlGF-1 and PlGF-2 transcription compared with serum from low-risk controls. Coexposure of high-risk serum with LMWH improved the in vitro angiogenic response such that it was equivalent to that of low-risk serum and promoted placental growth factor secretion. LMWH improves maternal endothelial function in pregnant women at high risk of developing preeclampsia, possibly mediated through increased placental growth factor bioavailability. © 2016 American Heart Association, Inc.

  17. 24 CFR 511.76 - Program income.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Program income. 511.76 Section 511... Program income. (a) General. Grantees and State recipients are neither encouraged to earn nor discouraged from earning program income in using rental rehabilitation grant amounts under this part. (b...

  18. Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

    Directory of Open Access Journals (Sweden)

    Xianglong Xu

    2017-07-01

    Full Text Available Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9% participants reported insufficient sleeping duration, whereas 485 (20.9% claimed excessive sleep duration. A total of 358 (15.2% of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications

  19. Church Member Support Benefits Psychological Well-Being of Pregnant African American Women

    Science.gov (United States)

    Giurgescu, Carmen; Murn, Nicole L.

    2016-01-01

    Depression during pregnancy is common, and pregnant African American (AA) women are more likely to experience depressive symptoms compared with pregnant non-Hispanic white women. This study explored AA women’s experience of church attendance, church member support, depressive symptoms, and psychological well-being at 15–25 weeks’ gestation. Nurses need to be aware of the importance of church support and encourage clergy and church members to be supportive of pregnant women. PMID:27119803

  20. Food stress in Adelaide: the relationship between low income and the affordability of healthy food.

    Science.gov (United States)

    Ward, Paul R; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

    2013-01-01

    Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a "Healthy Food Basket" methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing "food stress." Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

  1. 77 FR 25787 - Low Income Taxpayer Clinic Grant Program; Availability of 2013 Grant Application Package

    Science.gov (United States)

    2012-05-01

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Low Income Taxpayer Clinic Grant Program... Package and Guidelines (Publication 3319) for organizations interested in applying for a Low Income... nominal fee to low income taxpayers involved in tax controversies with the IRS, or inform individuals for...

  2. Alcohol taxation policy in Thailand: implications for other low- to middle-income countries.

    Science.gov (United States)

    Sornpaisarn, Bundit; Shield, Kevin D; Rehm, Jürgen

    2012-08-01

      Prevention of drinking initiation is a significant challenge in low- and middle-income countries that have a high prevalence of abstainers, including life-time abstainers. This paper aims to encourage a debate on an alternative alcohol taxation approach used currently in Thailand, which aims specifically to prevent drinking initiation in addition to reduce alcohol-attributable harms.   Theoretical evaluation, simulation and empirical analysis.   The taxation method of Thailand, 'Two-Chosen-One' (2C1) combines specific taxation (as a function of the alcohol content) and ad valorem taxation (as a function of the price), resulting in an effective tax rate that puts a higher tax both on beverages which are preferred by heavy drinkers and on beverages which are preferred by potential alcohol consumption neophytes, compared to either taxation system alone. As a result of these unique properties of the 2C1 taxation system, our simulations indicate that 2C1 taxation leads to a lower overall consumption than ad valorem or specific taxation alone. In addition, it puts a relatively high tax on beverages attractive to young people, the majority of whom are currently abstaining. Currently, the abstention rates in Thailand are higher than expected based on its economic wealth, which could be taken as an indication that the taxation strategy is successful.   'Two-chosen-one' (2C1) taxation has the potential to simultaneously reduce alcohol consumption and prevent drinking initiation among youth; however, additional empirical evidence is needed to assess its effectiveness in terms of the public health impact in low- and middle-income countries. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  3. CROWDING AND SHOPPING VALUE IN LOW-INCOME RETAIL CENTERS

    Directory of Open Access Journals (Sweden)

    Izabelle Quezado

    2014-07-01

    Full Text Available Considering the great potential of low-income consumption, this research is based on the scales developed by Babin, Darden and Griffin (1994 and by Machleit, Kellaris and Eroglu (1994, aiming to investigate hedonic and utilitarian consumer behavior and its relation with low-income perception of crowding. A research was performed with 404 consumers in real store environment and the results showed that consumers revealed being prone to utilitarian behavior in both centers. About crowding phenomenon, the consumers felt more uncomfortable by crowding at the commercial center with less infrastructure. There were indices that this discomfort was less intense in hedonic consumers.

  4. Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda.

    Science.gov (United States)

    Niessen, Louis W; Mohan, Diwakar; Akuoku, Jonathan K; Mirelman, Andrew J; Ahmed, Sayem; Koehlmoos, Tracey P; Trujillo, Antonio; Khan, Jahangir; Peters, David H

    2018-05-19

    Five Sustainable Development Goals (SDGs) set targets that relate to the reduction of health inequalities nationally and worldwide. These targets are poverty reduction, health and wellbeing for all, equitable education, gender equality, and reduction of inequalities within and between countries. The interaction between inequalities and health is complex: better economic and educational outcomes for households enhance health, low socioeconomic status leads to chronic ill health, and non-communicable diseases (NCDs) reduce income status of households. NCDs account for most causes of early death and disability worldwide, so it is alarming that strong scientific evidence suggests an increase in the clustering of non-communicable conditions with low socioeconomic status in low-income and middle-income countries since 2000, as previously seen in high-income settings. These conditions include tobacco use, obesity, hypertension, cancer, and diabetes. Strong evidence from 283 studies overwhelmingly supports a positive association between low-income, low socioeconomic status, or low educational status and NCDs. The associations have been differentiated by sex in only four studies. Health is a key driver in the SDGs, and reduction of health inequalities and NCDs should become key in the promotion of the overall SDG agenda. A sustained reduction of general inequalities in income status, education, and gender within and between countries would enhance worldwide equality in health. To end poverty through elimination of its causes, NCD programmes should be included in the development agenda. National programmes should mitigate social and health shocks to protect the poor from events that worsen their frail socioeconomic condition and health status. Programmes related to universal health coverage of NCDs should specifically target susceptible populations, such as elderly people, who are most at risk. Growing inequalities in access to resources for prevention and treatment need to

  5. Family Investments in Low-Income Children's Achievement and Socioemotional Functioning

    Science.gov (United States)

    Longo, Francesca; McPherran Lombardi, Caitlin; Dearing, Eric

    2017-01-01

    Family processes and parenting practices help explain developmental differences between children in low- versus higher-income households. There are, however, few studies addressing the question of: what are the key family processes and parenting practices for promoting low-income children's growth? We address this question in the present study,…

  6. Internet use among low-income persons recently diagnosed with HIV infection.

    Science.gov (United States)

    Mayben, J K; Giordano, T P

    2007-10-01

    Patients are increasingly using the Internet to obtain health-related information, communicate with providers and access research. Use of the Internet to obtain health-related information by low-income patients recently diagnosed with HIV infection has not been examined. In 2005, we surveyed 126 low-income patients diagnosed with HIV infection within the last three years. Eighty-five percent of the patients wereInternet to access information about HIV, 52% had never used the Internet, 28% had never used it to obtain health-related information and only 18% had done so at least monthly for the last six months. Two-thirds of the population studied would need instruction on how to use the Internet. In multivariable regression, 2004 income > or =$15,000 predicted monthly Internet use to obtain health-related information. Older age, heterosexual intercourse as HIV risk factor and inadequate health literacy were independent predictors of needing instruction. The low-income population with HIV infection lags behind the general population in Internet access and may not benefit from Internet-dependent advances in health communication, including HIV-related interventions.

  7. Prevalence and Sociodemographic and Lifestyle Determinants of Anemia during Pregnancy: A Cross-Sectional Study of Pregnant Women in China

    Directory of Open Access Journals (Sweden)

    Xianglong Xu

    2016-09-01

    Full Text Available Objective: This study aimed to assess the differences regarding anemia among pregnant women with diverse characteristics and lifestyle factors. Methods: A cross-sectional study of pregnant women was conducted between June and August 2015 in 16 hospitals in five provinces of Mainland China. Self-reported doctor-diagnosed anemia was used in the study. Results: We included 2345 pregnant women. Of the participants, 1755 (74.8% were pregnant women of first pregnancy (PWFP and 590 (25.2% were second pregnancy (PWSP. The mean age of the participants was 28.1 years (SD 4.1. Overall, the prevalence of anemia was 12.7% (13.4% and 10.7% among PWFP and PWSP, respectively. The prevalence for not eating breakfast was 11.0%. Compared with PWFP, PWSP was inversely associated with the risk of anemia (odds ratio (OR 0.66, 95% CI 0.48–0.91. Compared with those being registered in a low ranking hospital, pregnant women who were admitted to a high (OR 0.40, 95% CI 0.28–0.57 or a medium ranking hospital (OR 0.58, 95% CI 0.37–0.92 were inversely associated with the risk of anemia. Compared with women of low income (<¥4,500, those with high income were less likely to have anemia (OR 0.68, 95% CI 0.50–0.94. Compared with women with non-manual jobs, women with manual jobs (OR 1.70, 95% CI 1.17–2.45 and unemployed women (OR 1.42, 95% CI 1.04–1.93 were associated with a greater likelihood of suffering from anemia. Conclusions: Pregnant women not eating breakfast are of concern. Anemia is highly prevalent among pregnant women in China. Lower socio-economic status, manual jobs, PWFP, and those who attend a lower quality hospital have a greater likelihood of suffering from anemia. Tailored interventions are needed to address these issues.

  8. Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

    Directory of Open Access Journals (Sweden)

    Paul R. Ward

    2013-01-01

    Full Text Available Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy Food Basket” methodology, this study costed a week’s supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability. It is argued that families that spend more than 30% of household income on food could be experiencing “food stress.” Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

  9. Assessment of Low-Income Adults' Access to Technology: Implications for Nutrition Education

    Science.gov (United States)

    Neuenschwander, Lauren M.; Abbott, Angela; Mobley, Amy R.

    2012-01-01

    Objective: The main objective of this study was to investigate access and use of technologies such as the Internet among Indiana's low-income population. The secondary objective was to determine whether access and use of computers significantly differed by age, race, and/or education level. Methods: Data were collected from low-income adult…

  10. Effects of simplifying outreach materials for energy conservation programs that target low-income consumers

    International Nuclear Information System (INIS)

    Wong-Parodi, Gabrielle; Bruine de Bruin, Wändi; Canfield, Casey

    2013-01-01

    Critics have speculated that the limited success of energy conservation programs among low-income consumers may partly be due to recipients having insufficient literacy to understand the outreach materials. Indeed, we found outreach materials for low-income consumers to require relatively high levels of reading comprehension. We therefore improved the Flesch–Kincaid readability statistics for two outreach brochures, by using shorter words and shorter sentences to describe their content. We examined the effect of that simplification on low-income consumers′ responses. Participants from low-income communities in the greater Pittsburgh area, who varied in literacy, were randomly assigned to either original communications about energy conservation programs or our simplified versions. Our findings suggest that lowering readability statistics successfully simplified only the more straightforward brochure in our set of two, likely because its content lent itself better to simplification. Findings for this brochure showed that simplification improved understanding of its content among both low-literacy and high-literacy recipients, without adversely affecting their evaluation of the materials, or their intention to enroll in the advertised programs. We discuss strategies for improving communication materials that aim to reach out to low-income populations. - Highlights: • Brochures about energy programs for low-income consumers can be too hard to read. • We made brochures easier to read by using shorter words and shorter sentences. • Simplifying a straightforward brochure improved the understanding of all recipients. • However, simplifying a complex brochure had no effect on understanding. • We suggest strategies for improving outreach to low-income consumers

  11. Anaemia among pregnant women in northern Tanzania: prevalence, risk factors and effect on perinatal outcomes.

    Science.gov (United States)

    Msuya, Sia E; Hussein, Tamara H; Uriyo, Jacqueline; Sam, Noel E; Stray-Pedersen, Babill

    2011-01-01

    Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, there is limited data regarding prevalence and effects of anaemia during pregnancy in northern Tanzania. The objective of this study was to determine the prevalence and possible risk factors for anaemia and its effect on perinatal outcomes among pregnant women attending antenatal care in Moshi Municipality in northern Tanzania. A cohort of pregnant women aged 14-43 years and in their 3rd trimester, was recruited from two primary health care clinics between June 2002 and March 2004. Interviews, anthropometric measurements and haematological examinations were conducted on 2654 consenting women. Perinatal outcomes were recorded during delivery and at 1 week after delivery. Of the 2654 participants, 47.4% had anaemia (haemoglobin [Hb] anaemia (Hb= 9-10.9g/dl), 9.9% had moderate anaemia (Hb =7- 8.9g/dl), and 2.1% had severe anaemia (Hb Anaemia was significantly more prevalent in HIV-positive (56.4%) than in HIV-negative women (46.7%), (P = 0.01). In logistic regression anaemia was independently associated with maternal HIV (OR= 1.5), malaria (OR= 5.2), clinic of recruitment (OR= 1.5) and low income (OR= 1.9). Pregnant women with anaemia were more likely to have low birth weight (LBW) infants. Compared with non-anaemic women, the risk of LBW was 1.6 times and 4.8 times higher for children born to women with moderate and severe anaemia, respectively. In conclusion, anaemia in pregnancy is a severe public health problem in northern Tanzania. Control of maternal anaemia may be one important strategy to prevent LBW in this setting. Measures to prevent malaria and to control anaemia among all pregnant women irrespective of HIV status, should be strengthened. Outside of the health sector broader approaches for anaemia prevention targeting women of lower income, are required.

  12. Iron, folate and cobalamin deficiency in anaemic pregnant females in tertiary care centre at Rawalpindi

    Energy Technology Data Exchange (ETDEWEB)

    Khan, D A; Fatima, S; Imran, R; Khan, F A [National Univ. of Science and Technology, Army Medical College, Rawalpindi (Pakistan). Department of Pathology

    2010-01-15

    Background: Anaemia in pregnancy is a common clinical problem contributing to increased maternal and foetal morbidity. This study was carried out to determine frequency of iron, folate and cobalamin deficiency and associated risk factors in the anaemic pregnant females who reported first time during second and third trimester for antenatal check-up in the tertiary care hospital at Rawalpindi. Methods: This case control study was carried out in a tertiary care hospital at Rawalpindi. Two hundred and fifty pregnant women (age: 19-43 years) consisting of 125 anaemic (Hb< 110 g/L) and 125 non-anaemic who reported first time at antenatal clinic were included. Data on socio-demographic characteristics, parity and dietary intake were collected. Complete blood counts were done. Serum ferritin, folate and cobalamin assays were performed by using DPC kits on Immulite-1000. Results: The pregnant women were categorised having mild (Hb up to 54%), moderate (Hb up to 36%), or severe (Hb up to 10%) anaemia during antennal visit. They had significantly lower median (range) levels of haemoglobin 96 (40-110) g/L, ferritin 8 (3-54) nu mu/L, folate 15 (3-54) mu mol/L and cobalamin 171 (111-629) mu mol/L than controls (p=<0.01). Micro nutrient analysis revealed secondary pregnancy related deficiency of Iron (57%), folate (20%), combined iron and folate (19%) and cobalamin (4%) in the female. Among the risk factors, low income (OR: 7.69), multi party (OR: 2.93), lack of iron/folate supplementation (OR 2.91) and inadequate dietary intakes (OR 2.51) were associated with anaemia. Conclusion: The pregnant anaemic women had iron (57%); folate (20%), followed by combined iron folate (19%), and cobalamin (4%) deficiency during first antenatal visit. Low income, multi party, poor diet and lack of supplements are the main contributor in development of anaemia during pregnancy. (author)

  13. Iron, folate and cobalamin deficiency in anaemic pregnant females in tertiary care centre at Rawalpindi

    International Nuclear Information System (INIS)

    Khan, D.A.; Fatima, S.; Imran, R.; Khan, F.A.

    2010-01-01

    Background: Anaemia in pregnancy is a common clinical problem contributing to increased maternal and foetal morbidity. This study was carried out to determine frequency of iron, folate and cobalamin deficiency and associated risk factors in the anaemic pregnant females who reported first time during second and third trimester for antenatal check-up in the tertiary care hospital at Rawalpindi. Methods: This case control study was carried out in a tertiary care hospital at Rawalpindi. Two hundred and fifty pregnant women (age: 19-43 years) consisting of 125 anaemic (Hb< 110 g/L) and 125 non-anaemic who reported first time at antenatal clinic were included. Data on socio-demographic characteristics, parity and dietary intake were collected. Complete blood counts were done. Serum ferritin, folate and cobalamin assays were performed by using DPC kits on Immulite-1000. Results: The pregnant women were categorised having mild (Hb up to 54%), moderate (Hb up to 36%), or severe (Hb up to 10%) anaemia during antennal visit. They had significantly lower median (range) levels of haemoglobin 96 (40-110) g/L, ferritin 8 (3-54) nu mu/L, folate 15 (3-54) mu mol/L and cobalamin 171 (111-629) mu mol/L than controls (p=<0.01). Micro nutrient analysis revealed secondary pregnancy related deficiency of Iron (57%), folate (20%), combined iron and folate (19%) and cobalamin (4%) in the female. Among the risk factors, low income (OR: 7.69), multi party (OR: 2.93), lack of iron/folate supplementation (OR 2.91) and inadequate dietary intakes (OR 2.51) were associated with anaemia. Conclusion: The pregnant anaemic women had iron (57%); folate (20%), followed by combined iron folate (19%), and cobalamin (4%) deficiency during first antenatal visit. Low income, multi party, poor diet and lack of supplements are the main contributor in development of anaemia during pregnancy. (author)

  14. Adverse childhood experiences of low-income urban youth.

    Science.gov (United States)

    Wade, Roy; Shea, Judy A; Rubin, David; Wood, Joanne

    2014-07-01

    Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults. Copyright © 2014 by the American Academy of Pediatrics.

  15. Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

    Science.gov (United States)

    Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

    2017-12-01

    Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

  16. Examining the implications of dental treatment costs for low-income families.

    Science.gov (United States)

    Snow, Patrick; McNally, Mary E

    2010-01-01

    Dental disease is concentrated among those with low socioeconomic status. Dental care is not publicly funded, and many Canadians must therefore make difficult financial choices when accessing dental care. Families who live in poverty have difficulty meeting even their most basic household needs, so dental treatment may not be affordable. The objective of this study was to understand how the cost of dental treatment affects the monthly budgets of families with low incomes. A chart review was conducted for a sample of 213 new patients examined at the Dalhousie University dental clinic over a 1-year period. Costs for proposed treatment plans were averaged. The patients" ability to pay for proposed treatment was examined in the context of various income scenarios. Two hundred and one patients were included in the final analysis. Dental treatment costs per patient averaged approximately $1600 for the year, with 42% of the planned treatment completed within the first year. The estimated monthly cost of completed treatment was $55. When the cost of a healthy diet was included in the monthly budget, it was determined that families in Nova Scotia with parents working for minimum wage and those receiving income assistance would experience a 100% shortfall for dental expenses. Low-income families in Nova Scotia were unable to afford both a nutritious diet and dental care. This is disturbing, given the links between a healthy diet and both overall health and dental health. An understanding of the significance of income shortfalls for those with low incomes, especially as they affect even basic nutritional needs, will help dental professionals to appreciate the seriousness of this issue and the difficulties that many Canadians face when trying to access basic dental care.

  17. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Gilmore, Brynne; McAuliffe, Eilish

    2013-09-13

    Community Health Workers are widely utilised in low- and middle-income countries and may be an important tool in reducing maternal and child mortality; however, evidence is lacking on their effectiveness for specific types of programmes, specifically programmes of a preventive nature. This review reports findings on a systematic review analysing effectiveness of preventive interventions delivered by Community Health Workers for Maternal and Child Health in low- and middle-income countries. A search strategy was developed according to the Evidence for Policy and Practice Information and Co-ordinating Centre's (EPPI-Centre) guidelines and systematic searching of the following databases occurred between June 8-11th, 2012: CINAHL, Embase, Ovid Nursing Database, PubMed, Scopus, Web of Science and POPLINE. Google, Google Scholar and WHO search engines, as well as relevant systematic reviews and reference lists from included articles were also searched. Inclusion criteria were: i) Target beneficiaries should be pregnant or recently pregnant women and/or children under-5 and/or caregivers of children under-5; ii) Interventions were required to be preventive and delivered by Community Health Workers at the household level. No exclusion criteria were stipulated for comparisons/controls or outcomes. Study characteristics of included articles were extracted using a data sheet and a peer tested quality assessment. A narrative synthesis of included studies was compiled with articles being coded descriptively to synthesise results and draw conclusions. A total of 10,281 studies were initially identified and through the screening process a total of 17 articles detailing 19 studies were included in the review. Studies came from ten different countries and consisted of randomized controlled trials, cluster randomized controlled trials, before and after, case control and cross sectional studies. Overall quality of evidence was found to be moderate. Five main preventive intervention

  18. Medicines coverage and community-based health insurance in low-income countries

    Directory of Open Access Journals (Sweden)

    Wagner Anita K

    2008-10-01

    Full Text Available Abstract Objectives The 2004 International Conference on Improving Use of Medicines recommended that emerging and expanding health insurances in low-income countries focus on improving access to and use of medicines. In recent years, Community-based Health Insurance (CHI schemes have multiplied, with mounting evidence of their positive effects on financial protection and resource mobilization for healthcare in poor settings. Using literature review and qualitative interviews, this paper investigates whether and how CHI expands access to medicines in low-income countries. Methods We used three complementary data collection approaches: (1 analysis of WHO National Health Accounts (NHA and available results from the World Health Survey (WHS; (2 review of peer-reviewed articles published since 2002 and documents posted online by national insurance programs and international organizations; (3 structured interviews of CHI managers about key issues related to medicines benefit packages in Lao PDR and Rwanda. Results In low-income countries, only two percent of WHS respondents with voluntary insurance belong to the lowest income quintile, suggesting very low CHI penetration among the poor. Yet according to the WHS, medicines are the largest reported component of out-of-pocket payments for healthcare in these countries (median 41.7% and this proportion is inversely associated with income quintile. Publications have mentioned over a thousand CHI schemes in 19 low-income countries, usually without in-depth description of the type, extent, or adequacy of medicines coverage. Evidence from the literature is scarce about how coverage affects medicines utilization or how schemes use cost-containment tools like co-payments and formularies. On the other hand, interviews found that medicines may represent up to 80% of CHI expenditures. Conclusion This paper highlights the paucity of evidence about medicines coverage in CHI. Given the policy commitment to expand CHI

  19. Social Interaction Needs and Entertainment Approaches to Pregnancy Well-Being in mHealth Technology Design for Low-Income Transmigrant Women: Qualitative Codesign Study.

    Science.gov (United States)

    AlJaberi, Hana

    2018-04-13

    Low-income Caribbean transmigrant women face unique health challenges during pregnancy that set forth multidimensional implications for the design of mobile health (mHealth). Acknowledgment of the unique health needs of low-income Caribbean immigrant women in the United States and what that entails regarding technology design remains rarely examined in the literature of mHealth technologies. The goal of this study was to reveal the needs and gaps in mHealth interventions for pregnant immigrant women not yet realized in this field. These understandings reveal design opportunities for mHealth. The use of the qualitative participatory action research approach of codesign workshops in this study resulted in design solutions by the participants after reflecting on their earlier focus group discussions. The highlights are not the resulting designs per se but rather the inferences derived from the researcher reflecting on these designs. The designs exposed two themes relevant to this paper. First, the participants desired the inclusion and rebuilding of social and organizational relationships in mHealth. The resulting designs formulate an understanding of the women's health-related social support needs and how technology can facilitate them. Second, the participants wanted entertainment with an element of social participation incorporated in mHealth pregnancy management interventions. This brings attention to the role entertainment can add to the impact mHealth can deliver for pregnancy well-being. The study concluded with an examination of social and entertainment design implications that reveal pregnant immigrant women's virtual health-related sharing habits, choice of sharing interaction scenarios during pregnancy (eg, local, long distance, one-way, two-way, and many-many), and choice of sharing media (eg, text, voice, and video). Additionally, the study revealed exclusions to social sharing capabilities in health technologies for these women. ©Hana Al

  20. Social marketing nutrition education for low-income population.

    Science.gov (United States)

    Hagues, Rachel; Stotz, Sarah; Childers, Austin; Phua, Joe; Hibbs, Judy; Murray, Deborah; Lee, Jung Sun

    2018-01-01

    As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.

  1. Bucking the trend? Health care expenditures in low-income countries 1990-1995.

    Science.gov (United States)

    Jowett, M

    1999-01-01

    Health care expenditures in low-income countries are analysed for the years 1990 and 1995 using four key indicators. Key findings include a substantial reduction in public spending per capita across low-income countries between 1990-95; a significant shift towards private expenditures, which appears increasingly to be substituting rather than supplementing public expenditures; a fall in total and public health spending in many countries despite growth in national income, contradicting the relationship found in other studies. Two possible explanations are put forward. First that the patterns found are a direct result of the structural adjustment policies adopted by many low-income countries, which aim to control and often cut public financing, whilst promoting private health expenditures. Secondly, that following the wave of privatization of state industries, many governments are finding problems adapting to their new role as a tax collector, and are thus not benefiting from economic growth to the extent that might be expected.

  2. Do breastfeeding intentions of pregnant inner-city teens and adult women differ?

    Science.gov (United States)

    Alexander, Ashley; O'Riordan, Mary Ann; Furman, Lydia

    2010-12-01

    This study compared the breastfeeding intentions and attitudes of pregnant low-income inner-city teens (age ≤19 years) and non-teens (age ≥20) to determine if age is a significant determinant of intent to breastfeed in this population. We used structured interviews to examine the feeding intentions and attitudes of consecutive healthy pregnant women receiving obstetrical care at the Women's Health Center, MacDonald Women's Hospital, Cleveland, OH (June 1-July 31, 2007). The primary outcome measure was rate of intent to breastfeed among teen versus non-teen participants. Attitudes and self-assessed knowledge regarding breastfeeding were compared between teens and non-teens, and multiple logistic regression analysis was used to examine the effect of age on breastfeeding intent. We interviewed 176 pregnant women (95% African-American, 94% single marital status, median age 22 years [range, 15-41 years], 46 [26%] teens) at a median of 27 weeks of pregnancy. There were no significant differences between teens and non-teens in race, marital status, or timing of first prenatal visit or interview. Rate of intent to breastfeed and planned duration and exclusivity of breastfeeding, as well as most measured attitudes about breastfeeding including "back to work" plans, were not significantly different between groups. Significant determinants of feeding intent included primiparity, good self-assessed knowledge about breastfeeding, and having support from the father of the baby. In a population at high risk for choosing not to breastfeed, we found no significant explanatory effect of age on breastfeeding intention, implying that an inclusive targeted breastfeeding intervention program may be effective for both teens and non-teens in a low-income inner-city population. We also found that the support of the father of the baby significantly influenced breastfeeding intent among our participants, suggesting that paternal involvement will be integral to the success of

  3. Pharmaceutical quality assurance of local private distributors: a secondary analysis in 13 low-income and middle-income countries

    Science.gov (United States)

    Caudron, Jean Michel; Schiavetti, Benedetta; Pouget, Corinne; Tsoumanis, Achilleas; Meessen, Bruno; Ravinetto, Raffaella

    2018-01-01

    Introduction The rapid globalisation of the pharmaceutical production and distribution has not been supported by harmonisation of regulatory systems worldwide. Thus, the supply systems in low-income and middle-income countries (LMICs) remain exposed to the risk of poor-quality medicines. To contribute to estimating this risk in the private sector in LMICs, we assessed the quality assurance system of a convenient sample of local private pharmaceutical distributors. Methods This descriptive study uses secondary data derived from the audits conducted by the QUAMED group at 60 local private pharmaceutical distributors in 13 LMICs. We assessed the distributors’ compliance with good distribution practices (GDP), general quality requirements (GQR) and cold chain management (CCM), based on an evaluation tool inspired by the WHO guidelines ’Model Quality Assurance System (MQAS) for procurement agencies'. Descriptive statistics describe the compliance for the whole sample, for distributors in sub-Saharan Africa (SSA) versus those in non-SSA, and for those in low-income countries (LICs) versus middle-income countries (MICs). Results Local private pharmaceutical distributors in our sample were non-compliant, very low-compliant or low-compliant for GQR (70%), GDP (60%) and CCM (41%). Only 7/60 showed good to full compliance for at least two criteria. Observed compliance varies by geographical region and by income group: maximum values are higher in non-SSA versus SSA and in MICs versus LICs, while minimum values are the same across different groups. Conclusion The poor compliance with WHO quality standards observed in our sample indicates a concrete risk that patients in LMICs are exposed to poor-quality or degraded medicines. Significant investments are needed to strengthen the regulatory supervision, including on private pharmaceutical distributors. An adapted standardised evaluation tool inspired by the WHO MQAS would be helpful for self-evaluation, audit and inspection

  4. Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

    Directory of Open Access Journals (Sweden)

    Arafat Tfayli

    2010-01-01

    Full Text Available Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

  5. Micronutrients in Pregnancy in Low- and Middle-Income Countries

    Directory of Open Access Journals (Sweden)

    Ian Darnton-Hill

    2015-03-01

    Full Text Available Pregnancy is one of the more important periods in life when increased micronutrients, and macronutrients are most needed by the body; both for the health and well-being of the mother and for the growing foetus and newborn child. This brief review aims to identify the micronutrients (vitamins and minerals likely to be deficient in women of reproductive age in Low- and Middle-Income Countries (LMIC, especially during pregnancy, and the impact of such deficiencies. A global prevalence of some two billion people at risk of micronutrient deficiencies, and multiple micronutrient deficiencies of many pregnant women in LMIC underline the urgency to establishing the optimal recommendations, including for delivery. It has long been recognized that adequate iron is important for best reproductive outcomes, including gestational cognitive development. Similarly, iodine and calcium have been recognized for their roles in development of the foetus/neonate. Less clear effects of deficiencies of zinc, copper, magnesium and selenium have been reported. Folate sufficiency periconceptionally is recognized both by the practice of providing folic acid in antenatal iron/folic acid supplementation and by increasing numbers of countries fortifying flours with folic acid. Other vitamins likely to be important include vitamins B12, D and A with the water-soluble vitamins generally less likely to be a problem. Epigenetic influences and the likely influence of micronutrient deficiencies on foetal origins of adult chronic diseases are currently being clarified. Micronutrients may have other more subtle, unrecognized effects. The necessity for improved diets and health and sanitation are consistently recommended, although these are not always available to many of the world’s pregnant women. Consequently, supplementation programmes, fortification of staples and condiments, and nutrition and health support need to be scaled-up, supported by social and cultural measures

  6. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries.

    Science.gov (United States)

    Engle, Patrice L; Fernald, Lia C H; Alderman, Harold; Behrman, Jere; O'Gara, Chloe; Yousafzai, Aisha; de Mello, Meena Cabral; Hidrobo, Melissa; Ulkuer, Nurper; Ertem, Ilgi; Iltus, Selim

    2011-10-08

    This report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrolment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include children's educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Effective investments in early child development have the potential to reduce inequalities perpetuated by poverty, poor nutrition, and restricted learning opportunities. A simulation model of the potential long-term economic effects of increasing preschool enrolment to 25% or 50% in every low-income and middle-income country showed a benefit-to-cost ratio ranging from 6·4 to 17·6, depending on preschool enrolment rate and discount rate. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Bringing Bike Share to a Low-Income Community

    Centers for Disease Control (CDC) Podcasts

    This podcast is an interview with Sarah Kretman Stewart, MPH, MEd, Healthy Living Minneapolis Project Specialist at the Minneapolis Health Department. In this program, Sarah talks about the impact a bike share program had on the low-income town of Near North, Minnesota.

  8. The Life Course Implications of Ready to Use Therapeutic Food for Children in Low-Income Countries.

    Science.gov (United States)

    Bazzano, Alessandra N; Potts, Kaitlin S; Bazzano, Lydia A; Mason, John B

    2017-04-11

    The development of ready-to-use therapeutic food (RUTF) for the treatment of uncomplicated cases of severe acute malnutrition in young children from 6 months to 5 years old has greatly improved survival through the ability to treat large numbers of malnourished children in the community setting rather than at health facilities during emergencies. This success has led to a surge in demand for RUTF in low income countries that are frequently food insecure due to environmental factors such as cyclical drought. Worldwide production capacity for the supply of RUTF has increased dramatically through the expansion and development of new manufacturing facilities in both low and high income countries, and new business ventures dedicated to ready-to-use foods have emerged not only for emergencies, but increasingly, for supplementing caloric intake of pregnant women and young children not experiencing acute undernutrition. Due to the lack of evidence on the long term health impact these products may have, in the midst of global nutrition transitions toward obesity and metabolic dysfunction, the increased use of manufactured, commercial products for treatment and prevention of undernutrition is of great concern. Using a framework built on the life course health development perspective, the current research presents several drawbacks and limitations of RUTF for nutrition of mothers and young children, especially in non-emergency situations. Recommendations follow for potential strategies to limit the use of these products to the treatment of acute undernutrition only, study the longer term health impacts of RUTF, prevent conflict of interests arising for social enterprises, and where possible, ensure that whole foods are supported for life-long health and nutrition, as well as environmental sustainability.

  9. 26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

    Science.gov (United States)

    2010-04-01

    ... credit agencies for exclusive use in making housing credit allocations to buildings that are part of... housing credit allocations in excess of an agency's aggregate housing credit dollar amount. In the event... not perform an independent investigation of the qualified low-income building in order to certify on...

  10. "When a woman is pregnant, her grave is open": health beliefs concerning dietary practices among pregnant Kalenjin women in rural Uasin Gishu County, Kenya.

    Science.gov (United States)

    Riang'a, Roselyter Monchari; Nangulu, Anne Kisaka; Broerse, Jacqueline E W

    2017-12-16

    Reducing malnutrition remains a major global challenge especially in low- and middle-income countries. Lack of knowledge on the motive of nutritional behaviour could ultimately cripple nutrition intervention outcomes. The purpose of this study was to investigate how health beliefs influence nutritional behaviour intention of the pregnant Kalenjin women of rural Uasin Gishu County in Kenya. The study findings provide useful information for culturally congruent nutrition counselling and intervention. In this qualitative study semi-structured interviews were conducted with 42 pregnant and post-natal (with children less than one year) Kalenjin women in selected rural public health facilities of Uasin Gishu County Kenya. Furthermore, key informant interviews took place with 6 traditional birth attendants who were also pregnancy herbalists, two community health workers and one nursing officer in charge of Maternal and Child Health (MCH) for triangulation and provision of in-depth information. Content analysis of interview transcripts followed a grounded theory (Protection Motivation Theory) approach, using software MAXQDA version 12.1.3. Abstracted labour (big babies and lack of maternal strength), haemorrhage (low blood), or having other diseases and complications (evil or bad food) were the major perceived health threats that influence nutritional behaviour intention of the pregnant Kalenjin women in rural Uasin Gishu County in Kenya. The pregnancy nutritional behaviour and practices of the Kalenjin women in rural Uasin Gishu County act as an adaptive response to the perceived health threats, which seem to be within the agency of pregnant women. As a result, just giving antenatal nutritional counselling without addressing these key health assumptions that underlie a successful pregnancy outcome is unlikely to lead to changes in nutritional behaviour.

  11. Food Choices of Minority and Low-Income Employees

    Science.gov (United States)

    Levy, Douglas E.; Riis, Jason; Sonnenberg, Lillian M.; Barraclough, Susan J.; Thorndike, Anne N.

    2012-01-01

    Background Effective strategies are needed to address obesity, particularly among minority and low-income individuals. Purpose To test whether a two-phase point-of-purchase intervention improved food choices across racial, socioeconomic (job type) groups. Design A 9-month longitudinal study from 2009 to 2010 assessing person-level changes in purchases of healthy and unhealthy foods following sequentially introduced interventions. Data were analyzed in 2011. Setting/participants Participants were 4642 employees of a large hospital in Boston MA who were regular cafeteria patrons. Interventions The first intervention was a traffic light–style color-coded labeling system encouraging patrons to purchase healthy items (labeled green) and avoid unhealthy items (labeled red). The second intervention manipulated “choice architecture” by physically rearranging certain cafeteria items, making green-labeled items more accessible, red-labeled items less accessible. Main outcome measures Proportion of green- (or red-) labeled items purchased by an employee. Subanalyses tracked beverage purchases, including calories and price per beverage. Results Employees self-identified as white (73%), black (10%), Latino (7%), and Asian (10%). Compared to white employees, Latino and black employees purchased a higher proportion of red items at baseline (18%, 28%, and 33%, respectively, p0.05 for interaction between race or job type and intervention). Mean calories per beverage decreased similarly over the study period for all racial groups and job types, with no increase in per-beverage spending. Conclusions Despite baseline differences in healthy food purchases, a simple color-coded labeling and choice architecture intervention improved food and beverage choices among employees from all racial and socioeconomic backgrounds. PMID:22898116

  12. Evaluation of DOE's Partnership in Low-Income Residential Retrofit (PILIRR) Program

    Energy Technology Data Exchange (ETDEWEB)

    Callaway, J.W.; Lee, A.D.

    1989-05-01

    In July 1986, the US Department of Energy (DOE) awarded competitive grants to five states to conduct pilot projects to establish partnerships and use resource leveraging to stimulate support for low-income residential energy retrofits. The projects were conducted under DOE's Partnerships in Low-Income Residential Retrofit (PILIRR) Program. These projects have been monitored and analyzed through a concurrent process evaluation conducted by the Pacific Northwest Laboratory (PNL). This study reports the findings of that evaluation. The overriding goal of the PILIRR Program was to determine whether the states could stimulate support for low-income residential energy improvements from non-federal sources. The goal for the process evaluation was to conduct an assessment of the processes used by the states and the extent to which they successfully established partnerships and leveraged resources. Five states were selected to participate in the program: Florida, Iowa, Kentucky, Oklahoma and Washington. Each state proposed a different approach to promote non-federal support for low-income residential weatherization. Three of the five states--Florida, Iowa, and Washington--established partnerships that led to retrofits during the monitoring period (October 1986--October 1988). Kentucky established its partnership during the monitoring period, but did not accomplish its retrofits until after monitoring was complete. Oklahoma completed development of its marketing program and had begun marketing efforts by the end of the monitoring period. 16 refs., 7 figs., 1 tab.

  13. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Siriwardhana, Dhammika D; Hardoon, Sarah; Rait, Greta; Weerasinghe, Manuj C; Walters, Kate R

    2018-03-01

    To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. Low-income and middle-income countries. Community-dwelling older adults aged ≥60 years. We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I 2 =99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I 2 =97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. CRD42016036083. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Playing Linear Numerical Board Games Promotes Low-Income Children's Numerical Development

    Science.gov (United States)

    Siegler, Robert S.; Ramani, Geetha B.

    2008-01-01

    The numerical knowledge of children from low-income backgrounds trails behind that of peers from middle-income backgrounds even before the children enter school. This gap may reflect differing prior experience with informal numerical activities, such as numerical board games. Experiment 1 indicated that the numerical magnitude knowledge of…

  15. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kunst, Anton; Harper, Sam; Guthold, Regina; Rekve, Dag; d'Espaignet, Edouard Tursan; Naidoo, Nirmala; Chatterji, Somnath

    2012-10-28

    Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different

  16. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women.

    Science.gov (United States)

    Feitosa, Danielle Cristina Alves; da Silva, Márcia Guimarães; de Lima Parada, Cristina Maria Garcia

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to UTI diagnoses. The analysis of positive (PPV) and negative (NPV) predictive values showed that, when a regular simple urine test was performed, the chance of UTI occurrence was small (NPV 99.2%). In view of an altered result for such a test, the possibility of UTI existence was small (PPV 22.4%). It was concluded that the accuracy of the simple urine test as a diagnostic means for UTI was low, and that performing a urine culture is essential for appropriate diagnosis.

  17. Narrowing the Early Mathematics Gap: A Play-Based Intervention to Promote Low-Income Preschoolers’ Number Skills

    Directory of Open Access Journals (Sweden)

    Nicole R. Scalise

    2018-01-01

    Full Text Available Preschoolers from low-income households lag behind preschoolers from middle-income households on numerical skills that underlie later mathematics achievement. However, it is unknown whether these gaps exist on parallel measures of symbolic and non-symbolic numerical skills. Experiment 1 indicated preschoolers from low-income backgrounds were less accurate than peers from middle-income backgrounds on a measure of symbolic magnitude comparison, but they performed equivalently on a measure of non-symbolic magnitude comparison. This suggests activities linking non-symbolic and symbolic number representations may be used to support children’s numerical knowledge. Experiment 2 randomly assigned low-income preschoolers (Mean Age = 4.7 years to play either a numerical magnitude comparison or a numerical matching card game across four 15 min sessions over a 3-week period. The magnitude comparison card game led to significant improvements in participants’ symbolic magnitude comparison skills in an immediate posttest assessment. Following the intervention, low-income participants performed equivalently to an age- and gender-matched sample of middle-income preschoolers in symbolic magnitude comparison. These results suggest a brief intervention that combines non-symbolic and symbolic magnitude representations can support low-income preschoolers’ early numerical knowledge.

  18. Critical Components of a Summer Enrichment Program for Urban Low-Income Gifted Students

    Science.gov (United States)

    Kaul, Corina R.; Johnsen, Susan K.; Witte, Mary M.; Saxon, Terrill F.

    2015-01-01

    Effective program models are needed for low-income youth. This article describes one successful summer enrichment program, University for Young People's Project Promise, and outlines three key components of a Partnership for Promoting Potential in Low-Income Gifted Students (Partnership Model), which is based on Lee, Olszewski-Kubilius, and…

  19. The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women - A randomised controlled trial

    DEFF Research Database (Denmark)

    Backhausen, Mette G; Tabor, Ann; Albert, Hanne

    2017-01-01

    BACKGROUND: Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise-either land or water based-has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program...... on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. METHODS: In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either...... unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16-17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32...

  20. Neurodevelopmental Disorders in Low- and Middle-Income Countries

    Science.gov (United States)

    Newton, Charles R.

    2012-01-01

    In "Global Perspective on Early Diagnosis and Intervention for Children with Developmental Delays and Disabilities" (p1079-1084, this issue), Scherzer et al. highlighted the potential increase in neurodevelopmental impairments and disabilities affecting an increasing number of children in low- and middle-income countries (LMIC). In this…

  1. Conditioned to eat while watching television? Low-income caregivers' perspectives on the role of snacking and television viewing among pre-schoolers.

    Science.gov (United States)

    Blaine, Rachel E; Fisher, Jennifer Orlet; Blake, Christine E; Orloski, Alexandria; Younginer, Nicholas; Bruton, Yasmeen; Ganter, Claudia; Rimm, Eric B; Geller, Alan C; Davison, Kirsten K

    2016-06-01

    Although television (TV) viewing is frequently paired with snacking among young children, little is known about the environment in which caregivers promote this behaviour. We describe low-income pre-schoolers' snacking and TV viewing habits as reported by their primary caregivers, including social/physical snacking contexts, types of snacks and caregiver rationales for offering snacks. These findings may support the development of effective messages to promote healthy child snacking. Semi-structured interviews assessed caregiver conceptualizations of pre-schoolers' snacks, purpose of snacks, snack context and snack frequency. Interviews occurred in Boston, Massachusetts and Philadelphia, Pennsylvania, USA. Forty-seven low-income multi-ethnic primary caregivers of children aged 3-5 years (92 % female, 32 % Hispanic/Latino, 34 % African American) described their child's snacking in the context of TV viewing. TV viewing and child snacking themes were described consistently across racial/ethnic groups. Caregivers described snacks offered during TV viewing as largely unhealthy. Labels for TV snacks indicated non-nutritive purposes, such as 'time out', 'enjoyment' or 'quiet.' Caregivers' primary reasons for providing snacks included child's expectations, behaviour management (e.g. to occupy child) and social time (e.g. family bonding). Some caregivers used TV to distract picky children to eat more food. Child snacking and TV viewing were contextually paired by providing child-sized furniture ('TV table') specifically for snacking. Low-income caregivers facilitate pre-schoolers' snacking and TV viewing, which are described as routine, positive and useful for non-nutritive purposes. Messages to caregivers should encourage 'snack-free' TV viewing, healthy snack options and guidance for managing children's behaviour without snacks or TV.

  2. Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria.

    Science.gov (United States)

    Abimiku, Alash'le; Villalba-Diebold, Pacha; Dadik, Jelpe; Okolo, Felicia; Mang, Edwina; Charurat, Man

    2009-09-01

    To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections.

  3. Pregnant adolescents living with HIV: what we know, what we need to know, where we need to go.

    Science.gov (United States)

    Callahan, Tegan; Modi, Surbhi; Swanson, Jennifer; Ng'eno, Bernadette; Broyles, Laura N

    2017-08-04

    HIV-infected pregnant and breastfeeding adolescents are a particularly vulnerable group that require special attention and enhanced support to achieve optimal maternal and infant outcomes. The objective of this paper is to review published evidence about antenatal care (ANC) service delivery and outcomes for HIV-infected pregnant adolescents in low-income country settings, identify gaps in knowledge and programme services and highlight the way forward to improve clinical outcomes of this vulnerable group. Emerging data from programmes in sub-Saharan Africa highlight that HIV-infected pregnant adolescents have poorer prevention of mother-to-child HIV transmission (PMTCT) service outcomes, including lower PMTCT service uptake, compared to HIV-infected pregnant adults. In addition, the limited evidence available suggests that there may be higher rates of mother-to-child HIV transmission among infants of HIV-infected pregnant adolescents. While the reasons for the inferior outcomes among adolescents in ANC need to be further explored and addressed, there is sufficient evidence that immediate operational changes are needed to address the unique needs of this population. Such changes could include integration of adolescent-friendly services into PMTCT settings or targeting HIV-infected pregnant adolescents with enhanced retention and follow-up activities.

  4. Influenza vaccine acceptance among pregnant women in urban slum areas, Karachi, Pakistan.

    Science.gov (United States)

    Khan, Afshin Alaf; Varan, Aiden Kennedy; Esteves-Jaramillo, Alejandra; Siddiqui, Mariam; Sultana, Shazia; Ali, Asad S; Zaidi, Anita K M; Omer, Saad B

    2015-09-22

    Facilitators and barriers to influenza vaccination among pregnant women in the developing world are poorly understood, particularly in South Asia. We assessed intention to accept influenza vaccine among ethnically diverse low-income pregnant women in Pakistan. From May to August 2013, we conducted a cross-sectional survey of pregnant women who visited health centers in urban slums in Karachi city. We assessed intention to accept influenza vaccine against socio-demographic factors, vaccination history, vaccine recommendation sources, and other factors. In an unvaccinated study population of 283 respondents, 87% were willing to accept the vaccine, if offered. All except two participants were aware of symptoms typically associated with influenza. Perceived vaccine safety, efficacy, and disease susceptibility were significantly associated with intention to accept influenza vaccine (p<0.05). Regardless of intention to accept influenza vaccine, 96% rated healthcare providers as highly reliable source of vaccine information. While a recommendation from a physician was critical for influenza vaccine acceptance, parents-in-law and husbands were often considered the primary decision-makers for pregnant women seeking healthcare including vaccination. Maternal influenza vaccination initiatives in South Asia should strongly consider counseling of key familial decision-makers and inclusion of healthcare providers to help implement new vaccination programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Access to and use of paid sick leave among low-income families with children.

    Science.gov (United States)

    Clemans-Cope, Lisa; Perry, Cynthia D; Kenney, Genevieve M; Pelletier, Jennifer E; Pantell, Matthew S

    2008-08-01

    The ability of employed parents to meet the health needs of their children may depend on their access to sick leave, especially for low-income workers, who may be afforded less flexibility in their work schedules to accommodate these needs yet also more likely to have children in poor health. Our goal was to provide rates of access to paid sick leave and paid vacation leave among low-income families with children and to assess whether access to these benefits is associated with parents' leave taking to care for themselves or others. We used a sample of low-income families (paid leave and characteristics of children, families, and parents' employer. Access to paid leave was lower among children in low-income families than among those in families with higher income. Within low-income families, children without >or=1 full-time worker in the household were especially likely to lack access to this benefit, as were children whose parents work for small employers. Among children whose parents had access to paid sick leave, parents were more likely to take time away from work to care for themselves or others. This relationship is even more pronounced among families with the highest need, such as children in fair or poor health and children with all parents in full-time employment. Legislation mandating paid sick leave could dramatically increase access to this benefit among low-income families. It would likely diminish gaps in parents' leave taking to care for others between families with and without the benefit. However, until the health-related consequences are better understood, the full impact of such legislation remains unknown.

  6. Cost-effectiveness of maternal GBS immunization in low-income sub-Saharan Africa.

    Science.gov (United States)

    Russell, Louise B; Kim, Sun-Young; Cosgriff, Ben; Pentakota, Sri Ram; Schrag, Stephanie J; Sobanjo-Ter Meulen, Ajoke; Verani, Jennifer R; Sinha, Anushua

    2017-12-14

    A maternal group B streptococcal (GBS) vaccine could prevent neonatal sepsis and meningitis. Its cost-effectiveness in low-income sub-Saharan Africa, a high burden region, is unknown. We used a decision tree model, with Markov nodes to project infants' lifetimes, to compare maternal immunization delivered through routine antenatal care with no immunization. 37 countries were clustered on the basis of economic and health resources and past public health performance. Vaccine efficacy for covered serotypes was ranged from 50% to 90%. The model projected EOGBS (early-onset) and LOGBS (late-onset) cases and deaths, disability-adjusted life years (DALYs), healthcare costs (2014 US$), and cost-effectiveness for a representative country in each of the four clusters: Guinea-Bissau, Uganda, Nigeria, and Ghana. Maximum vaccination costs/dose were estimated to meet two cost-effectiveness benchmarks, 0.5 GDP and GDP per capita/DALY, for ranges of disease incidence (reported and adjusted for under-reporting) and vaccine efficacy. At coverage equal to the proportion of pregnant women with≥4 antenatal visits (ANC4) and serotype-specific vaccine efficacy of 70%, maternal GBS immunization would prevent one-third of GBS cases and deaths in Uganda and Nigeria, where ANC4 is 50%, 42-43% in Guinea-Bissau (ANC4=65%), and 55-57% in Ghana (ANC4=87%). At a vaccination cost of $7/dose, maternal immunization would cost $320-$350/DALY averted in Guinea-Bissau, Nigeria, and Ghana, less than half these countries' GDP per capita. In Uganda, which has the lowest case fatality ratios, the cost would be $573/DALY. If the vaccine prevents a small proportion of stillbirths, it would be even more cost-effective. Vaccination cost/dose, disease incidence, and case fatality were key drivers of cost/DALY in sensitivity analyses. Maternal GBS immunization could be a cost-effective intervention in low-income sub-Saharan Africa, with cost-effectiveness ratios similar to other recently introduced vaccines

  7. Low-Income Demand for Local Telephone Service: Effects of Lifeline and Linkup

    OpenAIRE

    Daniel Ackerberg; Michael Riordan; Gregory Rosston; Bradley Wimmer

    2008-01-01

    A comprehensive data set on local telephone service prices is used to evaluate the effect of Lifeline and Linkup programs on the telephone penetration rates of low-income households in the United States. Lifeline and Linkup programs respectively subsidize the monthly subscription and initial installation charges of eligible low-income households. Telephone penetration rates are explained by an estimated nonlinear function of local service characteristics (including subsidized prices) and the ...

  8. Health-related quality-of-life in low-income, uninsured men with prostate cancer.

    Science.gov (United States)

    Krupski, Tracey L; Fink, Arlene; Kwan, Lorna; Maliski, Sally; Connor, Sarah E; Clerkin, Barbara; Litwin, Mark S

    2005-05-01

    The objective was to describe health-related quality-of-life (HRQOL) in low-income men with prostate cancer. Subjects were drawn from a statewide public assistance prostate cancer program. Telephone and mail surveys included the RAND 12-item Health Survey and UCLA Prostate Cancer Index Short Form and were compared with normative age-matched men without cancer from the general population reported on in the literature. Of 286 eligible men, 233 (81%) agreed to participate and completed the necessary items. The sample consisted of 51% Hispanics, 23% non-Hispanic whites, and 17% African Americans. The low-income men had worse scores in every domain of prostate-specific and general HRQOL than had the age-matched general population controls. The degree of disparity indicated substantial clinical differences in almost every domain of physical and emotional functioning between the sample group and the control group. Linear regression modeling determined that among the low-income men, Hispanic race, and income level were predictive of worse physical functioning, whereas only comorbidities predicted mental health. Low-income patients with prostate cancer appear to have quality-of-life profiles that are meaningfully worse than age-matched men from the general population without cancer reported on in the literature.

  9. Institutional Variation in Enrollment of Low-Income Students

    Science.gov (United States)

    Monks, James

    2018-01-01

    Socioeconomic diversity in tertiary education has come under heightened scrutiny in the past few years. This paper estimates the relationship between prices (both sticker price and net price), financial aid policies, and selectivity on the variation of low-income students across postsecondary institutions. All three factors are significant in…

  10. Impact of Pneumococcal Conjugate Vaccines on Pneumonia Hospitalizations in High- and Low-Income Subpopulations in Brazil

    DEFF Research Database (Denmark)

    Warren, Joshua L.; Shioda, Kayoko; Kürüm, Esra

    2017-01-01

    Background Pneumococcal conjugate vaccines (PCVs) are being used worldwide. A key question is whether the impact of PCVs on pneumonia is similar in low- and high-income populations. However, most low-income countries, where the burden of disease is greatest, lack reliable data that can be used...... to evaluate the impact. Data from middle-income countries that have both low- and high-income subpopulations can provide a proxy measure for the impact of the vaccine in low-income countries. Methods We evaluated the impact of PCV10 on hospitalizations for all-cause pneumonia in Brazil, a middle......-income country with localities that span a broad range of human development index (HDI) levels. We used complementary time series and spatiotemporal methods (synthetic controls and hierarchical Bayesian spatial regression) to test whether the decline in pneumonia hospitalizations associated with vaccine...

  11. Food Insecurity as a Risk Factor for Obesity in Low-Income Boushehrian Women

    Directory of Open Access Journals (Sweden)

    Masoumeh Mohammadpour Kaldeh

    2010-12-01

    Full Text Available Background: Food insecurity contributes to poor health and nutritional status such as higher prevalence of overweight and obesity and other mental and physical problems. This study was conducted to investigate the relationship between food insecurity and obesity in low-income women living in Bushehr. Methods: A cross sectional study was conducted among 300 Bushehrian women (19-49 years, non pregnant and non lactating. The women were interviewed for socio-economic, demographic, physical and household food security. The radimer-cornell food insecurity instrument and international physical activity questionnaire were used. For data analysis, logistic regression was conducted. Results: Overall, a majority of the households (86% experienced food insecurity. About more than half (55% of the women were obese. The mean body mass index of food insecure groups (30.43 ± 4.67 Kg/cm2 were significantly higher than food secure group (21.41 ± 1.61 Kg/cm2 (p<0.05. After adjusting for other variables using logistic regression, housewives (OR=3.99 and lower physical activity (OR=2.65 significantly increased as well as food security (OR= 0.04 significantly decreased the risk of obesity. Conclusion: The consumption of chip and high dense food and lower physical activity can be important reasons for overweight and obesity in food insecure women.

  12. Dental pain and associated factors among pregnant women: an observational study.

    Science.gov (United States)

    Krüger, Marta S M; Lang, Celina A; Almeida, Luiza H S; Bello-Corrêa, Fernanda O; Romano, Ana R; Pappen, Fernanda G

    2015-03-01

    The present study aimed to determine the prevalence of dental pain during pregnancy and its association with sociodemographic factors and oral health conditions among 315 pregnant women in South Brazil. Participants were interviewed to obtain sociodemographic data, such as age, educational level, employment status, family income, and marital and parity status. Medical and dental histories were also collected, including the occurrence of dental pain and the use of dental services during pregnancy. Clinical examinations were performed to assess the presence of visible plaque and gingival bleeding and to calculate the decayed, missing, and filled teeth index. Means and standard deviations of continuous variables and frequencies and percentages of categorical variables were calculated. Independent variables were included in a multivariate logistic regression analysis. A total of 173 (54.9 %) pregnant women reported dental pain during pregnancy. After adjustment of the analysis, caries activity remained the main determinant of dental pain (odds ratio 3.33, 95 % CI 1.67-6.65). The prevalence of dental pain during pregnancy was high and the presence of caries activity was a determinant of dental pain. Moreover, access to oral health care was low, despite pregnant women's increased need for dental assistance.

  13. Postpartum Health Information Seeking Using Mobile Phones: Experiences of Low-Income Mothers.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Harris, Asia L; Siek, Katie A

    2016-11-01

    Objectives To assess low-income mothers' perceptions of their postpartum information needs; describe their information seeking behavior; explore their use of mobile technology to address those needs; and to contribute to the sparse literature on postpartum health and wellness. Methods Exploratory community-based qualitative approach. Interviewees were recruited among clients of community partners and had children aged 48 months and under. A survey assessing demographics was used to identify low-income mothers. 10 low-income mothers were recruited from survey participants to complete in-depth interviews regarding postpartum information needs, information seeking, and technology use. Interviews were transcribed verbatim and coded by three researchers independently. Narratives were analyzed along predetermined (etic) and emergent (emic) categories. Results Establishing breastfeeding and solving breastfeeding problems were central postpartum concerns leading to information seeking. Interviewees reported almost exclusive use of mobile phones to access the Internet. Mobile applications were widely used during pregnancy, but were not valuable postpartum. Face-to-face information from medical professionals was found to be repetitive. Online information seeking was mediated by default mobile phone search engines, and occurred over short, fragmented time periods. College graduates reported searching for authoritative knowledge sources; non-graduates preferred forums. Conclusions for Practice Low-income postpartum women rely on their smartphones to find online infant care and self-care health information. Websites replace pregnancy-related mobile applications and complement face-to-face information. Changes in searching behavior and multitasking mean information must be easily accessible and readily understood. Knowledge of page-rank systems and use of current and emergent social media will allow health-related organizations to better engage with low-income mothers online and

  14. Energy Efficiency and Renewable Energy in Low-Income Communities

    Science.gov (United States)

    State and local governments can provide benefits to low-income communities by investing in energy efficiency. Use the Program Finder table to identify those programs that reach the sectors and audiences of interest in your organization.

  15. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

    DEFF Research Database (Denmark)

    Lee, Anne C C; Katz, Joanne; Blencowe, Hannah

    2013-01-01

    million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were......BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low...... birthweight (age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from...

  16. Tailoring science education graduate programs to the needs of science educators in low-income countries

    Science.gov (United States)

    Lunetta, Vincent N.; van den Berg, Euwe

    Science education graduate programs in high-income countries frequently enroll students from low-income countries. Upon admission these students have profiles of knowledge, skills, and experiences which can be quite different from those of students from the host high-income countries. Upon graduation, they will normally return to work in education systems with conditions which differ greatly from those in high-income countries. This article attempts to clarify some of the differences and similarities between such students. It offers suggestions for making graduate programs more responsive to the special needs of students from low-income countries and to the opportunities they offer for enhancing cross-cultural sensitivity. Many of the suggestions can be incorporated within existing programs through choices of elective courses and topics for papers, projects, and research. Many references are provided to relevant literature on cultural issues and on science education in low-income countries.

  17. Positive Reading Attitudes of Low-Income Bilingual Latinos

    Science.gov (United States)

    Bussert-webb, Kathy M.; Zhang, Zhidong

    2018-01-01

    Many assume low-income, emergent bilingual Latinos have poor reading attitudes. To investigate this issue, we surveyed 1,503 Texas public high school students through stratified cluster sampling to determine their reading attitudes. Most represented Latinos and mixed-race Latinos/Whites who heard Spanish at home and whose mother tongue was…

  18. Potential unintended consequences of smoke-free policies in public places on pregnant women in China.

    Science.gov (United States)

    Yao, Tingting; Lee, Anita H; Mao, Zhengzhong

    2009-08-01

    Smoke-free policies in public places have become more common in China. Little is known, however, about the potential unintended consequences of such policies on pregnant women. The study was conducted in 2006 in Chengdu, China. Nonsmoking pregnant women (N=55) whose husband were smokers participated in a study of their knowledge about secondhand smoke and smoke-free policies, their exposure to secondhand smoke, and their husbands' smoking status at home. This study presents descriptive statistics, analyses based on family income and pregnant women's education level, and the findings of focus group discussions that examined the potential unintended consequences of the smoke-free policies on pregnant women. Exposure to secondhand smoke at home was reported by 69.1% of the pregnant women. Both family income and the education level of the pregnant women had a significant (ppolicies were: (1) increased exposure of pregnant women to secondhand smoke at home; (2) reduced work efficiency; (3) adverse effect on family harmony; and (4) poor air quality at home. Education is needed to increase knowledge of secondhand smoke among smokers and nonsmokers alike. When the smoking location is shifted from public places and workplaces to home, women, and in particular pregnant women, become the victims. Policymakers should recognize such potential unintended consequences and take necessary measures to increase awareness about the harms of secondhand smoke.

  19. Mental health interventions in schools in low-income and middle-income countries.

    Science.gov (United States)

    Fazel, Mina; Patel, Vikram; Thomas, Saji; Tol, Wietse

    2014-10-01

    Increasing enrolment rates could place schools in a crucial position to support mental health in low-income and middle-income countries. In this Review, we provide evidence for mental health interventions in schools in accordance with a public mental health approach spanning promotion, prevention, and treatment. We identified a systematic review for mental health promotion, and identified further prevention and treatment studies. Present evidence supports schools as places for promotion of positive aspects of mental health using a whole-school approach. Knowledge of effectiveness of prevention and treatment interventions is more widely available for conflict-affected children and adolescents. More evidence is needed to identify the many elements likely to be associated with effective prevention and treatment for children exposed to a range of adversity and types of mental disorders. Dissemination and implementation science is crucial to establish how proven effective interventions could be scaled up and implemented in schools. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Educational technologies to encourage (self) care in postpartum women.

    Science.gov (United States)

    Barbosa, Eryjosy Marculino Guerreiro; Sousa, Albertina Antonielly Sydney de; Vasconcelos, Mardênia Gomes Ferreira; Carvalho, Rhanna Emanuela Fontenele Lima de; Oriá, Mônica Oliveira Batista; Rodrigues, Dafne Paiva

    2016-06-01

    to evaluate national and international literature regarding the use of educational technologies to encourage self care in postpartum women. an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis Results: based on the information found, the scales, counseling and home visits were among the most recommended educational technologies. the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.

  1. Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

    Science.gov (United States)

    Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo Yong; El Sadr, Wafaa; Wolf, Nicholas; Silkensen, Shannon; Brand, Nathan; Looi, Lai Meng; Pai, Sanjay A; Wilson, Michael L; Milner, Danny; Flanigan, John; Fleming, Kenneth A

    2018-05-12

    Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

    OpenAIRE

    Paul R. Ward; Fiona Verity; Patricia Carter; George Tsourtos; John Coveney; Kwan Chui Wong

    2013-01-01

    Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy ...

  3. Prevalence study of compulsive buying in a sample with low individual monthly income.

    Science.gov (United States)

    Leite, Priscilla Lourenço; Silva, Adriana Cardoso

    2015-01-01

    Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Despite the small sample, the results of this study are important for understanding the problem in question.

  4. How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families.

    Science.gov (United States)

    Glied, Sherry; Chakraborty, Ougni; Russo, Therese

    2017-08-01

    ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs. waiver programs. METHODS. Analysis of the Consumer Expenditure Survey 2010–2015. KEY FINDINGS AND CONCLUSIONS. Compared to families in nonexpansion states, low-income families in states that did expand Medicaid saved an average of $382 in annual spending on health care. In these states, low-income families were less like to report any out-of-pocket spending on insurance premiums or medical care than were similar families in nonexpansion states. For families that did have some out-of-pocket spending, spending levels were lower in states that expanded Medicaid. Low-income families in Medicaid expansion states were also much less likely to have catastrophically high spending levels. The form of coverage expansion — conventional Medicaid or waiver rules — did not have a statistically significant effect on these outcomes.

  5. Population density, distance to public transportation, and health of women in low-income neighborhoods.

    Science.gov (United States)

    DeGuzman, Pamela B; Merwin, Elizabeth I; Bourguignon, Cheryl

    2013-01-01

    The purpose of this research was to determine the impact of two neighborhood walkability (the extent to which the built environment is pedestrian friendly) metrics on health outcomes of women living in low-income urban neighborhoods, both before and after accounting for individual and neighborhood factors. A cross-sectional, retrospective design was used. The sample of 1800 low-income women was drawn from Welfare, Children and Families: A Three-City Study (a study of low-income women from three U.S. cities). Using multilevel modeling and geographic information systems, the study sought to determine the effect of distance to public transportation and residential density on health status, mental health symptoms, and health-related limitations. No significant relationship was found between the two walkability metrics and health outcomes. Instead, neighborhood problems that affect crime and safety impacted health status and mental health symptoms. As cities make changes to the built environment with the hope of affecting residents' health outcomes, public health nurses need to be aware that changing walkability characteristics in a neighborhood may not affect the health of residents of high crime, low-income neighborhoods. Without first addressing neighborhood crime, efforts to improve walkability in low-income neighborhoods may fail. © 2013 Wiley Periodicals, Inc.

  6. Wanting better: a qualitative study of low-income parents about their children's oral health.

    Science.gov (United States)

    Lewis, Charlotte W; Linsenmayer, Kristi A; Williams, Alexis

    2010-01-01

    Using qualitative methods, the purpose of this study was to understand low-income parents' experiences and how these influenced their oral health-related behavior toward their children. Twenty-eight parents were recruited from 7 sites that serve low-income families. Interviews, which were audiotaped and transcribed, were comprised of mostly open-ended questions. Transcripts were analyzed for common themes. Parents' experiences influenced their oral health-related beliefs, intentions, and behaviors. Finding dentists who accept Medicaid was the greatest barrier to realizing intended preventive dental care. Physicians appeared to have relatively little impact on these families' oral health care, even though parents believed that oral health is part of overall health care. WIC (the Supplemental Nutrition Program for Women, Infants and Children) played an important role in facilitating oral health knowledge and access to dental care. Most low-income parents had received little attention to their own oral health, yet wanted better for their children. This motivated the high value placed on their children's preventive oral health. Parents faced challenges finding dental care for their children. Difficulty finding a regular source of dental care for low-income adults, however, was nearly universal. The authors identified strategies, which emerged from their interviews, to improve the oral health knowledge and dental care access for these low-income families.

  7. Communicating public health preparedness information to pregnant and postpartum women: an assessment of Centers for Disease Control and Prevention web pages.

    Science.gov (United States)

    McDonough, Brianna; Felter, Elizabeth; Downes, Amia; Trauth, Jeanette

    2015-04-01

    Pregnant and postpartum women have special needs during public health emergencies but often have inadequate levels of disaster preparedness. Thus, improving maternal emergency preparedness is a public health priority. More research is needed to identify the strengths and weaknesses of various approaches to how preparedness information is communicated to these women. A sample of web pages from the Centers for Disease Control and Prevention intended to address the preparedness needs of pregnant and postpartum populations was examined for suitability for this audience. Five of the 7 web pages examined were considered adequate. One web page was considered not suitable and one the raters split between not suitable and adequate. None of the resources examined were considered superior. If these resources are considered some of the best available to pregnant and postpartum women, more work is needed to improve the suitability of educational resources, especially for audiences with low literacy and low incomes.

  8. Associations between family food behaviors, maternal depression, and child weight among low-income children

    OpenAIRE

    McCurdy, Karen; Gorman, Kathleen S.; Kisler, Tiffani; Metallinos-Katsaras, Metallinos-Katsaras

    2014-01-01

    Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and ...

  9. Perceptions of New Zealand nutrition labels by Māori, Pacific and low-income shoppers.

    Science.gov (United States)

    Signal, Louise; Lanumata, Tolotea; Robinson, Jo-Ani; Tavila, Aliitasi; Wilton, Jenny; Ni Mhurchu, Cliona

    2008-07-01

    In New Zealand the burden of nutrition-related disease is greatest among Māori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Māori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems. Māori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Māori group, one Samoan, one Tongan, and three low-income groups. Māori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase. Current New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of 'healthy' food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.

  10. The rationale behind small food store interventions in low-income urban neighborhoods: insights from New Orleans.

    Science.gov (United States)

    Bodor, J Nicholas; Ulmer, Vanessa M; Dunaway, Lauren Futrell; Farley, Thomas A; Rose, Donald

    2010-06-01

    Environmental approaches to the obesity problem in the US have garnered favor due to growing evidence that changes to the environment are at the root of the epidemic. Low-income urban neighborhoods, where obesity rates are disproportionately high, typically lack supermarkets yet have a high density of small food stores. This may increase the risk for unhealthy diets and obesity for neighborhood residents, because small stores carry mostly energy-dense foods and few fruits and vegetables. This paper pulls together various studies and pilot work conducted in New Orleans to explore the rationale behind small store interventions. Many low-income residents in New Orleans live within walking distance of small food stores and shop at them frequently. Marketing research has documented that changes to in-store shelf space and displays of specific foods affect the sales of these foods. Initiatives in New Orleans and elsewhere have demonstrated some success with improving healthy food availability in small stores, and an intercept survey of customers at small stores suggests that customers would purchase more fruits and vegetables if available. Efforts to encourage small store operators to offer a healthier mix of foods may, in the end, depend on the profitability of such changes. Evidence from a typical small store in New Orleans indicates that a greater percentage of gross profits come from snack foods and beverages than from fruits and vegetables. More research is needed to better understand the financial operations of small food stores and whether altering the mix of foods is economically feasible.

  11. The role of urban agriculture for food security in low income areas in Nairobi

    NARCIS (Netherlands)

    Mwangi, A.M.

    1995-01-01

    This paper, which is based on research carried out among 210 households in Nairobi (Kenya) in 1994, examines the role of urban agriculture in household food security among low-income urban households. It determines the different strategies the low-income population of Nairobi deploys in order to

  12. Growth faltering in low-income countries.

    Science.gov (United States)

    Prentice, Andrew M; Moore, Sophie E; Fulford, Anthony J

    2013-01-01

    Meta-analysis of growth data from over 50 low and low-middle income countries shows a consistent pattern of stunting and poor weight gain from about 3 months of age and persisting until at least 5 years. Children tend not to be wasted because their short stature offsets their underweight, leading to a rather adequately proportioned appearance. This frequently conceals the true levels of malnutrition in communities. At the macro-environmental level such growth faltering is due to the combined effects of poverty, food insecurity, low-dietary diversity, a highly infectious environment, poor washing facilities and poor understanding of the principles of nutrition and hygiene. These tend to be ameliorated as communities pass through the demographic transition with improved incomes and education. Because such changes will take generations to achieve, the global health community continues to search for effective interim solutions. Disappointingly, apart from intensive feeding programmes aimed at rehabilitating severely malnourished children, there are few examples of very successful nutrition interventions. This emphasizes the need for a better understanding of the etiology of growth failure. This paper uses anthropometric data collected over 6 decades in subsistence-farming communities from rural Gambia to illustrate the typical key features of growth faltering. Arising from this analysis, and from gaps in the published literature, the following issues are highlighted as still requiring a better resolution: (1) the pre-natal and inter-generational influences on growth failure; (2) the ontogeny of the infant immune system; (3) the exact nature of the precipitating insults that initiate gastroenteropathy; (4) the effects of both enteric and systemic infections on the hormonal regulation of growth; (5) interactions between macro- and micro-nutrient deficiencies and infections in causing growth failure, and (6) the role of the microbiome in modulating dietary influences on

  13. Economics, Marketing and Low Income Individuals: interest after a history of indifference

    Directory of Open Access Journals (Sweden)

    Marcus Wilcox Hemais

    2014-08-01

    Full Text Available During the early years of marketing, researchers used theories and concepts from economics as base for the development of their own theories and concepts. This similarity can be seen in the way marketing viewed the low income individual and his relationship with consumption, in the first studies of the subject. Like the economists, researchers in marketing described these individuals as dependents of society and governments to better their lives. This view changes when Prahalad defends a new perspective, through which individuals in this context are seen as consumers, with desires to consume products of diverse nature. The objective of this article, therefore, is to analyze the paths trailed by economics and two moments in marketing about the low income individual. Initially, the view economics has on low income individuals is discussed, so that, afterwards, two perspectives of marketing about this segment can be presented.

  14. Prenatal care utilization for mothers from low-income areas of New Mexico, 1989-1999.

    Directory of Open Access Journals (Sweden)

    Michael A Schillaci

    2010-09-01

    Full Text Available Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999.Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings.These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes.

  15. [Coverage of nutritional and health programs in the low income strata].

    Science.gov (United States)

    Cruzat, M A; González, N; Mardones, F; Moenne, A M; Sánchez, H

    1982-06-01

    The extent and consequences of exclusion of low income strata from maternal and child health programs in Chile are analyzed using available data. Infant mortality has been shown by several studies to be closely associated with socioeconomic status in Chile. Babies of illiterate mothers showed the highest rate of mortality and the least improvement in rate between 1972-78. The effect of socioeconomic status on the mortality rate of infants in greatly influenced by birth weight; low birth weight infants of low income groups suffer significantly higher mortality than among higher income groups. Several national studies in Chile demonstrated a relationship between infant malnutrition and health program coverage. Infant malnutrition is greatest in groups benefiting least from health care. Based on the fact that 90.5% of births in 1980 were professionally attended, it is estimated that 9.5% of the low income population lacks access to health care. A recent survey showed that 9.9% of the population under 6 years, some 105,848 children, was not covered by the National Complementary Feeding Program. Another study showed that 12.3% of mothers had no prenatal medical attention prior to their most recent birth; mothers with little or no education, living in rural areas, and of high parity were most likely not to have received medical attention. Factors responsible for lack of access to health and nutrition programs appeared to include unsatisfactory relationships with the health workers, poor acceptability of foods offered, excessive distance and waiting times, and lack of interest or motivation on the part of the mothers.

  16. The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

    Science.gov (United States)

    Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

    2011-01-01

    We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

  17. Posttraumatic stress disorder among low-income women exposed to perinatal intimate partner violence : Posttraumatic stress disorder among women exposed to partner violence.

    Science.gov (United States)

    Kastello, Jennifer C; Jacobsen, Kathryn H; Gaffney, Kathleen F; Kodadek, Marie P; Bullock, Linda C; Sharps, Phyllis W

    2016-06-01

    Women exposed to intimate partner violence (IPV) and other forms of lifetime trauma may be at risk for negative mental health outcomes including posttraumatic stress disorder (PTSD). The purpose of this study was to examine potential predictors of PTSD among low-income women exposed to perinatal IPV. This study analyzed baseline cross-sectional data from 239 low-income pregnant women in the USA who participated in a nurse home visitation intervention between 2006 and 2012 after reporting recent IPV. PTSD was assessed with the Davidson Trauma Scale (DTS) in which participants answer questions about the most disturbing traumatic event (MDTE) in their lifetime that affected them the week before the interview. In total, 40 % of the women were identified as having PTSD (DTS ≥40). PTSD prevalence significantly increased with age to nearly 80 % of women ages 30 and older (n = 23). Age was also the strongest predictor of PTSD (p violence were not significantly associated with PTSD status. Despite recent exposure to IPV, most participants identified other traumatic events as more disturbing than IPV-related trauma. Further, the risk for PTSD increased with age, suggesting that the cumulative effect of trauma, which may include IPV, increases the risk for PTSD over a lifetime. Implementing comprehensive screening for trauma during prenatal care may lead to the early identification and treatment of PTSD during pregnancy in a community setting.

  18. Authorship ethics in global health research partnerships between researchers from low or middle income countries and high income countries.

    Science.gov (United States)

    Smith, Elise; Hunt, Matthew; Master, Zubin

    2014-05-28

    Over the past two decades, the promotion of collaborative partnerships involving researchers from low and middle income countries with those from high income countries has been a major development in global health research. Ideally, these partnerships would lead to more equitable collaboration including the sharing of research responsibilities and rewards. While collaborative partnership initiatives have shown promise and attracted growing interest, there has been little scholarly debate regarding the fair distribution of authorship credit within these partnerships. In this paper, we identify four key authorship issues relevant to global health research and discuss their ethical and practical implications. First, we argue that authorship guidance may not adequately apply to global health research because it requires authors to write or substantially revise the manuscript. Since most journals of international reputation in global health are written in English, this would systematically and unjustly exclude non-English speaking researchers even if they have substantially contributed to the research project. Second, current guidance on authorship order does not address or mitigate unfair practices which can occur in global health research due to power differences between researchers from high and low-middle income countries. It also provides insufficient recognition of "technical tasks" such as local participant recruitment. Third, we consider the potential for real or perceived editorial bias in medical science journals in favour of prominent western researchers, and the risk of promoting misplaced credit and/or prestige authorship. Finally, we explore how diverse cultural practices and expectations regarding authorship may create conflict between researchers from low-middle and high income countries and contribute to unethical authorship practices. To effectively deal with these issues, we suggest: 1) undertaking further empirical and conceptual research regarding

  19. Reducing the Incidence of Low Birth Weight in Low-Income Countries Has Substantial Economic Benefits

    OpenAIRE

    Alderman, Harold; Behrman, Jere R.

    2006-01-01

    Reducing the incidence of low birth weight not only lowers infant mortality rates but also has multiple benefits over the life cycle. This study estimates the economic benefits of reducing the incidence of low birth weight in low-income countries, both through lower mortality rates and medical costs and through increased learning and productivity. The estimated economic benefits, under pla...

  20. The impact of income inequality and national wealth on child and adolescent mortality in low and middle-income countries.

    Science.gov (United States)

    Ward, Joseph L; Viner, Russell M

    2017-05-11

    Income inequality and national wealth are strong determinants for health, but few studies have systematically investigated their influence on mortality across the early life-course, particularly outside the high-income world. We performed cross-sectional regression analyses of the relationship between income inequality (national Gini coefficient) and national wealth (Gross Domestic Product (GDP) averaged over previous decade), and all-cause and grouped cause national mortality rate amongst infants, 1-4, 5-9, 10-14, 15-19 and 20-24 year olds in low and middle-income countries (LMIC) in 2012. Gini models were adjusted for GDP. Data were available for 103 (79%) countries. Gini was positively associated with increased all-cause and communicable disease mortality in both sexes across all age groups, after adjusting for national wealth. Gini was only positively associated with increased injury mortality amongst infants and 20-24 year olds, and increased non-communicable disease mortality amongst 20-24 year old females. The strength of these associations tended to increase during adolescence. Increasing GDP was negatively associated with all-cause, communicable and non-communicable disease mortality in males and females across all age groups. GDP was also associated with decreased injury mortality in all age groups except 15-19 year old females, and 15-24 year old males. GDP became a weaker predictor of mortality during adolescence. Policies to reduce income inequality, rather than prioritising economic growth at all costs, may be needed to improve adolescent mortality in low and middle-income countries, a key development priority.

  1. Longitudinal effects of group music instruction on literacy skills in low-income children.

    Directory of Open Access Journals (Sweden)

    Jessica Slater

    Full Text Available Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

  2. Longitudinal effects of group music instruction on literacy skills in low-income children.

    Science.gov (United States)

    Slater, Jessica; Strait, Dana L; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2014-01-01

    Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

  3. Longitudinal Effects of Group Music Instruction on Literacy Skills in Low-Income Children

    Science.gov (United States)

    Slater, Jessica; Strait, Dana L.; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2014-01-01

    Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6–9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development. PMID:25409300

  4. Exposing and addressing tobacco industry conduct in low-income and middle-income countries.

    Science.gov (United States)

    Gilmore, Anna B; Fooks, Gary; Drope, Jeffrey; Bialous, Stella Aguinaga; Jackson, Rachel Rose

    2015-03-14

    The tobacco industry's future depends on increasing tobacco use in low-income and middle-income countries (LMICs), which face a growing burden of tobacco-related disease, yet have potential to prevent full-scale escalation of this epidemic. To drive up sales the industry markets its products heavily, deliberately targeting non-smokers and keeps prices low until smoking and local economies are sufficiently established to drive prices and profits up. The industry systematically flaunts existing tobacco control legislation and works aggressively to prevent future policies using its resource advantage to present highly misleading economic arguments, rebrand political activities as corporate social responsibility, and establish and use third parties to make its arguments more palatable. Increasingly it is using domestic litigation and international arbitration to bully LMICs from implementing effective policies and hijacking the problem of tobacco smuggling for policy gain, attempting to put itself in control of an illegal trade in which there is overwhelming historical evidence of its complicity. Progress will not be realised until tobacco industry interference is actively addressed as outlined in Article 5.3 of the Framework Convention on Tobacco Control. Exemplar LMICs show this action can be achieved and indicate that exposing tobacco industry misconduct is an essential first step. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Cigarette stick as valuable communicative real estate: a content analysis of cigarettes from 14 low-income and middle-income countries.

    Science.gov (United States)

    C Smith, Katherine; Washington, Carmen; Welding, Kevin; Kroart, Laura; Osho, Adami; Cohen, Joanna E

    2016-09-01

    The current cigarette market is heavily focused on low-income and middle-income countries. Branding of tobacco products is key to establishing and maintaining a customer base. Greater restrictions on marketing and advertising of tobacco products create an incentive for companies to focus more on branding via the product itself. We consider how tobacco sticks are used for communicative purposes in 14 low-income and middle-income countries with extensive tobacco markets. In 2013, we collected and coded 3232 cigarette and kretek packs that were purchased from vendors in diverse neighbourhoods in 44 cities across the 14 low-income and middle-income countries with the greatest number of smokers. A single stick from each pack was assessed for branding, decorative and communicative elements using a common coding framework. Stick communication variables included brand name, brand image/logo, brand descriptor, colour and design carried through from pack, 'capsule cigarette' symbol, and embellishment of filter end. Communication and branding on the stick is essentially ubiquitous (99.75%); 97% of sticks include explicit branding (brand name or logo present). Colour is commonly carried through from the pack (95%), and some sticks (13%) include decorative elements matching the pack. Decorative elements can be found anywhere on the stick, including the filter tip (8%), and 'convertible' cigarettes include a symbol to show where to push. Cigarette sticks are clearly valuable 'real estate' that tobacco companies are using for communicative purposes. Across all countries and brands, the stick communicates branding via text, colour and imagery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Financial hardship and self-rated health among low-income housing residents.

    Science.gov (United States)

    Tucker-Seeley, Reginald D; Harley, Amy E; Stoddard, Anne M; Sorensen, Glorian G

    2013-08-01

    Self-rated health (SRH) has been shown to be predictive of morbidity and mortality. Evidence also shows that SRH is socioeconomically patterned, although this association differs depending on the indicator of socioeconomic status used. The purpose of this study was to determine the association between SRH and financial hardship among residents of low-income housing. We analyzed cross-sectional data from the Health in Common Study (N = 828), an observational study to investigate social and physical determinants of cancer risk-related behaviors among residents of low-income housing in three cities in the Boston metropolitan area. Modified Poisson regression models were used to obtain the relative risk of low SRH (fair or poor), adjusting for demographic and socioeconomic characteristics. Unadjusted models revealed that the respondents reporting financial hardship were 53% more likely to report low SRH compared with those not reporting financial hardship. After controlling for demographic characteristics, socioeconomic characteristics, and psychological distress, the results showed that those reporting financial hardship were 44% more likely to report low SRH. Our results suggest that financial hardship is a robust predictor of SRH; and over and above the influence of demographic and traditional socioeconomic indicators, and even psychological distress, financial hardship remains strongly associated with low SRH. Additional research needs to be conducted to further elucidate this pathway and to better understand the determinants of variability in financial hardship among low-income housing residents to ensure the most appropriate policy levers (e.g., housing-related policy, food-related policy) are chosen to improve health outcomes in this population.

  7. Low-Income Housing Tax Credit (LIHTC) Qualified Census Tract (QCT)

    Data.gov (United States)

    Department of Housing and Urban Development — It allows to generate tables for Low-Income Housing Tax Credit (LIHTC) Qualified Census Tracts (QCT) and for Difficult Development Areas (DDA). LIHTC Qualified...

  8. Increasing fresh fruit and vegetable availability in a low-income neighborhood convenience store: a pilot study.

    Science.gov (United States)

    Jetter, Karen M; Cassady, Diana L

    2010-09-01

    Changing the food environment in low-income communities may be an effective way to increase the consumption of fruits and vegetables by low-income consumers. This study examines the impacts of a pilot study that increases the availability of fresh produce in a convenience store in a low-income neighborhood not served by a supermarket. Two hypotheses based on theories of technology adoption are tested regarding the lack of fresh produce in low-income neighborhood stores: the first is that high fixed costs present a barrier for store owners in developing produce sections; the second is that there is insufficient consumer demand to cover the variable costs of a fresh produce section. The impacts of changing the food environment on store owners and the consumer response to environmental change are measured through weekly inventories of fresh produce. The results show that fixed costs are one barrier for store owners and that although the consumer response is sufficient to cover the direct costs of operating the produce case, it is not enough to cover variable management costs. Consequently, alternative management paradigms or venues may offer a better method to meet the demand for fresh produce by low-income consumers to promote better health through healthier diets in low-income communities.

  9. Building and Using a Social Network: Nurture for Low-Income Chinese American Adolescents' Learning

    Science.gov (United States)

    Li, Jin; Holloway, Susan D.; Bempechat, Janine; Loh, Elaine

    2008-01-01

    Little research has examined how low-income Asian American children are supported to achieve well in school. The authors used the notion of social capital to study higher versus lower achieving Chinese adolescents from low-income backgrounds. They found that families of higher-achieving adolescents built and used more effectively three kinds of…

  10. Online discussions with pregnant and parenting adolescents: perspectives and possibilities.

    Science.gov (United States)

    Valaitis, Ruta K; Sword, Wendy A

    2005-10-01

    The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population. Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.

  11. Prevalence study of compulsive buying in a sample with low individual monthly income

    Directory of Open Access Journals (Sweden)

    Priscilla Lourenço Leite

    2015-12-01

    Full Text Available Introduction: Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. Objectives: To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. Methods: The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. Results: The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Conclusion: Despite the small sample, the results of this study are important for understanding the problem in question.

  12. Safety and pharmacokinetics of dolutegravir in HIV-positive pregnant women: a systematic review.

    Science.gov (United States)

    Hill, Andrew; Clayden, Polly; Thorne, Claire; Christie, Rachel; Zash, Rebecca

    2018-04-01

    The integrase strand transfer inhibitor dolutegravir (DTG) is being introduced into low- and middle-income countries (LMICs) as an alternative to first-line treatment with non-nucleoside reverse transcriptase inhibitors. However, DTG is not yet widely recommended for use in pregnant women. The aim of this systematic review was to analyse all available data on birth outcomes and congenital anomalies in the infants of pregnant women treated with DTG. A PubMed and Embase search was conducted using the terms "dolutegravir" or "DTG" and "pregnancy" or "pregnant" from the earliest available date on the database to 26 July 2017. Any reports involving women who were pregnant, HIV positive and taking DTG were included. The percentage of pregnant women with adverse birth outcomes or congenital anomalies in their infants after taking dolutegravir was compared with five historical control databases. There were six databases included in the main analysis of birth outcomes and congenital anomalies, with a total of 1200 pregnant women. The percentage of pregnant women taking DTG with adverse birth outcomes and congenital abnormalities was similar to results from historical control studies of HIV-positive women. However, there was significant heterogeneity among the six databases - the percentage of infants with congenital anomalies ranged from 0.0% in Botswana (0/116 infants) to 13.3% in IMPAACT P1026S (2/15 infants). Up to 15 million people could be on treatment with DTG in LMICs within the next 5 years, of whom a substantial percentage is likely to be women of child-bearing potential. In many countries with large HIV epidemics, unplanned pregnancies are common and access to antenatal clinic facilities may be limited. Continued pharmacovigilance is essential, but it is reassuring that no clear safety signals have been detected, to date, for pregnant women treated with DTG in terms of birth outcomes or congenital anomalies.

  13. The Sociocultural Context of Mexican-Origin Pregnant Adolescents' Attitudes Toward Teen Pregnancy and Links to Future Outcomes.

    Science.gov (United States)

    Killoren, Sarah E; Zeiders, Katharine H; Updegraff, Kimberly A; Umaña-Taylor, Adriana J

    2016-05-01

    Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers' lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents' cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents' pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes.

  14. The Sociocultural Context of Mexican-origin Pregnant Adolescents’ Attitudes toward Teen Pregnancy and Links to Future Outcomes

    Science.gov (United States)

    Killoren, Sarah E.; Zeiders, Katharine H.; Updegraff, Kimberly A.; Umaña-Taylor, Adriana J.

    2016-01-01

    Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers’ lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents’ cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents’ pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes. PMID:26573862

  15. Free tax assistance and the earned income tax credit: vital resources for social workers and low-income families.

    Science.gov (United States)

    Lim, Younghee; DeJohn, Tara V; Murray, Drew

    2012-04-01

    As the United States' economy continues to experience challenges, more families at or near the poverty level fall prey to predatory financial practices. Their vulnerability to these operations is increased by a lack of knowledge of asset-building resources and alternative financial services. This article focuses on Volunteer Income Tax Assistance (VITA)--a free income tax preparation program, which is a vital resource available to low-income families. Unfortunately, VITA is largely underused and often unknown to economically strained families and to the social workers and other professionals to whom these families turn for assistance. This article concludes with policy and practice implications for social workers and other professionals engaged in providing services to financially vulnerable families.

  16. Low-income women with early-stage breast cancer: physician and patient decision-making styles.

    Science.gov (United States)

    McVea, K L; Minier, W C; Johnson Palensky, J E

    2001-01-01

    Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study. Copyright 2001 John Wiley & Sons, Ltd.

  17. Availability of healthy snack foods and beverages in stores near high-income urban, low-income urban, and rural elementary and middle schools in Oregon.

    Science.gov (United States)

    Findholt, Nancy E; Izumi, Betty T; Nguyen, Thuan; Pickus, Hayley; Chen, Zunqiu

    2014-08-01

    Food stores near schools are an important source of snacks for children. However, few studies have assessed availability of healthy snacks in these settings. The aim of this study was to assess availability of healthy snack foods and beverages in stores near schools and examine how availability of healthy items varied by poverty level of the school and rural-urban location. Food stores were selected based on their proximity to elementary/middle schools in three categories: high-income urban, low-income urban, and rural. Audits were conducted within the stores to assess the presence or absence of 48 items in single-serving sizes, including healthy beverages, healthy snacks, fresh fruits, and fresh vegetables. Overall, availability of healthy snack foods and beverages was low in all stores. However, there was significant cross-site variability in availability of several snack and fruit items, with stores near high-income urban schools having higher availability, compared to stores near low-income urban and/or rural schools. Stores near rural schools generally had the lowest availability, although several fruits were found more often in rural stores than in urban stores. There were no significant differences in availability of healthy beverages and fresh vegetables across sites. Availability of healthy snack foods and beverages was limited in stores near schools, but these limitations were more severe in stores proximal to rural and low-income schools. Given that children frequent these stores to purchase snacks, efforts to increase the availability of healthy products, especially in stores near rural and low-income schools, should be a priority.

  18. Low income product innovation

    Directory of Open Access Journals (Sweden)

    Maria Cecília Sobral

    2008-10-01

    Full Text Available At affluent markets, the literature on product development management tells us to aggregate value and technology, to differentiate products and to launch fast. And at the low-income markets? This exploratory research defines a popular product, characterizes and measures their markets in Brazil, and identifies innovation strategies for them. The results suggest that the effective strategic orientation differs from affluent markets. It includes: to enhance the auto service component; to identify and service the key functionalities to the targeted public; to standardize products and increase the production scale; to extend the product life cycle; to use convenient distribution and marketing channels; to build product images that have appeal in the popular market; to offer longer financing horizons with befittingly lower installments. Data came from market researches and general demographic census. General media published stories were used to identify companies and their strategies. And a few case studies allowed the authors a deeper exploration of the relevant themes.

  19. Gender Differences in Emotion Expression in Low-Income Adolescents Under Stress.

    Science.gov (United States)

    Panjwani, Naaila; Chaplin, Tara M; Sinha, Rajita; Mayes, Linda C

    2016-06-01

    Gender roles in mainstream U.S. culture suggest that girls express more happiness, sadness, anxiety, and shame/embarrassment than boys, while boys express more anger and externalizing emotions, such as contempt. However, gender roles and emotion expression may be different in low-income and ethnically diverse families, as children and parents are often faced with greater environmental stressors and may have different gender expectations. This study examined gender differences in emotion expression in low-income adolescents, an understudied population. One hundred and seventy nine adolescents (aged 14-17) participated in the Trier Social Stress Test (TSST). Trained coders rated adolescents' expressions of happiness, sadness, anxiety, shame/embarrassment, anger, and contempt during the TSST using a micro-analytic coding system. Analyses showed that, consistent with gender roles, girls expressed higher levels of happiness and shame than boys; however, contrary to traditional gender roles, girls showed higher levels of contempt than boys. Also, in contrast to cultural stereotypes, there were no differences in anger between boys and girls. Findings suggest gender-role inconsistent displays of externalizing emotions in low-income adolescents under acute stress, and may reflect different emotion socialization experiences in this group.

  20. Three models of community mental health services In low-income countries

    Directory of Open Access Journals (Sweden)

    De Silva Mary

    2011-01-01

    Full Text Available Abstract Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models.

  1. Child Disinhibition, Parent Restriction, and Child Body Mass Index in Low-Income Preschool Families

    Science.gov (United States)

    Sparks, Martha A.; Radnitz, Cynthia L.

    2013-01-01

    Objective: To examine both unique and interactive effects of parent restrictive feeding and child disinhibited eating behavior on child body mass index (BMI) in low-income Latino and African American preschoolers. Methods: The sample included 229 parent-child pairs, the majority of whom were low-income and Latino (57%) or African American (25%).…

  2. Contemporary Work and Family Issues Affecting Marriage and Cohabitation among Low-Income Single Mothers

    Science.gov (United States)

    Joshi, Pamela; Quane, James M.; Cherlin, Andrew J.

    2009-01-01

    In this paper, we advance and test an integrative model of the effects of employment status, nonstandard work schedules, male employment, and women's perceptions of economic instability on union formation among low-income single mothers. On the basis of the longitudinal data from 1,299 low-income mothers from the Three-City Welfare Study, results…

  3. Inclusive Development through Providing Vertical Housing for Low Income Family in Yogyakarta Urban Areas

    Directory of Open Access Journals (Sweden)

    Rini Rachmawati

    2017-12-01

    Full Text Available Inclusive development is mean to accommodate the marginalized people, most of whom are the poor with problem of fulfilling their need of housing. The government has tried hard to meet the need of housing by constructing rusunawa. This paper is aimed at describing about the provision and uses of rusunawa, both in cities and peri urban area by studying the cases in the City of Yogyakarta, Sleman Regency, and Bantul Regency. The study was conducted by doing observation and both structured and in-depth interviews. The research results show that rusunawa was viewed as one solutions to help low-income family in fulfilling their need of housing. In some cases in the City of Yogyakarta, rusunawa plays an important role in preventing the settlement along both sides of rivers from becoming slum areas. Rusunawa in both Regencies of Sleman and Bantul are located near the city so it is easy for the settlers to get to their workplace. The construction of rusunawa has also paid attention to the disabled by providing special facilities. The same case is providing playground for children and facilities for early education for young kids. However, there have not been special facilities for the elderly and pregnant women.

  4. Antagonistic effects of cadmium on lead accumulation in pregnant and non-pregnant mice

    International Nuclear Information System (INIS)

    Smith, Euan; Gancarz, Dorota; Rofe, Allan; Kempson, Ivan M.; Weber, John; Juhasz, Albert L.

    2012-01-01

    Highlights: ► We investigate the exposure of pregnant and non-pregnant mice to cadmium (Cd) on lead (Pb) contaminated soil. ► We examine the changes in lead accumulation in mice due to the presence of cadmium in soil. ► Lead accumulation is higher in pregnant compared to non-pregnant mice. ► Cadmium decreases lead accumulation in all mice irrespective of status. - Abstract: People are frequently exposed to combinations of contaminants but there is a paucity of data on the effects of mixed contaminants at low doses. This study investigated the influence of cadmium (Cd) on lead (Pb) accumulation in pregnant and non-pregnant mice following exposure to contaminated soil. Exposure to Pb from contaminated soils increased Pb accumulation in both pregnant and non-pregnant mice compared to unexposed control animals (pregnant and non-pregnant). Lead accumulation in the liver and kidneys of exposure pregnant mice (40 ± 15 mg Pb kg −1 ) was significantly higher (P −1 ). The presence of Cd in contaminated soil had a major effect on the Pb and Fe accumulation in the kidneys and liver, respectively. This study shows that Pb uptake is mediated by the presence of Cd in the co-contaminated soil and demonstrates that further research is required to investigate the influence of co-contaminants on human exposure at sub-chronic concentrations.

  5. Pattern of Ownership and Income Distribution:In View of “Middle-Income Trap”

    Directory of Open Access Journals (Sweden)

    Liu Rui Na

    2016-01-01

    Full Text Available China comes into the ranks of middle-income countries, “middle-income trap” problem become highly attention. Income inequality is the most important factor of fall into this trap. By analyzing the actual information and data, finds out that the main reason for this widening gap between income distributions is the vigorous developments of the private owned company, led to the big gap of the income between owner of the company and normal workers. Then by analyzing and validating the actual mathematical model, and turns out the same result. To solve the problem of “middle-income trap”, we must deal with the income inequality, need to strengthen the guidance and supervision while encourage the development of the private economy. Unswervingly adhere to the public sector of the economy’s dominant position, and continue to develop and perfect the public sector of the economy, along with the corresponding supporting measures.

  6. Outstanding challenges for rotavirus vaccine introduction in low-income countries

    DEFF Research Database (Denmark)

    Ustrup, Marte; Madsen, Lizell B; Bygbjerg, Ib C

    2011-01-01

    Rotavirus infections are the most common cause of severe diarrhoea in children worldwide. Two internationally licensed rotavirus vaccines have proven to be efficacious in middle and high-income countries and they could potentially be valuable tools for the prevention of rotavirus....... There is also a need for political commitment to prevent rotavirus infections as well as a need for an overall strengthening of the health systems in low-income countries. If these challenges were met, rotavirus vaccination could substantially improve child health and survival from rotavirus...

  7. The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling.

    Science.gov (United States)

    Choi, Sunha; Lee, Sungkyu; Matejkowski, Jason

    2018-06-01

    This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

  8. Learning from Low Income Market-driven Innovations and Social ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Learning from Low Income Market-driven Innovations and Social Entrepreneurship in India. A social enterprise is one that uses innovation, finance and business acumen in a business setting to produce social outcomes such as poverty alleviation, health benefits or social inclusion. Social enterprises generate products and ...

  9. Antagonistic effects of cadmium on lead accumulation in pregnant and non-pregnant mice

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Euan, E-mail: euan.smith@unisa.edu.au [Centre for Environmental Risk Assessment and Remediation, University of South Australia, Mawson Lakes, SA 5095 (Australia); Gancarz, Dorota; Rofe, Allan [Veterinary Services Division, Institute of Medical and Veterinary Science, Gilles Plains, SA 5086 (Australia); Kempson, Ivan M. [Institute of Physics, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 11529, Taiwan (China); Weber, John; Juhasz, Albert L. [Centre for Environmental Risk Assessment and Remediation, University of South Australia, Mawson Lakes, SA 5095 (Australia)

    2012-01-15

    Highlights: Black-Right-Pointing-Pointer We investigate the exposure of pregnant and non-pregnant mice to cadmium (Cd) on lead (Pb) contaminated soil. Black-Right-Pointing-Pointer We examine the changes in lead accumulation in mice due to the presence of cadmium in soil. Black-Right-Pointing-Pointer Lead accumulation is higher in pregnant compared to non-pregnant mice. Black-Right-Pointing-Pointer Cadmium decreases lead accumulation in all mice irrespective of status. - Abstract: People are frequently exposed to combinations of contaminants but there is a paucity of data on the effects of mixed contaminants at low doses. This study investigated the influence of cadmium (Cd) on lead (Pb) accumulation in pregnant and non-pregnant mice following exposure to contaminated soil. Exposure to Pb from contaminated soils increased Pb accumulation in both pregnant and non-pregnant mice compared to unexposed control animals (pregnant and non-pregnant). Lead accumulation in the liver and kidneys of exposure pregnant mice (40 {+-} 15 mg Pb kg{sup -1}) was significantly higher (P < 0.05) than concentrations detected in control pregnant mice (<1 mg Pb kg{sup -1}). The presence of Cd in contaminated soil had a major effect on the Pb and Fe accumulation in the kidneys and liver, respectively. This study shows that Pb uptake is mediated by the presence of Cd in the co-contaminated soil and demonstrates that further research is required to investigate the influence of co-contaminants on human exposure at sub-chronic concentrations.

  10. Occupational Engagement in Low-Income Latina Breast Cancer Survivors.

    Science.gov (United States)

    Sleight, Alix G

    This qualitative study examined the experience of occupational engagement in low-income Latina breast cancer survivors and suggests the potential for occupational therapy practitioners to improve health outcomes in this vulnerable and underserved population. Semistructured interviews were conducted with 9 participants. Inductive analysis was used to code for themes and patterns related to occupational engagement and quality of life (QOL). Lack of occupational engagement negatively affected QOL, but participation in occupations such as religious activity and caregiving promoted well-being. Financial concerns and communication barriers decreased QOL. Breast cancer can have a negative impact on occupational engagement in low-income Latina breast cancer survivors; however, some occupations may increase QOL. Socioeconomic status and cultural values influence occupational engagement and QOL. Occupational therapy practitioners can improve health outcomes in this population through awareness of relevant sociocultural factors and attention to appropriate patient communication. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  11. Early Math Trajectories: Low-Income Children's Mathematics Knowledge From Ages 4 to 11.

    Science.gov (United States)

    Rittle-Johnson, Bethany; Fyfe, Emily R; Hofer, Kerry G; Farran, Dale C

    2017-09-01

    Early mathematics knowledge is a strong predictor of later academic achievement, but children from low-income families enter school with weak mathematics knowledge. An early math trajectories model is proposed and evaluated within a longitudinal study of 517 low-income American children from ages 4 to 11. This model includes a broad range of math topics, as well as potential pathways from preschool to middle grades mathematics achievement. In preschool, nonsymbolic quantity, counting, and patterning knowledge predicted fifth-grade mathematics achievement. By the end of first grade, symbolic mapping, calculation, and patterning knowledge were the important predictors. Furthermore, the first-grade predictors mediated the relation between preschool math knowledge and fifth-grade mathematics achievement. Findings support the early math trajectories model among low-income children. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

  12. Reducing the Gap in Numerical Knowledge between Low- and Middle-Income Preschoolers

    Science.gov (United States)

    Ramani, Geetha B.; Siegler, Robert S.

    2011-01-01

    We compared the learning from playing a linear number board game of preschoolers from middle-income backgrounds to the learning of preschoolers from low-income backgrounds. Playing this game produced greater learning by both groups than engaging in other numerical activities for the same amount of time. The benefits were present on number line…

  13. Educator Perceptions of Low-Income Elementary Students and Their Effects on Reading

    Science.gov (United States)

    Fenske, Mark S.

    2013-01-01

    The correlation between income level and achievement has led some educators to believe that low-income students cannot learn at the same level as can middle-class and affluent peers. This problem is significant because as more families become impoverished, more students may be at risk for failure. Many studies have identified challenges facing…

  14. LOW INCOME CONSUMERS AND ONLINE SHOPPING: APPREHENSIONS IN CONSUMING THROUGH THE INTERNET

    Directory of Open Access Journals (Sweden)

    Juan Pablo da Silva Dias

    2015-08-01

    Full Text Available The growth in access of low income consumers to the internet has taken them to use the net in search of entertainment, education and relationships. However, consuming online is still an activity surrounded by distrust. The present study aims to discuss the reasons why low income consumers have apprehension in consuming through the internet. For this, in depth interviews were conducted with 23 low income consumers. The collected data shows that the internet is still seen by the interviewees as being, mainly, for leisure and entertainment. Online shopping still is a task they fear, because of different motives. Initially, one can point the preference to consume in physical stores, since the consumers can touch the desired product, enjoy the trip to the store as a moment of pleasure and the possibility of interacting with salesmen, who help them in their choice. The apprehensions in buying online are also influenced by the perception that sites are not safe, because they offer threats, such as viruses or theft of personal information. Furthermore, interviewees believe that online stores are not compromised with their customers, since they permit problems to occur in the delivery of merchandise, are not clear about the shopping process, and create difficulties in payment method. Another reason for them not to buy online is the perception that if a negative consuming episode of online shopping happened to someone they know, it is also bound to happen with them. Despite this reasoning, these consumers point the importance of help from a third party in their reference group as main incentive for them to face the obstacles to consuming through the internet. In conclusion, it is possible to consider that low income consumers have apprehensions that are similar to their higher income peers, but, also, show different feelings, which are seldom discussed in the literature about online shopping.

  15. Parenting Practices among Low-Income Parents/Guardians of Academically Successful Fifth Grade African American Children

    Science.gov (United States)

    West-Olatunji, Cirecie; Sanders, Tiffany; Mehta, Sejal; Behar-Horenstein, Linda

    2010-01-01

    Research investigating the relationship between parenting and academic achievement has provided conflicting results, particularly for low-income, culturally-diverse parents. Using resilience theory, the researchers conducted a case study with five low-income African American mothers. Findings suggest that educators can benefit from partnering with…

  16. The vector of the tobacco epidemic: tobacco industry practices in low and middle-income countries.

    Science.gov (United States)

    Lee, Sungkyu; Ling, Pamela M; Glantz, Stanton A

    2012-03-01

    To understand transnational tobacco companies' (TTCs) practices in low and middle-income countries which serve to block tobacco-control policies and promote tobacco use. Systematic review of published research on tobacco industry activities to promote tobacco use and oppose tobacco-control policies in low and middle-income countries. TTCs' strategies used in low and middle-income countries followed four main themes-economic activity; marketing/promotion; political activity; and deceptive/manipulative activity. Economic activity, including foreign investment and smuggling, was used to enter new markets. Political activities included lobbying, offering voluntary self-regulatory codes, and mounting corporate social responsibility campaigns. Deceptive activities included manipulation of science and use of third-party allies to oppose smoke-free policies, delay other tobacco-control policies, and maintain support of policymakers and the public for a pro-tobacco industry policy environment. TTCs used tactics for marketing, advertising, and promoting their brands that were tailored to specific market environments. These activities included direct and indirect tactis, targeting particular populations, and introducing new tobacco products designed to limit marketing restrictions and taxes, maintain the social acceptability of tobacco use, and counter tobacco-control efforts. TTCs have used similar strategies in high-income countries as these being described in low and middle-income countries. As required by FCTC Article 5.3, to counter tobacco industry pressures and to implement effective tobacco-control policies, governments and health professionals in low and middle-income countries should fully understand TTCs practices and counter them.

  17. Composite measures of women's empowerment and their association with maternal mortality in low-income countries.

    Science.gov (United States)

    Lan, Chiao-Wen; Tavrow, Paula

    2017-11-08

    Maternal mortality has declined significantly since 1990. While better access to emergency obstetrical care is partially responsible, women's empowerment might also be a contributing factor. Gender equality composite measures generally include various dimensions of women's advancement, including educational parity, formal employment, and political participation. In this paper, we compare several composite measures to assess which, if any, are associated with maternal mortality ratios (MMRs) in low-income countries, after controlling for other macro-level and direct determinants. Using data from 44 low-income countries (half in Africa), we assessed the correlation of three composite measures - the Gender Gap Index, the Gender Equity Index (GEI), and the Social Institutions and Gender Index (SIGI) - with MMRs. We also examined two recognized contributors to reduce maternal mortality (skilled birth attendance (SBA) and total fertility rate (TFR)) as well as several economic and political variables (such as the Corruption Index) to see which tracked most closely with MMRs. We examined the countries altogether, and disaggregated by region. We then performed multivariate analysis to determine which measures were predictive. Two gender measures (GEI and SIGI) and GDP per capita were significantly correlated with MMRs for all countries. For African countries, the SIGI, TFR, and Corruption Index were significant, whereas the GEI, SBA, and TFR were significant in non-African countries. After controlling for all measures, SBA emerged as a predictor of log MMR for non-African countries (β = -0.04, P = 0.01). However, for African countries, only the Corruption Index was a predictor (β = -0.04, P = 0.04). No gender measure was significant. In African countries, corruption is undermining the quality of maternal care, the availability of critical drugs and equipment, and pregnant women's motivation to deliver in a hospital setting. Improving gender equality and

  18. Cadmium, lead and mercury exposure in non smoking pregnant women

    International Nuclear Information System (INIS)

    Hinwood, A.L.; Callan, A.C.; Ramalingam, M.; Boyce, M.; Heyworth, J.; McCafferty, P.; Odland, J.Ø.

    2013-01-01

    Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04 µg/L; Pb soil <3.0 µg/g; Pb dust 16.5 µg/g; Pb blood 3.67 µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0 µg/g; Hg dust <1.0 µg/g; Hg blood 0.46 µg/L; Hg urine <0.40 µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02 µg/L; Cdsoil <0.30 ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55 µg/L, creatinine corrected 0.70 µg/g (range <0.2–7.06 µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects. -- Highlights: • Biological heavy metals concentrations in women in their 3rd trimester of pregnancy. • Exposure assessment including environmental, lifestyle and activity

  19. Cadmium, lead and mercury exposure in non smoking pregnant women

    Energy Technology Data Exchange (ETDEWEB)

    Hinwood, A.L., E-mail: a.hinwood@ecu.edu.au [Centre for Ecosystem Management, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 (Australia); Callan, A. C.; Ramalingam, M.; Boyce, M. [Centre for Ecosystem Management, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027 (Australia); Heyworth, J. [School Population Health, The University of Western Australia, 35 Stirling Highway Crawley, WA 6009 (Australia); McCafferty, P. [ChemCentre, PO Box 1250, Bentley, WA 6983 (Australia); Odland, J. Ø. [Department of Community Medicine, University of Tromsø, N-9037 Tromsø (Norway)

    2013-10-15

    Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04 µg/L; Pb soil <3.0 µg/g; Pb dust 16.5 µg/g; Pb blood 3.67 µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0 µg/g; Hg dust <1.0 µg/g; Hg blood 0.46 µg/L; Hg urine <0.40 µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02 µg/L; Cdsoil <0.30 ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55 µg/L, creatinine corrected 0.70 µg/g (range <0.2–7.06 µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects. -- Highlights: • Biological heavy metals concentrations in women in their 3rd trimester of pregnancy. • Exposure assessment including environmental, lifestyle and activity

  20. How children with special health care needs affect the employment decisions of low-income parents.

    Science.gov (United States)

    Loprest, Pamela; Davidoff, Amy

    2004-09-01

    To better understand the impact of having a child with special health care needs (CSHCN), on low-income parents' employment decisions. Using data from the 1999 and 2000 National Health Interview Survey (NHIS), we estimate multivariate statistical regressions (logit and tobit models) to estimate the relationship between having a CSHCN and the likelihood of employment and hours of employment for a sample-of low-income single parents. Controlling for differences in demographic and family characteristics, we find no significant association between having a CSHCN and the probability of work or the number of hours worked among low-income single-parent families. Separate analysis of different dimensions of special health care needs shows that parents of children with activity limitations are significantly less likely to work and work fewer hours. This result does not hold true for the group of children defined based on elevated or special service use, or for the group of children with specific chronic conditions. These results indicate that only a specific subset of children with special needs present difficulties for low-income parents' work. This suggests that policies to help low-income single parents of children with disabilities move into work should target this specific subset of children with special health care needs.

  1. Opportunities for Prevention: Assessing Where Low-Income Patients Seek Care for Preventable Coronary Artery Disease.

    Science.gov (United States)

    Klaiman, Tamar A; Valdmanis, Vivian G; Bernet, Patrick; Moises, James

    2015-10-01

    The Affordable Care Act has many aspects that are aimed at improving health care for all Americans, including mandated insurance coverage for individuals, as well as required community health needs assessments (CHNAs), and reporting of investments in community benefit by nonprofit hospitals in order to maintain tax exemptions. Although millions of Americans have gained access to health insurance, many--often the most vulnerable--remain uninsured, and will continue to depend on hospital community benefits for care. Understanding where patients go for care can assist hospitals and communities to develop their CHNA and implementation plans in order to focus resources where the need for prevention is greatest. This study evaluated patient care-seeking behavior among patients with coronary artery disease (CAD) in Florida in 2008--analyzed in 2013--to assess whether low-income patients accessed specific safety net hospitals for treatment or received care from hospitals that were geographically closer to their residence. This study found evidence that low-income patients went to hospitals that treated more low-income patients, regardless of where they lived. The findings demonstrate that hospitals-especially public safety net hospitals with a tradition of treating low-income patients suffering from CAD-should focus prevention activities where low-income patients reside.

  2. Perinatal characteristics among early (10–14 years old and late (15–19 years old pregnant adolescents

    Directory of Open Access Journals (Sweden)

    Alves João

    2012-09-01

    Full Text Available Abstract Background Pregnancy in adolescents is a worldwide health problem and has been mostly common in poor populations. It is not clear if socioeconomic or biological factors are the main determinants of perinatal adverse outcomes in pregnant adolescents. Adolescents under 15 years old may present a high growth rate which may contribute to impair fetal growth. Our aim is to compare perinatal characteristics among early (aged 10 to 14 years and late (aged 15 to 19 years pregnant adolescents. Methods A cross-sectional study was performed using data from Pernambuco State 2009, obtained from DATASUS/SISNAC, a Brazilian Government, open-access public health database. Maternal and neonatal outcomes were compared between early (aged 10–14 years and late (aged 15–19 years pregnant adolescents. Family income was compared between early and late pregnant adolescents using a sample of 412 subjects evaluated at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP during 2011. Statistical comparisons were made using the chi-square test was used with a significant level of 0.05; bivariate and multivariate analysis were performed. This project was approved by the Institutional Ethics Review Board. Results Data from 31,209 pregnant adolescents were analyzed. 29,733 (95.2% were aged 15 to 19 years and 1,476 (4.7% were aged 10 to 14 years. There were significant differences with respect to marital status, education level and number of prenatal visits of mothers aged 10 to 14 years compared to 15 to 19 years. Of importance, early adolescents had a greater rate of neonates born premature and with low birth weight. Prematurity and low birth weight remained statistically significant after multivariate analysis. Conclusions Early aged adolescents may have an increased risk of prematurity and low birth weight. These findings highlight the potential role of biological factors in newborn outcomes in pregnant adolescents.

  3. Risk and Protective Factors for Family Violence among Low-Income Fathers: Implications for Violence Prevention and Fatherhood Programs.

    Science.gov (United States)

    Hayward, R Anna; Honegger, Laura; Hammock, Amy Cristina

    2018-01-01

    Over the last decade there has been an increased focus on improving father engagement to improve child and family outcomes. Recent research suggests that child and family outcomes improve with increased fatherhood engagement. This exploratory study examined risk and protective factors associated with approval of family violence among a sample of low-income fathers (N = 686) enrolled in a responsible fatherhood program. The program goals include increasing father involvement and economic stability and encouraging healthy relationships-with a focus on preventing intimate partner violence. Toward these aims, this study explored factors associated with fathers' self-reported approval of family violence. Understanding the prevalence of risk and protective factors in this population and factors associated with fathers' potential for family violence is important in developing programs to address responsible fatherhood and healthy relationships. © 2017 National Association of Social Workers.

  4. Using Banks: Teaching Banking Skills to Low-Income Consumers.

    Science.gov (United States)

    Shurtz, Mary Ann; LeFlore, Ann Becker

    This module, one of six on teaching consumer matters to low-income adults, discusses banking skills. Topics include banking services (savings accounts, safety deposit boxes, Christmas clubs, loans, etc.), checking accounts (deposits, checkwriting, check registers, opening an account), how to use the check register (cancelled checks, deposits),…

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

    Science.gov (United States)

    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…

  6. Alienation: A Concept for Understanding Low-Income, Urban Clients

    Science.gov (United States)

    Holcomb-McCoy, Cheryl

    2004-01-01

    The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

  7. So near, yet so far: tobacco dependence treatment for pregnant women.

    Science.gov (United States)

    Barker, Dianne; Orleans, Tracy; Halpin, Helen; Barry, Matthew

    2004-04-01

    Almost one-half million babies in the United States are born yearly to women who report smoking while pregnant. Almost all of these pregnant women have access to prenatal care, through federally financed health clinics, state and county health programs, or private providers. However, many pregnant smokers are unlikely to receive any type of counseling or assistance to help them stop smoking--despite the availability of evidence-based treatment and the considerable return on investment. This article recommends four next steps to ensure that tobacco dependence treatment is available for all pregnant women. These steps are (a). expanding Medicaid coverage for, and promotion of, effective counseling services for pregnant smokers, (b). improving health care systems by building the capacity of prenatal providers and health care systems to deliver effective treatments, (c). encouraging purchasers of private and public health benefit packages to demand coverage for, and promotion of, effective counseling services for pregnant smokers, and (d). redirecting state resources to ensure a statewide system of care for pregnant smokers. Implementation of these steps requires leadership, diligence, and action by the public health community--as well as ongoing monitoring to assess progress in improving coverage, capacity, and coordination.

  8. Low-protein diet does not alter reproductive, biochemical, and hematological parameters in pregnant Wistar rats

    Directory of Open Access Journals (Sweden)

    M.A.V. Barros

    2018-05-01

    Full Text Available The aim of this study was to investigate the reproductive, biochemical, and hematological outcomes of pregnant rats exposed to protein restriction. Wistar rat dams were fed a control normal-protein (NP, 17% protein, n=8 or a low-protein (LP, 8% protein, n=14 diet from the 1st to the 20th day of pregnancy. On the 20th day, the clinical signs of toxicity were evaluated. The pregnant rats were then anesthetized and blood samples were collected for biochemical-hematological analyses, and laparotomy was performed to evaluate reproductive parameters. No sign of toxicity, or differences (P>0.05 in body weight gain and biochemical parameters (urea, creatinine, albumin, globulin, and total protein between NP and LP pregnant dams were observed. Similarly, hematological data, including red blood cell count, white blood cell count, hemoglobin, hematocrit, red blood cell distribution width (coefficient of variation, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, % lymphocytes, absolute lymphocyte count, platelet count, and mean platelet volume were similar (P>0.05 at the end of pregnancy. Reproductive parameters (the dam-offspring relationship, ovary mass, placenta mass, number of corpora lutea, implantation index, resorption index, and the pre- and post-implantation loss rates were also not different (P>0.05 between NP and LP pregnant dams. The present data showed that a protein-restricted diet during pregnancy did not alter reproductive, biochemical, and hematological parameters and seems not to have any toxic effect on pregnant Wistar rats.

  9. Rooftop Solar Technical Potential for Low-to-Moderate Income Households in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Sigrin, Benjamin O [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mooney, Meghan E [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-17

    This report presents a first-of-kind assessment of the technical potential of rooftop solar for low and moderate-income households, as well as providing insight on the distribution of solar potential by tenure, income, and other building characteristics. We find that a substantial fraction of the national rooftop solar potential is located on LMI buildings and, for all incomes, a substantial fraction on multi-family and renter-occupied buildings. We also find that rooftop solar can significantly contribute to long-term penetration targets established by the U.S. DOE, though to do so requires deployment on multi-family and renter-occupied buildings. Traditional deployment models have insufficiently enabled access to solar for these income groups and building types. Without innovation either in regulatory, market, or policy factors, a large fraction of the U.S. potential is unlikely to be addressed, as well as leading to inequalities in solar access. Ironically, potential electric bill savings from rooftop solar would have the greatest material impact on the lives of low-income households as compared to their high-income counterparts.

  10. Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Anderson Amy E

    2012-09-01

    Full Text Available Abstract Background In 2009, Australian alcohol guidelines for pregnancy changed from low to no alcohol intake. Previous research found a high proportion of pregnant Australian women drank during pregnancy; however, there has been limited investigation of whether pregnant women comply with 2009 alcohol guidelines. The purpose of this study was to provide an assessment of pregnant women’s compliance with 2009 Australian alcohol guidelines and identify predictors of such compliance, including previous drinking behaviour. Methods Cross-sectional analysis of prospective data from the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health was conducted. Women aged 30–36 years who were pregnant at the 2009 survey and had data on alcohol use were included (n = 837. Compliance with 2009 alcohol guidelines for pregnancy was defined as no alcohol intake. Predictors of compliance were analysed using multivariate logistic regression, controlling for area of residence, in three separate models to account for multicollinearity between measures of previous alcohol intake (compliance with 2001 guidelines; frequency and quantity; bingeing. Private health insurance, household income, and illicit drug use were entered into all models and retained if significant. Results 72% of pregnant women did not comply with the 2009 alcohol guidelines and 82% of these women drank less than seven drinks per week, with no more than one or two drinks per drinking day. The odds of complying with abstinence increased by a factor of 3.48 (95% CI 2.39-5.05 for women who previously complied with the 2001 alcohol guidelines and decreased by a factor of 0.19 (95% CI 0.08-0.66 if household incomes were $36,400 or more. In other models the odds of complying were lower for women who consumed alcohol before pregnancy at least weekly (OR = 0.40, 95% CI 0.25-0.63 or binged (OR ≥ 0.18, 95% CI 0.10-0.31 and were higher for those who abstained (OR

  11. Prenatal Care Utilization for Mothers from Low-Income Areas of New Mexico, 1989–1999

    Science.gov (United States)

    Schillaci, Michael A.; Waitzkin, Howard; Carson, E. Ann; Romain, Sandra J.

    2010-01-01

    Background Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999. Methodology/Principal Findings Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings. Conclusions/Significance These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes. PMID:20862298

  12. Performance Pay Improves Engagement, Progress, and Satisfaction in Computer-Based Job Skills Training of Low-Income Adults

    Science.gov (United States)

    Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Silverman, Kenneth

    2013-01-01

    Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training…

  13. Pediatric clinical drug trials in low-income countries: key ethical issues.

    Science.gov (United States)

    MacLeod, S M; Knoppert, D C; Stanton-Jean, M; Avard, D

    2015-02-01

    Potential child participants in clinical research trials in low-income countries are often vulnerable because of poverty, high morbidity and mortality, inadequate education, and varied local cultural norms. However, vulnerability by itself must not be accepted as an obstacle blocking children from the health benefits that may accrue as an outcome of sound clinical research. As greater emphasis is placed on evidence-based treatment of children, it should be anticipated that there will be a growing call for agreement on principles to guide clinical investigations in low-income countries. There is now general acceptance of the view that children must be protected from non-evidence-based interventions and from substandard treatments. The questions remaining relate to how best to stimulate clinical research activity that will serve the needs of infants, children, and youth in developing countries and how best to assign priority to ethically sound research that will meet their clinical requirements. In low-income countries, 39 % of citizens are 13 years of age or younger, and consequently it is certain that clinical investigations of some new therapeutic products will be conducted there more frequently. This review offers some suggestions for approaches that will help to achieve more effective ethical consideration, including (1) improving the quality of research ethics boards; (2) fostering collaborative partnerships among important stakeholders; (3) making concerted efforts to build capacity; (4) improving the quality of the consent and waiver process; and (5) developing improved governance for harmonized ethics platforms. Continuing support by international organizations is required to sustain the establishment and maintenance of stronger research ethics boards to protect children enrolled in clinical trials. This review underscores the importance of developing a culture of solidarity and true partnership between developed and low-income country organizations, which

  14. Empowering low-income black families of handicapped children.

    Science.gov (United States)

    Kalyanpur, M; Rao, S S

    1991-10-01

    A qualitative study of four black, low-income, single mothers used in-depth interviews and participant observation to evaluate their interactions with outreach agency professionals. Three perceived aspects (disrespect, focus on deficits, and discounting parenting style differences) were associated with exclusionary (unempowering) relationships. A reciprocal and supportive approach was associated with collaborative (empowering) relationships. Implications of these findings for professionals serving minority families are discussed.

  15. The views of low-income employees regarding mandated comprehensive employee benefits for the sake of health.

    Science.gov (United States)

    Adikes, Katherin A; Hull, Sara C; Danis, Marion

    2010-01-01

    Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers.

  16. The Views of Low-Income Employees Regarding Mandated Comprehensive Employee Benefits for the Sake of Health

    Science.gov (United States)

    Adikes, Katherin A.; Hull, Sara C.; Dams, Marion

    2013-01-01

    Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers. PMID:20391255

  17. Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

    2012-01-01

    To assess the magnitude and pattern of socioeconomic inequality in current smoking in low and middle income countries. We used data from the World Health Survey [WHS] in 48 low-income and middle-income countries to estimate the crude prevalence of current smoking according to household wealth quintile. A Poisson regression model with a robust variance was used to generate the Relative Index of Inequality [RII] according to wealth within each of the countries studied. In males, smoking was disproportionately prevalent in the poor in the majority of countries. In numerous countries the poorest men were over 2.5 times more likely to smoke than the richest men. Socioeconomic inequality in women was more varied showing patterns of both pro-rich and pro-poor inequality. In 20 countries pro-rich relative socioeconomic inequality was statistically significant: the poorest women had a higher prevalence of smoking compared to the richest women. Conversely, in 9 countries women in the richest population groups had a statistically significant greater risk of smoking compared to the poorest groups. Both the pattern and magnitude of relative inequality may vary greatly between countries. Prevention measures should address the specific pattern of smoking inequality observed within a population.

  18. Prevalence of Arbovirus Infections among Pregnant Women at a Maternity Hospital School

    Directory of Open Access Journals (Sweden)

    Maria das Neves Figueiroa

    2017-04-01

    Full Text Available Objective: Survey the prevalence of arbovirus infections among pregnant women provided with care at a maternity hospital school in Recife, Pernambuco, Brazil. Method: Descriptive, cross-sectional, retrospective, and quantitative study, carried out with data collected from the notification forms filled in during obstetric screening between August 2015 and July 2016. Results: Positive serology was found for arboviruses in 40.2% of the 103 suspected cases. Serology was not performed or it showed inconclusive results in 59.8% of the cases. Dengue fever occurred in 44% of the cases, chikungunya in 34%, and zika fever in 22%. Infections were more frequent among pregnant women over 20 years old, with low income and low schooling levels, living in Recife (48.5% and Olinda, Pernambuco, Brazil (24.3%. The most frequently mentioned symptoms were arthralgia (94%, exanthema (82%, and fever (78%. Infections occurred within the first trimester of pregnancy (54.5%, 63.3% of the pregnant women had to be hospitalized, and 45.4% of them did not undergo morphological ultrasonography. Most babies were born full-term and they had adequate weight. The prevalence of microcephaly was 9.7% when considering cases of arbovirose and 62.5% when considering specific cases of zika fever. Conclusion: The prevalence and repercussions of arboviruses justify the consolidation of actions to fight Aedes aegypti, as well as the effective deployment of clinical protocols and recommendations aimed at the mother and child care.

  19. Harsh, Firm, and Permissive Parenting in Low-Income Families.

    Science.gov (United States)

    Shumow, Lee; Vandell, Deborah Lowe; Posner, Jill K.

    1998-01-01

    Parents' reports of their child-rearing expectations and intentions were measured for 184 low-income urban families when children were in the third and fifth grades. Parenting strategies were stable over time. Parenting strategies were related to measures of adjustment at school, behavior problems in the home, academic achievement, and…

  20. How Low-Income Children Use the Internet at Home

    Science.gov (United States)

    Jackson, Linda A.; von Eye, Alexander; Biocca, Frank; Barbatsis, Gretchen; Zhao, Yong; Fitzgerald, Hiram E.

    2005-01-01

    HomeNetToo is a longitudinal field study designed to examine home Internet use by low-income families in the United States. Participants were 140 children, mostly African American, whose Internet use was continuously and automatically recorded for one year. This article focuses on relationships between children's main computer activities, academic…

  1. 78 FR 33154 - Low Income Taxpayer Clinic Grant Program; Availability of 2014 Grant Application Package

    Science.gov (United States)

    2013-06-03

    ... Package and Guidelines (Publication 3319) for organizations interested in applying for a Low Income... nominal fee to low income taxpayers involved in tax disputes with the IRS, or educate individuals for whom... Grant Application Package and Guidelines, IRS Publication 3319 (Rev. 5-2013), can be downloaded from the...

  2. The Experience of Low-Income College Students at a Selective University: An Interpretative Phenomenological Analysis

    Science.gov (United States)

    Dias, Paula Ribeiro

    2017-01-01

    Low-income students at selective institutions report feeling a sense of isolation, alienation, and marginalization. However, it is essential that the voices of low-income students that have successfully navigated the college experience be part of the conversation. Rather than approach the study from a deficit perspective, this Interpretative…

  3. Management of Noncommunicable Disease in Low- and Middle-Income Countries

    Science.gov (United States)

    Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S.; Miranda, J. Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L.

    2014-01-01

    Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified “best buys” it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. PMID:25592798

  4. Dimensions of Family Functioning: Perspectives of Low-Income African American Single Parent Families

    Science.gov (United States)

    Mccreary, Linda L.; Dancy, Barbara L.

    2004-01-01

    Family functioning is influenced by socio-economic status, culture, family structure, and developmental stage, and is assessed primarily using instruments developed for middle-income European American two-parent families. These instruments may not validly assess low-income African American single-parent families. This qualitative study was…

  5. Health outcomes in low-income children with current asthma in Canada.

    Science.gov (United States)

    To, T; Dell, S; Tassoudji, M; Wang, C

    2009-01-01

    Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

  6. The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study

    Science.gov (United States)

    Moneta, Maria Victoria; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Sainio, Päivi; Galas, Aleksander; Haro, Josep Maria

    2015-01-01

    Objective The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE). Design Population-based cross-sectional study Setting The survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012. Participants 42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded. Primary outcome measure Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL). Results The mean body mass index (BMI) ranged from 20.4 kg/m2 in India to 30.7 kg/m2 in South Africa. Compared to normal BMI (18.5–24.9 kg/m2), BMI≥35 kg/m2 was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries. Conclusions The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults. PMID:25838510

  7. Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

    Science.gov (United States)

    Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

    2017-07-01

    Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

  8. Effect of low-dose irradiation on pregnant mouse haemopoiesis

    International Nuclear Information System (INIS)

    Weinberg, S.R.; McCarthy, E.G.; MacVittie, T.J.; Baum, S.J.

    1981-01-01

    The effects of low-dose gamma radiation to haemopoietic progenitor cell compartments of the marrow and spleen of virgin female mice and pregnant mice were studied. Microplasma clot cultures were used to assess burst-forming uniterythroid (BFU-E) and colony-forming unit-erythroid (CFU-E) activity, and double-layer agar cultures were established to evaluate granulocyte-macrophage colony-forming cell (GM-CFC) and macrophage colony-forming cell (M-CFC). The apparent shift in maternal erythropoiesis from the bone marrow to the enlarged spleen was reflected by an increase in CFU-E and BFU-E per spleen and a concomitant decrease in CFU-E and BFU-E per femur. Whereas maternal GM-CFC values per femur increased 36%, maternal GM-CFC per spleen increased by 172% compared to virgin values. Total-body irradiation to the day-10.5 pregnant mouse caused a further suppression of day-14.5 medullary erythropoiesis (i.e. decreased CFU-E values) compared to the virgin female mouse. An ability of the maternal spleen to support further compensatory erythropoiesis following increasing doses of radiation was demonstrated. Four days after 1.0 Gy exposure, maternal values for GM-CFC per femur or spleen decreased to nonirradiated virgin mice values. M-CFC per maternal femur decreased to nonirradiated virgin mice values. M-CFC per maternal femur decreased following 1.5 Gy, but M-CFC per spleen appeared to be unaffected with doses from 0.5 to 2.0 Gy. (author)

  9. Improving Readability of an Evaluation Tool for Low-Income Clients Using Visual Information Processing Theories

    Science.gov (United States)

    Townsend, Marilyn S.; Sylva, Kathryn; Martin, Anna; Metz, Diane; Wooten-Swanson, Patti

    2008-01-01

    Literacy is an issue for many low-income audiences. Using visual information processing theories, the goal was improving readability of a food behavior checklist and ultimately improving its ability to accurately capture existing changes in dietary behaviors. Using group interviews, low-income clients (n = 18) evaluated 4 visual styles. The text…

  10. Camouflage: The Experiences of Low-Income Business College Students

    Science.gov (United States)

    Ponton de Dutton, Scarlett

    2011-01-01

    This qualitative study shares the complex stories of two low-income business students who attend a flagship, public university as out-of-state students with the purpose of understanding, describing, giving voice to, and discovering insight from their experiences. Throughout U.S. Higher Education history, there is a pattern of limited participation…

  11. Prevalence of peripheral blood parasitaemia, anaemia and low birthweight among pregnant women in a suburban area in coastal Ghana.

    Science.gov (United States)

    Stephens, Judith Koryo; Ofori, Michael F; Quakyi, Isabella Akyinbah; Wilson, Mark Lee; Akanmori, Bartholomew Dicky

    2014-01-01

    Malaria and anaemia have adverse effects in pregnant women and on the birth weight of infants in malaria endemic areas. P. falciparum malaria, the most virulent species continues to be a major health problem in sub-Saharan Africa. This study was carried out to establish the prevalence of pregnancy-associated malaria and its associated consequences including maternal anaemia and low birthweight (LBW) deliveries and placental malaria among pregnant women in a sub-urban area in coastal Ghana. A facility-based investigation was carried out among 320 pregnant women seeking antenatal care in a hospital in suburban coastal Ghana. Information on the use of Insecticide Treated Nets (ITNs) and Intermittent Preventive Treatment in pregnancy (IPTp) were collected using a structured questionnaire at enrollment. Venous blood was collected for microscopy and screening for Glucose 6-phosphate dehydrogenase (G6PD) deficiency. Haemoglobin concentration was obtained from an automatic blood analyzer. Placental smears and birth weight measurements were taken at delivery. The prevalence of Plasmodium falciparum parasitaemia was 5%. The mean haemoglobin (Hb) level at registration was 11.44 g/dL (95% CI 11.29 - 11.80). Placental blood parasitaemia and low birthweight were 2.5% and 3% respectively. ITN possession was 31.6% with 5.4% usage. The IPTp coverage was 55%. The prevalence of malaria and anaemia among the pregnant women were low at enrollment. Placental blood parasitaemia and LBW at delivery were also low. These are clear indications of the high coverage of the IPTp. Increase in ITN use will further improve birthweight outcomes and reduce placental malaria.

  12. Measuring the bias against low-income country research: an Implicit Association Test.

    Science.gov (United States)

    Harris, Matthew; Macinko, James; Jimenez, Geronimo; Mullachery, Pricila

    2017-11-06

    With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries. Computer-based Implicit Association Test (IAT) distributed to healthcare professionals and researchers. Stimuli representing Rich Countries were chosen from OECD members in the top ten (>$36,000 per capita) World Bank rankings and Poor Countries were chosen from the bottom thirty (based medicine and diffusion of innovations.

  13. Bringing Bike Share to a Low-Income Community

    Centers for Disease Control (CDC) Podcasts

    2013-08-14

    This podcast is an interview with Sarah Kretman Stewart, MPH, MEd, Healthy Living Minneapolis Project Specialist at the Minneapolis Health Department. In this program, Sarah talks about the impact a bike share program had on the low-income town of Near North, Minnesota.  Created: 8/14/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/14/2013.

  14. 76 FR 34297 - Low Income Taxpayer Clinic Grant Program; Availability of 2012 Grant Application Package

    Science.gov (United States)

    2011-06-13

    ... guidelines (Publication 3319) for organizations interested in applying for a Low Income Taxpayer Clinic (LITC... representation for free or for a nominal fee to low income taxpayers involved in tax controversies with the IRS..., IRS Publication 3319 (Rev. 5-2011), can be downloaded from the IRS Internet site at http://www.irs.gov...

  15. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Mayén, Ana-Lucia; Marques-Vidal, Pedro; Paccaud, Fred; Bovet, Pascal; Stringhini, Silvia

    2014-12-01

    In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs. © 2014 American Society for Nutrition.

  16. A Health Equity Problem for Low Income Children: Diet Flexibility Requires Physician Authorization.

    Science.gov (United States)

    Stookey, Jodi D

    2015-09-01

    USDA programs, such as the Child and Adult Care Food Program (CACFP), School Breakfast Program (SBP), and/or National School Lunch Program (NSLP), enable child care centers and schools to provide free and reduced price meals, daily, to millions of low income children. Despite intention to equalize opportunity for every child to have a healthy diet, USDA program rules may be contributing to child obesity disparities and health inequity. USDA program rules require child care centers and schools to provide meals that include a specified number of servings of particular types of foods and beverages. The rules are designed for the average, healthy weight child to maintain weight and growth. They are not designed for the underweight child to gain weight, obese child to normalize weight, or pre-diabetic child to avoid incident diabetes. The rules allow for only one meal pattern and volume, as opposed to a flexible spectrum of meal patterns and portion sizes. Parents of children who participate in the CACFP, SBP, and/or NSLP do not have control over the amount or composition of the subsidized meals. Parents of overweight, obese, or diabetic children who participate in the subsidized meal programs can request dietary change, special meals or accommodations to address their child's health status, but child care providers and schools are not required to comply with the request unless a licensed physician signs a "Medical statement to request special meals and/or accommodations". Although physicians are the only group authorized to change the foods, beverages, and portion sizes served daily to low income children, they are not doing so. Over the past three years, despite an overweight and obesity prevalence of 30% in San Francisco child care centers serving low income children, zero medical statements were filed to request special meals or accommodations to alter daily meals in order to prevent obesity, treat obesity, or prevent postprandial hyperglycemia. Low income children

  17. Environment and air pollution like gun and bullet for low-income countries: war for better health and wealth.

    Science.gov (United States)

    Zou, Xiang; Azam, Muhammad; Islam, Talat; Zaman, Khalid

    2016-02-01

    The objective of the study is to examine the impact of environmental indicators and air pollution on "health" and "wealth" for the low-income countries. The study used a number of promising variables including arable land, fossil fuel energy consumption, population density, and carbon dioxide emissions that simultaneously affect the health (i.e., health expenditures per capita) and wealth (i.e., GDP per capita) of the low-income countries. The general representation for low-income countries has shown by aggregate data that consist of 39 observations from the period of 1975-2013. The study decomposes the data set from different econometric tests for managing robust inferences. The study uses temporal forecasting for the health and wealth model by a vector error correction model (VECM) and an innovation accounting technique. The results show that environment and air pollution is the menace for low-income countries' health and wealth. Among environmental indicators, arable land has the largest variance to affect health and wealth for the next 10-year period, while air pollution exerts the least contribution to change health and wealth of low-income countries. These results indicate the prevalence of war situation, where environment and air pollution become visible like "gun" and "bullet" for low-income countries. There are required sound and effective macroeconomic policies to combat with the environmental evils that affect the health and wealth of the low-income countries.

  18. Complexity of food preparation and food security status in low-income young women.

    Science.gov (United States)

    Engler-Stringer, Rachel; Stringer, Bernadette; Haines, Ted

    2011-01-01

    This study was conducted to explore whether preparing more complex meals was associated with higher food security status. This mixed-methods, community-based study involved the use of semistructured interviews to examine the cooking practices of a group of young, low-income women in Montreal. Fifty participants aged 18 to 35 were recruited at 10 locations in five low-income neighbourhoods. Food security status was the main outcome measure and the main exposure variable, "complex food preparation," combined the preparation of three specific food types (soups, sauces, and baked goods) using basic ingredients. Low-income women preparing a variety of meals using basic ingredients at least three times a week were more than twice as likely to be food secure as were women preparing more complex meals less frequently. Women who prepared more complex meals more frequently had higher food security. Whether this means that preparing more complex foods results in greater food security remains unclear, as this was an exploratory study.

  19. Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

    Science.gov (United States)

    Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

    2005-12-01

    To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

  20. The Role of Educational Aspirations and Expectations in the Discontinuity of Intergenerational Low-Income Status

    Science.gov (United States)

    Lee, Jungeun Olivia; Hill,, Karl G.; Hawkins, J. David

    2012-01-01

    This study investigated one potential mechanism mediating continuity and discontinuity in low-income status across generations: children's educational aspirations and expectations. Data were drawn from a community sample of 808 participants who were followed from age 10 to 30. Four trajectory groups of children's educational aspirations and expectations were identified from ages 10 to 18 (grades five through 12): “stable-high” group, “stable-low” group, “increaser” group, and “decreaser” group. Among participants from low-income families, those in the stable-high group and the increaser group were equally likely to graduate from high school. High school graduation was positively associated with level of total household income at age 30. Findings suggest that social work efforts that support the development of high educational aspirations and expectations in children might serve to reduce the intergenerational continuity of low-income status. PMID:24385713

  1. Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case-control study design.

    Science.gov (United States)

    Gebrekidan, Kahasse; Worku, Alemayehu

    2017-01-01

    Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country. The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia. A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case-control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation. The odds of attending ANC late were significantly higher for mothers with a monthly household income of $8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67). Low educational level, low income of the household, unplanned pregnancy, stay for ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened.

  2. Domestic Violence Among Pregnant Women.

    Science.gov (United States)

    Habib, Sadia; Abbasi, Nasreen; Khan, Bushra; Danish, Nargis; Nazir, Quratulain

    2018-01-01

    Domestic violence during pregnancy is an important social & health issue in all societies. In Muslim world and particularly underdeveloped countries, domestic violence is often under reported. It is the need of hour to encourage reporting of such events & implementation of research-based policies for prevention of women abuse & support of the victims of domestic violence (DV). The objective of this study was to highlight this neglected social problem of our society & to identify at risk population. This is a cross sectional study conducted at Ayub Teaching Hospital & Benazir Bhutto Shaheed Teaching Hospital, Abbottabad (January 2014 to December. 2016). Pregnant women were inquired regarding history of abuse by husband and sociodemographic characteristics were noted in a Performa to analyse the risk factors for domestic violence. The overall prevalence was found to be 35%. Out of 1000 pregnant women, 270 (27%) suffered from simple violence and 60 (6%) were victims of grievous assault. Violence among pregnant women is found to be more prevalent among residents of urban areas, women of older age being uneducated & belonging to poor socioeconomic status. Domestic violence during pregnancy is a common & often neglected psychosocial health problem. High risk population needs to be identified so that preventive strategies can be planned & implemented.

  3. Policy options for the split incentive: Increasing energy efficiency for low-income renters

    International Nuclear Information System (INIS)

    Bird, Stephen; Hernández, Diana

    2012-01-01

    The split incentive problem concerns the lack of appropriate incentives to implement energy efficiency measures. In particular, low income tenants face a phenomenon of energy poverty in which they allocate significantly more of their household income to energy expenditures than other renters. This problem is substantial, affecting 1.89% of all United States' energy use. If effectively addressed, it would create a range of savings between 4 and 11 billion dollars per year for many of the nation's poorest residents. We argue that a carefully designed program of incentives for participants (including landlords) in conjunction with a unique type of utility-managed on-bill financing mechanism has significant potential to solve many of the complications. We focus on three kinds of split incentives, five concerns inherent to addressing split incentive problems (scale, endurance, incentives, savings, political disfavor), and provide a detailed policy proposal designed to surpass those problems, with a particular focus on low-income tenants in a U.S. context. - Highlights: ► We demonstrate the significant impact of the split incentive on low-income tenants. ► We discuss split incentive characteristics, and policy failures. ► We described an on-bill financing model with unique features. ► This policy has protections and incentives for tenants and landlords.

  4. Life After Welfare Reform: Low-Income Single Parent Families, Pre- and Post-TANF.

    Science.gov (United States)

    Peterson, Janice; Song, Xue; Jones-DeWeever, Avis

    This study used data from the first and last waves of the 1996 U.S. Census Bureau's Survey of Income and Program Participation to compare the characteristics and wellbeing of low-income, single parent families before and after passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), noting the characteristics and…

  5. A NEW ANIMAL-MODEL FOR HUMAN PREECLAMPSIA - ULTRA-LOW-DOSE ENDOTOXIN INFUSION IN PREGNANT RATS

    NARCIS (Netherlands)

    FAAS, MM; SCHUILING, GA; BALLER, JFW; VISSCHER, CA; BAKKER, WW

    OBJECTIVE: An animal model for preeclampsia was developed by means of an ultra-low-dose endotoxin infusion protocol in conscious pregnant rats. STUDY DESIGN: Rats received a permanent jugular vein cannula on day 0 of pregnancy, through which endotoxin (1.0 mu/kg body weight) (n = 10) or saline

  6. Bad experience, good birthing: Dutch low-risk pregnant women with a history of sexual abuse

    NARCIS (Netherlands)

    van der Hulst, Leonie A. M.; Bonsel, Gouke J.; Eskes, Martine; Birnie, Erwin; van Teijlingen, Edwin; Bleker, Otto P.

    2006-01-01

    OBJECTIVE: The long-term effects on women in childbirth with a history of sexual abuse have only been studied to a limited degree. We estimated the prevalence of lifetime experience among low-risk pregnant women (non-clinical) in The Netherlands as well as the association with (1) psycho-social

  7. Characteristics of prepared food sources in low-income neighborhoods of Baltimore City.

    Science.gov (United States)

    Lee, Seung Hee; Rowan, Megan T; Powell, Lisa M; Newman, Sara; Klassen, Ann Carroll; Frick, Kevin D; Anderson, Jennifer; Gittelsohn, Joel

    2010-01-01

    The food environment is associated with obesity risk and diet-related chronic diseases. Despite extensive research conducted on retail food stores, little is known about prepared food sources(PFSs). We conducted an observational assessment of all PFSs(N = 92) in low-income neighborhoods in Baltimore. The most common PFSs were carry-outs, which had the lowest availability of healthy food choices. Only a small proportion of these carry-outs offered healthy sides, whole wheat bread, or entrée salads (21.4%, 7.1%, and 33.9%, respectively). These findings suggest that carry-out-specific interventions are necessary to increase healthy food availability in low-income urban neighborhoods.

  8. Higher prevalence of anemia among pregnant immigrant women compared to pregnant ethnic Danish women

    DEFF Research Database (Denmark)

    Nybo, Mads; Friis-Hansen, Lennart; Felding, Peter

    2007-01-01

    The aim of the study was to investigate whether the well-known high anemia prevalence in pregnant women from the eastern Mediterranean and Asian regions decreased when the women immigrated to a low-frequency region (Denmark). During 70 months, 1,741 pregnant immigrant women referred from primary...... status parameters were examined in the two groups. The prevalence of anemia was higher in the immigrant group (20.0%) compared to the Danish women (4.9%) (P ... indicated iron deficiency. Conclusively, the pregnant immigrant women had significantly higher prevalence of anemia compared to pregnant women of Danish origin. It indicates the need for an alternative routine screening procedure for this population group, which should also include nutritional counselling....

  9. Experiential Cooking Programs for Low-Income Adults: Strategies for Success

    Science.gov (United States)

    Franck, Karen; Vineyard, Michelle; Olson, Ann; Peterson, Ashley

    2012-01-01

    Experiential cooking classes for low-income adults can help improve healthy nutrition behaviors. However, nutrition educators and Extension professionals can face challenges in successful implementation of these programs such as difficulties recruiting and retaining participants. Drawing upon lessons learned from a cooking intervention with…

  10. Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review.

    Science.gov (United States)

    Fesenfeld, Michaela; Hutubessy, Raymond; Jit, Mark

    2013-08-20

    The World Health Organization recommends establishing that human papillomavirus vaccination is cost-effective before vaccine introduction. We searched Pubmed, Embase and the Cochrane Library to 1 April 2012 for economic evaluations of human papillomavirus vaccination in low and middle income countries. We found 25 articles, but almost all low income countries and many middle income countries lacked country-specific studies. Methods, assumptions and consequently results varied widely, even for studies conducted for the same country. Despite the heterogeneity, most studies conclude that vaccination is likely to be cost-effective and possibly even cost saving, particularly in settings without organized cervical screening programmes. However, study uncertainty could be reduced by clarity about vaccine prices and vaccine delivery costs. The review supports extending vaccination to low income settings where vaccine prices are competitive, donor funding is available, cervical cancer burden is high and screening options are limited. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. The global burden of visual difficulty in low, middle, and high income countries.

    Directory of Open Access Journals (Sweden)

    Ellen E Freeman

    Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

  12. The Effectiveness Of Rental Housing Finance For Low-Income Households In Sombo Rental Flats Surabaya

    Directory of Open Access Journals (Sweden)

    Annisa Nur Ramadhani

    2017-07-01

    Full Text Available Fullfilment for the needs of housing is a priority that cannot be suspended especially in urban areas of developing country whose population continues to increase because of the rapid urbanization. Indonesia as the developing country still has a fairly high backlog approximately at 7.6 millions unit house in 2014 most of them are low income people. The Government has several plan in striving for the scarcity of housing. One of them is the development of rental flats which have goals for the social housing fulfillment for low income people and increase their housing affordability by lowering the rental rates. The intention is to assist the low income people save their money to buy their own homes. But in facts there are several constraints related to this rental flats finance such as late payment by the residents uncontroled right transfer and the tariff adjusted to the ability of the inhabitants can not cover the cost of the physical building management and maintanance. This study aims to evaluate Sombo rental flat finance for for low income people in which the data are collected through in depth interview observation and documentation. The results of several qualitatively descriptive analysis show that the effectiveness of rental flat financing in the aspect of the purpose and goal to facilitating low income community needs of housing is quiet accomplished. Beside that the organization is also well structured and have the efficient human resources. But Sombo rental flats effectivenes is relatively low in the aspect of profit ability rental financing program and in the enforcement of rules and regulation. The main problem is in the arrears of residents rental payment and the deficiency for maintanance cost so it has to depend on the city government subsidies. The rental finance constraint are caused by several factors which are historic factors residents factors and the vision and commitment of the city government to facilitate housing for low

  13. "The Kids Still Come First": Creating Family Stability during Partnership Instability in Rural, Low-Income Families

    Science.gov (United States)

    Sano, Yoshie; Manoogian, Margaret M.; Ontai, Lenna L.

    2012-01-01

    This qualitative study examined the nature of partnerships among 28 rural low-income mothers who experienced partnership transitions across three waves of annual interviews. Guided by "lens of uncertainty" and "boundary ambiguity theory," the authors specifically explored (a) how low-income mothers in rural communities experience partnership…

  14. Does modifying the household food budget predict changes in the healthfulness of purchasing choices among low- and high-income women?

    Science.gov (United States)

    Inglis, Victoria; Ball, Kylie; Crawford, David

    2009-04-01

    Food cost has a strong influence on food purchases and given that persons of low income often have more limited budgets, healthier foods may be overlooked in favour of more energy-dense lower-cost options. The aim of this study was to investigate whether modifications to the available household food budget led to changes in the healthfulness of food purchasing choices among women of low and high income. A quasi-experimental design was used which included a sample of 74 women (37 low-income women and 37 high-income women) who were selected on the basis of their household income and sent an itemised shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and those foods they would remove if they were restricted by 25% of their budget. When asked what foods they would add with a larger household food budget, low-income women chose more foods from the 'healthier' categories whereas high-income women chose more foods from the less 'healthier' categories. However, making the budgets of low- and high-income women more 'equivalent' did not eradicate income differences in overall healthfulness of food purchasing choices. This study highlights the importance of cost when making food purchasing choices among low- and high-income groups. Public health strategies aimed at reducing income inequalities in diet might focus on promoting healthy diets that are low cost.

  15. Out-of-pocket health expenditures and antimicrobial resistance in low-income and middle-income countries: an economic analysis.

    Science.gov (United States)

    Alsan, Marcella; Schoemaker, Lena; Eggleston, Karen; Kammili, Nagamani; Kolli, Prasanthi; Bhattacharya, Jay

    2015-10-01

    The decreasing effectiveness of antimicrobial agents is a growing global public health concern. Low-income and middle-income countries are vulnerable to the loss of antimicrobial efficacy because of their high burden of infectious disease and the cost of treating resistant organisms. We aimed to assess if copayments in the public sector promoted the development of antibiotic resistance by inducing patients to purchase treatment from less well regulated private providers. We analysed data from the WHO 2014 Antibacterial Resistance Global Surveillance report. We assessed the importance of out-of-pocket spending and copayment requirements for public sector drugs on the level of bacterial resistance in low-income and middle-income countries, using linear regression to adjust for environmental factors purported to be predictors of resistance, such as sanitation, animal husbandry, and poverty, and other structural components of the health sector. Our outcome variable of interest was the proportion of bacterial isolates tested that showed resistance to a class of antimicrobial agents. In particular, we computed the average proportion of isolates that showed antibiotic resistance for a given bacteria-antibacterial combination in a given country. Our sample included 47 countries (23 in Africa, eight in the Americas, three in Europe, eight in the Middle East, three in southeast Asia, and two in the western Pacific). Out-of-pocket health expenditures were the only factor significantly associated with antimicrobial resistance. A ten point increase in the percentage of health expenditures that were out-of-pocket was associated with a 3·2 percentage point increase in resistant isolates (95% CI 1·17-5·15; p=0·002). This association was driven by countries requiring copayments for drugs in the public health sector. Of these countries, moving from the 20th to 80th percentile of out-of-pocket health expenditures was associated with an increase in resistant bacterial isolates

  16. Defense Mechanisms of Pregnant Mothers Predict Attachment Security, Social-Emotional Competence, and Behavior Problems in Their Toddlers.

    Science.gov (United States)

    Porcerelli, John H; Huth-Bocks, Alissa; Huprich, Steven K; Richardson, Laura

    2016-02-01

    For at-risk (single parent, low income, low support) mothers, healthy adaptation and the ability to manage stress have clear implications for parenting and the social-emotional well-being of their young offspring. The purpose of this longitudinal study was to examine associations between defense mechanisms in pregnant women and their toddlers' attachment security, social-emotional, and behavioral adjustment. Participants were 84 pregnant women during their last trimester of pregnancy, recruited from community agencies primarily serving low-income families. Women were followed prospectively from pregnancy through 2 years after birth and completed several multimethod assessments during that period. Observations of mother-child interactions were also coded after the postnatal visits. Multiple regression analyses revealed that mothers' defense mechanisms were significantly associated with several toddler outcomes. Mature, healthy defenses were significantly associated with greater toddler attachment security and social-emotional competence and fewer behavior problems, and less mature defenses (disavowal in particular) were associated with lower levels of attachment security and social-emotional competence. Associations remained significant, or were only slightly attenuated, after controlling for demographic variables and partner abuse during pregnancy. The study findings suggest that defensive functioning in parents preparing for and parenting toddlers influences the parent-child attachment relationship and social-emotional adjustment in the earliest years of life. Possible mechanisms for these associations may include parental attunement and mentalization, as well as specific caregiving behavior toward the child. Defensive functioning during times of increased stress (such as the prenatal to postnatal period) may be especially important for understanding parental influences on the child.

  17. The feasibility of a Paleolithic diet for low-income consumers

    NARCIS (Netherlands)

    Metzgar, Matthew; Rideout, Todd C.; Fontes-Villalba, Maelan; Kuipers, Remko S.

    Many low-income consumers face a limited budget for food purchases. The United States Department of Agriculture developed the Thrifty Food Plan to address this problem of consuming a healthy diet given a budget constraint. This dietary optimization program uses common food choices to build a

  18. Impact of Pneumococcal Conjugate Vaccines on Pneumonia Hospitalizations in High- and Low-Income Subpopulations in Brazil

    DEFF Research Database (Denmark)

    Warren, Joshua L.; Shioda, Kayoko; Kürüm, Esra

    2017-01-01

    Background: Pneumococcal conjugate vaccines (PCVs) are being used worldwide. A key question is whether the impact of PCVs on pneumonia is similar in low- and high-income populations. However, most low-income countries, where the burden of disease is greatest, lack reliable data that can be used t...

  19. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

    Science.gov (United States)

    Islam, Rakibul M; Billah, Baki; Hossain, Md Nassif; Oldroyd, John

    2017-07-27

    Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs. Creative Commons Attribution License

  20. Evaluating the co-benefits of low-income energy-efficiency programmes

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, Grayson; Campbell, Nina

    2011-06-15

    The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

  1. Evaluating the co-benefits of low-income energy-efficiency programmes

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, Grayson; Campbell, Nina

    2011-06-15

    The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

  2. The conceptual mismatch: transportation stressors and experiences for low-income adults.

    Science.gov (United States)

    2015-10-01

    Physical access to jobs has long been identified as a barrier to employment and earnings, with prior : research identifying the spatial mismatch between suburban entry-level jobs and low-income workers. : However, existing transportation resear...

  3. Periodontal status in pregnant women in comparison with non-pregnant individuals

    Directory of Open Access Journals (Sweden)

    R Surekha

    2014-01-01

    Full Text Available Background: Our understanding of pathogenesis of periodontal disease has changed remarkably over a few decades. Rather than being confined to periodontium, periodontal disease may have a wide ranging systemic effects. It is now recognized that it shares most of the common risk factors for diabetes, coronary heart disease preterm low birth weight, miscarriage or early pregnancy loss and preeclampsia. Materials and Methods: The study group comprised of 400 women (200 pregnant women and 200 non-pregnant with an age range of 18-40 years. Maternal demographic and medical data were collected. Periodontal examinations included: Oral hygiene index (OHI-S, gingival index (GI, pocket probing depth and clinical attachment loss (CAL. Results: The results were analyzed using test of proportion when OHI-S was compared in pregnant women with that of non-pregnant individuals, there was no significant difference in good oral hygiene group (P = 0.187, Z = 1.32. When the GI index was evaluated, a definite statistical difference was noted in mild, moderate and severe gingivitis (P - 0.000, Z = 0.365; P - 0.00, Z = 4.17; P - 0.000, Z = 0.75. CAL index revealed a statistical difference was observed healthy periodontium, mild, moderate and severe periodontitis in both pregnant and non-pregnant women (P = −0.000, Z = 3.65; P - 0.000, Z = 5.83; P - 0.001, Z - 3.24; P - 0.000, Z - 6.47. Conclusion: The present study conducted supports the hypothesis that there is a definite correlation between the pregnant women and poor oral hygiene (gingivitis and periodontitis as compared with the non-pregnant controls.

  4. The effects of eliminating supplemental security income drug addiction and alcoholism eligibility on the mental health of low-income substance abusers.

    Science.gov (United States)

    Hogan, Sean R; Speiglman, Richard; Norris, Jean C

    2010-09-01

    On January 1, 1997, as the result of federal legislation, many low-income substance abusers lost income and healthcare benefits provided by the Supplemental Security Income (SSI) program. This study examined the effects of eliminating drug addiction and alcoholism (DAA) as qualifying impairments for SSI benefits on the mental health and mental health treatment utilization of former beneficiaries 3.5 years following the policy change. Study participants in four Northern California counties were categorized into three comparison groups based on their primary income source over the lifetime of the study. Findings indicated that overall the reported mental health status of former SSI DAA beneficiaries improved following the policy change; however, study participants who relied primarily on some other type of public assistance post-termination reported an increase in mental health treatment utilization.

  5. Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.

    Science.gov (United States)

    Källander, Karin; Tibenderana, James K; Akpogheneta, Onome J; Strachan, Daniel L; Hill, Zelee; ten Asbroek, Augustinus H A; Conteh, Lesong; Kirkwood, Betty R; Meek, Sylvia R

    2013-01-25

    clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems.

  6. Midline versus transverse incision for cesarean delivery in low-income countries

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Aabakke, Anna J M; Secher, Niels J

    2014-01-01

    While transverse incision is the recommended entry technique for cesarean delivery in high-income countries, it is our experience that midline incision is still used routinely in many low-income settings. Accordingly, international guidelines lack uniformity on this matter. Although evidence...... is limited, the literature suggests important advantages of the transverse incision, with lower risk of long-term disabilities such as wound disruption and hernia. Also, potential extra time spent on this incision appears not to impact neonatal outcome. Therefore, we suggest that it is time for a change...

  7. Low-income DSM Programs: Methodological approach to determining the cost-effectiveness of coordinated partnerships

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Hill, L.J.

    1994-05-01

    As governments at all levels become increasingly budget-conscious, expenditures on low-income, demand-side management (DSM) programs are being evaluated more on the basis of efficiency at the expense of equity considerations. Budgetary pressures have also caused government agencies to emphasize resource leveraging and coordination with electric and gas utilities as a means of sharing the expenses of low-income programs. The increased involvement of electric and gas utilities in coordinated low-income DSM programs, in turn, has resulted in greater emphasis on estimating program cost-effectiveness. The objective of this study is to develop a methodological approach to estimate the cost- effectiveness of coordinated low-income DSM programs, given the special features that distinguish these programs from other utility-operated DSM programs. The general approach used in this study was to (1) select six coordinated low-income DSM programs from among those currently operating across the United States, (2) examine the main features of these programs, and (3) determine the conceptual and pragmatic problems associated with estimating their cost-effectiveness. Three types of coordination between government and utility cosponsors were identified. At one extreme, local agencies operate {open_quotes}parallel{close_quotes} programs, each of which is fully funded by a single sponsor (e.g., one funded by the U.S. Department of Energy and the other by a utility). At the other extreme are highly {open_quotes}coupled{close_quotes} programs that capitalize on the unique capabilities and resources offered by each cosponsor. In these programs, agencies employ a combination of utility and government funds to deliver weatherization services as part of an integrated effort. In between are {open_quotes}supplemental{close_quotes} programs that utilize resources to supplement the agency`s government-funded weatherization, with no changes to the operation of that program.

  8. Financial management of low-income urban families

    Energy Technology Data Exchange (ETDEWEB)

    Schnittgrund, K.P. (Univ. of California, Riverside); Baker, G.

    1983-09-01

    The major focus of this research was the difference in financial-management practices used by low-income urban white, black, and Mexican-American families. A random sample of 199 interviews was completed during the spring of 1980 in Phoenix, Arizona, USA. The sample consisted of 69 white, 70 black, and 60 Mexican-American families. Differences in financial behavior did occur for each race. In addition, they were optimistic regarding their own ability to handle money and resolve financial problems but generally negative toward the ability of other families to manage money, use credit, and plan purchases. 20 references, 3 tables.

  9. Prospera Digital Phase II: Financial inclusion for low-income women ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Prospera Digital Phase II: Financial inclusion for low-income women in Mexico ... a research network in Latin America, to identify barriers and opportunities to scale up ... Call for new OWSD Fellowships for Early Career Women Scientists now open ... conference of McGill's Institute for the Study of International Development.

  10. Low income Russian families adopt effective behavioral strategies to maintain dietary stability in times of economic crisis.

    Science.gov (United States)

    Dore, Anna R; Adair, Linda S; Popkin, Barry M

    2003-11-01

    The social, political and economic reforms of 1992 in Russia led to a decade of rising income inequality, unemployment and economic crises, the most severe of which occurred in 1998. This study assesses dietary trends for children in low and high income households during this politically and economically unstable period from 1994 to 2000. Several possible food-related behaviors were also assessed to evaluate coping strategies adopted in the face of decreasing economic stability. Low income children maintained a steady energy intake per kilogram weight throughout the study period (251.0-259.4 kJ/kg), whereas intake for high income children increased significantly to a per capital average of 297.1 kJ/kg by 2000. At the food group level, the trend in per capita intake for all food groups was maintained for low income children except for a 22% decrease in meat and poultry consumption (P economic crisis.

  11. Poverty Is Low Consumption and Low Wealth, Not Just Low Income

    Science.gov (United States)

    Headey, Bruce

    2008-01-01

    The purpose of this paper is to suggest an improved measure of financial poverty, based on household consumption and wealth as well as income. Data come from the Household, Income and Labour Dynamics Australia (HILDA) Survey, which appears to be the first national socio-economic panel survey to provide longitudinal data on all three measures of…

  12. Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting

    Directory of Open Access Journals (Sweden)

    Festus Njuguna

    2017-10-01

    Full Text Available Purpose: Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. Patients and Methods: We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Results: Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%, II (7%, III (43%, IV (40%, or V (10%. The most likely treatment outcome in patients with low-stage (I to III disease was event-free survival (67%, whereas in those with high-stage (IV to V disease, it was death (40%. No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes (P = .014 and event-free survival estimates (P < .001. Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates. Conclusion: Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

  13. Feasibility of Internet-based Parent Training for Low-income Parents of Young Children.

    Science.gov (United States)

    McGoron, Lucy; Hvizdos, Erica; Bocknek, Erika L; Montgomery, Erica; Ondersma, Steven J

    2018-01-01

    Parent training programs promote positive parenting and benefit low-income children, but are rarely used. Internet-based delivery may help expand the reach of parent training programs, although feasibility among low-income populations is still unclear. We examined the feasibility of internet-based parent training, in terms of internet access/use and engagement, through two studies. In Study 1, 160 parents recruited from Women, Infants, and Children (WIC) centers completed a brief paper survey regarding internet access and use (all parents received government aid). We found high levels of access, openness, and comfort with the internet and internet-enabled devices. In Study 2, a pilot study, we assessed use of an online parenting program in a project with a sample of 89 predominately low-income parents (75% received government aid). Parents learned about a new, online parenting program (the "5-a-Day Parenting Program") and provided ratings of level of interest and program use 2-weeks and 4-weeks later. Local website traffic was also monitored. At baseline, parents were very interested in using the web-based program, and the majority of parents (69.6%) reported visiting the website at least once. However, in-depth use was rare (only 9% of parents reported frequent use of the online program). Results support the feasibility of internet-based parent training for low-income parents, as most parent were able to use the program and were interested in doing so. However, results also suggest the need to develop strategies to promote in-depth program use.

  14. Outpatient case management in low-income epilepsy patients.

    Science.gov (United States)

    Tatum, William O; Al-Saadi, Sam; Orth, Thomas L

    2008-12-01

    Case management (CM) has been shown to improve the medical care of patients in several paradigms of general medicine. This study was undertaken to assess the impact of CM on low-income patients with epilepsy. From 2002 to 2003, 737 epilepsy patients had CM provided by a non-profit, state-supported, epilepsy service subserving a four county region in southeastern Florida. Standardized survey forms distributed by the Florida Department of Health were completed by 159 consecutive patients at program admission. Follow-up information regarding seizure frequency, antiepileptic drugs, and quality of life self-rating was performed after 1 year of CM. The patients evaluated were composed of 58.5% men, with a mean age of 41.0 years. After CM, an increase in self-reported seizure control was seen in 40.2% of patients (preduction of ED visits per patient from 1.83 per patient per year before CM to 0.14 per patient per year after CM (p<0.0001, Wilcoxon matched-pairs test). Following CM, fewer patients reported difficulty with friends, employers, problems socializing, and feelings of anger (p<0.05, Fisher's exact test). CM of low-income patients with epilepsy resulted in self-reported improvement in seizure control, QoL, and significantly reduced ED visitation. CM in epilepsy is feasible and represents a cost-effective improvement in outpatient epilepsy management.

  15. Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993-2015).

    Science.gov (United States)

    Roth, Daniel E; Krishna, Aditi; Leung, Michael; Shi, Joy; Bassani, Diego G; Barros, Aluisio J D

    2017-12-01

    The causes of early childhood linear growth faltering (known as stunting) in low-income and middle-income countries remain inadequately understood. We aimed to determine if the progressive postnatal decline in mean height-for-age Z score (HAZ) in low-income and middle-income countries is driven by relatively slow growth of certain high-risk children versus faltering of the entire population. Distributions of HAZ (based on WHO growth standards) were analysed in 3-month age intervals from 0 to 36 months of age in 179 Demographic and Health Surveys from 64 low-income and middle-income countries (1993-2015). Mean, standard deviation (SD), fifth percentiles, and 95th percentiles of the HAZ distribution were estimated for each age interval in each survey. Associations between mean HAZ and SD, fifth percentile, and 95th percentile were estimated using multilevel linear models. Stratified analyses were performed in consideration of potential modifiers (world region, national income, sample size, year, or mean HAZ in the 0-3 month age band). We also used Monte Carlo simulations to model the effects of subgroup versus whole-population faltering on the HAZ distribution. Declines in mean HAZ from birth to 3 years of age were accompanied by declines in both the fifth and 95th percentiles, leading to nearly symmetrical narrowing of the HAZ distributions. Thus, children with relatively low HAZ were not more likely to have faltered than taller same-age peers. Inferences were unchanged in surveys regardless of world region, national income, sample size, year, or mean HAZ in the 0-3 month age band. Simulations showed that the narrowing of the HAZ distribution as mean HAZ declined could not be explained by faltering limited to a growth-restricted subgroup of children. In low-income and middle-income countries, declines in mean HAZ with age are due to a downward shift in the entire HAZ distribution, revealing that children across the HAZ spectrum experience slower growth compared to

  16. Interviews with low-income Pennsylvanians verify a need to enhance eating competence.

    Science.gov (United States)

    Stotts Krall, Jodi; Lohse, Barbara

    2009-03-01

    Continuation of unhealthful dietary patterns and poor diet-related health outcomes among socioeconomically disadvantaged populations underscores the need to improve diet quality for this group. Enhancing eating competence, based on the Satter model of eating competence (ecSatter), may be one effective method to reach this goal, but requires substantiation in a low-income audience. This study utilized a qualitative approach to examine the congruence of the ecSatter model with the cognitive eating behaviors of a low-income audience. Structured interviews were conducted during summer of 2006 with 70 low-income adults in Pennsylvania. Themes about decisional factors that guide food selection, nutrition/health interests, and cognitive and affective responses to eating experiences were generated through content analysis. Thematic differences among eating competence levels and food security categories were examined. Nutrition information access preferences were also obtained. Eating competence, measured with the ecSatter Inventory, was low for this sample (mean 28.8+/-8.3). Convenience, mood, family, and availability of food at home, but not nutrition, were salient factors guiding meal and snack planning for both eating competent and noneating competent participants. Nearly equal proportions of persons with eating competence and without eating competence reported that they would make changes to their food purchases if they had more money to spend on food. Interestingly, for participants without eating competence, but not for those with eating competence, weight management played an important role in meal/snack planning, food purchases, and nutrition/health interests. ecSatter provided a tenable framework for rationalizing participants' cognitive and affective responses to eating experiences. Participants without eating competence were more likely to express negative thoughts and feelings associated with eating, regardless of food security status. The Internet, which was

  17. Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines.

    Science.gov (United States)

    Bernstein, Steven L; Rosner, June-Marie; Toll, Benjamin

    2016-08-01

    Quitlines (QLs) are free, effective sources of treatment for tobacco dependence. Although the QL number is toll-free, the use of cell phones as the sole source of telephony may impose an unintended cost, in terms of cell minutes. To quantify the use of cell-only telephony among self-pay or Medicaid smokers, assess their calling plans, and estimate the impact of a typical course of QL counseling. A survey of smokers age at least 18 years visiting an American urban emergency department from April to July, 2013. Seven-hundred seventy-three smokers were surveyed, of whom 563 (72.8%) were low-income, defined as having Medicaid or no insurance. All low-income smokers had at least one phone: 48 (8.5%) reported land-lines only, 159 (28.2%) land-lines and cells, and 356 (63.2%) cells only. Of the cell phone owners, monthly calling plans provided unlimited minutes for 339/515 (65.8%), at most 250 minutes for 124 (24.1%), and more than 250 minutes for 52 (10.0%). Another recent trial found that QL users make a median of 1 call lasting 28 minutes, with the 75th and 90th percentiles of calls and minutes at 3 and 4 calls, and 48 and 73.6 minutes, respectively. Thus, robust use of QL services could consume 11%-29% of a low-income smoker's typical 250 monthly cell minutes. Among low-income smokers, cell phones are often the sole telephone. Robust use of the QL may impose a substantial burden on low-income smokers' calling plans, and therefore deter use of the QL. Exempting calls to QLs from counting against smokers' plans may help promote QL utilization. Low-income individuals have high rates of smoking, and are more likely to own only cell phones, not landlines, for telephone access. Because cell phone calling plans often have limited numbers of monthly minutes, cell-only individuals may have to spend a substantial proportion of their monthly minutes on QL services. This may act as a deterrent to using an otherwise free, effective means of treatment for tobacco dependence

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

    Science.gov (United States)

    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.

  19. 78 FR 63993 - ``Low-Income Levels'' Used for Various Health Professions and Nursing Programs

    Science.gov (United States)

    2013-10-25

    ... changes in the Consumer Price Index. The Secretary annually adjusts the low-income levels based on the... applicable programs. The income figures below have been updated to reflect increases in the Consumer Price... recognition of same-sex spouses and same-sex marriages, was unconstitutional. In light of this decision...

  20. Understanding the role of mHealth and other media interventions for behavior change to enhance child survival and development in low- and middle-income countries: an evidence review.

    Science.gov (United States)

    Higgs, Elizabeth S; Goldberg, Allison B; Labrique, Alain B; Cook, Stephanie H; Schmid, Carina; Cole, Charlotte F; Obregón, Rafael A

    2014-01-01

    Given the high morbidity and mortality among children in low- and middle-income countries as a result of preventable causes, the U.S. government and the United Nations Children's Fund convened an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change on June 3-4, 2013, in Washington, D.C. This article summarizes evidence for technological advances associated with population-level behavior changes necessary to advance child survival and healthy development in children under 5 years of age in low- and middle-income countries. After a rigorous evidence selection process, the authors assessed science, technology, and innovation papers that used mHealth, social/transmedia, multiplatform media, health literacy, and devices for behavior changes supporting child survival and development. Because of an insufficient number of studies on health literacy and devices that supported causal attribution of interventions to outcomes, the review focused on mHealth, social/transmedia, and multiplatform media. Overall, this review found that some mHealth interventions have sufficient evidence to make topic-specific recommendations for broader implementation, scaling, and next research steps (e.g., adherence to HIV/AIDS antiretroviral therapy, uptake and demand of maternal health service, and compliance with malaria treatment guidelines). While some media evidence demonstrates effectiveness in changing cognitive abilities, knowledge, and attitudes, evidence is minimal on behavioral endpoints linked to child survival. Population level behavior change is necessary to end preventable child deaths. Donors and low- and middle-income countries are encouraged to implement recommendations for informing practice, policy, and research decisions to fully maximize the impact potential of mHealth and multimedia for child survival and development.

  1. Periodontal disease and some adverse perinatal outcomes in a cohort of low risk pregnant women

    Directory of Open Access Journals (Sweden)

    Cecatti Jose G

    2010-11-01

    Full Text Available Abstract Objective To evaluate the association of periodontal disease (PD in pregnancy with some adverse perinatal outcomes. Method This cohort study included 327 pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. The rates of preterm birth (PTB, low birth weight (LBW, small for gestational age (SGA neonates and prelabor rupture of membranes (PROM were evaluated using Risk Ratios (95%CI and Population Attributable Risk Fractions. Results PD was associated with a higher risk of PTB (RRadj. 3.47 95%CI 1.62-7.43, LBW (RRadj. 2.93 95%CI 1.36-6.34 and PROM (RRadj. 2.48 95%CI 1.35-4.56, but not with SGA neonates (RR 2.38 95%CI 0.93 - 6.10. Conclusions PD was a risk factor for PT, LBW and PROM among Brazilian low risk pregnant women.

  2. The Rationale behind Small Food Store Interventions in Low-Income Urban Neighborhoods: Insights from New Orleans1–3

    Science.gov (United States)

    Bodor, J. Nicholas; Ulmer, Vanessa M.; Futrell Dunaway, Lauren; Farley, Thomas A.; Rose, Donald

    2010-01-01

    Environmental approaches to the obesity problem in the US have garnered favor due to growing evidence that changes to the environment are at the root of the epidemic. Low-income urban neighborhoods, where obesity rates are disproportionately high, typically lack supermarkets yet have a high density of small food stores. This may increase the risk for unhealthy diets and obesity for neighborhood residents, because small stores carry mostly energy-dense foods and few fruits and vegetables. This paper pulls together various studies and pilot work conducted in New Orleans to explore the rationale behind small store interventions. Many low-income residents in New Orleans live within walking distance of small food stores and shop at them frequently. Marketing research has documented that changes to in-store shelf space and displays of specific foods affect the sales of these foods. Initiatives in New Orleans and elsewhere have demonstrated some success with improving healthy food availability in small stores, and an intercept survey of customers at small stores suggests that customers would purchase more fruits and vegetables if available. Efforts to encourage small store operators to offer a healthier mix of foods may, in the end, depend on the profitability of such changes. Evidence from a typical small store in New Orleans indicates that a greater percentage of gross profits come from snack foods and beverages than from fruits and vegetables. More research is needed to better understand the financial operations of small food stores and whether altering the mix of foods is economically feasible. PMID:20410086

  3. Interconnected microbiomes and resistomes in low-income human habitats

    OpenAIRE

    Pehrsson, Erica C.; Tsukayama, Pablo; Patel, Sanket; Mej?a-Bautista, Melissa; Sosa-Soto, Giordano; Navarrete, Karla M.; Calderon, Maritza; Cabrera, Lilia; Hoyos-Arango, William; Bertoli, M. Teresita; Berg, Douglas E.; Gilman, Robert H.; Dantas, Gautam

    2016-01-01

    Summary Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by resistance gene exchange between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. We characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human fecal and environmental samples from two low-income Latin A...

  4. Comparison the effects of poor health and low income on early retirement: a systematic review and meta-analysis.

    Science.gov (United States)

    Homaie Rad, Enayatollah; Rashidian, Arash; Arab, Mohamad; Souri, Ali

    2017-08-08

    The main aim of this study was to estimate the effects of poor health and low income on early retirement. For this purpose systematic review and meta-analysis were conducted. Web of Science, PUBMED and Scopus databases were searched systematically. Finally 17 surveys were added in meta-analysis. These studies were conducted in 13 countries. At the end a Meta regression was done to show the effects of welfare system type on effect sizes of poor health and low income. The results of this study showed that poor health had effect on the risk of early retirement. (Poor health pooled effect sizes: 1.279 CI: (1.15 1.41), low income pooled effect sizes: 1.042 CI: (0.92 1.17), (poor health pooled marginal effects: 0.046 CI: (-0.03 0.12), low income pooled marginal effects: -0.002 CI: (-0.003 0.000). The results of this study showed that association between poor health and early retirement was stronger in comparison with low income and early retirement.

  5. A New Majority: Low Income Students Now a Majority in the Nation's Public Schools. Research Bulletin

    Science.gov (United States)

    Southern Education Foundation, 2015

    2015-01-01

    For the first time in recent history, a majority of the schoolchildren attending the nation's public schools come from low income families. The latest data collected from the states by the National Center for Education Statistics (NCES), evidence that 51 percent of the students across the nation's public schools were low income in 2013. The…

  6. Empowerment in the process of health messaging for rural low-income mothers: an exploratory message design project.

    Science.gov (United States)

    Aldoory, Linda; Braun, Bonnie; Maring, Elisabeth Fost; Duggal, Mili; Briones, Rowena Lynn

    2015-01-01

    Rural, low-income mothers face challenges to their health equal to or greater than those of low-income mothers from urban areas. This study put health message design into the hands of low-income rural mothers. The current study filled a research gap by analyzing a participatory process used to design health messages tailored to the everyday lives of rural low-income mothers. A total of forty-three mothers participated in nine focus groups, which were held from 2012 to 2013, in eight states. The mothers were from different racial and ethnic backgrounds. Participants discussed food security, physical activity, and oral health information. They created messages by considering several elements: visuals, length of message, voice/perspective, self-efficacy and personal control, emotional appeals, positive and negative reinforcements, and steps to health behavior change. This study was innovative in its focus on empowerment as a key process to health message design.

  7. Stigma and hostility towards pregnant smokers: does individuating information reduce the effect?

    Science.gov (United States)

    Wigginton, Britta; Lee, Christina

    2013-01-01

    Australia is at the forefront of tobacco control, yet 17% of Australian women smoke during pregnancy. Negative attitudes to smoking are intensified when the smoker is pregnant, consistent with a discourse that encourages surveillance of pregnant women. Such overt anti-smoking attitudes create a context which may make it difficult for pregnant smokers to seek assistance to stop. However, there is little evidence on the extent to which pregnant smokers are stigmatised by community members. We used vignettes to examine the degree of smoking-related stigma expressed by 595 Australian university students who rated a woman, described as a mother who was smoking or not, and pregnant or not. Further, we examined whether provision of individuating information reduced the degree of stigma. Mothers described as smokers were rated more negatively than those not, particularly if they were pregnant: smokers were perceived as unhealthy, and also as bad mothers. Provision of individuating information slightly reduced these effects. These findings support the view that smokers--particularly if pregnant--are subject to negative moral judgement. Our findings contribute to the ethical debate about stigma-inducing tobacco control efforts, and suggest that anti-smoking campaigns that contextualise smoking in pregnancy might reduce stigma and assist cessation.

  8. Self-esteem of pregnant substance abusers.

    Science.gov (United States)

    Higgins, P G; Clough, D H; Wallerstedt, C

    1995-01-01

    To explore patterns and levels of self-esteem of pregnant substance abusers. A descriptive prospective study to describe the self-esteem of pregnant substance abusers. Subjects (N = 31) were abusing and dependent on three or more legal and/or illegal substances. Subjects were asked one open-ended question regarding their self-esteem, then the Rosenberg Self-Esteem Inventory (RSI) was administered. Subjects gave 46 responses to the open-ended question. Overall, they used a single word to describe self-esteem. The most frequent response on the RSI was "low" for self-esteem, 23 subjects used positive terms, 20 used negative terms, and 3 reported a neutral term. The RSI confirmed the aspects of low self-esteem. Problems with low self-esteem were evident. Intervention strategies need to be developed to increase self-esteem in pregnant substance abusers.

  9. Stakeholder perspectives on barriers for healthy living for low-income african american families.

    Science.gov (United States)

    Jones, Veronnie Faye; Rowland, Michael L; Young, Linda; Atwood, Katherine; Thompson, Kirsten; Sterrett, Emma; Honaker, Sarah Morsbach; Williams, Joel E; Johnson, Knowlton; Davis, Deborah Winders

    2014-01-01

    Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI ≥ 85) and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Child and parent focus group analysis revealed 11 barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities. Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family informed interventions are needed to support low-income African American families in dealing with childhood obesity.

  10. Upgrade energy building standards and develop rating system for existing low-income housing

    International Nuclear Information System (INIS)

    Muller, D.; Norville, C.

    1993-07-01

    The city of Memphis Division of Housing and Community Development (HCD) receives grant funding each year from the U.S. Department of Housing and Urban Development (HUD) to provide local housing assistance to low-income residents. Through the years, HCD has found that many of the program recipients have had difficulty in managing their households, particularly in meeting monthly financial obligations. One of the major operating costs to low-income households is the utility bill. Furthermore, HCD's experience has revealed that many low-income residents are simply unaware of ways to reduce their utility bill. Most of the HCD funds are distributed to low-income persons as grants or no/low interest loans for the construction or rehabilitation of single-family dwellings. With these funds, HCD builds 80 to 100 new houses and renovates about 500 homes each year. Houses constructed or renovated by HCD must meet HUD's minimum energy efficiency standards. While these minimum standards are more than adequate to meet local building codes, they are not as aggressive as the energy efficiency standards being promoted by the national utility organizations and the home building industry. Memphis Light, Gas and Water (MLGW), a city-owned utility, has developed an award-winning program named Comfort Plus which promotes energy efficiency open-quote in new residential construction. Under Comfort Plus, MLGW models house plans on computer for a fee and recommends cost-effective alterations which improve the energy efficiency of the house. If the builder agrees to include these recommendations, MLGW will certify the house and guarantee a maximum annual heating/cooling bill for two years. While the Comfort Plus program has received recognition in the new construction market, it does not address the existing housing stock

  11. Upgrade energy building standards and develop rating system for existing low-income housing

    Energy Technology Data Exchange (ETDEWEB)

    Muller, D.; Norville, C. [Memphis and Shelby County Div. of Planning and Development, TN (United States)

    1993-07-01

    The city of Memphis Division of Housing and Community Development (HCD) receives grant funding each year from the U.S. Department of Housing and Urban Development (HUD) to provide local housing assistance to low-income residents. Through the years, HCD has found that many of the program recipients have had difficulty in managing their households, particularly in meeting monthly financial obligations. One of the major operating costs to low-income households is the utility bill. Furthermore, HCD`s experience has revealed that many low-income residents are simply unaware of ways to reduce their utility bill. Most of the HCD funds are distributed to low-income persons as grants or no/low interest loans for the construction or rehabilitation of single-family dwellings. With these funds, HCD builds 80 to 100 new houses and renovates about 500 homes each year. Houses constructed or renovated by HCD must meet HUD`s minimum energy efficiency standards. While these minimum standards are more than adequate to meet local building codes, they are not as aggressive as the energy efficiency standards being promoted by the national utility organizations and the home building industry. Memphis Light, Gas and Water (MLGW), a city-owned utility, has developed an award-winning program named Comfort Plus which promotes energy efficiency{open_quote} in new residential construction. Under Comfort Plus, MLGW models house plans on computer for a fee and recommends cost-effective alterations which improve the energy efficiency of the house. If the builder agrees to include these recommendations, MLGW will certify the house and guarantee a maximum annual heating/cooling bill for two years. While the Comfort Plus program has received recognition in the new construction market, it does not address the existing housing stock.

  12. Parental Mathematics Homework Involvement of Low-Income Families with Middle School Students

    Science.gov (United States)

    O'Sullivan, Robyn Hackford; Chen, Yung-Chi; Fish, Marian C.

    2014-01-01

    This study explores the relationships between methods of parental assistance (i.e., provision of structure, direct assistance, and autonomy support) with mathematics homework for high-achieving and low-achieving students and children's achievement in mathematics in low-income families and examines the impact of parental efficacy on these…

  13. 75 FR 9609 - Low-Income Housing Tax Credit (LIHTC) Tenant Data Collection: Responses To Advance Solicitation...

    Science.gov (United States)

    2010-03-03

    ... comment on methodology for the collection of data on low-income housing tax credit housing, as required by... 36 (to be codified as 42 U.S.C. 1437z-8) that requires each State agency administering tax credits under section 42 of the Internal Revenue Code of 1986 (low-income housing tax credits or LIHTC) to...

  14. Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

    Directory of Open Access Journals (Sweden)

    Bhattacharya Shelley B

    2009-09-01

    Full Text Available Abstract Background Completion of colorectal cancer (CRC screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT among a low-income, minority primary care population in an urban setting. Methods We recruited a convenience sample of adults over age 40 (n = 282 from a federally qualified community health center (70% African American. Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening. Results Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p Conclusion Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.

  15. An evaluation of college and low-income youth writing together: self-discovery and cultural connection.

    Science.gov (United States)

    Chandler, Genevieve E

    2002-01-01

    Although the health and healing effects of writing have been documented in the literature, most of the studies have focused primarily on individuals writing alone. This formative evaluation is a component of an intervention reported elsewhere. The evaluation describes the experience of low-income youth and college students (n = 7) writing in a group during a 10-week workshop. The results revealed the development of protective processes of self-esteem, self-efficacy, coping strategies, social support, and cultural connections. In the weekly 2-hr writing sessions, using the Amherst Writers and Artists method, participants were encouraged to write their stories in their own voices in response to prompts, followed by reading aloud and positive feedback. At the end of the 10 weeks participants were interviewed about their experience within the group and outside the group. Analysis of interviews revealed two themes that emerged from the experience of writing together: connection to self through feelings, reflection, and behaviors; and connection to others through learning and empathy. The results suggest that writing in a group using a specific approach facilitated emotional catharsis, increased self knowledge, coping strategies, and understanding and appreciating of others.

  16. Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Bulgiba, Awang; Majid, Hazreen Abdul

    2015-01-01

    We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

  17. Prediction of Cardiovascular Disease Risk among Low-Income Urban Dwellers in Metropolitan Kuala Lumpur, Malaysia

    Directory of Open Access Journals (Sweden)

    Tin Tin Su

    2015-01-01

    Full Text Available We aimed to predict the ten-year cardiovascular disease (CVD risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM. Altogether 882 adults (≥30 years old with no CVD history were randomly selected. The classic FRS model (figures in parentheses are from the modified model revealed that 20.5% (21.8% and 38.46% (38.9% of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

  18. Patient-provider communication and low-income adults: age, race, literacy, and optimism predict communication satisfaction.

    Science.gov (United States)

    Jensen, Jakob D; King, Andy J; Guntzviller, Lisa M; Davis, LaShara A

    2010-04-01

    To assess whether literacy, numeracy, and optimism are related to low-income adults' satisfaction with their healthcare provider's communication skills. Low-income adults (N=131) were recruited from seven counties in Indiana through University extension programs. To achieve research triangulation, participants were surveyed and interviewed about their communication satisfaction with health providers. Survey data revealed that four variables significantly predicted satisfaction: age, race, literacy, and optimism. Low-income adults in the current study were more critical of their healthcare provider's communication skills if they were younger, White, functionally literate, and pessimistic. Follow-up interviews confirmed this pattern and suggested it was a byproduct of patient activism. In low-income populations, communication satisfaction may be lower for groups that are traditionally active in doctor-patient interactions (e.g., younger patients, patients with higher literacy skills). Healthcare providers should be aware that older, non-White, optimistic, and literacy deficient patients report greater communication satisfaction than their younger, White, pessimistic, and functionally literate peers. Both groups may be coping with their situation, the former by withdrawing and the latter by actively pushing for a higher standard of care. Healthcare providers should continue to seek out ways to facilitate dialogue with these underserved groups. 2009 Elsevier Ireland Ltd. All rights reserved.

  19. Sustainable performance of microinsurance in low-income markets

    Directory of Open Access Journals (Sweden)

    Last Mazambani

    2018-06-01

    Full Text Available Sustainable performance in microinsurance offering in low-income markets is important to ensure that the service simultaneously achieves corporate profitability and poverty alleviation. Sustainable performance requires a balanced integration of supply and demand factors in the offering of the service. Microinsurance is still supply driven thereby creating a lopsided mismatch between demand and supply that leads to oversupply and low uptake. On the basis of extant literature, the paper aims to propose and discuss factors critical to demand and supply of microinsurance. A conceptual framework for sustainable microinsurance is presented with individual metrics that can be addressed as managerial tools for driving and controlling sustained superior performance. While this is a theoretical paper, microinsurance practitioners may benefit from the application of the presented theory

  20. Staffing remote rural areas in middle- and low-income countries : a literature review of attraction and retention

    NARCIS (Netherlands)

    Lehmann, Uta; Dieleman, Marjolein; Martineau, Tim

    2008-01-01

    BACKGROUND: Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the

  1. Governance arrangements for health systems in low-income countries: an overview of systematic reviews

    Science.gov (United States)

    Herrera, Cristian A; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Wiysonge, Charles S; Bastías, Gabriel; Garcia Marti, Sebastian; Okwundu, Charles I; Peñaloza, Blanca; Oxman, Andrew D

    2017-01-01

    using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low-income countries. Main results We identified 7272 systematic reviews and included 21 of them in this overview (19 primary reviews and 2 supplementary reviews). We focus here on the results of the 19 primary reviews, one of which had important methodological limitations. The other 18 were reliable (with only minor limitations). We grouped the governance arrangements addressed in the reviews into five categories: authority and accountability for health policies (three reviews); authority and accountability for organisations (two reviews); authority and accountability for commercial products (three reviews); authority and accountability for health professionals (seven reviews); and stakeholder involvement (four reviews). Overall, we found desirable effects for the following interventions on at least one outcome, with moderate- or high-certainty evidence and no moderate- or high-certainty evidence of undesirable effects. Decision-making about what is covered by health insurance - Placing restrictions on the medicines reimbursed by health insurance systems probably decreases the use of and spending on these medicines (moderate-certainty evidence). Stakeholder participation in policy and organisational decisions - Participatory learning and action groups for women probably improve newborn survival (moderate-certainty evidence). - Consumer involvement in preparing patient information probably improves the quality of the information and patient knowledge (moderate-certainty evidence). Disclosing performance information to patients and the public - Disclosing performance data on hospital quality to the public probably encourages hospitals to implement quality improvement activities (moderate-certainty evidence). - Disclosing performance data on individual

  2. Hong Kong men with low incomes have worse health-related quality of life as judged by SF-36 scores.

    Science.gov (United States)

    Ko, G T C; Wai, H P S; Tsang, P C C; Chan, H C K

    2006-10-01

    To analyse the association between income and health-related quality of life using the Medical Outcome Study Short Form 36 (SF-36) Chinese version in Hong Kong Chinese working population. Cross-sectional observation study. A commercial company in Hong Kong. All clerical and administrative staff of a commercial company was invited to participate; 876 of the 1003 staff agreed. The subjects were categorised into three income groups according to monthly income in Hong Kong dollars (low, 10,000-25,000; high, >25,000). The mean age of the 288 men and 588 women was 34.9 (standard deviation, 7.9; median, 34.0; range, 18-71) years. SF-36 scores on health-related quality of life. The distribution of income was 30% in high-, 54.8% in middle-, and 15.2% in low-income groups. Women had similar SF-36 scores among different income groups. In men, for most variables there was a significant positive linear correlation between income and SF-36 scores. Low income is associated with a worse health-related quality of life in Hong Kong Chinese men.

  3. Estimating costs of care for meningitis infections in low- and middle-income countries.

    Science.gov (United States)

    Portnoy, Allison; Jit, Mark; Lauer, Jeremy; Blommaert, Adriaan; Ozawa, Sachiko; Stack, Meghan; Murray, Jillian; Hutubessy, Raymond

    2015-05-07

    Meningitis infections are often associated with high mortality and risk of sequelae. The costs of treatment and care for meningitis are a great burden on health care systems, particularly in resource-limited settings. The objective of this study is to review data on the costs of care for meningitis in low- and middle-income countries, as well as to show how results could be extrapolated to countries without sound data. We conducted a systematic review of the literature from six databases to identify studies examining the cost of care in low- and middle-income countries for all age groups with suspected, probable, or confirmed meningitis. We extracted data on treatment costs and sequelae by infectious agent and/or pathogen, where possible. Using multiple regression analysis, a relationship between hospital costs and associated determinants was investigated in order to predict costs in countries with missing data. This relationship was used to predict treatment costs for all 144 low- and middle-income countries. The methodology of conducting a systematic review, extrapolating, and setting up a standard database can be used as a tool to inform cost-effectiveness analyses in situations where cost of care data are poor. Both acute and long-term costs of meningitis could be extrapolated to countries without reliable data. Although only bacterial causes of meningitis can be vaccine-preventable, a better understanding of the treatment costs for meningitis is crucial for low- and middle-income countries to assess the cost-effectiveness of proposed interventions in their country. This cost information will be important as inputs in future cost-effectiveness studies, particularly for vaccines. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Diet intake trends among pregnant women in rural area of rawalpindi, pakistan

    International Nuclear Information System (INIS)

    Quresshi, Z; Khan, R.

    2015-01-01

    Abstract: Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and new-born. This study was designed to know the health status of pregnant women and new-born by determining food taking habits of pregnant women. Methods: A cross sectional study was conducted on pregnant women of 2nd and 3rd trimester in a rural area of district Rawalpindi. Food frequency questionnaire and 24 hours dietary recall methods were used to identify their food consumption practices. Analysis was done by SPSS, while Nutrisurvey software was used to check the presence of Vitamin A, C, and Iron in specific fruits or vegetables. Results: A total of 110 pregnant women participated in the study. Most of them were illiterate, had low household income, and unemployed. Intake of meal frequency was according to the standards of Institute of Medicine (IOM), but food group consumption was not according to the recommendations of the United State Department of Agriculture (USDA). Most participants 102 (93.2%) knew that food is important during pregnancy. However a increase in frequency intake was observed in 63 (57.3%); while, 19 (17.3%) reported no change in food intake practices. About 67 (61%) were taking some sort of dietary supplements. Avoidance of any food 24 (22%), intake of additional food 51 (46%), craving 86 (78%), and aversion to any sort of food 42 (38%) was also identified in the study sample. No significant association was found between food group consumption, food availability and accessibility. Dietary diversity score, calculated according to the Food and Agriculture Organization (FAO) guidelines, indicated that about half study participants were not consuming adequate food. Conclusion: Study results show that food intake practices of pregnant women in the study area were not satisfactory. (author)

  5. Estimating the Impact of Low-Income Universal Service Programs

    OpenAIRE

    Daniel A. Ackerberg; David R. DeRemer; Michael H. Riordan; Gregory L. Rosston; Bradley S. Wimmer

    2013-01-01

    This policy study uses U.S. Census microdata to evaluate how subsidies for universal telephone service vary in their impact across low-income racial groups, gender, age, and home ownership. Our demand specification includes both the subsidized monthly price (Lifeline program) and the subsidized initial connection price (Linkup program) for local telephone service. Our quasi-maximum likelihood estimation controls for location differences and instruments for price endogeneity. The microdata all...

  6. Gauging the Impact of Various Definitions of Low- and Moderate-Income Communities on Possible Electricity Savings From Weatherization

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-06-20

    With rising interest in lowering energy costs for low- and moderate-income households, the U.S. Department of Energy (DOE) asked Lawrence Berkeley National Laboratory (LBNL) to assess the implications of pursuing energy efficiency neighborhood-by-neighborhood where those households are most prevalent. DOE provided certain scenarios for qualifying geographic areas as “low- and moderate-income communities,” and LBNL used data on demographics, housing types and recent savings from low-income retrofits or weatherization to provide rough electricity savings estimates under those scenarios.

  7. Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case–control study design

    Science.gov (United States)

    Gebrekidan, Kahasse; Worku, Alemayehu

    2017-01-01

    Background Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country. Objective The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia. Subjects and methods A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case–control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation. Results The odds of attending ANC late were significantly higher for mothers with a monthly household income of $8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67). Conclusion Low educational level, low income of the household, unplanned pregnancy, stay for ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened. PMID:29138615

  8. Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting.

    Science.gov (United States)

    Njuguna, Festus; Martijn, Hugo A; Kuremu, Robert Tenge; Saula, Peter; Kirtika, Patel; Olbara, Gilbert; Langat, Sandra; Martin, Steve; Skiles, Jodi; Vik, Terry; Kaspers, Gertjan J L; Mostert, Saskia

    2017-10-01

    Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%), II (7%), III (43%), IV (40%), or V (10%). The most likely treatment outcome in patients with low-stage (I to III) disease was event-free survival (67%), whereas in those with high-stage (IV to V) disease, it was death (40%). No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes ( P = .014) and event-free survival estimates ( P abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

  9. The dynamic implications of debt relief for low-income countries

    Directory of Open Access Journals (Sweden)

    Alma Lucía Romero-Barrutieta

    2015-06-01

    Full Text Available Debt relief provides low-income countries with an incentive to accumulate debt, boost consumption, and reduce investment over time. We quantify this incentive effect employing a dynamic stochastic general equilibrium model, calibrated to 1982–2006 Ugandan data, and find that long-run debt and consumption-to-GDP ratios are about twice as high with debt relief than without it, while the investment-to-GDP ratio is sixty percent lower. Our simulations show that debt-relief episodes are likely to have only a temporary impact on debt levels but may have a lasting effect over the size of the economy, lowering GDP growth up to twenty percent over time. These results fill a gap in the debt relief literature since, to the best of our knowledge, the quantification of incentive effects is rather scarce. The paper further contributes to the literature by constructing a tractable structural model that is able to replicate the data well and captures key features of low-income countries facing the possibility of debt relief.

  10. Cigarette smoking and food insecurity among low-income families in the United States, 2001

    OpenAIRE

    Armour, Brian S.; Pitts, M. Melinda; Lee, Chung-won

    2007-01-01

    The goal of this research is to quantify the association between food insecurity and smoking among low-income families. This analysis is a retrospective study using data from the 2001 Panel Study of Income Dynamics, a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Family income is linked with U.S. poverty thresholds to identify 2,099 families living near or below 200 percent of the federal poverty level. Food insecurit...

  11. The uptake of integrated perinatal prevention of mother-to-child HIV transmission programs in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Tudor Car, Lorainne; Brusamento, Serena; Elmoniry, Hoda; van Velthoven, Michelle H M M T; Pape, Utz J; Welch, Vivian; Tugwell, Peter; Majeed, Azeem; Rudan, Igor; Car, Josip; Atun, Rifat

    2013-01-01

    The objective of this review was to assess the uptake of WHO recommended integrated perinatal prevention of mother-to-child transmission (PMTCT) of HIV interventions in low- and middle-income countries. We searched 21 databases for observational studies presenting uptake of integrated PMTCT programs in low- and middle-income countries. Forty-one studies on programs implemented between 1997 and 2006, met inclusion criteria. The proportion of women attending antenatal care who were counseled and who were tested was high; 96% (range 30-100%) and 81% (range 26-100%), respectively. However, the overall median proportion of HIV positive women provided with antiretroviral prophylaxis in antenatal care and attending labor ward was 55% (range 22-99%) and 60% (range 19-100%), respectively. The proportion of women with unknown HIV status, tested for HIV at labor ward was 70%. Overall, 79% (range 44-100%) of infants were tested for HIV and 11% (range 3-18%) of them were HIV positive. We designed two PMTCT cascades using studies with outcomes for all perinatal PMTCT interventions which showed that an estimated 22% of all HIV positive women attending antenatal care and 11% of all HIV positive women delivering at labor ward were not notified about their HIV status and did not participate in PMTCT program. Only 17% of HIV positive antenatal care attendees and their infants are known to have taken antiretroviral prophylaxis. The existing evidence provides information only about the initial PMTCT programs which were based on the old WHO PMTCT guidelines. The uptake of counseling and HIV testing among pregnant women attending antenatal care was high, but their retention in PMTCT programs was low. The majority of women in the included studies did not receive ARV prophylaxis in antenatal care; nor did they attend labor ward. More studies evaluating the uptake in current PMTCT programs are urgently needed.

  12. Changes in Hypertension Prevalence, Awareness, Treatment, and Control in High-, Middle-, and Low-Income Countries: An Update.

    Science.gov (United States)

    Cifkova, Renata; Fodor, George; Wohlfahrt, Peter

    2016-08-01

    The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level.

  13. Boosting Low-Income Children's Opportunities to Succeed Through Direct Income Support.

    Science.gov (United States)

    Sherman, Arloc; DeBot, Brandon; Huang, Chye-Ching

    2016-04-01

    Direct income supports have long been known to substantially reduce the extent and depth of poverty. Evidence suggests that they can also bolster children's opportunities to succeed and enhance long-term mobility. A growing body of research, for example, links income from 2 related tax credits for working families-the Earned Income Tax Credit and the Child Tax Credit-to benefits for children in those families, such as improved birth weight, better school outcomes, and increased rates of employment in adulthood. Similarly, the introduction of food stamps has been found to improve not only the birth weight of infants given access to the program but also their educational achievement, as well as indicators of health, well-being, and self-sufficiency decades later. These are striking research results for income support that is not typically thought of as improving children's health or education. The mechanisms through which these income supports lead to such benefits are likely varied and complex, but emerging research suggests that helping families with children afford basic necessities can reduce the added stress of financial difficulties, preventing downstream neuroendocrine and biochemical changes that affect children's longer-term outcomes. These findings have important implications for policy makers. Research suggests that potential weakening of the safety net would not only substantially increase poverty, but also have damaging long-term effects on children. Policy makers should reject funding cuts and instead strengthen the safety net, which this analysis suggests could reduce poverty further and also enhance children's opportunities to succeed. Copyright © 2016. Published by Elsevier Inc.

  14. Integrating Photovoltaic Systems into Low-Income Housing Developments: A Case Study on the Creation of a New Residential Financing Model and Low-Income Resident Job Training Program, September 2011 (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    Dean, J.; Smith-Dreier, C.; Mekonnen, G.; Hawthorne, W.

    2011-09-01

    This case study covers the process of successfully integrating photovoltaic (PV) systems into a low-income housing development in northeast Denver, Colorado, focusing specifically on a new financing model and job training. The Northeast Denver Housing Center (NDHC), working in cooperation with Del Norte Neighborhood Development Corporation, Groundwork Denver, and the National Renewable Energy Laboratory (NREL), was able to finance the PV system installations by blending private equity funding with utility rebates, federal tax credits, and public sector funding. A grant provided by the Governor's Energy Office allowed for the creation of the new financing model. In addition, the program incorporated an innovative low-income job training program and an energy conservation incentive program.

  15. Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements

    Directory of Open Access Journals (Sweden)

    John Twigg

    2017-02-01

    Full Text Available Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

  16. Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

    Science.gov (United States)

    Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

    2017-02-01

    Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

  17. Low-income Euro-American mothers' perceptions of health and self-care practices.

    Science.gov (United States)

    Mendias, Elnora P; Clark, Michele C; Guevara, Edilma B; Svrcek, Claire Y

    2011-01-01

    Health promotion activities may decrease preventable diseases and health system overuse. This study examined how low-income Euro-American mothers described their health/wellness, self-care practices (SCP), and SCP benefits, barriers, and interpersonal influences (norms, modeling, and social support) affecting their SCP. This descriptive qualitative study used a convenience sample of 10 low-income, English-speaking mothers, 25-43 years old, seeking women's/children's health services at a large urban Texas health clinic. Data were collected via face-to-face interviews, using a standardized semistructured interview guide; data were analyzed using Miles and Huberman's qualitative research methods. All participants primarily described themselves positively and as mothers and workers. Most viewed health and wellness as distinct but typically included physical and emotional well-being. Mothers valued health and SCP for personal and family reasons. All identified SCP benefits. Most identified SCP barriers. Women viewed themselves as vital to family function and well-being, learned SCP primarily from parents during childhood, and described limited support for SCP. The results provide a better understanding of participants' self-care decision making and are useful in designing appropriate clinical health promotions. Reducing health inequities in low-income women requires further study of the underlying causes and development of effective policies and measures to address them. © 2011 Wiley Periodicals, Inc.

  18. Systematic Review of Factors Influencing Farmers' Market Use Overall and among Low-Income Populations.

    Science.gov (United States)

    Freedman, Darcy A; Vaudrin, Nicole; Schneider, Christine; Trapl, Erika; Ohri-Vachaspati, Punam; Taggart, Morgan; Ariel Cascio, M; Walsh, Colleen; Flocke, Susan

    2016-07-01

    Recent evidence indicates a widening gap in fruit and vegetable (F/V) consumption between high- and low-income Americans. This gap is related, in part, to decreased access to food retailers that sell fresh F/V in low-income communities. Farmers' markets are identified as a strategy for improving F/V consumption by increasing access to these foods. The aim of this systematic review was to examine literature published from 1994 to 2014 to identify facilitators and barriers of farmers' markets use, particularly among low-income consumers. Peer-reviewed literature was identified in Ebsco Host (Academic Search Complete). Inclusion criteria for abstract review was primary research focused on farmers' market use identifying 87 studies for full-text review. Full-text review identified articles focused on facilitators and/or barriers of farmers' market use resulting in 49 articles. At least two reviewers completed review of all articles. Of the 49 articles, 39% specified inclusion of low-income consumers and fewer than 15% focused on racial and ethnic minorities. Few studies were guided by theory and/or used standardized metrics. Results indicate farmers' market use is influenced by multiple economic, service delivery, spatial-temporal, social, and personal factors. Among studies that included low-income populations (n=19), key barriers to farmers' market use were perceptions that food assistance benefits were not accepted, belief that food variety at farmers' markets was limited, lack of access to transportation, lack of racial/ethnic diversity in the market space, and mismatch between markets and personal lifestyles. There is wide variation in study design and reporting standards and infrequent use of standardized measures limiting comparisons across studies. There is a need to establish valid and reliable metrics and reporting standards for evaluating farmers' markets. Findings may inform interventions, programs, and policies to promote farmers' market use. Copyright

  19. Financial barriers and pricing strategies related to participation in sports activities: the perceptions of people of low income.

    Science.gov (United States)

    Steenhuis, Ingrid H M; Nooy, Steffie B C; Moes, Machiel J G; Schuit, Albertine J

    2009-11-01

    Physical activity levels in most affluent countries are low and many people do not meet the current recommendations. Particularly for people with a low income, economic strategies seem promising to stimulate taking part in sports activities. This study investigated the importance of economic restraints for taking part in sports activities as well as perceptions of low-income people toward different pricing interventions. A qualitative study was conducted, using semistructured, individual interviews with 27 low-income men and women. The framework approach was used to analyze the transcripts of the interviews. The respondents considered finances to be an important barrier for participating in sports activities, together with some individual barriers. Promising pricing strategies are a discount on the subscription to the fitness or sports club, a 1 month free trial, and free entrance to the swimming pool once a week. Pricing strategies may be a promising intervention to increase physical activity levels of low-income people. However, this study indicates that this should be coupled with an intervention directed at individual barriers. Some pricing strategies will be used and appreciated more by low-income people than other pricing strategies. In addition, pricing strategies should be tailored to individual needs and preferences.

  20. Goal-oriented incentive payment in CUDAM institution and variation in medical visit indicators in children under one and pregnant women

    Directory of Open Access Journals (Sweden)

    Marcelo Morales

    2011-11-01

    Full Text Available ntroduction: The establishment of National Integrated Health System in Uruguay from 2007 led to changes in the financing of the Collective Health Care Institutions (IAMC. They charge the National Health Fund (FONASA for their partners from social security (SS a health fee consists of: a A risk-adjusted capita (94%b A component for compliance with performance (6%, depending on the fulfillment of three goals of care. Goal 1 is a component of the child under 1 year and a component of the pregnant woman. For both components were established institutional baseline (July 2007-September 2008 in the control patients in both age groups. This motif COMPLIANCE quarterly reports with a fee of $48/user FONASA/month for average baseline compliment. Las for children and pregnant women were monitored for IAMC CUDAM 64% and 59% respectively.This institution has 42,000 users, 95% derived from SS, featuring 45 births, 585 children <1 year and 405 pregnant women tested monthly.Objectives: Evaluate two years (July-September 2010:a The mean percentages of compliance for children and pregnant CUDAM with medical controlb Relationship between income through the FONASA insitucional for goal 1 and children and pregnant women in medical management during the quarter.Methods: a retrospective study of children and pregnant women with medical control CUDAM. In turn, each target has 6 indicators (N: children, F: females. Child: N1 and N2: derivation and acquisition of the newborn, N3: controls as a guideline, N4: current vaccination, N5: ultrasound hip and pregnant, N6: accreditation in good feeding practices for infants and young children and pregnant women. Pregnant woman: M1 controls as a guideline, M2: leaf perinatal information system, M3: HIV and VDRL performed, M4: uptake in 1 st quarter, M5 and M6: dental checkup during pregnancy and postpartum.Results: The mean percentages of compliance for children and pregnant women increased to 92% (164 additional children and 88

  1. Family and Cultural Influences on Low-Income Latino Children's Adjustment

    Science.gov (United States)

    Santiago, Catherine DeCarlo; Wadsworth, Martha E.

    2011-01-01

    This study examined family and cultural influences on adjustment among 90 low-income Latino middle school children (46% girls; average age = 11.38, SD = 0.66) and their primary caregivers (93% female; average age = 36.12, SD = 6.13). All participants identified as Hispanic/Latino, with 75% of families identifying as Mexican-origin Latino, and 77%…

  2. Nutritional and Weight-Management Behaviors in Low-Income Women Trying to Conceive

    Science.gov (United States)

    Berenson, Abbey B.; Pohlmeier, Ali M.; Laz, Tabassum H.; Rahman, Mahbubur; McGrath, Christine J.

    2014-01-01

    Objective To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared to women not trying to conceive. Methods This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16–40 years who were low-income, racially diverse, (n=1,711) and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. Results At total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements or herbs (13.5% vs. 8.8%; adjusted odds ratio (aOR) 1.97, 95% confidence interval (CI) 1.11–3.49;), using laxatives or diuretics or inducing vomiting (7.7% vs. 3.0%; aOR 2.70, CI 1.23–5.91;), and fasting for 24 hours (10.7% vs. 5.5%; aOR 2.15, CI 1.03–4.51;). There were no significant differences between the two groups in amount of exercise, current smoking status or current alcohol consumption Further, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. Conclusion This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. PMID:25162259

  3. Nutritional and weight management behaviors in low-income women trying to conceive.

    Science.gov (United States)

    Berenson, Abbey B; Pohlmeier, Ali M; Laz, Tabassum H; Rahman, Mahbubur; McGrath, Christine J

    2014-09-01

    To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared with women not trying to conceive. This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16-40 years who were low income, racially diverse, (n=1,711), and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. A total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements, or herbs (13.5% compared with 8.8%; adjusted odds ratio [OR] 1.97, 95% confidence interval [CI] 1.11-3.49), using laxatives or diuretics or inducing vomiting (7.7% compared with 3.0%; adjusted OR 2.70, CI 1.23-5.91), and fasting for 24 hours (10.7% compared with 5.5%; adjusted OR 2.15, CI 1.03-4.51). There were no significant differences between the two groups in amount of exercise, current smoking status, or current alcohol consumption Furthermore, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. II.

  4. Understanding Barriers and Solutions Affecting Preschool Attendance in Low-Income Families

    Science.gov (United States)

    Susman-Stillman, Amy; Englund, Michelle M.; Storm, Karen J.; Bailey, Ann E.

    2018-01-01

    Preschool attendance problems negatively impact children's school readiness skills and future school attendance. Parents are critical to preschoolers' attendance. This study explored parental barriers and solutions to preschool attendance in low-income families. School-district administrative data from a racially/ethnically diverse sample of…

  5. Access and Mobilization: How Social Capital Relates to Low-Income Youth's Postsecondary Educational (PSE) Attainment

    Science.gov (United States)

    Ashtiani, Mariam; Feliciano, Cynthia

    2018-01-01

    Youth from advantaged backgrounds have more social relationships that provide access to resources facilitating their educational success than those from low-income families. Does access to and mobilization of social capital also relate to success among the few low-income youth who "overcome the odds" and persist in higher education?…

  6. 24 CFR 1000.110 - Under what conditions may non low-income Indian families participate in the program?

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Under what conditions may non low-income Indian families participate in the program? 1000.110 Section 1000.110 Housing and Urban... ACTIVITIES Affordable Housing Activities § 1000.110 Under what conditions may non low-income Indian families...

  7. Role of expendable income and price in food choice by low income families.

    Science.gov (United States)

    Burns, Cate; Cook, Kay; Mavoa, Helen

    2013-12-01

    The public health literature suggests that the cheapness of energy-dense foods is driving the obesity epidemic. We examined food purchases in low-income families and its relationship to the price of food and availability of funds. In-depth interviews were conducted with 22 parents with children less than 15 years of age whose major source of income was a government pension. A photo taxonomy, where participants sorted 50 photos of commonly purchased foods, was used to explore food choice. The most common food groupings used by the participants were: basic, emergency, treat and comfort. The process of food purchase was described by participants as weighing up the attributes of a food in relation to price and money available. Shoppers nominated the basic unit of measurement as quantity per unit price and the heuristic for food choice when shopping as determining "value for money" in a process of triage relating to food purchase decisions. Participants stated satiation of hunger to be the most common "value" relative to price. Given that the foods nominated as filling tended to be carbohydrate-rich staples, we suggest that public health initiatives need to acknowledge this triage process and shape interventions to promote nutrition over satiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Targeting strategies of mHealth interventions for maternal health in low and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Ilozumba, Onaedo; Abejirinde, Ibukun-Oluwa Omolade; Dieleman, Marjolein; Bardají, Azucena; Broerse, Jacqueline E W; Van Belle, Sara

    2018-02-24

    Recently, there has been a steady increase in mobile health (mHealth) interventions aimed at improving maternal health of women in low-income and middle-income countries. While there is evidence indicating that these interventions contribute to improvements in maternal health outcomes, other studies indicate inconclusive results. This uncertainty has raised additional questions, one of which pertains to the role of targeting strategies in implementing mHealth interventions and the focus on pregnant women and health workers as target groups. This review aims to assess who is targeted in different mHealth interventions and the importance of targeting strategies in maternal mHealth interventions. We will search for peer-reviewed, English-language literature published between 1999 and July 2017 in PubMed, Web of Knowledge (Science Direct, EMBASE) and Cochrane Central Registers of Controlled Trials. The study scope is defined by the Population, Intervention, Comparison and Outcomes framework: P, community members with maternal or reproductive needs; I, electronic health or mHealth programmes geared at improving maternal or reproductive health; C, other non-electronic health or mHealth-based interventions; O, maternal health measures including family planning, antenatal care attendance, health facility delivery and postnatal care attendance. This study is a review of already published or publicly available data and needs no ethical approval. Review results will be published in a peer-reviewed journal and presented at international conferences. CRD42017072280. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Growth in Means-Tested Programs and Tax Credits for Low-Income Households

    Science.gov (United States)

    Carrington, William; Dahl, Molly; Falk, Justin

    2013-01-01

    The federal government devotes roughly one-sixth of its spending to 10 major means-tested programs and tax credits, which provide cash payments or assistance in obtaining health care, food, housing, or education to people with relatively low income or few assets. Those programs and credits consist of the following: (1) Medicaid; (2) the low-income…

  10. Stakeholder Perspectives on Barriers for Healthy Living for Low-income African American Families

    Directory of Open Access Journals (Sweden)

    Veronnie Faye Jones

    2014-12-01

    Full Text Available Background: Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. Objective: The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. Methods: This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI > 85 and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Results: Child and parent focus group analysis revealed eleven barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities.Conclusions: Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family-informed interventions are needed to support low-income African American families in dealing with childhood obesity.

  11. The potential of low-intensity and online interventions for depression in low- and middle-income countries

    NARCIS (Netherlands)

    Bockting, C. L. H.; Williams, A. D.; Carswell, K.; Grech, A. E.

    The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care

  12. Factors contributing to background television exposure in low-income Mexican American preschoolers

    Science.gov (United States)

    Thompson, Darcy A.; Tschann, Jeanne M.

    2016-01-01

    Objective Background television (TV) exposure is harmful to young children, yet few studies have focused on predictors of exposure. This study’s objectives were to elucidate demographic, environmental, and behavioral correlates of background TV exposure in low-income Mexican American preschoolers and to explore caregiver beliefs about the impact of such exposure. Methods A convenience sample of low-income Mexican American female primary caregivers of preschoolers (3–5 years old, n=309), recruited in safety-net clinics, were surveyed by phone. Caregivers reported the frequency of their child’s exposure to background TV and responded to questions on the home media environment, TV use, and whether they had thought about background TV exposure and its impact on their child. Results Background TV exposure was common; 43% reported that their child was often, very often, or always exposed to background TV. More hours of TV viewing by the caregiver and greater frequency of TV viewing during meals were associated with an increased frequency of exposure to background TV. Only 49% of participants had ever thought about the impact of background TV. Believing that background TV is not harmful was associated with higher levels of background TV exposure. Conclusions Findings suggest that background TV exposure is frequent and caregiver awareness of its potential impact is low in low-income Mexican American families. Beliefs that background TV is not harmful may predict risk of exposure. Potential targets for interventions focused on reducing background TV exposure in this population include increasing caregiver awareness of the potential negative impact of such TV exposure. PMID:27007983

  13. Poverty and disability in low- and middle-income countries: A systematic review.

    Science.gov (United States)

    Banks, Lena Morgon; Kuper, Hannah; Polack, Sarah

    2017-01-01

    Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of

  14. A Discourse Analysis of Denmark´s Public Health Policy Concerning Overweight among Pregnant Women

    DEFF Research Database (Denmark)

    Toxvig, Lene; Bak, Carsten Kronborg; Kristiansen, Tine Mechlenborg

    2017-01-01

    . Health care professionals’ approach to governing overweight pregnant women is affected by this breach in the discursive field. Thus, overweight pregnant women have become an issue for medical experts, who are encouraged to use stricter rhetoric when addressing them. This shift also renders pregnant women......A recent Danish public health report classified being overweight during pregnancy as a chronic disease, marking a discursive shift from its previous classification as a risk factor for complications in maternal and foetal health. This discursive shift is considered a breach in the discursive field...... subject to interventions by medical experts. The aim of this article is to critically analyse recommendations for how health professionals should govern these highrisk individuals and to discuss the implications of such governance for overweight pregnant women. In this study, overweight is classified...

  15. Prevalence of anaemia among pregnant women at booking in the University of Uyo Teaching Hospital, Uyo, Nigeria.

    Science.gov (United States)

    Olatunbosun, Olujimi A; Abasiattai, Aniekan M; Bassey, Emem A; James, Robert S; Ibanga, Godwin; Morgan, Anyiekere

    2014-01-01

    Anaemia with an estimated prevalence of 35-75% among pregnant women is a major cause of maternal deaths in Nigeria. objective: To determine the prevalence of anaemia, associated sociodemographic factors and red cell morphological pattern among pregnant women during booking at the University Teaching Hospital, Uyo. A cross-sectional analytical study of 400 women at the booking clinic over a 16-week period. The packed cell volume and red cell morphology of each pregnant woman were determined. Their biodata, obstetric and medical histories, and results of other routine investigations were obtained with questionnaires and analyzed with SPSS Package version 17.0. The mean packed cell volume was 31.8% ±3.2 and 54.5% of the women were anaemic. The commonest blood picture was microcytic hypochromia and normocytic hypochromia suggesting iron deficiency anaemia. Anaemia was significantly and independently related to a history of fever in the index pregnancy (OR = 0.4; P = 0.00; 95% CI = 0.3-0.7), HIV positive status (OR = 0.2; P = 0.01; 95% CI = 0.1-0.6), and low social class (OR = 0.3; P = 0.00; 95% CI = 0.2-0.7). Women need to be economically empowered and every pregnant woman should be encouraged to obtain antenatal care, where haematinics supplementation can be given and appropriate investigations and treatment of causes of fever and management of HIV can be instituted.

  16. BARRIERS AND OPPORTUNITIES IN DEVELOPING 'DO-IT-YOURSELF' (DIY PRODUCTS FOR LOW-INCOME HOUSING

    Directory of Open Access Journals (Sweden)

    Priscilla Lepre

    2010-06-01

    Full Text Available Direct involvement of the user in the assembling process of his/her own products or even entire house is a reality among low-income populations in developing countries. Nevertheless, there are a limited number of products that have actually been designed from a do-it-yourself (DIY perspective, which results in several problems, such as poor user safety while the product is being assembled or inadequate results from an improvised assembling. Hence, the main goal of this paper is to analyse barriers to and opportunities for developing DIY products for low-income housing in developing countries. The research method utilises a case study of a DIY product consisting of a hybrid solution that acted as both a partition wall and a wardrobe. The identified opportunities included more systematic use of existing craft competencies among low-income families and the possibility of cost reduction through DIY concepts. Major barriers included the perception of the DIY product as inferior and the difficulty of communicating the DIY assembly process to users who quite often are illiterate.

  17. Correlates of healthy life expectancy in low- and lower-middle-income countries.

    Science.gov (United States)

    Islam, Md Shariful; Mondal, Md Nazrul Islam; Tareque, Md Ismail; Rahman, Md Aminur; Hoque, Md Nazrul; Ahmed, Md Munsur; Khan, Hafiz T A

    2018-04-11

    Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

  18. Advancing HIV research with pregnant women: navigating challenges and opportunities.

    Science.gov (United States)

    Krubiner, Carleigh B; Faden, Ruth R; Cadigan, R Jean; Gilbert, Sappho Z; Henry, Leslie M; Little, Margaret O; Mastroianni, Anna C; Namey, Emily E; Sullivan, Kristen A; Lyerly, Anne D

    2016-09-24

    Concerns about including pregnant women in research have led to a dearth of evidence to guide safe and effective treatment and prevention of HIV in pregnancy. To better understand why these evidence gaps persist and inform guidance for responsible inclusion of pregnant women in the HIV research agenda, we aimed to learn what HIV experts perceive as barriers and constraints to conducting this research. We conducted a series of group and one-on-one consultations with 62 HIV investigators and clinicians to elicit their views and experiences conducting HIV research involving pregnant women. Thematic analysis was used to identify priorities and perceived barriers to HIV research with pregnant women. Experts discussed a breadth of needed research, including safety, efficacy, and appropriate dosing of: newer antiretrovirals for pregnant women, emerging preventive strategies, and treatment for coinfections. Challenges to conducting research on pregnancy and HIV included ethical concerns, such as how to weigh risks and benefits in pregnancy; legal concerns, such as restrictive interpretations of current regulations and liability issues; financial and professional disincentives, including misaligned funder priorities and fear of reputational damage; and analytical and logistical complexities, such as challenges recruiting and retaining pregnant women to sufficiently power analyses. Investigators face numerous challenges to conducting needed HIV research with pregnant women. Advancing such research will require clearer guidance regarding ethical and legal uncertainties; incentives that encourage rather than discourage investigators to undertake such research; and a commitment to earlier development of safety and efficacy data through creative trial designs.

  19. Associations between family food behaviors, maternal depression, and child weight among low-income children.

    Science.gov (United States)

    McCurdy, Karen; Gorman, Kathleen S; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

    2014-08-01

    Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P maternal control of child's eating routines (P maternal presence whenever the child ate was significantly associated with lower child BMI z scores (β = .166, P Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Energy consumption and economic growth relationship: Evidence from panel data for low and middle income countries

    International Nuclear Information System (INIS)

    Ozturk, Ilhan; Aslan, Alper; Kalyoncu, Huseyin

    2010-01-01

    This paper uses the panel data of energy consumption (EC) and economic growth (GDP) for 51 countries from 1971 to 2005. These countries are divided into three groups: low income group, lower middle income group and upper middle income group countries. Firstly, a relationship between energy consumption and economic growth is investigated by employing panel cointegration method. Secondly, panel causality test is applied to investigate the way of causality between the energy consumption and economic growth. Finally, we test whether there is a strong or weak relationship between these variables by using method. The empirical results of this study are as follows: i) Energy consumption and GDP are cointegrated for all three income group countries. ii) The panel causality test results reveal that there is long-run Granger causality running from GDP to EC for low income countries and there is bidirectional causality between EC and GDP for middle income countries. iii) The estimated cointegration factor, β, is not close to 1. In other words, no strong relation is found between energy consumption and economic growth for all income groups considered in this study. The findings of this study have important policy implications and it shows that this issue still deserves further attention in future research.

  1. Children's Effects on Parenting Stress in a Low Income, Minority Population.

    Science.gov (United States)

    Bendell, R. Debra; And Others

    1989-01-01

    Relationships between parenting stress and other maternal and child characteristics were investigated with 66 low income mothers and their five- to eight-year-old children at risk for educational disabilities. Child characteristics (self esteem, behavior conduct, and spelling achievement) and maternal characteristics (self esteem and crowding…

  2. The teratogenic effects of low dose 60Co γ-rays on the early pregnant rats

    International Nuclear Information System (INIS)

    Lu Chunlin

    1991-01-01

    The pregnant Wistar rats were exposed to 0.5 Gy and 1.0 Gy 60 Co γ-rays at the 9th day after conception. The results: 60 Co γ-rays at dose of 1.0 Gy could induced many defects: excenphaly, hydrocephalus, gastroschisis, cleft palate and cleft lip, anophthalmia, microphthalmia, shorten tail and absent tail in surviving fetuses. The growth retardation was found from the parameters of fetal weight, height, head circle and development of skeleton. In the group of radiation dose 0.5 Gy, only hydrocephalus, absent tail and growth retardation of skeleton appeared. The results suggest that low-dose exposure in the early pregnant rats can induce fetal defects and growth retardation. The probable mechanism of teratogen and growth retardation was discussed. The cAMP levels of brain and liver of rat fetuses were reported

  3. Socioeconomic status and COPD among low- and middle-income countries.

    Science.gov (United States)

    Grigsby, Matthew; Siddharthan, Trishul; Chowdhury, Muhammad Ah; Siddiquee, Ali; Rubinstein, Adolfo; Sobrino, Edgardo; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Checkley, William

    2016-01-01

    Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low- and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.

  4. Smoking, cessation and expenditure in low income Chinese: cross sectional survey.

    Science.gov (United States)

    Hesketh, Therese; Lu, Li; Jun, Ye Xue; Mei, Wang Hong

    2007-03-04

    This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day). Smoking was least common in migrant men (51%), compared with 58% of urban workers and 64% rural inhabitants (P opportunity costs, including in terms of healthcare access. The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

  5. Smoking, cessation and expenditure in low income Chinese: cross sectional survey

    Directory of Open Access Journals (Sweden)

    Jun Ye

    2007-03-01

    Full Text Available Abstract Background This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. Methods A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Results Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day. Smoking was least common in migrant men (51%, compared with 58% of urban workers and 64% rural inhabitants (P Conclusion The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

  6. LESS SPACE, MORE SPATIALITY FOR LOW-INCOME HOUSING UNITS IN EGYPT: IDEAS FROM JAPAN

    Directory of Open Access Journals (Sweden)

    Nermine Abdel Gelil

    2011-07-01

    Full Text Available In 1996, the Egyptian government launched a national housing project for low-income families. To minimize cost, it has progressively reduced units’ sizes. Numerous surveys indicate that unit specifications were based on political and economic criteria, rather than on users’ needs, which resulted in the recurrence of the persistent phenomenon of individual modifications. A number of scholars and architects concerned with this phenomenon are advocating the revival of the social design principles of traditional Cairene houses (16th –19th century after adapting them to contemporary needs. However, they provide no concrete solutions as to how to achieve this in small-scale units located in multi-storey buildings. During my research in Japan, I was introduced to traditional middle class urban houses. Their practical designs used to resolve issues of privacy, internal flexibility, storage, and family growth can be beneficially applied to housing units in Egypt. This paper first explains why relying solely on traditional housing designs to resolve social issues associated with low-income units in Egypt is both fanciful and incomplete, then discusses why ideas from Japanese homes can be beneficially applied to low-income housing units in Egypt. Third, this paper examines issues in these units and the resultant modifications by Egyptian households. Next, it analyzes concepts of spatial organization, modular systems, partitioning, and storage in traditional middle class urban houses in Japan. Finally, this paper formulates proposals for fulfilling the social needs of occupants in Egypt by integrating these ideas into low-income housing units.

  7. 78 FR 16277 - Notice of Submission of Proposed Information Collection to OMB: Low Income Housing Tax Credit...

    Science.gov (United States)

    2013-03-14

    ... Proposed Information Collection to OMB: Low Income Housing Tax Credit Database AGENCY: Office of the Chief... codified as 42 U.S.C. 1437z-8) that requires each state agency administering tax credits under section 42 of the Internal Revenue Code of 1986 (low-income housing tax credits or LIHTC) to furnish HUD, not...

  8. Factors That Contribute to Transfer and Bachelor's Degree Attainment of Low-Income Community College Beginners

    Science.gov (United States)

    Felder, Andrea Darlene

    2016-01-01

    Transfer and bachelor's degree attainment rates of low-income community college beginners lag behind their middle- and high-income peers. As community college continues to be an affordable and accessible route to higher education, consideration should be given to how to close the gap in transfer and bachelor's degree attainment rates of low-income…

  9. Low income homebuyers, low housing infrastructure quality, and disaster threat (Case study: Landslide in Trangkil Sejahtera and Trangkil Baru Residential Area, Semarang)

    Science.gov (United States)

    Indrianingrum, Lulut; Andiyarto, Hanggoro Tri Cahyo

    2018-03-01

    The Housing of Trangkil Sejahtera and Trangkil Baru are two housing areas located in the Village of Sukorejo, Gunungpati District, Semarang Municipality. In 2014, these housing areas were experienced landslide triggered by heavy rains that continued to fall across Semarang for several days. Successive landslides occurred on January 23, 2014 early in the morning until 07.30 am. Seven houses in Trangkil Sejahtera Housing were damaged by landslide, while in Trangkil Baru Housing there were 32 homes that severely damaged. The housing was located in a zone with high degree of susceptibility to landslide and stated as landslide prone areas by the Directorate of Environmental Geology. The objective of this article is to analyze the facts that the low income homebuyers basically do not understand the importance of accessing the information of land, infrastructure quality and specifications of the house. The analysis is conducted by comparing the landslide background and the homebuyer's condition background at the time the housing was purchased. The results showed that people who occupied the housing were victims of evictions and in low-income condition. A low-income homeowner has a low bargaining position in obtaining adequate housing infrastructure quality. Developers did not prepare proper infrastructure system to anticipate landslides and fulfill legal aspects of the real estate development. Low income homeowners should be educated about legal aspect of land purchased as well as their rights when buying a home.

  10. Anguish, Yearning, and Identity: Toward a Better Understanding of the Pregnant Hispanic Woman's Prenatal Care Experience.

    Science.gov (United States)

    Fitzgerald, Elizabeth Moran; Cronin, Sherill Nones; Boccella, Sarah Hess

    2016-09-01

    The purpose of this phenomenological study was to seek a better understanding of needs and access issues among pregnant, low-income Hispanic women. Hispanic women who attended a community prenatal education program participated in follow-up focus groups to explore their experiences regarding prenatal education, pregnancy resources, access to, and satisfaction with, the care available to them. Focus groups were facilitated by a leader, bilingual in English and Spanish, with knowledge of the Hispanic culture. Sessions were audiotaped, then translated into English for transcription. Data were analyzed according to guidelines by Colaizzi and three themes emerged: pregnant Hispanic women experienced a sense of anguish (la angustia) from questions and unknowns rampant during pregnancy, leading to a yearning (el anhelo) to learn and understand more, but with a desire to do so without sacrificing native identity (la identidad). Implications of these themes for improving prenatal care for this population are explored. © The Author(s) 2015.

  11. A Comparison of Postpartum Depression among Low-risk-pregnant Women with Emotion- and Problem-focused Coping Strategies

    Directory of Open Access Journals (Sweden)

    Habibeh Salehi

    2013-03-01

    Full Text Available Background and Objectives: Postpartum depression is one of most important health problems in women. This study was performed with the purpose of comparing the frequency of postpartum depression in pregnant women with emotion and problem-focused coping strategies. Methods: This study was conducted as a prospective cohort study on 200 pregnant women with stress (low and high levels. The samples were pregnant women referred to all health-treatment, centers of Ardabil, which were selected using a multi-stage sampling method; and according to coping strategy, they were divided into two groups: emotion-focused and problem-focused. Low-risk pregnant women completed questionnaires about demographic characteristics, perceived stress, and Billings and Moos coping strategies in the 38th to 42th week of their pregnancy, and completed the Edinburgh depression scale in the 3th to 4th weeks after childbirth. Data were analyzed using chi 2 and t tests. p<0.05 considered significant.Results: In this study, 170 participant women (85% used emotion-focused strategy and 30 women (15% used problem-focused strategy. Frequency of postpartum depression was 6.7% in the problem-focused group and 8.2% in the emotion-focused group. There was no significant difference in the frequency of postpartum depression between women with the problem- and emotion-focused strategies. Relative risk for postpartum depression was 1.2 times more among the women used emotion-focused strategy than women used problem-focused strategy (p<0.05.Conclusion: According to the results of this study, there was no significant relationship between postpartum depression and the two emotion-focused and problem-focused coping strategies. This can be due to high influence of postpartum specific endocrine factors in the etiology of this type of depression compared to other depressions.

  12. Maternal and child undernutrition and overweight in low-income and middle-income countries.

    Science.gov (United States)

    Black, Robert E; Victora, Cesar G; Walker, Susan P; Bhutta, Zulfiqar A; Christian, Parul; de Onis, Mercedes; Ezzati, Majid; Grantham-McGregor, Sally; Katz, Joanne; Martorell, Reynaldo; Uauy, Ricardo

    2013-08-03

    Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Folate inadequacy in the diet of pregnant women

    Directory of Open Access Journals (Sweden)

    Lívia de Castro Crivellenti

    2014-06-01

    Full Text Available OBJECTIVE: To estimate food and dietary folate inadequacies in the diets of adult pregnant women. METHODS: A prospective study was conducted with 103 healthy pregnant adult users of the Public Health Care System of Ribeirão Preto, São Paulo, Brazil. The present study included the 82 women with complete food intake data during pregnancy, which were collected by three 24-hour dietary recalls. Food folate (folate naturally present in foods and dietary folate (food folate plus folate from fortified wheat flour and cornmeal inadequacies were determined, using the Estimated Average Requirement as cutoff. RESULTS: The diets of 100% and 94% of the pregnant women were inadequate in food folate and dietary folate, respectively. However, fortified foods increased the medium availability of the nutrient by 87%. CONCLUSION: The large number of pregnant women consuming low-folate diets was alarming. Nationwide population studies are needed to confirm the hypothesized high prevalence of low-folate diets among pregnant women.

  14. Exploring identity and aging: auto-photography and narratives of low income older adults.

    Science.gov (United States)

    Kohon, Jacklyn; Carder, Paula

    2014-08-01

    This study focused on meanings of health, housing, independence and aging among low-income adults age 55 and older who live in, or are on a waiting list for, publicly subsidized rental housing. The purpose was to learn how low-income older adults perceive their independence and health, and how their place of residence contributes to these perceptions, as well as related perceptions of self. Qualitative data were collected using in-person narrative interviews with 45 individuals and a second photo elicitation interview with 31 of these persons. Themes describe how disrupted identities influence subjective thoughts about the aging process, housing, health, and finances, the process of clinicalization, and place identities. These findings highlight the relationship between housing status, dignity, and shifting identities as older adults experience the aging process in a low-income context. This study expands the current scholarship on the relationship between environment and aging as well as our understanding of poverty among older persons. These topics are relevant for new policies and programs to support the aging in place of older persons in subsidized housing. Understanding the life worlds of those who live in or have applied to this form of housing will be instrumental in developing such strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Healthy and comfortable dwellings for the low-income settlements in Surakarta

    NARCIS (Netherlands)

    Arsandrie, Y.; Bokel, R.M.J.; Van der Linden, A.C.; Kurvers, S.R.; Cauberg, J.J.M.

    2012-01-01

    Technology for the low-income group of people should be as simple as their daily life. Giving recommendations for simple dwelling design and changing people’s behaviour for a better living are the concerns of this research. A field-survey was conducted in November-December 2010 involving 426

  16. Characterizing Air Pollution in Two Low-Income Neighborhoods in Accra, Ghana

    Science.gov (United States)

    Sub-Saharan Africa has the highest rate of urban population growth in the world, with a large number of urban residents living in low-income “slum” neighborhoods. We conducted a study for an initial assessment of the levels and spatial and/or temporal patterns of multiple polluta...

  17. Fruit and vegetable attitudes, norms, and intake in low-income youth

    Science.gov (United States)

    Fruit and vegetable (FV) attitudes and norms have been shown to influence intake in youth; yet research with low-income youth and studies supplementing self-report with objective measures of intake are lacking. Cross-sectional survey data on self-rated FV intake, FV attitudes, and FV norms were coll...

  18. Multidisciplinary Perspectives towards the Education of Young Low-Income Immigrant Children

    Science.gov (United States)

    Isik-Ercan, Zeynep; Demir-Dagdas, Tuba; Cakmakci, Huzeyfe; Cava-Tadik, Yasemin; Intepe-Tingir, Seyma

    2017-01-01

    This paper examines the issues surrounding low-income immigrants in the U.S. and the ways they shape the educational experiences of their young children. Using a multidisciplinary lens including sociology, family studies, education, and mental health, the authors analyse multiple perspectives towards the educational experiences of children in…

  19. Food (In)Security in Rapidly Urbanising, Low-Income Contexts

    OpenAIRE

    Cecilia Tacoli

    2017-01-01

    Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure he...

  20. A systematic review of hepatitis B screening economic evaluations in low- and middle-income countries.

    Science.gov (United States)

    Wright, Cameron M; Boudarène, Lydia; Ha, Ninh Thi; Wu, Olivia; Hawkins, Neil

    2018-03-20

    Chronic hepatitis B infection is a significant cause of morbidity and mortality worldwide; low- and middle-income countries (LMICs) are disproportionately affected. Economic evaluations are a useful decision tool to assess costs versus benefits of hepatitis B virus (HBV) screening. No published study reviewing economic evaluations of HBV screening in LMICs has been undertaken to date. The following databases were searched from inception to 21 April 2017: MEDLINE, PubMed, EMBASE, CINAHL Plus, the Cochrane Library, Global Health and the Cost-effectiveness Analysis Registry. English-language studies were included if they assessed the costs against the benefits of HBV screening in LMICs. PROSPERO registration: CRD42015024391, 20 July 2015. Nine studies fulfilled the eligibility criteria. One study from Thailand indicated that adding hepatitis B immunoglobulin (HBIG) to HBV vaccination for newborns following screening of pregnant women might be cost-effective for some LMICs, though inadequate total funding and health infrastructure were likely to limit feasibility. A similar study from China indicated a benefit to cost ratio of 2.7 from selective HBIG administration to newborns, if benefits were considered from a societal perspective. Of the two studies assessing screening amongst the general adult population, a single cost-benefit analysis from China found a benefit to cost ratio (BCR) of 1.73 with vaccination guided by HBV screening of adults aged 21-39, compared to 1.42 with vaccination with no screening, both from a societal perspective. Community-based screening of adults in The Gambia with linkage to treatment yielded an incremental cost per disability-adjusted life year averted of $566 (in 2017 USD), less than two-times gross domestic product per capita for that country. Screening with 'catch-up' vaccination for younger adults yielded benefits above costs, and screening linked with treatment has shown cost-effectiveness that may be affordable for some LMICs