Role of income in intergenerational co-residence: Evidence from selected African and Asian countries.

Science.gov (United States)

Aziz, Nusrate; Hossain, Belayet; Emran, Masum

2018-06-01

The study investigates the macroeconomic determinants of co-residing arrangement between generations in selected developing countries with a focus on examining the effect of changing income level of the working generation. A reduced form model is specified for co-residence between the older generation and altruistic working generation. The fixed- and random-effects models are applied in two waves of data for 22 countries. Estimated results indicate that the income of the altruistic working generation has a negative effect on co-residence, suggesting that if the income of the working generation increases, co-residence decreases. This decrease is greater for older men compared with their female counterparts. Life expectancy, literacy and culture also have significant influences on co-residence. Co-residence is expected to fall in developing countries with economic growth over time. Consequently, a higher proportion of older citizens will be vulnerable in the future. Hence, governments of developing countries will face increasing pressure from their older people to provide appropriate planning and strategy to face this challenge. © 2018 AJA Inc.

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 CFR 1282.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

Science.gov (United States)

2010-01-01

... GOALS AND MISSION Housing Goals § 1282.17 Affordability—Income level definitions—family size and income..., for rental housing, family size and income information for the dwelling unit is known to the... sizes: Number of persons in family Percentageof area median income 1 70 2 80 3 90 4 100 5 or more...

Unlocking Solar for Low- and Moderate-Income Residents: A Matrix of Financing Options by Resident, Provider, and Housing Type

Energy Technology Data Exchange (ETDEWEB)

Cook, Jeffrey J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2018-01-02

Historically the low and moderate income (LMI) market has been underserved by solar photovoltaics (PV), in part due to the unique barriers LMI residents face to participation in the PV market. The intent of this report is to identify the most promising strategies state policymakers might consider to finance PV for LMI customers across three housing types: single family, multi-family, and manufactured housing. The result is a financing matrix that documents the first and second tier financing options states may consider for each housing type. The first tier options were selected based upon their potential impact on LMI PV deployment. Second tier financing approaches could also be used to achieve state policy goals, but may not have as much effect on the relevant LMI market segment. Nevertheless, each financing option comes with tradeoffs that state policymakers may wish to consider when they make decisions about which financing approaches are best suited to achieve their LMI PV deployment goals.

Timing of Family Income, Borrowing Constraints, and Child Achievement

DEFF Research Database (Denmark)

Humlum, Maria Knoth

2011-01-01

to many earlier studies, the results suggest that the timing of income does not matter for long-term child outcomes. This is a reasonable result given the setting in a Scandinavian welfare state with generous child and education subsidies. Actually, later family income (age 12–15) is a more important......I investigate the effects of the timing of family income on child achievement production. Detailed administrative data augmented with Programme for International Student Assessment test scores at age 15 are used to analyze the effects of the timing of family income on child achievement. Contrary...... determinant of child achievement than earlier income....

Common Factors Among Family Medicine Residents Who Encounter Difficulty.

Science.gov (United States)

Binczyk, Natalia M; Babenko, Oksana; Schipper, Shirley; Ross, Shelley

2018-04-01

Residents in difficulty are costly to programs in both time and resources, and encountering difficulty can be emotionally harmful to residents. Approximately 10% of residents will encounter difficulty at some point in training. While there have been several studies looking at common factors among residents who encounter difficulty, some of the findings are inconsistent. The objective of this study was to determine whether there are common factors among the residents who encounter difficulty during training in a large Canadian family medicine residency program. Secondary data analysis was performed on archived resident files from a Canadian family medicine residency program. Residents who commenced an urban family medicine residency program between the years of 2006 and 2014 were included in the study. Five hundred nine family medicine residents were included in data analysis. Residents older than 30 years were 2.33 times (95% CI: 1.27-4.26) more likely to encounter difficulty than residents aged 30 years or younger. Nontransfer residents were 8.85 times (95% CI: 1.17-66.67) more likely to encounter difficulty than transfer residents. The effects of sex, training site, international medical graduate status, and rotation order on the likelihood of encountering difficulty were nonsignificant. Older and nontransfer residents may be facing unique circumstances and may benefit from additional support from the program.

Family medicine residency training and burnout: a qualitative study.

Science.gov (United States)

Rutherford, Kimberly; Oda, Joanna

2014-01-01

Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one's work is valued and rotations in family medicine. The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors.

No More Second-Class Taxpayers: How Income Splitting Can Bring Fairness to Canada’s Single Income Families

Directory of Open Access Journals (Sweden)

Matt Krzepkowski

2013-04-01

Full Text Available The Canadian personal income tax system does not pay much attention to whether the amount of money an individual brings home is supplemented by the income of a spouse or not. That means that families where one spouse earns more than the other get taxed at a higher rate than families where two working partners earn the same total income split evenly between two paycheques. In fact, a family with just a single earner making $70,000 a year pays 30 per cent more in taxes every year than a family with two partners making $35,000 a year. A single-earner family taking in $120,000 a year pays the same income tax as a dualearning couple making $141,000 between them. The federal Conservative government has at least suggested it wants to finally level that playing field — nearly six decades after a royal commission recommended that the income tax system be changed to recognize total family household income, rather than focusing on each individual’s income. Given that Canada’s income tax system aims to treat people in similar circumstances as equally as possible, it is certainly time to let couples split their income so they do not face a penalty in higher tax rates than those faced by couples bringing home the same amount of total pay. While couples with just a single earner enjoy some advantages, a dual-earning couple does not — namely the extra time the stay-at-home spouse is able to use to raise children and produce other unpaid, home-based benefits — that can be accounted for using other means. Specifically, cutting out the transferability of the unused portion of the basic personal tax exemption for couples splitting income — requiring couples splitting their income to each earn money in order to use this credit — is one way to account for the difference in unpaid benefits that single-income families do typically enjoy more than dual-income couples. That is one mechanism; there may still be others the government might consider. But the

The impact of retirement account distributions on measures of family income.

Science.gov (United States)

Iams, Howard M; Purcell, Patrick J

2013-01-01

In recent decades, employers have increasingly replaced defined benefit (DB) pensions with defined contribution (DC) retirement accounts for their employees. DB plans provide annuities, or lifetime benefits paid at regular intervals. The timing and amounts of DC distributions, however, may vary widely. Most surveys that provide data on the family income of the aged either collect no data on nonannuity retirement account distributions, or exclude such distributions from their summary measures of family income. We use Survey of Income and Program Participation (SIPP) data for 2009 to estimate the impact of including retirement account distributions on total family income calculations. We find that about one-fifth of aged families received distributions from retirement accounts in 2009. Measured mean income for those families would be about 15 percent higher and median income would be 18 percent higher if those distributions were included in the SIPP summary measure of family income.

Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

Science.gov (United States)

Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

2013-09-01

Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

Family medicine residency training and burnout: a qualitative study

Science.gov (United States)

Rutherford, Kimberly; Oda, Joanna

2014-01-01

Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

Childhood Family Structure and Intergenerational Income Mobility in the United States.

Science.gov (United States)

Bloome, Deirdre

2017-04-01

The declining prevalence of two-parent families helped increase income inequality over recent decades. Does family structure also condition how economic (dis)advantages pass from parents to children? If so, shifts in the organization of family life may contribute to enduring inequality between groups defined by childhood family structure. Using National Longitudinal Survey of Youth data, I combine parametric and nonparametric methods to reveal how family structure moderates intergenerational income mobility in the United States. I find that individuals raised outside stable two-parent homes are much more mobile than individuals from stable two-parent families. Mobility increases with the number of family transitions but does not vary with children's time spent coresiding with both parents or stepparents conditional on a transition. However, this mobility indicates insecurity, not opportunity. Difficulties maintaining middle-class incomes create downward mobility among people raised outside stable two-parent homes. Regardless of parental income, these people are relatively likely to become low-income adults, reflecting a new form of perverse equality. People raised outside stable two-parent families are also less likely to become high-income adults than people from stable two-parent homes. Mobility differences account for about one-quarter of family-structure inequalities in income at the bottom of the income distribution and more than one-third of these inequalities at the top.

Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income.

Science.gov (United States)

Bennett, Kevin J; Dismuke, Clara E

2010-05-01

High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden. The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics. Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios. Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

Simulation in Pre-departure Training for Residents Planning Clinical Work in a Low-Income Country

Directory of Open Access Journals (Sweden)

Kevin R. Schwartz

2015-12-01

Full Text Available Introduction: Increasingly, pediatric and emergency medicine (EM residents are pursuing clinical rotations in low-income countries. Optimal pre-departure preparation for such rotations has not yet been established. High-fidelity simulation represents a potentially effective modality for such preparation. This study was designed to assess whether a pre-departure high-fidelity medical simulation curriculum is effective in helping to prepare residents for clinical rotations in a low-income country. Methods: 43 pediatric and EM residents planning clinical rotations in Liberia, West Africa, participated in a simulation-based curriculum focused on severe pediatric malaria and malnutrition and were then assessed by survey at three time points: pre-simulation, post-simulation, and after returning from work abroad. Results: Prior to simulation, 1/43 (2% participants reported they were comfortable with the diagnosis and management of severe malnutrition; this increased to 30/42 (71% after simulation and 24/31 (77% after working abroad. Prior to simulation, 1/43 (2% of residents reported comfort with the diagnosis and management of severe malaria; this increased to 26/42 (62% after simulation and 28/31 (90% after working abroad; 36/42 (86% of residents agreed that a simulation-based global health curriculum is more useful than a didactic curriculum alone, and 41/42 (98% felt a simulator-based curriculum should be offered to all residents planning a clinical trip to a low-income country. Conclusion: High-fidelity simulation is effective in increasing residents’ self-rated comfort in management of pediatric malaria and malnutrition and a majority of participating residents feel it should be included as a component of pre-departure training for all residents rotating clinically to low-income countries.

Minimum Wages and the Distribution of Family Incomes

OpenAIRE

Dube, Arindrajit

2017-01-01

Using the March Current Population Survey data from 1984 to 2013, I provide a comprehensive evaluation of how minimum wage policies influence the distribution of family incomes. I find robust evidence that higher minimum wages shift down the cumulative distribution of family incomes at the bottom, reducing the share of non-elderly individuals with incomes below 50, 75, 100, and 125 percent of the federal poverty threshold. The long run (3 or more years) minimum wage elasticity of the non-elde...

Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies.

Science.gov (United States)

Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.

Dual Income Family, Gender and Adolescents´ Self-Esteem ...

African Journals Online (AJOL)

Dual Income Family, Gender and Adolescents´ Self-Esteem. ... Abstract. This study examined the influence of dual income family and gender on adolescents' self-esteem in Enugu, Nigeria. ... AJOL African Journals Online. HOW TO USE AJOL.

A social work study on family patterns and street children

Directory of Open Access Journals (Sweden)

Mohammad Reza Iravani

2014-06-01

Full Text Available This paper presents a social work study on relationship between various family characteristics and street children in rural area as well as city of Esfahan, Iran. The proposed study selects a sample of 150 street children, 75 from city and 75 from rural area, and using some statistical tests verifies the effects of three factors including family income, place of residency and family size on street children. The results indicate that the city residence had more street children than rural residence did. In addition, there was a meaningful difference between the number of street children in low-income families and high-income families. Finally, the survey results indicate that big size families more likely suffered from street children than low size families did.

24 CFR 1710.10 - Single-family residence exemption.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the...) Lot dimensions. (ii) Plat approval and recordation. (iii) Roads and access. (iv) Drainage. (v...

Family practice residents' maternity leave experiences and benefits.

Science.gov (United States)

Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

1995-09-01

A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

The implications of selective attrition for estimates of intergenerational elasticity of family income.

Science.gov (United States)

Schoeni, Robert F; Wiemers, Emily E

2015-09-01

Numerous studies have estimated a high intergenerational correlation in economic status. Such studies do not typically attend to potential biases that may arise due to survey attrition. Using the Panel Study of Income Dynamics - the data source most commonly used in prior studies - we demonstrate that attrition is particularly high for low-income adult children with low-income parents and particularly low for high-income adult children with high-income parents. Because of this pattern of attrition, intergenerational upward mobility has been overstated for low-income families and downward mobility has been understated for high-income families. The bias among low-income families is greater than the bias among high-income families implying that intergenerational elasticity in family income is higher than previous estimates with the Panel Study of Income Dynamics would suggest.

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…

Residents' views about family medicine specialty education in Turkey

Directory of Open Access Journals (Sweden)

Uzuner Arzu

2010-04-01

Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

State-level income inequality and family burden of U.S. families raising children with special health care needs.

Science.gov (United States)

Parish, Susan L; Rose, Roderick A; Dababnah, Sarah; Yoo, Joan; Cassiman, Shawn A

2012-02-01

Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household's absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005-06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child's care and whether the parent stopped working due to the child's health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child's health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child's impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden. Copyright © 2011 Elsevier Ltd. All rights reserved.

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.

Income, Family Context, and Self-Regulation in 5-Year-Old Children.

Science.gov (United States)

Li, Mengying; Riis, Jenna L; Ghazarian, Sharon R; Johnson, Sara B

Self-regulation (SR) is a core aspect of child development with enduring effects on health and wellbeing across the lifespan. Early childhood poverty may shape SR development. This study examined the cross-sectional relationship among family income, family context, and SR in 5-year-old children. A total of 140 five-year-old children and their mothers participated in the study. Children completed a battery of SR tasks; mothers completed questionnaires. Cognitive and emotional SR composite scores were generated based on a principal component analysis of the SR tasks. The SR scores were first regressed on family income (in 10 levels ranging from family context variables were subsequently added to the models. Controlling for age, sex, and race, each level increase in family income was associated with 0.04 SD increase in emotional SR (p = .32) and 0.08 SD increase in cognitive SR (p = .01). In fully adjusted models, exposure to household instability and experiencing 10 or more negative life events was associated with worse emotional SR; exposure to mother's depressive symptoms was associated with worse cognitive SR. Higher income buffered children's SR from some contextual risk factors. Family contextual variables explained 62% of the correlation between higher income and better cognitive SR scores. Income-based cognitive SR disparities were associated with family contextual factors. Screening for family adversity in pediatric care and linking families to needed resources may protect children's developing SR capacities, with benefits to health and well-being.

Trends in violence education in family medicine residency curricula.

Science.gov (United States)

Cronholm, Peter F; Singh, Vijay; Fogarty, Colleen T; Ambuel, Bruce

2014-09-01

Violence is a significant public health issue with far-reaching implications for the health of individuals and their communities. Our objective was to describe trends in violence-related training in family medicine residency programs since the last national survey was conducted in 1997. Surveys were sent to 337 US family medicine residency programs with the program director having active Society of Teachers of Family Medicine (STFM) membership. Measures included residency setting and characteristics, violence-related curricular content, teaching techniques and personnel, timing of content, and impact of changes in Residency Review Committee (RRC) and Accreditation Council for Graduate Medical Education (ACGME) requirements. Descriptive statistics and bivariate analyses comparing measures across time were used. A total of 201 (60%) surveys were completed. The most common violence curricula was child (83%) and elder abuse (76%), and the most common teachers of violence-related content were family physicians, psychologists, and social workers. The most common teaching methods were clinical precepting (94%), lectures (90%), case vignettes (71%), and intimate partner violence (IPV) shelter experiences (67%). ACGME and RRC changes were not reflected in self-reported measures of curricular emphasis or time. Violence curricular content and number of hours has been constant in family medicine residencies over time. An increase in the reported use of active learning strategies was identified as a trend across surveys. Next steps for violence curricula involve assessment of residents' competency to identify and intervene in violence.

Examining Critical Thinking Skills in Family Medicine Residents.

Science.gov (United States)

Ross, David; Schipper, Shirley; Westbury, Chris; Linh Banh, Hoan; Loeffler, Kim; Allan, G Michael; Ross, Shelley

2016-02-01

Our objective was to determine the relationship between critical thinking skills and objective measures of academic success in a family medicine residency program. This prospective observational cohort study was set in a large Canadian family medicine residency program. Intervention was the California Critical Thinking Skills Test (CCTST), administered at three points in residency: upon entry, at mid-point, and at graduation. Results from the CCTST, Canadian Residency Matching Service file, and interview scores were compared to other measures of academic performance (Medical Colleges Admission Test [MCAT] and College of Family Physicians of Canada [CCFP] certification examination results). For participants (n=60), significant positive correlations were found between critical thinking skills and performance on tests of knowledge. For the MCAT, CCTST scores correlated positively with full scores (n=24, r=0.57) as well as with each section score (verbal reasoning: r=0.59; physical sciences: r=0.64; biological sciences: r=0.54). For CCFP examination, CCTST correlated reliably with both sections (n=49, orals: r=0.34; short answer: r=0.47). Additionally, CCTST was a better predictor of performance on the CCFP exam than was the interview score at selection into the residency program (Fisher's r-to-z test, z=2.25). Success on a critical thinking skills exam was found to predict success on family medicine certification examinations. Given that critical thinking skills appear to be stable throughout residency training, including an assessment of critical thinking in the selection process may help identify applicants more likely to be successful on final certification exam.

What could family income be if health insurance were more affordable?

Science.gov (United States)

Young, Richard A; Devoe, Jennifer E

2012-10-01

Adjusted for inflation, household income has been relatively flat since the mid-1990s, but the inflation rate of employer-sponsored health insurance has been greater than both household income growth and general inflation for 50 years. We estimated the effect on average family income if health insurance inflation matched the general inflation rate since 1996, and those savings were given to employees as income. We used data from the Medical Expenditure Panel Survey, the Milliman Medical Index, and other federal sources to model the relationship between private health insurance costs and household income over the last 15 years. If the cost of family health care costs had kept pace with the Consumer Price Index (CPI) rate since 1996, the average family income could have been $8,410 higher in 2010 ($68,805 versus $60,395), 13.9% more than actual earnings. If health care costs had not exceeded the CPI rate since 1996 and if all the excess costs were converted into employee wages, median family income could be substantially higher today.

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.

Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

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Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

2015-11-01

To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

Value of a regional family practice residency training program site

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Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

2014-01-01

Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

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

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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.

Private Financial Transfers, Family Income, and the Great Recession

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Gottlieb, Aaron; Pilkauskas, Natasha; Garfinkel, Irwin

2014-01-01

Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,701; 1998–2010), the authors studied whether the unemployment rate was associated with private financial transfers (PFTs) among urban families with young children and whether family income moderated these associations. They found that an increase in the unemployment rate was associated with greater PFT receipt and that family income moderated the association. Poor and near-poor mothers experienced increases in PFT receipt when unemployment rates were high, whereas mothers with incomes between 2 and 3 times the poverty threshold experienced decreases. Simulations estimating the impact of the Great Recession suggest that moving from 5% to 10% unemployment is associated with a 9-percentage-point increase in the predicted probability of receiving a PFT for the sample as a whole, with greater increases in predicted probabilities among poor and near poor mothers. PMID:25505802

Recommended integrative medicine competencies for family medicine residents.

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Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

2013-01-01

The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

Social media beliefs and usage among family medicine residents and practicing family physicians.

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Klee, David; Covey, Carlton; Zhong, Laura

2015-03-01

Incorporation of social media (SM) use in medicine is gaining support. The Internet is now a popular medium for people to solicit medical information. Usage of social networks, such as Facebook and Twitter, is growing daily and provides physicians with nearly instantaneous access to large populations for both marketing and patient education. The benefits are myriad, but so are the inherent risks. We investigated the role providers' age and medical experience played in their beliefs and use of SM in medicine. Using multiple state-wide and national databases, we assessed social media use by family medicine residents, faculty, and practicing family physicians with a 24-question online survey. Descriptive data is compared by age and level of medical experience. A total of 61 family medicine residents and 192 practicing family physicians responded. There is a trend toward higher SM utilization in the younger cohort, with 90% of resident respondents reporting using SM, half of them daily. A total of 64% of family physician respondents over the age of 45 have a SM account. An equal percentage of senior physicians use SM daily or not at all. Practicing physicians, more than residents, agree that SM can be beneficial in patient care. The vast majority of residents and physicians polled believe that SM should be taught early in medical education. The high utilization of SM by younger providers, high prevalence of patient use of the Internet, and the countless beneficial opportunities SM offers should be catalysts to drive curriculum development and early implementation in medical education. This curriculum should focus around four pillars: professional standards for SM use, SM clinical practice integration, professional networking, and research.

Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

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Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

2017-02-01

Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

Family processes as pathways from income to young children's development.

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Linver, Miriam R; Brooks-Gunn, Jeanne; Kohen, Dafna E

2002-09-01

A variety of family processes have been hypothesized to mediate associations between income and young children's development. Maternal emotional distress, parental authoritative and authoritarian behavior (videotaped mother-child interactions), and provision of cognitively stimulating activities (Home Observation for Measurement of the Environment [HOME] scales) were examined as possible mediators in a sample of 493 White and African American low-birth-weight premature infants who were followed from birth through age 5. Cognitive ability was assessed by standardized test, and child behavior problems by maternal report, when the children were 3 and 5 years of age. As expected, family income was associated with child outcomes. The provision of stimulating experiences in the home mediated the relation between family income and both children's outcomes; maternal emotional distress and parenting practices mediated the relation between income and children's behavior problems.

Training family medicine residents to practice collaboratively with psychology trainees.

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Porcerelli, John H; Fowler, Shannon L; Murdoch, William; Markova, Tsveti; Kimbrough, Christina

2013-01-01

This article will describe a training curriculum for family medicine residents to practice collaboratively with psychology (doctoral) trainees at the Wayne State University/Crittenton Family Medicine Residency program. The collaborative care curriculum involves a series of patient care and educational activities that require collaboration between family medicine residents and psychology trainees. Activities include: (1) clinic huddle, (2) shadowing, (3) pull-ins and warm handoffs, (4) co-counseling, (5) shared precepting, (6) feedback from psychology trainees to family medicine residents regarding consults, brief interventions, and psychological testing, (7) lectures, (8) video-observation and feedback, (9) home visits, and (10) research. The activities were designed to teach the participants to work together as a team and to provide a reciprocal learning experience. In a brief three-item survey of residents at the end of their academic year, 83% indicated that they had learned new information or techniques from working with the psychology trainees for assessment and intervention purposes; 89% indicated that collaborating with psychology trainees enhanced their patient care; and 89% indicated that collaborating with psychology trainees enhanced their ability to work as part of a team. Informal interviews with the psychology trainees indicated that reciprocal learning had taken place. Family medicine residents can learn to work collaboratively with psychology trainees through a series of shared patient care and educational activities within a primary care clinic where an integrated approach to care is valued.

Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

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Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

2010-11-01

To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.

Entry of US Medical School Graduates Into Family Medicine Residencies: 2015-2016.

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Kozakowski, Stanley M; Travis, Alexandra; Bentley, Ashley; Fetter, Gerald

2016-10-01

This is the 35th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents. Approximately 8.7% of the 18,929 students graduating from US MD-granting medical schools and 15.5% of the 5,314 students graduating from DO-granting medical schools between July 2014 and June 2015 entered an ACGME family medicine residency in 2015. Together, 10.2% of graduates of MD- and DO-granting schools entered family medicine. Of the 1,640 graduates of the MD-granting medical schools who entered a family medicine residency in 2015, 80% graduated from 70 of the 134 schools (52%). In 2015, DO-granting medical schools graduated 823 into ACGME-accredited family medicine residencies, 80% graduating from 19 of the 32 schools (59%). In aggregate, medical schools west of the Mississippi River represent less than a third of all MD-granting schools but have a rate of students selecting family medicine that is 40% higher than schools located east of the Mississippi. Fifty-one percent (24/47) of states and territories containing medical schools produce 80% of the graduates entering ACGME-accredited family medicine residency programs. A rank order list of MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2015 and prior AAFP census data.

Geographic Region, Size, and Program Type in Family Practice Residencies.

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Berg, Jolene K.; Garrard, Judith

1981-01-01

Research on residency education in family practice is discussed. Programmatic variables are examined: geographic region, size, and type of program. Definitions of these variables are provided, the current distribution of family practice residency programs across each of these variables is described, and data for use by other researchers is…

Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

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Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

2014-01-01

Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

Racial Inequality Trends and the Intergenerational Persistence of Income and Family Structure

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Bloome, Deirdre

2015-01-01

Racial disparity in family incomes remained remarkably stable over the past 40 years in the United States despite major legal and social reforms. Previous scholarship presents two primary explanations for persistent inequality through a period of progressive change. One highlights continuity: because socioeconomic status is transmitted from parents to children, disparities created through histories of discrimination and opportunity denial may dissipate slowly. The second highlights change: because family income results from joining individual earnings in family units, changing family compositions can offset individuals’ changing economic chances. I examine whether black-white family income inequality trends are better characterized by the persistence of existing disadvantage (continuity) or shifting forms of disadvantage (change). I combine cross-sectional and panel analysis using Current Population Survey, Panel Study of Income Dynamics, Census, and National Vital Statistics data. Results suggest that African Americans experience relatively extreme intergenerational continuity (low upward mobility) and discontinuity (high downward mobility); both helped maintain racial inequality. Yet, intergenerational discontinuities allow new forms of disadvantage to emerge. On net, racial inequality trends are better characterized by changing forms of disadvantage than by continuity. Economic trends were equalizing but demographic trends were disequalizing; as family structures shifted, family incomes did not fully reflect labor-market gains. PMID:26456973

Entry of US Medical School Graduates Into Family Medicine Residencies: 2014-2015.

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Kozakowski, Stanley M; Fetter, Gerald; Bentley, Ashley

2015-10-01

This is the 34th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from US MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents in 2014. Approximately 8.5% of the 18,241 students graduating from US MD-granting medical schools between July 2013 and June 2014 entered a family medicine residency. Of the 1,458 graduates of the US MD-granting medical schools who entered a family medicine residency in 2014, 80% graduated from 69 of the 131 schools. Eleven schools lacking departments or divisions of family medicine produced only a total of 26 students entering family medicine. In aggregate, medical schools west of the Mississippi River represent less than a third of all US MD-granting schools but have an aggregate rate of students selecting family medicine that is two-thirds higher than schools to the east of the Mississippi. A rank order list of US MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2014 and prior AAFP census data. US MD schools continue to fail to produce a primary care workforce, a key measure of social responsibility as measured by their production of graduates entering into family medicine. DO-granting and international medical school graduates filled the majority of ACGME-accredited family medicine first-year resident positions in 2014.

Family medicine residency training and burnout: a qualitative study

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Kimberly Rutherford

2014-12-01

Conclusions: The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors.

The causal effect of family income on child health in the U.K.

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Kuehnle, Daniel

2014-07-01

Recent studies examining the effect of family income on child health have been unable to account for the endogeneity of income. Using data from a British cohort study, we address this gap by exploiting exogenous variation in local labour market characteristics to instrument for family income. We estimate the causal effect of family income on different measures of child health and explore the role of potential transmission mechanisms. We find that income has a very small but significant causal effect on subjective child health and no significant effect on chronic health conditions, apart from respiratory illnesses. Using the panel structure, we show that the timing of income does not matter for young children. Moreover, our results provide further evidence that parental health does not drive a spurious relationship between family income and child health. Our study implies that financial transfers are unlikely to deliver substantial improvements in child health. Copyright © 2014 Elsevier B.V. All rights reserved.

Resident and family member perceptions of cultural diversity in aged care homes.

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Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

2017-03-01

Similar to many developed nations, older people living in residential aged care homes in Australia and the staff who care for them have become increasingly multicultural. This cultural diversity adds challenges for residents in adapting to the care home. This study explores: (i) residents' and family members' perceptions about staff and cultural diversity, and (ii) culturally and linguistically diverse residents' and family members' experiences. An interpretive study design employing a thematic analysis was applied. Twenty-three residents and seven family members participated in interviews. Four themes were identified from interpreting residents and family members' perceptions of the impact of cultural diversity on their adaptation to aged care homes: (i) perceiving diversity as an attraction; (ii) adapting to cross-cultural communication; (iii) adjusting to diet in the residential care home; and (iv) anticipating individualized psychosocial interactions. The findings have implications for identifying strategies to support staff from all cultural backgrounds in order to create a caring environment that facilitates positive relationships with residents and supports residents to adjust to the care home. © 2016 John Wiley & Sons Australia, Ltd.

Family Income, Cumulative Risk Exposure, and White Matter Structure in Middle Childhood

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Alexander J. Dufford

2017-11-01

Full Text Available Family income is associated with gray matter morphometry in children, but little is known about the relationship between family income and white matter structure. In this paper, using Tract-Based Spatial Statistics, a whole brain, voxel-wise approach, we examined the relationship between family income (assessed by income-to-needs ratio and white matter organization in middle childhood (N = 27, M = 8.66 years. Results from a non-parametric, voxel-wise, multiple regression (threshold-free cluster enhancement, p < 0.05 FWE corrected indicated that lower family income was associated with lower white matter organization [assessed by fractional anisotropy (FA] for several clusters in white matter tracts involved in cognitive and emotional functions including fronto-limbic circuitry (uncinate fasciculus and cingulum bundle, association fibers (inferior longitudinal fasciculus, superior longitudinal fasciculus, and corticospinal tracts. Further, we examined the possibility that cumulative risk (CR exposure might function as one of the potential pathways by which family income influences neural outcomes. Using multiple regressions, we found lower FA in portions of these tracts, including those found in the left cingulum bundle and left superior longitudinal fasciculus, was significantly related to greater exposure to CR (β = -0.47, p < 0.05 and β = -0.45, p < 0.05.

WORKING WIVES, THEIR CONTRIBUTION TO FAMILY INCOME.

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Women's Bureau (DOL), Washington, DC.

DATA FROM THE U.S. DEPARTMENT OF COMMERCE AND THE U.S. DEPARTMENT OF LABOR, 1964-66, DESCRIBE THE CONTRIBUTION OF WORKING WIVES TO FAMILY INCOME. NEARLY HALF OF ALL WOMEN 18-64 YEARS OF AGE WORK. ABOUT THREE OF FIVE OF THESE WOMEN ARE MARRIED AND LIVING WITH THEIR HUSBANDS. OF THE 42.1 MILLION HUSBAND-WIFE FAMILIES IN THE UNITED STATES IN MARCH…

ECONOMETRIC DETERMINATION OF CONTRIBUTION OF FAMILY POULTRY TO WOMEN’S INCOME IN NIGER-DELTA, NIGERIA

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R ALABI

2007-07-01

Full Text Available This study shows that family poultry husbandry, business activities and paid employment contribute 35%, 30% and 18% respectively to the household income of women in Niger Delta, Nigeria. The average income from family poultry is N16, 784.53 ($124.33, which is about 25% and 50% of national minimum wage and per capita income in Nigeria respectively. The major constraints to the family poultry in the study area are disease and pest, pilfering and lack of capital. The econometric analysis indicates that wage, business and family poultry income are significant determinants of income of women in the study area. The estimated regression coefficients are, 0.35, 0.32 and 0.19 for wage, business and family poultry income respectively. This suggests that if wage income, business income and family poultry income increase by 100%, total income of the women will increase by 35%, 32% and 19% respectively. This indicates that family poultry husbandry has third rating in potentially influencing women income in the study area. It is recommended from the study that the contribution of family poultry to total income of the women can be improved through proper medication and vaccination of their birds with vaccines that are stable under tropical environment. It is also imperative that semi intensive, if not intensive, rearing technology should be considered as a reasonable option if the problem of pilfering is to be addressed. Improving the capital base of the women through formation of cooperating and micro-credit schemes should also be a welcome development in addressing the problem of lack of capital.

Child health insurance coverage: a survey among temporary and permanent residents in Shanghai.

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Lu, Mingshan; Zhang, Jing; Ma, Jin; Li, Bing; Quan, Hude

2008-11-17

Under the current healthcare system in China, there is no government-sponsored health insurance program for children. Children from families who move from rural and interior regions to large urban centres without a valid residency permit might be at higher risk of being uninsured due to their low socioeconomic status. We conducted a survey in Shanghai to describe children's health insurance coverage according to their migration status. Between 2005 and 2006, we conducted an in-person health survey of the adult care-givers of children aged 7 and under, residing in five districts of Shanghai. We compared uninsurance rates between temporary and permanent child residents, and investigated factors associated with child health uninsurance. Even though cooperative insurance eligibility has been extended to temporary residents of Shanghai, the uninsurance rate was significantly higher among temporary (65.6%) than permanent child residents (21.1%, adjusted odds ratio (OR): 5.85, 95% confidence interval (95% CI): 4.62-7.41). For both groups, family income was associated with having child health insurance; children in lower income families were more likely to be uninsured (OR: 1.96, 95% CI: 1.40-2.96). Children must rely on their parents to make the insurance purchase decision, which is constrained by their income and the perceived benefits of the insurance program. Children from migrant families are at even higher risk for uninsurance due to their lower socioeconomic status. Government initiatives specifically targeting temporary residents and providing health insurance benefits for their children are urgently needed.

The State of Communication Education in Family Medicine Residencies.

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Jansen, Kate L; Rosenbaum, Marcy E

2016-06-01

Communication skills are essential to medical training and have lasting effects on patient satisfaction and adherence rates. However, relatively little is reported in the literature identifying how communication is taught in the context of residency education. Our goal was to determine current practices in communication curricula across family medicine residency programs. Behavioral scientists and program directors in US family medicine residencies were surveyed via email and professional organization listservs. Questions included whether programs use a standardized communication model, methods used for teaching communication, hours devoted to teaching communication, as well as strengths and areas for improvement in their program. Analysis identified response frequencies and ranges complemented by analysis of narrative comments. A total of 204 programs out of 458 family medicine residency training sites responded (45%), with 48 out of 50 US states represented. The majority of respondents were behavioral scientists. Seventy-five percent of programs identified using a standard communication model; Mauksch's patient-centered observation model (34%) was most often used. Training programs generally dedicated more time to experiential teaching methods (video review, work with simulated patients, role plays, small groups, and direct observation of patient encounters) than to lectures (62% of time and 24% of time, respectively). The amount of time dedicated to communication education varied across programs (average of 25 hours per year). Respondent comments suggest that time dedicated to communication education and having a formal curriculum in place are most valued by educators. This study provides a picture of how communication skills teaching is conducted in US family medicine residency programs. These findings can provide a comparative reference and rationale for residency programs seeking to evaluate their current approaches to communication skills teaching and

Remediation plans in family medicine residency

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Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

2015-01-01

Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

Teaching wound care to family medicine residents on a wound care service

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Little SH

2013-08-01

Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

Preparing residents for family practice: role of an integrated “Triple C” curriculum

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Joseph Lee

2013-03-01

Full Text Available Background: There is limited understanding of the impact of Triple C competency-based curriculums on the preparation of residents for family practice. This paper describes a competency-based curriculum within an integrated longitudinal block design and presents preliminary evaluation data on the impact of this curriculum on preparedness for family practice. Methods: First and second year family medicine residents were surveyed as a component of a year-end program evaluation to assess the extent to which the residency program is preparing them to engage in a variety of practice domains, the likelihood that they would engage in these domains, and the extent to which this residency program is comprehensive, relevant to their development as a family physician, and promotes interprofessional practice. Results: Residents perceived themselves as prepared to engage in most practice areas and their intentions to engage in various practice domains were positively correlated to their ratings of preparedness. Ratings reflected that residents perceived this program as comprehensive and relevant to their development as a family physician and they perceived a high degree of encouragement for interprofessional practice. Conclusions: This study provides some preliminary evidence that an integrated competency-based curriculum, with an emphasis on interprofessional practice has the potential to effectively prepare residents for practice in family medicine.

Rising Inequality in Family Incomes and Children's Educational Outcomes

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Greg J. Duncan

2016-05-01

Full Text Available Increases in family income inequality in the United States have translated into widening gaps in educational achievement and attainments between children from low- and high-income families. We describe the mechanisms that have produced this disturbing trend. We argue that the three dominant policy approaches states and the federal government have used to improve the education of the disadvantaged have had at best modest success in improving education for disadvantaged children. To conclude, we describe the building blocks for an American solution to the problem of growing inequality of educational outcomes.

Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members.

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Aalgaard Kelly, Gina

2015-01-01

Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes . Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC).

Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance.

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Anthony, Jodi; Goldman, Roberta; Rees, Vaughan W; Frounfelker, Rochelle L; Davine, Jessica; Keske, Robyn R; Brooks, Daniel R; Geller, Alan C

2018-01-01

As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

Paying for College: A New Look at Family Income Trends.

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Levy, Frank

1989-01-01

Income growth and stagnation is discussed, several trends in income inequality among American families are examined, and the notion of a vanishing middle class that may be losing the college cost race is addressed. (MSE)

Does Students' Financial Behaviour Differ Based on Their Family Income?

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Dorjana Nano; Teuta Llukani

2015-01-01

This study investigates the differences on Financial Behaviour among Albanian university students based on their family income. The main objectives of this study are: i) firstly, to assess the level of financial behaviour of Albanian university students; ii) to examine whether the financial behaviour differs based on the level of students family income; and ii) finally, , to provide some conclusions and policy implications with regard to financial behaviour. An instrument comprised of specifi...

Impact of the Primary Care Exception on Family Medicine Resident Coding.

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Cawse-Lucas, Jeanne; Evans, David V; Ruiz, David R; Allcut, Elizabeth A; Andrilla, C Holly A; Thompson, Matthew; Norris, Thomas E

2016-03-01

The Medicare Primary Care Exception (PCE) allows residents to see and bill for less-complex patients independently in the primary care setting, requiring attending physicians only to see patients for higher-level visits and complete physical exams in order to bill for them as such. Primary care residencies apply the PCE in various ways. We investigated the impact of the PCE on resident coding practices. Family medicine residency directors in a five-state region completed a survey regarding interpretation and application of the PCE, including the number of established patient evaluation and management codes entered by residents and attending faculty at their institution. The percentage of high-level codes was compared between residencies using chi-square tests. We analyzed coding data for 125,016 visits from 337 residents and 172 faculty physicians in 15 of 18 eligible family medicine residencies. Among programs applying the PCE criteria to all patients, residents billed 86.7% low-mid complexity and 13.3% high-complexity visits. In programs that only applied the PCE to Medicare patients, residents billed 74.9% low-mid complexity visits and 25.2% high-complexity visits. Attending physicians coded more high-complexity visits at both types of programs. The estimated revenue loss over the 1,650 RRC-required outpatient visits was $2,558.66 per resident and $57,569.85 per year for the average residency in our sample. Residents at family medicine programs that apply the PCE to all patients bill significantly fewer high-complexity visits. This finding leads to compliance and regulatory concerns and suggests significant revenue loss. Further study is required to determine whether this discrepancy also reflects inaccuracy in coding.

Family income affects children's altruistic behavior in the dictator game.

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Yongxiang Chen

Full Text Available This study aimed to examine how family income and social distance influence young rural Chinese children's altruistic behavior in the dictator game (DG. A total of 469 four-year-old children from eight rural areas in China, including many children left behind by parents who had migrated to urban areas for work, played the DG. Stickers comprised the resource, while recipients in the game were assumed to be either their friends or strangers, with the social distance (i.e., strangers compared to friends as a between-subjects variable. Children donated significantly more stickers to their friends than to strangers. Moreover, children from lower income families donated more stickers than children from higher income families. However, no gender and parental migrant status differences in children's prosocial behaviors were evident in this sample. Findings of this study suggest that children's altruistic behaviours to peers are influenced by family characteristics since preschool age. The probable influence of local socialization practices on development and the possible adaptive significance were discussed.

Family Skills for General Psychiatry Residents: Meeting ACGME Core Competency Requirements

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Berman, Ellen M.; Heru, Alison M.; Grunebaum, Henry; Rolland, John; Wood, Beatrice; Bruty, Heidi

2006-01-01

Objective: The authors discuss the knowledge, attitudes, and skills needed for a resident to be competent in supporting and working with families, as mandated by the residency review committee (RRC) core competencies. Methods: The RRC core competencies, as they relate to patients and their families, are reviewed. The Group for Advancement of…

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

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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.

Family income and child health in the UK.

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Apouey, Bénédicte; Geoffard, Pierre-Yves

2013-07-01

Recent studies examining the relationship between family income and child health in the UK have produced mixed findings. We re-examine the income gradient in child general health and its evolution with child age in this country, using a very large sample of British children. We find that there is no correlation between income and child general health at ages 0-1, that the gradient emerges around age 2 and is constant from age 2 to age 17. In addition, we show that the gradient remains large and significant when we reduce the endogeneity of income. Furthermore, our results indicate that the gradient in general health reflects a greater prevalence of chronic conditions among low-income children and a greater severity of these conditions. Taken together, these findings suggest that income does matter for child health in the UK and may play a role in the intergenerational transmission of socioeconomic status. Copyright © 2013 Elsevier B.V. All rights reserved.

Financial management of low-income urban families

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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.

The impacts of rapid demographic transition on family structure and income inequality in Brazil, 1981-2011.

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Maia, Alexandre Gori; Sakamoto, Camila Strobl

2016-11-01

This study analysed the impact of changing family structure on income distribution. Specifically, it analysed how changes in the proportions of different categories of family in the population contributed to increases in the income of the richest and poorest social strata in Brazil, and the consequent impacts on income inequality. Rural and urban families were compared in order to understand how these dynamics had different impacts on more developed (urban) and less developed (rural) areas. The results emphasize how changes observed in family structure are more pronounced among the richest families, contributing to an increase in (i) the income of the richest families and (ii) income inequality between the richest and poorest families, as well as between urban and rural areas.

Closing the door on pharma? A national survey of family medicine residencies regarding industry interactions.

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Fugh-Berman, Adriane; Brown, Steven R; Trippett, Rachel; Bell, Alicia M; Clark, Paige; Fleg, Anthony; Siwek, Jay

2011-05-01

To assess the extent and type of interactions U.S. family medicine residencies permit industry to have with medical students and residents. In 2008, the authors e-mailed a four-question survey to residency directors or coordinators at all 460 accredited U.S. family medicine residencies concerning the types of industry support and interaction permitted. The authors conducted quantitative and qualitative analyses of survey responses and written comments. Residencies that did not permit any industry food, gifts, samples, or support of residency activities were designated "pharma-free." The survey response rate was 62.2% (286/460). Among responding family medicine residencies, 52.1% refused drug samples, 48.6% disallowed industry gifts or food, 68.5% forbade industry-sponsored residency activities, and 44.1% denied industry access to students and residents at the family medicine center. Seventy-five residencies (26.2%) were designated as "pharma-free." Medical-school-based and medical-school-administered residencies were no more likely than community-based residencies to be pharma-free. Among the 211 programs that permitted interaction, 68.7% allowed gifts or food, 61.1% accepted drug samples, 71.1% allowed industry representatives access to trainees in the family medicine center, and 37.9% allowed industry-sponsored residency activities. Respondents commented on challenges inherent to limiting industry interactions. Many programs noted recent changes in plans or practices. Most family medicine residencies limit industry interaction with trainees. Because industry interactions can have adverse effects on rational prescribing, residency programs should assess the benefits and harms of these relationships. Copyright © by the Association of American medical Colleges.

Family Satisfaction With Nursing Home Care: The Role of Facility Characteristics and Resident Quality-of-Life Scores

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Shippee, Tetyana P.; Henning-Smith, Carrie; Gaugler, Joseph E.; Held, Robert; Kane, Robert L.

2018-01-01

This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews (n = 16,790 family members), (2) multidimensional survey of resident QOL (n = 13,433 residents), and (3) facility characteristics (n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: “care,” “staff,” “environment,” and “food.” Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics. PMID:26534835

Balancing the Roles of a Family Medicine Residency Faculty: A Grounded Theory Study.

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Reitz, Randall; Sudano, Laura; Siler, Anne; Trimble, Kristopher

2016-05-01

Great variety exists in the roles that family medicine residency faculty fill in the lives of their residents. A family medicine-specific model has never been created to describe and promote effective training relationships. This research aims to create a consensus model for faculty development, ethics education, and policy creation. Using a modified grounded theory methods, researchers conducted phone interviews with 22 key informants from US family medicine residencies. Data were analyzed to delineate faculty roles, common role conflicts, and ethical principles for avoiding and managing role conflicts. Key informants were asked to apply their experience and preferences to adapt an existing model to fit with family medicine residency settings. The primary result of this research is the creation of a family medicine-specific model that describes faculty roles and provides insight into how to manage role conflicts with residents. Primary faculty roles include Role Model, Advisor, Teacher, Supervisor, and Evaluator. Secondary faculty roles include Friendly Colleague, Wellness Supporter, and Helping Hand. The secondary roles exist on a continuum from disengaged to enmeshed. When not balanced, the secondary roles can detract from the primary roles. Differences were found between role expectations of physician versus behavioral science faculty and larger/university/urban residencies versus smaller/community/rural residencies. Diversity of opinion exists related to the types of roles that are appropriate for family medicine faculty to maintain with residents. This new model is a first attempt to build consensus in the field and has application to faculty development, ethics education, and policy creation.

Family Income Reduces Risk of Obesity for White but Not Black Children

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Shervin Assari

2018-06-01

Full Text Available Background: Although the protective effects of socioeconomic status (SES on obesity and cardiovascular disease are well established, these effects may differ across racial and ethnic groups. Aims: Using a national sample, this study investigated racial variation in the association between family income and childhood obesity in White and Black families. Methods: This cross-sectional study used data from the National Survey of Children’s Health (NSCH, 2003–2004, a nationally representative survey in the United States. This analysis included 76,705 children 2–17 years old who were either White (n = 67,610, 88.14% or Black (n = 9095, 11.86%. Family income to needs ratio was the independent variable. Childhood obesity was the outcome. Race was the focal moderator. Logistic regression was used for data analysis. Results: Overall, higher income to needs ratio was protective against childhood obesity. Race, however, interacted with income to needs ratio on odds of childhood obesity, indicating smaller effects for Black compared to White families. Race stratified logistic regressions showed an association between family income and childhood obesity for White but not Black families. Conclusions: The protective effect of income against childhood obesity is smaller for Blacks than Whites. Merely equalizing population access to SES and economic resources would not be sufficient for elimination of racial disparities in obesity and related cardiovascular disease in the United States. Policies should go beyond access to SES and address structural barriers in the lives of Blacks which result in a diminished health return of very same SES resources for them. As the likely causes are multi-level barriers, multi-level interventions are needed to eliminate racial disparities in childhood obesity.

Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women.

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Jewell, Shannon L; Letham-Hamlett, Kirsten; Hanna Ibrahim, Mariam; Luecken, Linda J; MacKinnon, David P

2017-12-01

Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age. The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women. Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year. Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain. Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.

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

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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.

Otolaryngology Training for Family Practice Residents.

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And Others; Rood, Stewart R.

1980-01-01

The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

Designing and implementing a resiliency program for family medicine residents.

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Brennan, Julie; McGrady, Angele

2015-01-01

Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. © The Author(s) 2015.

The Role of Breakfast in the American Family Diet by Income Group.

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Bowman, Shanthy A.

1998-01-01

Examined data from Continuing Survey of Food Intakes by Individuals (USDA) concerning breakfast consumption in families and the kinds of food chosen. Found that 85% of families reported having breakfast; most of those reporting no breakfast came from lowest income group. Consumption of cereals, fruits and juices increased with income; consumption…

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

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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,…

Expanding wallets and waistlines: the impact of family income on the BMI of women and men eligible for the Earned Income Tax Credit.

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Schmeiser, Maximilian D

2009-11-01

The rising rate of obesity has reached epidemic proportions and is now one of the most serious public health challenges facing the US. However, the underlying causes for this increase are unclear. This paper examines the effect of family income changes on body mass index (BMI) and obesity using data from the National Longitudinal Survey of Youth 1979 cohort. It does so by using exogenous variation in family income in a sample of low-income women and men. This exogenous variation is obtained from the correlation of their family income with the generosity of state and federal Earned Income Tax Credit (EITC) program benefits. Income is found to significantly raise the BMI and probability of being obese for women with EITC-eligible earnings, and have no appreciable effect for men with EITC-eligible earnings. The results imply that the increase in real family income from 1990 to 2002 explains between 10 and 21% of the increase in sample women's BMI and between 23 and 29% of their increased obesity prevalence. (c) 2009 John Wiley & Sons, Ltd.

24 CFR 81.18 - Affordability-Income level definitions-family size not known (actual or prospective tenants).

Science.gov (United States)

2010-04-01

... definitions-family size not known (actual or prospective tenants). 81.18 Section 81.18 Housing and Urban... CORPORATION (FREDDIE MAC) Housing Goals § 81.18 Affordability—Income level definitions—family size not known... moderate-income families where family size is not known to the GSE, income will be adjusted using unit size...

Sense of community in Hong Kong: relations with community-level characteristics and residents' well-being.

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Mak, Winnie W S; Cheung, Rebecca Y M; Law, Lawrence S C

2009-09-01

Sense of community (SOC) has been one of the most studied topics in community psychology. However, no empirical study to date has investigated SOC in Hong Kong and its relations with community characteristics and residents' psychological well-being. A representative sample of 941 Hong Kong Chinese based on a randomized household survey was conducted in all 18 districts in Hong Kong. Results of hierarchical linear modeling indicated that SOC was not associated with sociodemographic indicators on both the individual-level (i.e., gender, age, family income, education level, type of residence, and area-to-capita ratio of residence) and the community-level (i.e., proportion of individuals with tertiary education, median family income, ownership of residence, population density, and resident stability). SOC was negatively related to daily hassles and positively with social support and quality of life. Conceptualization of SOC in Hong Kong was discussed.

Psychiatry Training in Canadian Family Medicine Residency Programs

OpenAIRE

Kates, Nick; Toews, John; Leichner, Pierre

1985-01-01

Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice...

Four years of training in family medicine: implications for residency redesign.

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Sigmon, J Lewis; McPherson, Vanessa; Little, John M

2012-09-01

In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years. Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes. All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained. This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.

The effects of residents' social identity and involvement on their advocacy of incoming tourism

OpenAIRE

Palmer, Adrian; Koenig-Lewis, Nicole; Medi Jones, Lisa Elinor

2013-01-01

A long stream of literature has identified cognitive, emotional and evaluative dimensions of social identity. Previous studies have examined identity self-congruence of incoming tourists. However, the application of identity theory to the study of host communities' support of incoming tourism has been under-researched. This paper seeks to make a contribution by closing this gap by investigating residents' identity and its association with their propensity to become advocates for inward touris...

Occupational Therapy in Multidisciplinary Residency in Family and Community Health

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Luzianne Feijó Alexandre Paiva

2013-12-01

Full Text Available In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, is faced with the challenge to build a new field of knowledge. Objective: To analyze the inclusion of occupational therapy in the Family Health Strategy within the scope of Multidisciplinary Residency. Methodology: This is a descriptive study of qualitative approach, which was based on the experience of four occupational therapy resident students, performed through the documental analysis of field diaries, scientific papers, and case studies produced between 2009 and 2011. Results: The occupational therapists as well as the other NASF professionals operated the logic of Matrix Support to the Family Health teams, sharing their knowledge and assisting in resolving complex cases of the families, groups, and communities served. In this context, we found people with different relationships with their doings and a reduced repertoire of activities. The occupational therapists invested in the creation or consolidation of groups in the Family Health Centers and in the territory, which also stood as living and socializing spaces, focusing on prevention and health promotion.

Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway

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Zachrisson, Henrik Daae; Dearing, Eric

2014-01-01

The sociopolitical context of Norway includes low poverty rates and universal access to subsidized and regulated Early Childhood Education and Care (ECEC). In this context, the association between family income dynamics and changes in early child behavior problems was investigated, as well as whether high quality ECEC buffers children from the effects of income dynamics. In a population-based sample (N = 75,296), within-family changes in income-to-needs predicted changes in externalizing and internalizing problems (from age 18 to 36 months), particularly for lower-income children. For internalizing problems, ECEC buffered the effect of income-to-needs changes. These findings lend further support to the potential benefits of ECEC for children from lower-income families. PMID:25345342

EKG analysis skills of family practice residents in the United Arab Emirates: a comparison with US data.

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Margolis, S; Reed, R

2001-06-01

Concern has been raised about the electrocardiogram (EKG) analysis skills of family practice residents in the United States. This study examined EKG analysis skills of family practice residents, medical students, interns, and general practitioners (GPs) in the United Arab Emirates (UAE), a different environment. The measurement instrument was a set of 10 EKGs, used in a study of US family practice residents. Two of the EKGs were normal, and there were 14 clinical abnormalities in the remainder. There was no significant difference in the correct diagnosis of acute myocardial infarction between US family practice residents and UAE family practice residents, medical students, or GPs. Interns' diagnoses were significantly poorer. The mean score for correctly identifying acute myocardial infarction and both normal EKGs was not significantly different between groups: 2.50 medical students, 2.35 interns, 2.58 UAE family practice residents, 2.67 FD, and 2.55 US family practice residents. However, the US family practice resident mean score of 11.26 for all 16 clinical findings was significantly higher than any group in the UAE: 5.35 medical students, 5.87 interns, 6.08 UAE family practice residents, 5.69 family physicians. Difficulty in EKG interpretation transcends geographic boundaries, suggesting that new approaches to teaching these skills need to be explored. Improved EKG reading skills by family physicians are generally needed in both the United States and the UAE.

Cultural transition of international medical graduate residents into family practice in Canada.

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Triscott, Jean A C; Szafran, Olga; Waugh, Earle H; Torti, Jacqueline M I; Barton, Martina

2016-05-04

To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.

Money vs. time: Family income, maternal labor supply, and child development

OpenAIRE

Agostinelli, Francesco; Sorrenti, Giuseppe

2018-01-01

We study the effect of family income and maternal hours worked on child development. Our instrumental variable analysis suggests different results for cognitive and behavioral development. An additional 1,000 USD in family income improves cognitive development by 4.4 percent of a standard deviation but has no effect on behavioral development. A yearly increase of 100 work hours negatively affects both outcomes by approximately 6 percent of a standard deviation. The quality of parental investm...

A comparison of surgery and family medicine residents' perceptions of cross-cultural care training.

Science.gov (United States)

Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-12-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. Hawaii Medical Journal Copyright 2010.

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.

Educational contracts in family medicine residency training.

OpenAIRE

Mahood, S.; Rojas, R.; Andres, D.; Zagozeski, C.; White, G.; Bradel, T.

1994-01-01

An educational contract for family medicine residency training and evaluation addresses many of the difficulties and challenges of current postgraduate medical education. This article identifies important principles for developing a contractual approach; describes the contract used in one program and its implementation; and discusses its theory, advantages, and limitations.

Assets among low-income families in the Great Recession.

Directory of Open Access Journals (Sweden)

Valentina Duque

Full Text Available This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898, we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents and by race/ethnicity (White, Black, and Hispanic mothers. Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty.

Assets among low-income families in the Great Recession.

Science.gov (United States)

Duque, Valentina; Pilkauskas, Natasha V; Garfinkel, Irwin

2018-01-01

This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898), we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents) and by race/ethnicity (White, Black, and Hispanic mothers). Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty.

Assets among low-income families in the Great Recession

Science.gov (United States)

Garfinkel, Irwin

2018-01-01

This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898), we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents) and by race/ethnicity (White, Black, and Hispanic mothers). Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty. PMID:29401482

Cost of Incremental Expansion of an Existing Family Medicine Residency Program.

Science.gov (United States)

Ashkin, Evan A; Newton, Warren P; Toomey, Brian; Lingley, Ronald; Page, Cristen P

2017-07-01

Expanding residency training programs to address shortages in the primary care workforce is challenged by the present graduate medical education (GME) environment. The Medicare funding cap on new GME positions and reductions in the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME program require innovative solutions to support primary care residency expansion. Sparse literature exists to assist in predicting the actual cost of incremental expansion of a family medicine residency program without federal or state GME support. In 2011 a collaboration to develop a community health center (CHC) academic medical partnership (CHAMP), was formed and created a THC as a training site for expansion of an existing family medicine residency program. The cost of expansion was a critical factor as no Federal GME funding or HRSA THC GME program support was available. Initial start-up costs were supported by a federal grant and local foundations. Careful financial analysis of the expansion has provided actual costs per resident of the incremental expansion of the residencyRESULTS: The CHAMP created a new THC and expanded the residency from eight to ten residents per year. The cost of expansion was approximately $72,000 per resident per year. The cost of incremental expansion of our residency program in the CHAMP model was more than 50% less than that of the recently reported cost of training in the HRSA THC GME program.

Socializing Identity Through Practice: A Mixed Methods Approach to Family Medicine Resident Perspectives on Uncertainty.

Science.gov (United States)

Ledford, Christy J W; Cafferty, Lauren A; Seehusen, Dean A

2015-01-01

Uncertainty is a central theme in the practice of medicine and particularly primary care. This study explored how family medicine resident physicians react to uncertainty in their practice. This study incorporated a two-phase mixed methods approach, including semi-structured personal interviews (n=21) and longitudinal self-report surveys (n=21) with family medicine residents. Qualitative analysis showed that though residents described uncertainty as an implicit part of their identity, they still developed tactics to minimize or manage uncertainty in their practice. Residents described increasing comfort with uncertainty the longer they practiced and anticipated that growth continuing throughout their careers. Quantitative surveys showed that reactions to uncertainty were more positive over time; however, the difference was not statistically significant. Qualitative and quantitative results show that as family medicine residents practice medicine their perception of uncertainty changes. To reduce uncertainty, residents use relational information-seeking strategies. From a broader view of practice, residents describe uncertainty neutrally, asserting that uncertainty is simply part of the practice of family medicine.

An Analysis of Arizona Individual Income Tax-Credit Scholarship Recipients' Family Income, 2009-10 School Year. Program on Education Policy and Governance Working Paper. PEPG 10-18

Science.gov (United States)

Murray, Vicki E.

2010-01-01

In 2009, the "East Valley Tribune and the Arizona Republic" alleged that Arizona's individual income tax-credit scholarship program disproportionately serves privileged students from higher-income families over those from lower-income backgrounds. Yet neither paper collected the student-level, scholarship recipient family income data…

Work, Family and Community Support as Predictors of Work-Family Conflict: A Study of Low-Income Workers

Science.gov (United States)

Griggs, Tracy Lambert; Casper, Wendy J.; Eby, Lillian T.

2013-01-01

This study examines relationships between support from work, family and community domains with time- and strain-based work-family conflict in a sample of low-income workers. Results reveal significant within-domain and cross-domain relationships between support from all three life domains with work--family conflict. With respect to family support,…

The effects of parental education and family income on mother-child relationships, father-child relationships, and family environments in the People's Republic of China.

Science.gov (United States)

Zhang, Xiao

2012-12-01

Using a cross-sectional design with 407 Chinese children aged 3-5 years and their parents, this study examined the effects of socioeconomic status, specifically parents' education and family income, on the children's mother-child relationships, father-child relationships, and the social environment in their families. The results indicated that income negatively predicted conflict in father-child relationships and positively predicted family active-recreational environments. Income also positively predicted family cohesion among girls but not boys. Maternal education negatively predicted conflict in mother-child relationships and positively predicted closeness in mother-child and father-child relationships, family cohesion, and the intellectual-cultural and active-recreational environments in the family. Paternal education positively predicted family cohesion and intellectual-cultural and active-recreational environments. Income was found to partially mediate the effects of both maternal and paternal education on family active-recreational environments. Findings are discussed in the frameworks of the family stress model and the family investment model. © FPI, Inc.

Financial stress, parent functioning and adolescent problem behavior: an actor-partner interdependence approach to family stress processes in low-, middle-, and high-income families.

Science.gov (United States)

Ponnet, Koen

2014-10-01

The family stress model proposes that financial stress experienced by parents is associated with problem behavior in adolescents. The present study applied an actor-partner interdependence approach to the family stress model and focused on low-, middle-, and high-income families to broaden our understanding of the pathways by which the financial stress of mothers and fathers are related to adolescent outcomes. The study uses dyadic data (N = 798 heterosexual couples) from the Relationship between Mothers, Fathers and Children study in which two-parent families with an adolescent between 11 and 17 years of age participated. Path-analytic results indicated that in each of the families the association between parents' financial stress and problem behavior in adolescents is mediated through parents' depressive symptoms, interparental conflict, and positive parenting. Family stress processes also appear to operate in different ways for low-, middle-, and high-income families. In addition to a higher absolute level of financial stress in low-income families, financial stress experienced by mothers and fathers in these families had significant direct and indirect effects on problem behavior in adolescents, while in middle- and high-income families only significant indirect effects were found. The financial stress of a low-income mother also had a more detrimental impact on her level of depressive feelings than it had on mothers in middle-income families. Furthermore, the study revealed gender differences in the pathways of mothers and fathers. Implications for research, clinical practice, and policy are also discussed.

Magnitude of income-related disparities in adverse perinatal outcomes.

Science.gov (United States)

Shankardass, Ketan; O'Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, Ks; Morinis, Julia; Allen, Victoria M

2014-03-04

To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases.

Women residents, women physicians and medicine's future.

Science.gov (United States)

Serrano, Karen

2007-08-01

The number of women in medicine has increased dramatically in the last few decades, and women now represent half of all incoming medical students. Yet residency training still resembles the historical model when there were few women in medicine. This article reviews the issues facing women in residency today. Data suggest that the experience of female residents is more negative than that of males. Unique challenges facing female residents include the existence of gender bias and sexual harassment, a scarcity of female mentors in leadership positions, and work/family conflicts. Further research is needed to understand the experience of female residents and to identify barriers that hinder their optimal professional and personal development. Structural and cultural changes to residency programs are needed to better accommodate the needs of female trainees.

Does clinical exposure matter? Pilot assessment of patient visits in an urban family medicine residency program.

Science.gov (United States)

Iglar, Karl; Murdoch, Stuart; Meaney, Christopher; Krueger, Paul

2018-01-01

To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. Family medicine teaching unit in a community hospital in Barrie, Ont. Practice profile data were from family medicine residents enrolled in the program from July 1, 2013, to June 30, 2014, and electronic medical record and ITE data were from those enrolled in the program from July 1, 2010, to June 30, 2015. Number of patient visits, patient characteristics (eg, sex, age), priority topics addressed in clinic, resident characteristics (eg, age, sex, level of residency), and residents' final ITE scores. Between July 1, 2013, and June 30, 2014, there were 11 115 patient visits. First-year residents had a mean of 5.48 patient visits per clinic, and second-year residents had a mean of 5.98 patient visits per clinic. A Pearson correlation coefficient of 0.68 was found to exist between the number of patients seen and the final ITE scores, with a 10.5% difference in mean score between residents who had 1251 or more visits and those who had 1150 or fewer visits. Three diagnoses (ie, epistaxis, meningitis, and neck pain) deemed important for Certification by the College of Family Physicians of Canada were not seen by any of the residents in clinic. There is a moderate correlation between the number of patients seen by residents in ambulatory care and ITE scores in family medicine. It is important to assess patients' demographic information and diagnoses made in resident practices to ensure an adequate clinical experience. Copyright© the College of Family Physicians of Canada.

Income Distribution and Economic Well-Being within European Families

DEFF Research Database (Denmark)

Bonke, Jens

well-being declines and wives raises the more she earns relatively to him. However, the relationships are often of an inversed u-shaped form for both sexes with men getting the highest well-being at an earlier stage than women. Within the Scandinavian welfare state regime this preferred distribution......-shaped relationship between the distribution of income and men and women’s economic well-being.......The article analyses the distribution of income within European families and the consequences for the spouses’ economic well-being. Thus, many studies have shown that women nowadays participate on the labour market in an increasing number resulting in a more equal distribution of income within...

Opportunity for All? Technology and Learning in Lower-Income Families. Appendix: Questionnaire and Topline Results

Science.gov (United States)

Rideout, Victoria; Katz, Vikki S.

2016-01-01

The data in this survey offer a unique perspective from low- and moderate-income families with school-age children in the United States. They reveal many of the nuances and complexities of digital life among lower income families today. Because lower-income parents are not usually the focus of studies on technology and learning, this report offers…

Family income and tooth decay in US children: does the association change with age?

Science.gov (United States)

Bernabé, E; Delgado-Angulo, E K; Murasko, J E; Marcenes, W

2012-01-01

This study explored whether the association of family income with tooth decay changes with age among children in the United States. A second objective was to explore the role of access to dental health care services in explaining the interrelationships between family income, child age and tooth decay. Data from 7,491 2- to 15-year-old children who participated in the 1999-2004 National and Health and Nutrition Examination Survey were analyzed. The association of family income with the prevalence of tooth decay in primary, permanent and primary or permanent teeth was first estimated in logistic regression models with all children, and then, separately in four age groups that reflect the development of the dentition (2-5, 6-8, 9-11 and 12-15 years, respectively). Findings showed that the income gradient in tooth decay attenuated significantly in 9- to 11-year-olds only to re-emerge in 12- to 15-year-olds. The age profile of the income gradient in tooth decay was not accounted for by a diverse set of family and child characteristics. This is the first study providing some evidence for age variations in the income gradient in tooth decay among children in the United States. Copyright © 2012 S. Karger AG, Basel.

Finding the Perfect Match: Factors That Influence Family Medicine Residency Selection.

Science.gov (United States)

Wright, Katherine M; Ryan, Elizabeth R; Gatta, John L; Anderson, Lauren; Clements, Deborah S

2016-04-01

Residency program selection is a significant experience for emerging physicians, yet there is limited information about how applicants narrow their list of potential programs. This study examines factors that influence residency program selection among medical students interested in family medicine at the time of application. Medical students with an expressed interest in family medicine were invited to participate in a 37-item, online survey. Students were asked to rate factors that may impact residency selection on a 6-point Likert scale in addition to three open-ended qualitative questions. Mean values were calculated for each survey item and were used to determine a rank order for selection criteria. Logistic regression analysis was performed to identify factors that predict a strong interest in urban, suburban, and rural residency programs. Logistic regression was also used to identify factors that predict a strong interest in academic health center-based residencies, community-based residencies, and community-based residencies with an academic affiliation. A total of 705 medical students from 32 states across the country completed the survey. Location, work/life balance, and program structure (curriculum, schedule) were rated the most important factors for residency selection. Logistic regression analysis was used to refine our understanding of how each factor relates to specific types of residencies. These findings have implications for how to best advise students in selecting a residency, as well as marketing residencies to the right candidates. Refining the recruitment process will ensure a better fit between applicants and potential programs. Limited recruitment resources may be better utilized by focusing on targeted dissemination strategies.

Psychiatry training in canadian family medicine residency programs.

Science.gov (United States)

Kates, N; Toews, J; Leichner, P

1985-01-01

Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement-particularly in finding psychiatrists with a better understanding of family practice, in integrating the teaching to a greater degree with clinical work, thereby increasing its relevance, and in utilizing more suitable clinical settings.

Leadership training in a family medicine residency program: Cross-sectional quantitative survey to inform curriculum development.

Science.gov (United States)

Gallagher, Erin; Moore, Ainsley; Schabort, Inge

2017-03-01

To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Cross-sectional quantitative survey. Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. A total of 152 first- and second-year family medicine residents. Family medicine residents' attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement "I am a leader" received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. Copyright© the College of Family Physicians of Canada.

Home Care Services as Teaching Sites for Geriatrics in Family Medicine Residencies.

Science.gov (United States)

Laguillo, Edgardo

1988-01-01

A national survey of family medicine programs and residency training in geriatrics found almost half using home care services as teaching sites. In the program design preferred by residents, the resident followed the patient long-term and discussed management with a multidisciplinary team. An alternative combined rotation is discussed. (Author/MSE)

Parent emotional distress and feeding styles in low-income families. The role of parent depression and parenting stress.

Science.gov (United States)

Hughes, Sheryl O; Power, Thomas G; Liu, Yan; Sharp, Carla; Nicklas, Theresa A

2015-09-01

Depression and other stressors have been associated with general parenting and child outcomes in low-income families. Given that parents shape child eating behaviors through their feeding interactions with their child, it is important to investigate factors that may influence parental feeding of young children. The aim of this study was to examine how depressive symptoms and parenting stress might influence the nature of parent feeding styles in low-income families. Questionnaires were completed by 290 African-American and Hispanic parents residing in a large urban city in the southwestern United States. Twenty-six percent of the parents reported depressive symptoms above the clinical cutoff. Multivariate logistic regression was used to examine how depressive symptoms and parenting stress might influence the nature of parent feeding styles. After adjusting for potential confounding variables (e.g., ethnicity, education, age), parents with an uninvolved feeding style reported less positive affect and more parenting stress than parents showing the other three feeding styles - authoritative, authoritarian, and indulgent. Because feeding styles tend to be associated with child obesity in low income samples, the results of this study provide important information regarding the parent-child eating dynamic that may promote less optimal child eating behaviors and the development of childhood obesity. This information could be useful for prevention studies aimed at changing parent behaviors that negatively impact the socialization of child eating behaviors. Copyright © 2015 Elsevier Ltd. All rights reserved.

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 ...

Toward shared decision making: using the OPTION scale to analyze resident-patient consultations in family medicine

NARCIS (Netherlands)

Pellerin, M.A.; Elwyn, G.; Rousseau, M.; Stacey, D.; Robitaille, H.; Legare, F.

2011-01-01

PURPOSE: Do residents in family medicine practice share decision making with patients during consultations? This study used a validated scale to score family medicine residents' shared decision-making (SDM) skills in primary care consultations and to determine whether residents' demographic

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%…

Tax on Incomes Obtained from Romania by Non-resident Taxpayers – Computation Methodology and the Fiscal Impact upon the Corporate Tax

Directory of Open Access Journals (Sweden)

Cristina IOVU

2017-04-01

Full Text Available Withholding tax for non-resident taxpayers is a tax due to the Romanian state budget by taxpayers, the expense for the amount related to this tax playing a fiscal impact upon the fiscal result and, therefore, upon the corporate tax due within a fiscal period of time. Most of the times, in practice, a series of questions arise, such as: which is the entity having the obligation to compute and pay the tax, respectively the income payer or the one collecting it; is the transaction taxable from the point of view of the tax on non-resident taxpayers’ income, function of the nature and object of the transaction; which is the tax rate owed, in case the operation has a taxable feature; which is the fiscal treatment applicable in case of expenses incurred in the accounting records, with the amount of the tax owed on non-resident taxpayers income. Due to this reason, in practice there are several approaches which could generate fiscal risks, related to the fiscal treatment applicable in case of different types pf transactions concluded with non-resident tax payers, depending on the nature and scope of the respective transaction.

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.

Does Concern Motivate Behavior Change?: Exploring the Relationship between Physical Activity and Body Mass Index among Low-Income Housing Residents

Science.gov (United States)

Tamers, Sara L.; Allen, Jennifer; Yang, May; Stoddard, Anne; Harley, Amy; Sorensen, Glorian

2014-01-01

Objective: To explore relationships between concerns and physical activity and body mass index (BMI) among a racially/ethnically diverse low-income population. Method: A cross-sectional survey documented behavioral risks among racially/ethnically diverse low-income residents in the Boston area (2005-2009). Multivariable logistic regressions were…

Reintegrating Family Therapy Training in Psychiatric Residency Programs: Making the Case

Science.gov (United States)

Rait, Douglas; Glick, Ira

2008-01-01

Objective: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. Methods: After reviewing recent trends in the field that…

Competency Assessment in Family Medicine Residency: Observations, Knowledge-Based Examinations, and Advancement.

Science.gov (United States)

Mainous, Arch G; Fang, Bo; Peterson, Lars E

2017-12-01

The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation. Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies. We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education-accredited programs during academic years 2014-2015 and 2015-2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data. The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r  = .195 ( P  ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not. Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.

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

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

2016-01-22

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

Conflict between nursing home staff and residents' families: does it increase burnout?

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Abrahamson, Kathleen; Jill Suitor, J; Pillemer, Karl

2009-09-01

In this study, the authors examine the influence of conflict between nursing home staff and family members of residents on staff burnout. Data were collected from interviews with a representative sample of 655 nursing home nurses and nursing assistants. Hypotheses were tested using structural equation modeling. Results indicate that conflict with family members increases staff burnout and decreases staff satisfaction. Staff and family conflict increases when staff members feel they do not have enough time to complete required tasks. Level of conflict decreases when staff perceive that family members have care expectations that are similar to their own. Interestingly, staff who have personal experience as family caregivers are more likely to report conflict with family members of residents, a result that necessitates further study. Staff burnout and dissatisfaction affects both individuals and organizations. Policy that addresses staff and family interaction can have an important place in the design and delivery of long-term care.

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

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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…

Use of computers and the Internet by residents in US family medicine programmes.

Science.gov (United States)

King, Richard V; Murphy-Cullen, Cassie L; Mayo, Helen G; Marcee, Alice K; Schneider, Gregory W

2007-06-01

Computers, personal digital assistants (PDA), and the Internet are widely used as resources in medical education and clinical care. Educators who intend to incorporate these resources effectively into residency education programmes can benefit from understanding how residents currently use these tools, their skills, and their preferences. The researchers sent questionnaires to 306 US family medicine residency programmes for all of their residents to complete. Respondents were 1177 residents from 125 (41%) programmes. Access to a computer was reported by 95% of respondents. Of these, 97% of desktop and 89% of laptop computers could access the Internet. Residents accessed various educational and clinical resources. Half felt they had 'intermediate' skills at Web searches, 23% had 'some skills,' and 27% were 'quite skilled.' Those under 30 years of age reported higher skill levels. Those who experienced a Web-based curriculum in medical school reported higher search skills and greater success in finding clinical information. Respondents preferred to use technology to supplement the didactic sessions offered in resident teaching conferences. Favourable conditions exist in family medicine residency programmes to implement a blend of traditional and technology-based learning experiences. These conditions include residents' experience, skills, and preferences.

Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

Science.gov (United States)

Adra, Marina Gharibian; Hopton, John; Keady, John

2015-12-01

Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

Helping Working Families: The Earned Income Tax Credit.

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Hoffman, Saul D.; Seidman, Laurence S.

The impact of the Earned Income Tax Credit (EITC) on working families was analyzed. The analysis established that the EITC is, on balance, a highly effective program that meets its primary objectives well. The following benefits of the EITC were identified: (1) it reduced the poverty rate in 1999 by an estimated 1.5 percentage points; (2) it is…

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.

Learning behaviour and preferences of family medicine residents under a flexible academic curriculum.

Science.gov (United States)

Sy, Alice; Wong, Eric; Boisvert, Leslie

2014-11-01

To determine family medicine residents' learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. London, Ont. All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians' teaching sessions (20%),and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents' homes (32%),and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents' various learning preferences and habits while providing guidance and training in the use of more effective learning methods and

Incoming human papillomavirus type 16 genome resides in a vesicular compartment throughout mitosis.

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DiGiuseppe, Stephen; Luszczek, Wioleta; Keiffer, Timothy R; Bienkowska-Haba, Malgorzata; Guion, Lucile G M; Sapp, Martin J

2016-05-31

During the entry process, the human papillomavirus (HPV) capsid is trafficked to the trans-Golgi network (TGN), whereupon it enters the nucleus during mitosis. We previously demonstrated that the minor capsid protein L2 assumes a transmembranous conformation in the TGN. Here we provide evidence that the incoming viral genome dissociates from the TGN and associates with microtubules after the onset of mitosis. Deposition onto mitotic chromosomes is L2-mediated. Using differential staining of an incoming viral genome by small molecular dyes in selectively permeabilized cells, nuclease protection, and flotation assays, we found that HPV resides in a membrane-bound vesicle until mitosis is completed and the nuclear envelope has reformed. As a result, expression of the incoming viral genome is delayed. Taken together, these data provide evidence that HPV has evolved a unique strategy for delivering the viral genome to the nucleus of dividing cells. Furthermore, it is unlikely that nuclear vesicles are unique to HPV, and thus we may have uncovered a hitherto unrecognized cellular pathway that may be of interest for future cell biological studies.

Impact of a family medicine resident wellness curriculum: a feasibility study.

Science.gov (United States)

Runyan, Christine; Savageau, Judith A; Potts, Stacy; Weinreb, Linda

2016-01-01

Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

Family Income and Child Cognitive and Noncognitive Development in Australia: Does Money Matter?

Science.gov (United States)

Khanam, Rasheda; Nghiem, Son

2016-06-01

This article investigates whether family income affects children's cognitive and noncognitive development by exploiting comprehensive information from the Longitudinal Study of Australian Children. We include variables that represent parental investment, parental stress, and neighborhood characteristics to examine if these factors mediate the effects of income. Using dynamic panel data, we find that family income is significantly associated with children's cognitive skills but not with noncognitive skills. Mother's education, parent's physical and mental health, parenting styles, child's own health, and presence of both biological parents are the most important factors for children's noncognitive development. For cognitive development, income as well as parents' education, child's birth weight, and number of books that children have at home are highly significant factors. We also find strong evidence to support the skill formation theory that children's previous cognitive and noncognitive outcomes are significantly related to their current outcomes.

Examining mindfulness-based stress reduction: Perceptions from minority older adults residing in a low-income housing facility

Directory of Open Access Journals (Sweden)

Connolly Amy B

2011-05-01

Full Text Available Abstract Background Mindfulness-based stress reduction (MBSR programs are becoming increasingly common, but have not been studied in low income minority older populations. We sought to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges. Methods We conducted three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. We tape recorded each session and subsequently used inductive content analysis to identify primary themes. Results and discussion Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. We found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger. Conclusion A reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health.

"We Keep the Education Goin' at Home All the Time": Family Literacy in Low-Income African American Families of Preschoolers

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Jarrett, Robin L.; Coba-Rodriguez, Sarai

2017-01-01

Researchers have examined the impact of family on child literacy among low-income African American families and preschoolers considered to be at risk for not being ready for kindergarten. Quantitative studies identify family-parental variables associated with poorer literacy outcomes, whereas qualitative studies detail family practices that…

Diabetes Mellitus Coding Training for Family Practice Residents.

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Urse, Geraldine N

2015-07-01

Although physicians regularly use numeric coding systems such as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to describe patient encounters, coding errors are common. One of the most complicated diagnoses to code is diabetes mellitus. The ICD-9-CM currently has 39 separate codes for diabetes mellitus; this number will be expanded to more than 50 with the introduction of ICD-10-CM in October 2015. To assess the effect of a 1-hour focused presentation on ICD-9-CM codes on diabetes mellitus coding. A 1-hour focused lecture on the correct use of diabetes mellitus codes for patient visits was presented to family practice residents at Doctors Hospital Family Practice in Columbus, Ohio. To assess resident knowledge of the topic, a pretest and posttest were given to residents before and after the lecture, respectively. Medical records of all patients with diabetes mellitus who were cared for at the hospital 6 weeks before and 6 weeks after the lecture were reviewed and compared for the use of diabetes mellitus ICD-9 codes. Eighteen residents attended the lecture and completed the pretest and posttest. The mean (SD) percentage of correct answers was 72.8% (17.1%) for the pretest and 84.4% (14.6%) for the posttest, for an improvement of 11.6 percentage points (P≤.035). The percentage of total available codes used did not substantially change from before to after the lecture, but the use of the generic ICD-9-CM code for diabetes mellitus type II controlled (250.00) declined (58 of 176 [33%] to 102 of 393 [26%]) and the use of other codes increased, indicating a greater variety in codes used after the focused lecture. After a focused lecture on diabetes mellitus coding, resident coding knowledge improved. Review of medical record data did not reveal an overall change in the number of diabetic codes used after the lecture but did reveal a greater variety in the codes used.

Awareness of dementia by family carers of nursing home residents dying with dementia: a post-death study.

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Penders, Yolanda W H; Albers, Gwenda; Deliens, Luc; Vander Stichele, Robert; Van den Block, Lieve

2015-01-01

High-quality palliative care for people with dementia should be patient-centered, family-focused, and include well-informed and shared decision-making, as affirmed in a recent white paper on dementia from the European Association for Palliative Care. To describe how often family carers of nursing home residents who died with dementia are aware that their relative has dementia, and study resident, family carer, and care characteristics associated with awareness. Post-death study using random cluster sampling. Structured questionnaires were completed by family carers, nursing staff, and general practitioners of deceased nursing home residents with dementia in Flanders, Belgium (2010). Of 190 residents who died with dementia, 53.2% of family carers responded. In 28% of cases, family carers indicated they were unaware their relative had dementia. Awareness by family carers was related to more advanced stages of dementia 1 month before death (odds ratio = 5.4), with 48% of family carers being unaware when dementia was mild and 20% unaware when dementia was advanced. The longer the onset of dementia after admission to a nursing home, the less likely family carers were aware (odds ratio = 0.94). Family carers are often unaware that their relative has dementia, that is, in one-fourth of cases of dementia and one-fifth of advanced dementia, posing considerable challenges for optimal care provision and end-of-life decision-making. Considering that family carers of residents who develop dementia later after admission to a nursing home are less likely to be aware, there is room for improving communication strategies toward family carers of nursing home residents. © The Author(s) 2014.

[Influence of income on food expenditures away from home among Brazilian families, 2002-2003].

Science.gov (United States)

Claro, Rafael Moreira; Levy, Renata Bertazzi; Bandoni, Daniel Henrique

2009-11-01

This study describes and evaluates the influence of income on the percentage of food expenditures away from home for Brazilian families. Food acquisition data from the National Household Budget Survey conducted from 2002 to 2003 (POF 2002/2003) by the Brazilian Institute of Geography and Statistics (IBGE) or National Census Bureau was used in the analysis. Information on food-and-drink expenditures away from home was analyzed. The influence of income on the share of food purchased away from home in the household budget, adjusted for socio-demographic variables, was analyzed through elasticity coefficients estimated in multiple linear regression. Food purchased away from home accounted for 21% of total food expenditures by Brazilian households. A 10% increase in income increased the share of food purchased away from home by 3%. Income elasticity was high, especially for the lowest income families. The results demonstrate an important influence of income on food expenditures away from home, and higher income is associated with a greater share of food purchased away from home.

Coping with Family Conflict: What's Helpful and What's Not for Low-Income Adolescents

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Santiago, Catherine DeCarlo; Wadsworth, Martha E.

2009-01-01

Family conflict is exacerbated by poverty-related stress and is detrimental to adolescent mental health. Adolescent coping with family conflict has the potential to buffer or exacerbate the negative effects of family conflict on internalizing symptoms. We examined coping with family conflict among 82 low-income adolescents (53.7% female, mean age…

Work–family conflict and self-rated health among Japanese workers: How household income modifies associations

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Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work–family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011–2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work–family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04–2.97) for men and 3.54 (95% CI; 2.92–4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work–family conflict were likely to be more evident in the low income group only among women. Work–family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women. PMID:28207757

Work-family conflict and self-rated health among Japanese workers: How household income modifies associations.

Science.gov (United States)

Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work-family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011-2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work-family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04-2.97) for men and 3.54 (95% CI; 2.92-4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work-family conflict were likely to be more evident in the low income group only among women. Work-family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women.

Training on the clock: family medicine residency directors' responses to resident duty hours reform.

Science.gov (United States)

Peterson, Lars E; Johnson, Hillary; Pugno, Perry A; Bazemore, Andrew; Phillips, Robert L

2006-12-01

The Accreditation Council for Graduate Medical Education's 2003 restrictions on resident duty hours (RDH) raised concerns among educators about potential negative impacts on residents' training. In the early wake of these restrictions, little is known about how RDH reform impacts training in primary care. The authors surveyed family medicine (FM) residency program directors (PDs) for their perceptions of the impact of RDH regulations on training in primary care. All PDs of 472 FM residency programs were asked via list-serve to complete an anonymous Internet-based survey in the fall of 2004. The survey solicited PDs' opinions about changes in staff and in residents' training experiences with respect to implementation of RDH regulations. Descriptive and qualitative analyses were conducted. There were 369 partial and 328 complete responses, for a response rate of 69% (328/472). Effects of the RDH regulations are varied. Fifty percent of FMPDs report increased patient-care duties for attendings, whereas 42% report no increase. Nearly 80% of programs hired no additional staff. Sixty percent of programs eliminated postcall clinics, and nearly 40% implemented a night-float system. Administrative hassles and losses of professionalism, educational opportunity, and continuity of care were common concerns, but a sizeable minority feel that residents will be better off under the new regulations. Many FMPDs cited increased faculty burden and the risk of lower-quality educational experiences for their trainees. Innovations for increasing the effectiveness of teaching may ultimately compensate for lost educational time. If not, alternatives such as extending the length of residency must be considered.

Aspects of indignity in nursing home residences as experienced by family caregivers

DEFF Research Database (Denmark)

Nåden, Dagfinn; Høy, Bente; Lohne, Vibeke

2013-01-01

or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in this part of this study consisted of individual research interviews. Altogether......, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: 'A feeling of being abandoned'. The sub-themes are designated as follows: deprived of the feeling of belonging...

Family residency and psychosomatic problems among adolescents in Sweden: The impact of child-parent relations.

Science.gov (United States)

Hagquist, Curt

2016-02-01

Profound changes in family structure took place in many countries, during the second part of the previous century. The purpose of this paper is to analyse the association between the type of family residency and psychosomatic problems in younger and older adolescents, particularly focusing on alternate residency, and to examine the impact of child-parent relations. We used data collected in 2009 by Statistics Sweden among 172,298 Swedish students in Grade 6 and Grade 9 (approximate ages 12 and 15 years old); comprising 80% and 86%, respectively, of the entire population of students in those grades. We collected the data with a questionnaire, completed anonymously in school: We used the Psychosomatic Problems (PSP) scale as the outcome measure. The type of family residency showed a weaker association with psychosomatic problems than the child-parent relationships did. Living in non-intact families increased the probability of adolescent psychosomatic problems by 0-0.05, compared to intact families. In Grade 9, there were no differences in psychosomatic problems between the students in alternate residency and those living with their two parents; and in Grade 6, these differences were relatively small. In comparison, a worse relationship with parents increased the probability of psychosomatic problems by 0.11-0.17, depending on the school grade and type of family residency. The structure of the family, as well as the child-parent relationships needs to be taken into account, to properly estimate the magnitude of the family situation as a determinant of adolescent psychosomatic problems. Our results justify universal intervention at the policy level. © 2015 the Nordic Societies of Public Health.

Similarities and differences between families who have frequent and infrequent family meals: A qualitative investigation of low-income and minority households.

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Berge, Jerica M; Draxten, Michelle; Trofholz, Amanda; Hanson-Bradley, Carrie; Justesen, Kathryn; Slattengren, Andrew

2018-04-01

Numerous quantitative studies have examined the association between family meal frequency and child/adolescent weight and weight-related behaviors. However, limited qualitative research has been conducted to identify mealtime characteristics (e.g., child behavior during meals, rules/expectations, family dynamics) that occur during family meals that may explain why some families engage in frequent family meals and others do not. This is particularly important within racially/ethnically diverse households, as these demographic groups are at higher risk for weight-related problems. The current study aimed to identify similarities and differences in mealtime characteristics between households that have frequent and infrequent family meals within a low-income and minority population. This qualitative study included 118 parents who participated in Family Meals, LIVE!, a mixed-methods, cross-sectional study. Parents (90% female; mean age = 35) were racially/ethnically diverse (62% African American, 19% White, 4% Native American, 4% Asian, 11% Mixed/Other) and from low-income (73% eating, involving family members in meal preparation) between households having frequent and infrequent family meals. Additionally, several differences in mealtime characteristics were identified between households having frequent (i.e., importance of family meals, flexibility in the definition of family meals, family meal rules, no pressure-to-eat feeding practices) versus infrequent family meals (i.e., pressure-to-eat parent feeding practices, family meals are dinner meals only, and difficult meal time behaviors). Study findings may be useful for developing intervention targets for low-income and racially/ethnically diverse households so more families can benefit from the protective nature of family meals. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Impact of Family Income on Child Achievement: Evidence from the Earned Income Tax Credit. Discussion Paper No. 1361-09

Science.gov (United States)

Dahl, Gordon; Lochner, Lance

2009-01-01

Past estimates of the effect of family income on child development have often been plagued by endogeneity and measurement error. In this paper, we use two simulated instrumental variables strategies to estimate the causal effect of income on children's math and reading achievement. Our identification derives from the large, non-linear changes…

Impact of a family medicine resident wellness curriculum: a feasibility study

Directory of Open Access Journals (Sweden)

Christine Runyan

2016-06-01

Full Text Available Background: Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives: The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods: The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results: Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions: This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

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…

Family Support in Nursing Homes Serving Residents with a Mental Health History

Science.gov (United States)

Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun

2010-01-01

Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…

Income tax in France

CERN Multimedia

HR Department

2009-01-01

Memorandum from the HR and FP Departments and the Legal Service concerning the annual internal taxation certificate and the declaration of income for 2008 You are reminded that each year the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that members of the personnel are thus exempt from external taxation on salaries and emoluments paid by CERN. This memorandum is intended to provide members of the personnel residing in France with information on how salaries and emoluments paid by CERN should be indicated in the 2008 income declaration form. For any other income, they are invited to comply with the instructions attached to the form. I - Annual internal taxation certificate for 2008 The annual certificate of internal taxation for 2008, issued by the FP Department, has been available since 1st March 2009 (see Bulletin No. 11-12/2009). It is int...

Income Tax in France

CERN Multimedia

HR Department

2009-01-01

Memorandum from the HR and FP Departments and the Legal Service concerning the annual internal taxation certificate and the declaration of income for 2008 You are reminded that each year the Organization levies an internal tax on the financial and family benefits it pays to the members of the personnel (see Chapter V, Section 2 of the Staff Rules and Regulations) and that members of the personnel are thus exempt from external taxation on salaries and emoluments paid by CERN. This memorandum is intended to provide members of the personnel residing in France with information on how salaries and emoluments paid by CERN should be indicated in the 2008 income declaration form. For any other income, they are invited to comply with the instructions attached to the form. I - Annual internal taxation certificate for 2008 The annual certificate of internal taxation for 2008, issued by the FP Department, has been available since 1st March 2009 (see Bulletin No. 11-12/2009). It is int...

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.

12 CFR 1282.18 - Affordability-Income level definitions-family size not known (actual or prospective tenants).

Science.gov (United States)

2010-01-01

....18 Affordability—Income level definitions—family size not known (actual or prospective tenants). In... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordability-Income level definitions-family size not known (actual or prospective tenants). 1282.18 Section 1282.18 Banks and Banking FEDERAL...

Interior design preferences of residents, families, and staff in two nursing homes.

Science.gov (United States)

Miller, D B; Goldman, L E; Woodman, S A

1985-01-01

The small number of respondents and the absence of specific demographic data concerning the three categories of respondents represented definite limitations. Further investigation in other long-term care facilities clearly is indicated. However, as a preliminary survey of preferences in nursing home interior design, several interesting findings have emerged: Patients, staff and families all emphasized patient safety and function over aesthetics. Yet, more residents than staff and families were concerned with appearance. Although experts advocate creating a home-like atmosphere in the nursing home, 50% or more of each group applied different criteria for specific design elements for private homes and for long-term care institutions. Design preferences for the three groups were similar, with an emphasis on modern furniture, painted walls, resilient tile rather than carpet, blinds, pastel and warm colors, and the use of paintings as accessories. Contrary to study assumptions, design features that promote patient individuality (e.g., patient artwork) received much greater emphasis from staff than from patients and families. Environmental change was considered an important aspect of interior design. Of the three constituencies, staff was most aware of periodic changes in decor and considered change as "very important" more often than did families or patients. As the nature of the nursing home patient population has changed--with residents presenting more disability and less rehabilitation potential and less likelihood of returning home--the ambiance of facilities has assumed even more importance. Clearly, the design preferences of residents who live in the facility are of paramount importance. However, it is also helpful to have an environment that is pleasing to family members who often experience difficulty in ongoing visitations, particularly to intellectually impaired relatives. Maintaining staff morale at a high level is a constant challenge in a long-term care

Cohabitating Partners and Domestic Labor in Low-Income Black Families

OpenAIRE

Reid, Megan; Golub, Andrew; Vazan, Peter

2014-01-01

This article examines the division of domestic labor in low-income cohabiting Black stepfamilies. We analyze survey data collected from 136 such families in order to understand how stepparent gender and relationship length impact the distribution of domestic labor. We hypothesize that women do more domestic work than men across all three family types, and that stepfathers are more involved in domestic labor in established relationships compared to new relationships. Findings indicate that coh...

Childhood parental divorce and cortisol in young adulthood: evidence for mediation by family income.

Science.gov (United States)

Kraft, Amy J; Luecken, Linda J

2009-10-01

Childhood parental divorce has been linked with negative physical and psychological health in adulthood, potentially due to alterations in adrenocortical activity resulting from chronic stress. The current study evaluated cortisol in 94 young adults (mean age 19.9) from families characterized by parental divorce (n=43) or intact parental marriages (n=51). Salivary cortisol was assessed prior to and at 3 time points after a challenging speech task. Participants from divorced families had significantly lower cortisol across the experimental period than those from intact families, even after controlling for family conflict and current depression and anxiety. Lower family income was also associated with lower cortisol, and partially mediated the relationship between parental divorce and cortisol. Findings suggest that childhood parental divorce is associated with attenuated cortisol in young adulthood, which may be explained by lower income in divorced families.

An Update of Oral Health Curricula in US Family Medicine Residency Programs.

Science.gov (United States)

Silk, Hugh; Savageau, Judith A; Sullivan, Kate; Sawosik, Gail; Wang, Min

2018-06-01

National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011. Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics. Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH (81% vs 96%) with fewer hours overall (31% vs 45% with 4 or more hours). Satisfaction with the competence of graduating residents in OH significantly decreased (17% in 2017 vs 32% in 2011). Program directors who report graduates being well prepared to answer board questions on oral health topics are more likely to have an oral health champion (P<0.001) and report satisfaction with the graduates' level of oral health competency (P<0.001). Programs with an oral health champion, or having a relationship with a state or national oral health coalition, or having routine teaching from a dental professional are significantly more likely to have more hours of oral health curriculum (P<0.001). Family medicine PDs are more aware of the importance of oral health, yet less oral health is being taught in residency programs. Developing more faculty oral health champions and connecting programs to dental faculty and coalitions may help reduce this educational void.

Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.

Science.gov (United States)

Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall

2014-04-01

Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

Female autonomy, the family, and industrialization in Java.

Science.gov (United States)

Wolf, D L

1988-03-01

It is generally argued that industrialization has an adverse affect on the position of women due to their exclusion from industrial employment and the resulting erosion of their status. This article addresses a case study of the question of gender stratification and industrialization by analyzing the relationship between factory daughters and their families in Java, Indonesia. From an initial 1-month daily survey of income and expenditures conducted among 14 workers in Nuwun, Wolf found that although they contributed 28% of their wages to the family, in cash or in kind, they overspent their wages by 40%. She then designed a more extensive survey, including questions about access to other income, debts, and savings. To determine if the relationship between daughters and family economy was related to residence, she expanded the survey to include 3 different groups of workers: commuters, migrants, and residents. Commuters lived with their parents in the agricultural village, Nuwan, and were the sole focus of the 1st income survey. Migrants were boarders in an industrialized village, Pamit, and residents walked to work. Single women are the focus of this paper due to the very different contribution daughters can potentially make to the family's welfare. The case study suggests that industrialization at the very least maintains, and may even enhance, female status within the family. To summarize, if a family can release a daughter for factory employment and can forgo the returns from her labor, there are eventual benefits for both the worker and her family. Worker-daughters are less of a financial burden on families. The savings provide surplus income that is not used for subsistence needs. Families gain tangible status goods that are displayed in the house and, at the same time, have access to insurance for crises and cash needs. Daughters, on the other hand, choose what to purchase and for whom. They gain prestige as donors of thoughtful gifts to family members, and

Parenting in low-income families from the perspective of social work

Directory of Open Access Journals (Sweden)

Banovcinova A.

2018-01-01

The goal of the study was to find how poverty affects parenting. For the data collection was used questionnaire Alabama Parenting Questionnaire (APQ, which measures parenthood through five dimensions (1 positive involvement with children, (2 Supervision and monitoring, (3 use of positive discipline techniques, (4 consistency in Theus of discipline chniques, (5 use of corporal punishment. The sample was divided into two groups, with the first group consisted of 188 parents living in poverty The reference group consisted of parents living in households with income standard (N−188.Analysis of the results showed differences between parents living in poverty and between parents with a standard rate of income especially in monitoring and supervision, and also in the use of positive disciplinary techniques. On the contrary, there were no significant differences in cooperation between the parents or the use of corporal punishment. Based on the results it is clear that poverty is one of the factors affecting parenting. Therefore, social worker who works with low-income families should focus attention on this area of family functioning.

Teaching-skills training programs for family medicine residents: systematic review of formats, content, and effects of existing programs.

Science.gov (United States)

Lacasse, Miriam; Ratnapalan, Savithiri

2009-09-01

To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs' effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are

Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

Science.gov (United States)

Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren

2009-04-01

The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must

Economic Stress and Cortisol Among Postpartum Low-Income Mexican American Women: Buffering Influence of Family Support.

Science.gov (United States)

Jewell, Shannon L; Luecken, Linda J; Gress-Smith, Jenna; Crnic, Keith A; Gonzales, Nancy A

2015-01-01

Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18-42; 82% Spanish-speaking; modal family income $10,000-$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6-week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress.

Association of Group Prenatal Care in US Family Medicine Residencies With Maternity Care Practice: A CERA Secondary Data Analysis.

Science.gov (United States)

Barr, Wendy B; Tong, Sebastian T; LeFevre, Nicholas M

2017-03-01

Group prenatal care has been shown to improve both maternal and neonatal outcomes. With increasing adaption of group prenatal care by family medicine residencies, this model may serve as a potential method to increase exposure to and interest in maternity care among trainees. This study aims to describe the penetration, regional and program variations, and potential impacts on future maternity care practice of group prenatal care in US family medicine residencies. The CAFM Educational Research Alliance (CERA) conducted a survey of all US family medicine residency program directors in 2013 containing questions about maternity care training. A secondary data analysis was completed to examine relevant data on group prenatal care in US family medicine residencies and maternity care practice patterns. 23.1% of family medicine residency programs report provision of group prenatal care. Programs with group prenatal care reported increased number of vaginal deliveries per resident. Controlling for average number of vaginal deliveries per resident, programs with group prenatal care had a 2.35 higher odds of having more than 10% of graduates practice obstetrics and a 2.93 higher odds of having at least one graduate in the past 5 years enter an obstetrics fellowship. Residency programs with group prenatal care models report more graduates entering OB fellowships and practicing maternity care. Implementing group prenatal care in residency training can be one method in a multifaceted approach to increasing maternity care practice among US family physicians.

The effects of job and family conditions on cumulative fatigue of working mothers in double income family.

OpenAIRE

Hirono Ishikawa

2000-01-01

The purpose of this study is to investigate the factors in the workplace and in the home which may have effects on cumulative fatigue, and to examine the moderating effect of the quality of family life on the relationship between job related stress and cumulative fatigue. The subject is the sample of working mothers with young children in double income family. Two hypotheses were examined in this study. First, higher level of job related stress and family related stress are both associated ...

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…

EDUCATION AND FAMILY INCOME: CAN POOR CHILDREN SIGNAL THEIR TALENT?

OpenAIRE

Gonzalo Olcina Vauteren; Luisa Escriche

2006-01-01

The aim of this paper is to explain how financial constraints and family background characteristics affect the signalling educational investments of individuals born in low-income families. We show that talented students who are poor are unable to signal their talent, as the maximum level of education they can attain may also be achieved by less talented students who are rich. Under this approach, a de-crease in inequalities across generations cannot be expected. The paper also shows that an ...

How do urology residents manage personal finances?

Science.gov (United States)

Teichman, J M; Bernheim, B D; Espinosa, E A; Cecconi, P P; Meyer, J; Pearle, M S; Preminger, G M; Leveillee, R J

2001-05-01

To examine personal financial management among residents to answer three research questions: do residents make reasonable financial choices; why do some residents not save; and what steps can be taken to improve residents' personal financial decisions. Portions of the Federal Reserve Board's Survey of Consumer Finances were modified and piloted to elicit demographic, expense, saving, and income data. The final questionnaire was completed by 151 urology residents at 20 programs. Comparing residents with the general population in the same age and income categories, the median debt/household income ratio was 2.38 versus 0.64. Residents had greater educational debt, greater noneducational debt, and lower savings. Resident participation in retirement accounts was 100% at institutions with employer-matching 401k or 403b plans, 63% at institutions with nonmatching 401k or 403b plans, and 48% at institutions without retirement plans for residents (P = 0.002). Fifty-nine percent of residents budgeted expenses, 27% had cash balances below $1000, 51% had paid interest charges on credit cards within the previous year, and 12% maintained unpaid credit card balances greater than $10,000. The median resident income was $38,400. A significant minority of residents appear not to make reasonable financial choices. Some residents save little because of a failure to budget, indebtedness, high projected income growth, or insufficient attention to personal financial management. Residents save more when they are eligible for tax-deferred retirement plans, particularly when their institution matches their contributions. Many residents would benefit from instruction concerning prudent financial management.

[Patient safety culture in Family practice residents of Galicia].

Science.gov (United States)

Portela Romero, Manuel; Bugarín González, Rosendo; Rodríguez Calvo, María Sol

To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. A cross-sectional study. Seven FP of Galicia teaching units. 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Choice of primary health care source in an urbanized low-income community in Singapore: a mixed-methods study.

Science.gov (United States)

Wee, Liang En; Lim, Li Yan; Shen, Tong; Lee, Elis Yuexian; Chia, Yet Hong; Tan, Andrew Yen Siong; Koh, Gerald Choon-Huat

2014-02-01

Cost and misperceptions may discourage lower income Singaporeans from utilizing primary care. We investigated sources of primary care in a low-income Singaporean community in a mixed-methods study. Residents of a low-income public rental flat neighbourhood were asked for sociodemographic details and preferred source of primary care relative to their higher income neighbours. In the qualitative component, interviewers elicited, from patients and health care providers, barriers/enablers to seeking care from Western-trained doctors. Interviewees were selected via purposive sampling. Transcripts were analyzed thematically, and iterative analysis was carried out using established qualitative method. Participation was 89.8% (359/400). Only 11.1% (40/359) preferred to approach Western-trained doctors, 29.5% (106/359) preferred alternative medicine, 6.7% (24/359) approached family/friends and 52.6% (189/359) preferred self-reliance. Comparing against higher income neighbours, rental flat residents were more likely to turn to alternative medicine and family members but less likely to turn to Western-trained doctors (P Self-reliance was perceived as acceptable for 'small' illnesses but not for 'big' ones, communal spirit was cited as a reason for consulting family/friends and social distance from primary care practitioners was highlighted as a reason for not consulting Western-trained doctors. Western-trained physicians are not the first choice of lower income Singaporeans for seeking primary care. Knowledge, primary care characteristics and costs were identified as potential barriers/enablers.

Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

Science.gov (United States)

Belek, I

2000-02-01

The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

Family income, maternal psychological distress and child socio-emotional behaviour: Longitudinal findings from the UK Millennium Cohort Study.

Science.gov (United States)

Noonan, Katharine; Burns, Richéal; Violato, Mara

2018-04-01

The association between low family income and socio-emotional behaviour problems in early childhood has been well-documented, and maternal psychological distress is highlighted as central in mediating this relationship. However, whether this relationship holds for older children, and the precise mechanisms by which income may influence child behaviour is unclear. This study investigated the relationship between family income and child socio-emotional behaviour at 11 years of age, and examined the mediating role of maternal psychological distress over time using the UK Millennium Cohort Study. The primary outcome was parent-reported behavioural problems, as captured by the Total Difficulties Score (TDS), derived from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcomes were the emotional, peer-related, conduct, and hyperactivity/inattention problems subscales of the SDQ; and teacher-reported TDS. Permanent family income was the primary exposure variable; frequency of poverty up to age 11 years was the secondary exposure variable. Maternal psychological distress was operationalised to reflect the trajectory from child birth to age 11. Multivariable logistic regression models were used to estimate the effect of permanent family income on child behaviour at age 11, controlling for maternal psychological distress and other relevant covariates. Results showed a statistically significant protective effect of increased permanent family income on the likelihood of behavioural problems at age 11. This finding was consistent for all SDQ subscales apart from emotional problems, and was strongest for teacher-reported behavioural problems. Maternal distress was an important mediator in the income-child behaviour relationship for parent-reported, but not teacher-reported, behavioural problems. The results of this study strengthen empirical evidence that the child behaviour-income gradient is maintained in older childhood. Mother's psychological distress

National income and income inequality, family affluence and life satisfaction among 13 year old boys and girls: a multilevel study in 35 countries

DEFF Research Database (Denmark)

Levin, Kate; Torsheim, Torbjørn; Vollebergh, Wilma

2011-01-01

Adolescence is a critical period where many patterns of health and health behaviour are formed. The objective of this study was to investigate cross-national variation in the relationship between family affluence and adolescent life satisfaction, and the impact of national income and income inequ...

Information for members of the personnel residing in the Canton of Vaud and who are required to complete the 2005 income tax declaration

CERN Document Server

HR Department

2006-01-01

CERN has recently been informed that the Swiss Federal tax authorities have still not authorised the Canton of Vaud to modify the taxation rules for members of the personnel residing in the Canton, in particular those of Swiss nationality, following the introduction of the internal taxation system at CERN. Pending a statement from the Federal tax authorities, the members of the personnel concerned are requested to complete the 2005 income tax declaration in compliance with the following instructions: Members of the personnel of Swiss nationality residing in the Canton of Vaud must complete the 2005 income tax declaration, declaring all their sources of income and assets, including the income they received from CERN (state the taxable amount as it appears in the annual certificate of internal taxation that you received in April). They must return their declaration forthwith to the relevant tax office. N.B.: they should write the following statement in the Comments section of the form, namely 'Membre du pers...

Are Self-study Procedural Teaching Methods Effective? A Pilot Study of a Family Medicine Residency Program.

Science.gov (United States)

Deffenbacher, Brandy; Langner, Shannon; Khodaee, Morteza

2017-11-01

A family medicine residency is a unique training environment where residents are exposed to care in multiple settings, across all ages. Procedures are an integral part of family medicine practice. Family medicine residency (FMR) programs are tasked with the job of teaching these skills at a level of intensity and frequency that allows a resident to achieve competency of such skills. In an environment that is limited by work hour restrictions, self-study teaching methods are one way to ensure all residents receive the fundamental knowledge of how to perform procedures. We developed and evaluated the efficacy of a self-study procedure teaching method and procedure evaluation checklist. A self-study procedure teaching intervention was created, consisting of instructional articles and videos on three procedures. To assess the efficacy of the intervention, and the competency of the residents, pre- and postintervention procedure performance sessions were completed. These sessions were reviewed and scored using a standardized procedure performance checklist. All 24 residents participated in the study. Overall, the resident procedure knowledge increased on two of the three procedures studied, and ability to perform procedure according to expert-validated checklist improved significantly on all procedures. A self-study intervention is a simple but effective way to increase and improve procedure training in a way that fits the complex scheduling needs of a residency training program. In addition, this study demonstrates that the procedure performance checklists are a simple and reliable way to increase assessment of resident procedure performance skills in a residency setting.

Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

Science.gov (United States)

DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

2007-01-01

PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

Family Income Loss and Economic Hardship: Antecedents of Adolescents' Problem Behavior.

Science.gov (United States)

Silbereisen, Rainer K.; And Others

1990-01-01

Results suggest that income loss leads to low family integration, which in turn increases adolescents' sensitivity to evaluation by peers. This can result in decreased self-esteem and an inclination to act against common rules and norms. (PCB)

Race, Income, and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training

Science.gov (United States)

Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall

2014-01-01

Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958

Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

Science.gov (United States)

Silk, Hugh; Shields, Sara

2012-01-01

Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

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...

Removing the Australian tax exemption on healthy food adds food stress to families vulnerable to poor nutrition.

Science.gov (United States)

Landrigan, Timothy J; Kerr, Deborah A; Dhaliwal, Satvinder S; Savage, Victoria; Pollard, Christina M

2017-12-01

To assess the impact of changing the Australian Goods and Services Tax (GST) on household food stress, which occurs when >25% of disposable income needs to be spent on food. Weekly healthy meal plan costs for average-income (AI), low-income (LI) and welfare-dependent (WDI) families were calculated using the 2013 Western Australian (WA) Food Access and Costs Survey. Four GST scenarios were compared: 1) status quo; 2) increasing GST to 15%; 3) expanding base to include exempt foods at 10% GST; and 4) expanding base to include exempt foods and increasing the tax to 15%. Single-parent families risk food stress regardless of their income or the GST scenario (requiring 24-42% of disposable income). The probability of food stress in Scenario 1 is 100% for WDI two-parent families and 36% for LI earners. In Scenarios 3 and 4, food stress probability is 60-72% for two-parent LI families and AI single-parent families, increasing to 88-94% if residing in very remote areas. There is food stress risk among single-parent, LI and WDI families, particularly those residing in very remote areas. Implications for public health: Expanding GST places an additional burden on people who are already vulnerable to poor nutrition and chronic disease due to their socioeconomic circumstances. © 2017 The Authors.

Family income, maternal psychological distress and child socio-emotional behaviour: Longitudinal findings from the UK Millennium Cohort Study

Directory of Open Access Journals (Sweden)

Katharine Noonan

2018-04-01

Full Text Available The association between low family income and socio-emotional behaviour problems in early childhood has been well-documented, and maternal psychological distress is highlighted as central in mediating this relationship. However, whether this relationship holds for older children, and the precise mechanisms by which income may influence child behaviour is unclear.This study investigated the relationship between family income and child socio-emotional behaviour at 11 years of age, and examined the mediating role of maternal psychological distress over time using the UK Millennium Cohort Study.The primary outcome was parent-reported behavioural problems, as captured by the Total Difficulties Score (TDS, derived from the Strengths and Difficulties Questionnaire (SDQ. Secondary outcomes were the emotional, peer-related, conduct, and hyperactivity/inattention problems subscales of the SDQ; and teacher-reported TDS. Permanent family income was the primary exposure variable; frequency of poverty up to age 11 years was the secondary exposure variable. Maternal psychological distress was operationalised to reflect the trajectory from child birth to age 11. Multivariable logistic regression models were used to estimate the effect of permanent family income on child behaviour at age 11, controlling for maternal psychological distress and other relevant covariates.Results showed a statistically significant protective effect of increased permanent family income on the likelihood of behavioural problems at age 11. This finding was consistent for all SDQ subscales apart from emotional problems, and was strongest for teacher-reported behavioural problems. Maternal distress was an important mediator in the income-child behaviour relationship for parent-reported, but not teacher-reported, behavioural problems.The results of this study strengthen empirical evidence that the child behaviour-income gradient is maintained in older childhood. Mother’s psychological

Family income, food prices, and household purchases of fruits and vegetables in Brazil.

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Claro, Rafael Moreira; Monteiro, Carlos Augusto

2010-12-01

To analyze the influence of family income and food prices on the participation of fruits and vegetables in the food purchases of Brazilian households. Data analyzed refers to the Household Budget Survey conducted by the Instituto Brasileiro de Geografia e Estatística on a probabilistic sample of 48,470 Brazilian households between 2002 and 2003. Fruit and vegetable participation in total food purchases was expressed as a percentage of total calories purchased and as calories from fruit and vegetables adjusted for total calories purchased. A multiple regression analysis was employed to estimate elasticity coefficients, controlling for sociodemographic variables and price of other foods. Fruit and vegetable participation in total food purchases increased as the price of these foods decreased, or as income increased. A 1% decrease in the price of fruit and vegetables would increase their participation by 0.79%, whereas a 1% increase in family income would increase participation by 0.27%. The effect of income tended to be smaller among higher income strata. Reducing the price of fruit and vegetables, either by supporting their production or through fiscal measures, is a promising public policy instrument, capable of increasing the participation of these foods in the diet of the Brazilian population.

"So we would all help pitch in:" The family literacy practices of low-income African American mothers of preschoolers.

Science.gov (United States)

Jarrett, Robin L; Hamilton, Megan-Brette; Coba-Rodriguez, Sarai

2015-01-01

The development of emergent literacy skills are important for the development of later literacy competencies and affect school readiness. Quantitative researchers document race- and social class-based disparities in emergent literacy competence between low-income African American and middle-income White children. Some researchers suggest that deficits in parenting practices account for limited literacy skills among low-income African American children. A small body of qualitative research on low-income African American families finds that despite economic challenges, some African American families were actively engaged in promoting child literacy development. Using qualitative interviews that emphasize family strengths, we add to this small body of research to highlight positive family practices obscured in many quantitative analyses that concentrate on family shortcomings. Specifically, we examine in-home literacy practices and child literacy development with a sample of low-income African American mothers (families) of preschoolers. Key findings include identification of various literacy activities promoting child literacy development and inclusion of multiple family members assisting in literacy activities. These findings add to substantive discussions of emergent literacy and resilience. Insights from the qualitative interviews also provide culturally-sensitive recommendations to childhood educators and speech-language pathologists (SLP) who work with low-income African American families and children. Reader should recognize that (1) there is not a 'right' phenotype and therefore not a right form of environmental input and (2) that context matters (at both the level of the cell and the individual organism). Copyright © 2015 Elsevier Inc. All rights reserved.

Supporting At-Risk Youth and Their Families to Manage and Prevent Diabetes: Developing a National Partnership of Medical Residency Programs and High Schools.

Science.gov (United States)

Gefter, Liana; Morioka-Douglas, Nancy; Srivastava, Ashini; Rodriguez, Eunice

2016-01-01

The Stanford Youth Diabetes Coaches Program (SYDCP) is a school based health program in which Family Medicine residents train healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. This study evaluates the impact of the SYDCP when disseminated to remote sites. Additionally, this study aims to assess perceived benefit of enhanced curriculum. From 2012-2015, 10 high schools and one summer camp in the US and Canada and five residency programs were selected to participate. Physicians and other health providers implemented the SYDCP with racial/ethnic-minority students from low-income communities. Student coaches completed pre- and posttest surveys which included knowledge, health behavior, and psychosocial asset questions (i.e., worth and resilience), as well as open-ended feedback questions. T-test pre-post comparisons were used to determine differences in knowledge and psychosocial assets, and open and axial coding methods were used to analyze qualitative data. A total of 216 participating high school students completed both pre-and posttests, and 96 nonparticipating students also completed pre- and posttests. Student coaches improved from pre- to posttest significantly on knowledge (pknowledge gain, pride in helping family members, improved relationships and connectedness with family members, and lifestyle improvements. Overall, when disseminated, this program can increase health knowledge and some psychosocial assets of at-risk youth and holds promise to empower these youth with health literacy and encourage them to adopt healthy behaviors.

Personal finances of residents at three Canadian universities.

Science.gov (United States)

Teichman, Joel M H; Matsumoto, Edward; Smart, Michael; Smith, Aspen E; Tongco, Wayne; Hosking, Denis E; MacNeily, Andrew E; Jewett, Michael A S

2005-02-01

To address 3 research questions (What financial choices do residents make? Are the financial choices of residents similar to those of the general public? Are the financial choices of surgical residents reasonable?), we examined financial data from Canadian residents. A written survey was administered to 338 residents (103 of them surgical residents) at 3 Canadian training institutions (University of Toronto, Queen's University and University of Manitoba). Resident household cash flows, assets and liabilities were characterized. Finances for residents were compared with those of the general public, by means of the Survey of Household Spending and Survey of Financial Security. Median resident income was 45,000 dollars annually (Can dollars throughout). With a working spouse, median household income was 87,500 dollars. Among residents, 62% had educational debt (median 37,500 dollars), 39% maintained unpaid credit-card balances (median 1750 dollars), 36% did not budget expenses, 25% maintained cash reserves card debts (39% v. 50%, respectively). Surgical residents had income expectations after graduation higher than current billings justified. Fewer surgical (69%) than anesthesiology residents (88%, p card debts. Surgical residents' expectations of future income may be unrealistic. Further study is warranted.

Childhood family income and life outcomes in adulthood: findings from a 30-year longitudinal study in New Zealand.

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Gibb, Sheree J; Fergusson, David M; Horwood, L John

2012-06-01

The aims of this study were to use data gathered over the course of a 30-year longitudinal study to examine the linkages between economic circumstances in childhood and subsequent developmental outcomes spanning educational achievement; economic circumstances; crime; mental health; and teenage pregnancy. All of these outcomes have been linked with childhood economic conditions and it is frequently argued that reducing income inequalities will mitigate psychosocial risks of children reared in families facing economic hardship. Alternatively it may be suggested that the associations between childhood family economic circumstances and later outcomes are mediated by individual, family and social factors that are correlated with low family income and contribute to later outcomes. To examine these issues, data were drawn from a birth cohort of New Zealand children born in 1977 and followed to age 30. Declining childhood family income was associated with a range of negative outcomes in adulthood, including: lower educational achievement; poorer economic circumstances; higher rates of criminal offending; higher rates of mental health problems; and higher rates of teenage pregnancy. After covariate adjustment, childhood family income remained significantly associated with educational achievement and economic circumstances, but was no longer significantly associated with the mental health, offending and teenage pregnancy outcomes. These findings suggest that, after due allowance has been made for social, family and individual contextual factors, low family income during childhood is associated with a range of educational and economic disadvantages in adulthood but is not directly related to increased risks of crime, mental health problems or teen pregnancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

The family context of low-income parents who restrict child screen time.

Science.gov (United States)

Lampard, Amy M; Jurkowski, Janine M; Davison, Kirsten K

2013-10-01

The American Academy of Pediatrics recommends that parents restrict child screen time to two hours per day, but many preschool-aged children exceed this viewing recommendation. Modifying children's viewing habits will require collaborating with parents, but little is known about the factors that influence parents' capacity for effective screen-related parenting. This study aimed to identify the demographic, family and community contextual factors associated with low-income parents' restriction of child screen time. Parents (N=146) of children (age 2-5 years) attending Head Start centers in the United States completed a self-report survey in 2010 assessing parent and child screen use (television, DVD, video, video games, and leisure-time computer use), parent restriction of child screen time, and family (parent stress, social support, and life pressures) and community (neighborhood safety and social capital) factors. Children were more likely to meet the American Academy of Pediatrics screen time recommendation if their parent reported high restriction of child screen time. Parent and child demographic characteristics were not associated with parents' restriction of child screen time. In multivariate analysis, less parent screen time, fewer parent life pressures, and greater social support were associated with parents' high restriction of screen time. Family contextual factors may play an important role in enabling low-income parents to restrict their children's screen time. When counseling low-income parents about the importance of restricting child screen time, practitioners should be sensitive to family contextual factors that may influence parents' capacity to implement this behavior change.

NON-MUSCULOSKELETAL SPORTS MEDICINE LEARNING IN FAMILY MEDICINE RESIDENCY PROGRAMS

Directory of Open Access Journals (Sweden)

Pasqualino Caputo

2008-06-01

Full Text Available Despite the increasing popularity of primary care sports medicine fellowships, as evidenced by the more than two-fold increase in family medicine sports medicine fellowships from a total of 31 accredited programs during the 1998/1999 academic year (ACGME, 1998 to 63 during the 2003/2004 academic year (ACGME, 2006, there are few empirical studies to support the efficacy of such programs. To the best of our knowledge, no studies have been conducted to assess the impact of primary care sports medicine fellowships on family medicine residents' learning of non-musculoskeletal sports medicine topics. Rigorous evaluations of the outcomes of such programs are helpful to document the value of such programs to both the lay public and interested medical residents. In order to evaluate such programs, it is helpful to apply the same objective standards to residents trained across multiple programs. Hence, we would like to know if there is a learning effect with respect to non-musculoskeletal sports medicine topics identified on yearly administered American Board of Family Medicine (ABFM in-training exams (ITE to family medicine residents in family medicine residency programs in the United States with and without primary care sports medicine fellowship programs. Review and approval for the research proposal was granted by the ABFM, who also allowed access to the required data. Permission to study and report only non-musculoskeletal sports medicine topics excluding musculoskeletal topics was granted at the time due to other ongoing projects at the ABFM involving musculoskeletal topics. ABFM allowed us access to examinations from 1998 to 2003. We were given copies of each exam and records of responses to each item (correct or incorrect by each examinee (examinees were anonymous for each year.For each year, each examinee was classified by the ABFM as either (a belonging to a program that contained a sports medicine fellowship, or (b not belonging to a program

Training the "assertive practitioner of behavioral science": advancing a behavioral medicine track in a family medicine residency.

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Butler, Dennis J; Holloway, Richard L; Fons, Dominique

2013-01-01

This article describes the development of a Behavioral Medicine track in a family medicine residency designed to train physicians to proactively and consistently apply advanced skills in psychosocial medicine, psychiatric care, and behavioral medicine. The Behavioral Medicine track emerged from a behavioral science visioning retreat, an opportunity to restructure residency training, a comparative family medicine-psychiatry model, and qualified residents with high interest in behavioral science. Training was restructured to increase rotational opportunities in core behavioral science areas and track residents were provided an intensive longitudinal counseling seminar and received advanced training in psychopharmacology, case supervision, and mindfulness. The availability of a Behavioral Medicine track increased medical student interest in the residency program and four residents have completed the track. All track residents have presented medical Grand Rounds on behavioral science topics and have lead multiple workshops or research sessions at national meetings. Graduate responses indicate effective integration of behavioral medicine skills and abilities in practice, consistent use of brief counseling skills, and good confidence in treating common psychiatric disorders. As developed and structured, the Behavioral Medicine track has achieved the goal of producing "assertive practitioners of behavioral science in family medicine" residents with advanced behavioral science skills and abilities who globally integrate behavioral science into primary care.

A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

Science.gov (United States)

Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-01-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and/or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility — more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. PMID:21225585

Trajectory of Material Hardship and Income Poverty in Families of Children Undergoing Chemotherapy: A Prospective Cohort Study.

Science.gov (United States)

Bona, Kira; London, Wendy B; Guo, Dongjing; Frank, Deborah A; Wolfe, Joanne

2016-01-01

Poverty is correlated with negative health outcomes in pediatric primary care, and is emerging as a negative prognostic indicator in pediatric oncology. However, measures of poverty amenable to targeted intervention, such as household material hardship (HMH)--including food, energy, and housing insecurity--have not been described in pediatric oncology. We describe the trajectory of family reported HMH and income poverty at a pediatric oncology referral center in New England with high psychosocial supports. Single site, prospective cohort study including 99 English-speaking families of children receiving chemotherapy for primary cancer. Families completed face-to-face surveys at two time-points: (1) Within 30 days of child's diagnosis (T1) (N = 99, response rate 88%); (2) 6-months following diagnosis (T2) (N = 93, response rate 94%). HMH was assessed in three domains: food, energy, and housing insecurity. Twenty percent of families reported low-income (≤200% Federal Poverty Level) and at least one HMH prior to their child's diagnosis. At T2, 25% of families lost >40% annual household income secondary to treatment-related work disruptions, and 29% of families reported HMH despite utilization of psychosocial supports. Low-income and HMH are prevalent in a significant proportion of newly diagnosed pediatric oncology families at a large referral center. Despite psychosocial supports, the proportion of families experiencing unmet basic needs increases during chemotherapy to nearly one in three families. HMH provides a quantifiable and remediable measure of poverty in pediatric oncology. Interventions to ameliorate this concrete component of poverty could benefit a significant proportion of pediatric oncology families. © 2015 Wiley Periodicals, Inc.

Income pooling within families

DEFF Research Database (Denmark)

Bonke, Jens; Uldall-Poulsen, Hans

This paper analyses the phenomenon of income-pooling by applying the Danish household expenditure survey, merged with authoritative register information. Responses to additional questions on income sharing among 1696 couples also allows us to analyses whether the intra-household distribution...

"Maintaining connections but wanting more": the continuity of familial relationships among assisted-living residents.

Science.gov (United States)

Tompkins, Catherine J; Ihara, Emily S; Cusick, Alison; Park, Nan Sook

2012-01-01

Social support is a key component of well-being for older adults, particularly for those who have moved from independent living to assisted living involving a transformation of roles, relationships, and responsibilities. Twenty-nine assisted-living facility residents were interviewed to understand the perceived continuity of relationships with family and friends. An inductive approach to thematic analysis revealed 1 main theme and 3 subthemes. The main theme that emerged was: maintaining connections but wanting more. Residents appreciated maintaining connections with family and friends, but often expressed feelings of discontentment with the continuity of former relationships. The subthemes included: appreciating family and friends, waiting for more, and losing control. Implications for research and practice are discussed.

The Importance of Family Income in the Formation and Evolution of Non-Cognitive Skills in Childhood

OpenAIRE

Jason M. Fletcher; Barbara Wolfe

2012-01-01

There is a well known positive association between family income and children's development, including health and academic performance. This relationship is a potentially importance factor in the intergenerational transmission of socioeconomic status and has been shown to be a robust finding across countries and time periods. In contrast, much less is known about the relationship between family income and other domains of children's development, such as noncognitive (or socio-emotional) skill...

The effect of a simple educational intervention on interest in early abortion training among family medicine residents.

Science.gov (United States)

Wu, Justine P; Bennett, Ian; Levine, Jeffrey P; Aguirre, Abigail Calkins; Bellamy, Scarlett; Fleischman, Joan

2006-06-01

We aimed to assess the effect of an educational intervention on the interest in and support for abortion training among family medicine residents. We conducted a cross-sectional survey before and after an educational lecture on medical and surgical abortion in primary care among 89 residents in 10 New Jersey family medicine programs. Before the lecture, there was more interest in medical abortion training than surgical abortion. Resident interest in surgical abortion and overall support for abortion training increased after the educational intervention (p<.01). Efforts to develop educational programs on early abortion care may facilitate the integration of abortion training in family medicine.

Improving family medicine resident training in dementia care: an experiential learning opportunity in Primary Care Collaborative Memory Clinics.

Science.gov (United States)

Lee, Linda; Weston, W Wayne; Hillier, Loretta; Archibald, Douglas; Lee, Joseph

2018-06-21

Family physicians often find themselves inadequately prepared to manage dementia. This article describes the curriculum for a resident training intervention in Primary Care Collaborative Memory Clinics (PCCMC), outlines its underlying educational principles, and examines its impact on residents' ability to provide dementia care. PCCMCs are family physician-led interprofessional clinic teams that provide evidence-informed comprehensive assessment and management of memory concerns. Within PCCMCs residents learn to apply a structured approach to assessment, diagnosis, and management; training consists of a tutorial covering various topics related to dementia followed by work-based learning within the clinic. Significantly more residents who trained in PCCMCs (sample = 98), as compared to those in usual training programs (sample = 35), reported positive changes in knowledge, ability, and confidence in ability to assess and manage memory problems. The PCCMC training intervention for family medicine residents provides a significant opportunity for residents to learn about best clinical practices and interprofessional care needed for optimal dementia care integrated within primary care practice.

National Income and Income Inequality, Family Affluence and Life Satisfaction among 13 Year Old Boys and Girls: A Multilevel Study in 35 Countries

Science.gov (United States)

Levin, Kate Ann; Torsheim, Torbjorn; Vollebergh, Wilma; Richter, Matthias; Davies, Carolyn A.; Schnohr, Christina W.; Due, Pernille; Currie, Candace

2011-01-01

Adolescence is a critical period where many patterns of health and health behaviour are formed. The objective of this study was to investigate cross-national variation in the relationship between family affluence and adolescent life satisfaction, and the impact of national income and income inequality on this relationship. Data from the 2006…

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…

Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

Science.gov (United States)

Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

2015-06-01

New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

Reducing Income Transfers to Refugee Immigrants

DEFF Research Database (Denmark)

Rosholm, Michael; Vejlin, Rune Majlund

2010-01-01

We estimate the effect of lowering income transfers to refugee immigrants in Denmark - labeled start-help - using a competing risk framework. Refugee immigrants obtaining residence permit before July 2002 received larger income transfers than those who obtained their residence permit later...

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.

Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013

Science.gov (United States)

Chuang, Emmeline; Aftosmes-Tobio, Alyssa; Blaine, Rachel E.; Giannetti, Mary; Land, Thomas; Davison, Kirsten K.

2015-01-01

Introduction The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM). Methods From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized. Results Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors. Conclusion The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity. PMID

Behavioral science priorities in residency education: The perspective of practicing family physicians.

Science.gov (United States)

Brandt-Kreutz, Richard L; Ferguson, Kyle E; Sawyer, Devin

2015-12-01

The family medicine residency behavioral science curriculum is more effective if prioritized to match what is needed in practice after graduation. Two prior studies (Kendall, Marvel, & Cruickshank, 2003; Marvel & Major, 1999) identified physician priorities for behavioral science education. The present study extends this research to include topics from more recent curriculum guidelines and examines the extent to which size of community and perceived competence correlate with prioritization of Washington state family physicians. Practicing family physicians in Washington state (N = 2,270) were invited to complete the survey. Respondents provided demographic and practice information. Respondents then rated, on a scale from 1 to 4, 35 behavioral science topics on 2 different scales including (a) priority to be given in residency education and (b) perceived level of competence. A total of 486 responded and 430 completed both priority and competence scales for a response rate of 19%. The top half of 35 topics of the present study included the top 13 topics found in the 2 prior studies. Priority and competence scales were moderately correlated (r = .48, n = 430, p = .001). There was a small significant correlation with size of community and priority ratings (r = .13, n = 435, p = .006). Family physicians in Washington state prioritize behavioral science topics in residency education similar to Colorado and Mississippi. The results of this study support recent ACGME guidelines, in that training should focus on common psychiatric illnesses, including depression and anxiety, and interpersonal processes. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

The association between racial and gender discrimination and body mass index among residents living in lower-income housing.

Science.gov (United States)

Shelton, Rachel C; Puleo, Elaine; Bennett, Gary G; McNeill, Lorna H; Sorensen, Glorian; Emmons, Karen M

2009-01-01

Research on the association between self-reported racial or gender discrimination and body mass index (BMI) has been limited and inconclusive to date, particularly among lower-income populations. The aim of the current study was to examine the association between self-reported racial and gender discrimination and BMI among a sample of adult residents living in 12 urban lower-income housing sites in Boston, Masschusetts (USA). Baseline survey data were collected among 1,307 (weighted N = 1907) study participants. For analyses, linear regression models with a cluster design were conducted using SUDAAN and SAS statistical software. Our sample was predominately Black (weighted n = 956) and Hispanic (weighted n = 857), and female (weighted n = 1420), with a mean age of 49.3 (SE: .40) and mean BMI of 30.2 kg m(-2) (SE: .19). Nearly 47% of participants reported ever experiencing racial discrimination, and 24.8% reported ever experiencing gender discrimination. In bivariate and multivariable linear regression models, no main effect association was found between either racial or gender discrimination and BMI. While our findings suggest that self-reported discrimination is not a key determinant of BMI among lower-income housing residents, these results should be considered in light of study limitations. Future researchers may want to investigate this association among other relevant samples, and other social contextual and cultural factors should be explored to understand how they contribute to disparities.

Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.

Science.gov (United States)

Falcone, John L; Middleton, Donald B

2013-01-01

The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location. In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05. Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.

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

2012-01-01

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…

Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently.

Science.gov (United States)

Bramsved, Rebecka; Regber, Susann; Novak, Daniel; Mehlig, Kirsten; Lissner, Lauren; Mårild, Staffan

2018-01-07

This study investigated the effects of two parental socio-economic characteristics, education and income, on growth and risk of obesity in children from birth to 8 years of age. Longitudinal growth data and national register-based information on socio-economic characteristics were available for 3,030 Swedish children. The development of body mass index (BMI) and height was compared in groups dichotomised by parental education and income. Low parental education was associated with a higher BMI from 4 years of age, independent of income, immigrant background, maternal BMI and smoking during pregnancy. Low family income was associated with a lower birthweight, but did not independently predict BMI development. At 8 years of age, children from less educated families had a three times higher risk of obesity, independent of parental income. Children whose parents had fewer years of education but high income had significantly higher height than all other children. Parental education protected against childhood obesity, even after adjusting for income and other important parental characteristics. Income-related differences in height, despite similar BMIs, raise questions about body composition and metabolic risk profiles. The dominant role of education underscores the value of health literacy initiatives for the parents of young children. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Expectations of clinical teachers and faculty regarding development of the CanMEDS-Family Medicine competencies: Laval developmental benchmarks scale for family medicine residency training.

Science.gov (United States)

Lacasse, Miriam; Théorêt, Johanne; Tessier, Sylvie; Arsenault, Louise

2014-01-01

The CanMEDS-Family Medicine (CanMEDS-FM) framework defines the expected terminal enabling competencies (EC) for family medicine (FM) residency training in Canada. However, benchmarks throughout the 2-year program are not yet defined. This study aimed to identify expected time frames for achievement of the CanMEDS-FM competencies during FM residency training and create a developmental benchmarks scale for family medicine residency training. This 2011-2012 study followed a Delphi methodology. Selected faculty and clinical teachers identified, via questionnaire, the expected time of EC achievement from beginning of residency to one year in practice (0, 6, 12, […] 36 months). The 15-85th percentile intervals became the expected competency achievement interval. Content validity of the obtained benchmarks was assessed through a second Delphi round. The 1st and 2nd rounds were completed by 33 and 27 respondents, respectively. A developmental benchmarks scale was designed after the 1st round to illustrate expectations regarding achievement of each EC. The 2nd round (content validation) led to minor adjustments (1.9±2.7 months) of intervals for 44 of the 92 competencies, the others remaining unchanged. The Laval Developmental Benchmarks Scale for Family Medicine clarifies expectations regarding achievement of competencies throughout FM training. In a competency-based education system this now allows identification and management of outlying residents, both those excelling and needing remediation. Further research should focus on assessment of the scale reliability after pilot implementation in family medicine clinical teaching units at Laval University, and corroborate the established timeline in other sites.

Introduction of handheld computing to a family practice residency program.

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Rao, Goutham

2002-01-01

Handheld computers are valuable practice tools. It is important for residency programs to introduce their trainees and faculty to this technology. This article describes a formal strategy to introduce handheld computing to a family practice residency program. Objectives were selected for the handheld computer training program that reflected skills physicians would find useful in practice. TRGpro handheld computers preloaded with a suite of medical reference programs, a medical calculator, and a database program were supplied to participants. Training consisted of four 1-hour modules each with a written evaluation quiz. Participants completed a self-assessment questionnaire after the program to determine their ability to meet each objective. Sixty of the 62 participants successfully completed the training program. The mean composite score on quizzes was 36 of 40 (90%), with no significant differences by level of residency training. The mean self-ratings of participants across all objectives was 3.31 of 4.00. Third-year residents had higher mean self-ratings than others (mean of group, 3.62). Participants were very comfortable with practical skills, such as using drug reference software, and less comfortable with theory, such as knowing the different types of handheld computers available. Structured training is a successful strategy for introducing handheld computing to a residency program.

24 CFR 5.611 - Adjusted income.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income (as...

Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: a qualitative study.

Science.gov (United States)

Ho, Ka Yan; Li, William H C; Chung, Joyce Oi Kwan; Lam, Katherine Ka Wai; Chan, Sophia S C; Xia, Wei

2016-01-01

Despite compelling evidence demonstrating the negative impact of poverty and income disparity on children's psychological well-being, there has been a lack of qualitative information which addresses its contributing factors. This study aimed to shed light on this area by comparing the experiences toward daily life between children living in low- and high-income families. A qualitative study using a phenomenological approach was conducted from May 2012 to January 2013. A random sample of 42 children aged 10-13, with 25 from low- and 17 from high-income families were asked to voluntarily response to a demographic sheet and undergo individual semi-structured interviews which lasted about 25-30 min. Content analysis was used to analyze the data. Approval for the study was obtained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (reference UW 12-237). The findings of this study revealed that the living environment, physical health, social life and ability to function at school of children from low-income families are severely impaired. It fills a gap in the literature by showing how poverty and income disparity affect the daily lives of children from low-income families on different levels. Also, adopting a sedentary lifestyle and unhealthy eating habits are possible factors mediating the effects of poverty and income disparity on the psychological well-being of children from low-income families. It is vital for healthcare professionals going beyond their normal roles to give advice on healthy lifestyles and behaviors by building multidisciplinary partnerships with schools and the community. Additionally, healthcare professionals should also target on these two possible factors to develop and implement appropriate interventions for promoting the psychological well-being among children living in poverty. Trial registration NCT02877719. 19 August 2016 retrospectively registered.

Does empowering resident families or nursing home employees in decision making improve service quality?

Science.gov (United States)

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework.

Science.gov (United States)

Chen, Luke Y C; Hubinette, Maria M

2017-08-01

Classroom-based learning such as academic half day has undervalued social aspects. We sought to explore its role in the professional identity development of family medicine residents. In this case study, residents and faculty from four training sites in the University of British Columbia Department of Family Practice were interviewed. The "experiences, trajectories, and reifications (ETR) framework" was used as a sensitizing tool for modified inductive (thematic) analysis of the transcripts. Classroom-based learning provided a different context for residents' interpretation of their clinical experiences, characterized as a "home base" for rotating urban residents, and a connection to a larger academic community for residents in rural training sites. Both these aspects were important in creating a positive trajectory of professional identity formation. Teaching directed at the learning needs of family physicians, and participation of family practice faculty as teachers and role models was a precipitation of a curriculum "centered in family medicine." Interactions between family medicine residents and faculty in the classroom facilitated the necessary engagements to reify a shared understanding of the discipline of family practice. Classroom-based learning has substantial impact on professional identity formation at an individual and collective level.

Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma.

Science.gov (United States)

Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M

2010-12-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children's symptoms of trauma-related distress.

Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

Science.gov (United States)

Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A

2007-01-01

Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.

Who are the fathers in Healthy Families Arizona? An examination of father data in at-risk families.

Science.gov (United States)

Shapiro, Alyson F; Krysik, Judy; Pennar, Amy L

2011-07-01

Despite substantial research documenting the importance of father-child relations, little is known about fathers in families considered at risk for child abuse, and this lack of information makes adequate targeting of fathers in interventions challenging. This research aims to provide information that will aid interventions in targeting fathers and addressing father-related family issues through: (a) providing descriptive information regarding fathers in families at risk for child abuse, and (b) examining aspects of family well-being relative to father involvement. Analyses were conducted on mother-report data in families eligible for the Healthy Families Arizona prevention program (N = 197). Results indicated that although only 15% of parents in the sample were married, 47% of families had resident fathers, and 77% of fathers had some contact with their new babies. Families with greater father involvement had better prenatal care, higher incomes, less maternal involvement in Child Protective Services, less physical domestic violence (DV), and greater maternal mental health reflected through less loneliness. These findings have implications for targeting nonresident as well as resident fathers in families at risk for child abuse and for exploring DV issues in families with noninvolved fathers. © 2011 American Orthopsychiatric Association.

Beyond Income Poverty: Measuring Disadvantage in Terms of Material Hardship and Health.

Science.gov (United States)

Neckerman, Kathryn M; Garfinkel, Irwin; Teitler, Julien O; Waldfogel, Jane; Wimer, Christopher

2016-04-01

The New York City (NYC) Longitudinal Study of Wellbeing, or "Poverty Tracker," is a survey of approximately 2300 NYC residents. Its purpose is to provide a multidimensional and dynamic understanding of economic disadvantage in NYC. Measures of disadvantage were collected at baseline and a 12-month follow-up, and include 3 types of disadvantage: 1) income poverty, using a measure on the basis of the new Supplemental Poverty Measure; 2) material hardship, including indicators of food insecurity, housing hardship, unmet medical needs, utility cutoffs, and financial insecurity; and 3) adult health problems, which can drain family time and resources. In this article initial results for NYC families with children younger than the age of 18 years are presented. At baseline, 56% of families with children had 1 or more type of disadvantage, including 28% with income poverty, 39% with material hardship, and 17% with an adult health problem. Even among nonpoor families, 33% experienced material hardship and 14% reported an adult health problem. Two-thirds of all families faced disadvantage at either baseline or follow-up, with 46% experiencing some kind of disadvantage at both time points. Respondents with a college education were much less likely to face disadvantage. Even after adjusting for educational attainment and family characteristics, the families of black and Hispanic respondents had increased rates of disadvantage. Considering income poverty alone the extent of disadvantage among families with children in NYC is greatly understated. These results suggest that in addition to addressing income poverty, policymakers should give priority to efforts to reduce material hardship and help families cope with chronic physical or mental illness. The need for these resources extends far above the poverty line. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

Science.gov (United States)

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-12-01

The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. To identify these challenges within these clinics, as well as potential strategies to address them. The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents' patient; 2) managing and balancing residents' appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents' patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models.

Association between women's autonomy and family planning outcome in couples residing in Isfahan

Science.gov (United States)

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-01-01

Background: One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. Materials and Methods: This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. Results: The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Conclusions: Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples’ family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration. PMID:25400671

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

Science.gov (United States)

da Silva, Jaqueline Aragoni; da Silva, Kelly Samara; Del Duca, Giovani Firpo; Dos Santos, Priscila Cristina; Wolker, Sofia; de Oliveira, Elusa Santina Antunes; de Barros, Mauro Virgílio Gomes; Nahas, Markus Vinicius

2016-06-01

To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults. Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied. The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata. There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting. Copyright © 2016 Elsevier Inc. All rights reserved.

Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

Science.gov (United States)

Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

2010-09-01

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

Long-term housing subsidies and SSI/SSDI income: Creating health-promoting contexts for families experiencing housing instability with disabilities.

Science.gov (United States)

Glendening, Zachary S; McCauley, Erin; Shinn, Marybeth; Brown, Scott R

2018-04-01

Though disability and housing instability are discussed separately in public health literature, few studies address families at their intersection. As a result, little is known about families who experience both homelessness and disability, how many receive disability benefits like SSI and SSDI, or the influence of those benefits on health-promoting outcomes like housing stability and self-sufficiency. Moreover, no previous research compares the ability of different housing and service interventions to increase disability benefit access. We examine relationships between disabilities and SSI/SSDI income reported when families enter emergency shelters and later health-promoting outcomes (housing stability and self-sufficiency) and how housing interventions affect SSI/SSDI receipt. Families in the (name removed) Study (N = 1857) were interviewed in emergency shelters, randomly offered of one of three housing interventions or usual care (i.e., no immediate referral to any intervention beyond shelter), and re-interviewed 20 months later. A third of families reported a disability at shelter entry. SSI/SSDI coverage of these families increased nearly 10% points over 20 months but never exceeded 40%. Disabilities predicted greater housing instability, food insecurity, and economic stress and less work and income. Among families reporting disabilities, SSI/SSDI receipt predicted fewer returns to emergency shelter, and more income despite less work. Offers of long-term housing subsidies increased SSI/SSDI receipt. Many families experiencing homelessness have disabilities; those receiving SSI/SSDI benefits have better housing and income outcomes. Providing families experiencing homelessness with long-term housing subsidies and SSI/SSDI could improve public health. Copyright © 2017 Elsevier Inc. All rights reserved.

LIVELIHOOD DIVERSIFICATION AND INCOME: A CASE STUDY OF COMMUNITIES RESIDENT ALONG THE KIRI DAM, ADAMAWA STATE, NIGERIA

Directory of Open Access Journals (Sweden)

Michael Amurtiya

2016-12-01

Full Text Available This research analysed livelihood diversifi cation and income in resident communities along the Kiri Dam, Adamawa state, Nigeria. The specifi c objectives of the study were: to describe the socio-economic characteristics of the respondents, assess the level of livelihood diversifi cation of the respondents, analyse income of the respondents, identify factors associated with varying levels of income, and identify constraints to livelihood diversifi cation in the area. A multistage sampling technique was used to collect primary data from 120 respondents from the study area. The data collected were subjected to descriptive and inferential statistical analysis. The results showed that the majority of the respondents were male (78%, married (76%, educated (70%, below 60 years of age (93% and employed in agricultural activities (83%. The Simpson index of diversifi cation shows that 43% of the respondents diversify at an average level. The majority (60% of the respondents’ annual income is over ₦ 200,000. The ordinary least square estimation shows that age, marital status, education, irrigation activities, fi shing, farm size and level of diversifi cation aff ect income level in the area. The main constraints to diversifi ed livelihood in the area were a lack of basic social infrastructure, a hippopotamus menace and fl ooding. The study recommended the provision of social infrastructure and the control of hippopotamuses. 

24 CFR 960.505 - Occupancy by police officers to provide security for public housing residents.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Occupancy by police officers to... HOUSING Occupancy by Over-Income Families or Police Officers § 960.505 Occupancy by police officers to provide security for public housing residents. (a) Police officer. For purpose of this subpart E, “police...

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries : A Systematic Review

NARCIS (Netherlands)

Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.

2016-01-01

Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions

A Test of the Family Stress Model on Toddler-Aged Children's Adjustment among Hurricane Katrina Impacted and Nonimpacted Low-Income Families

Science.gov (United States)

Scaramella, Laura V.; Sohr-Preston, Sara L.; Callahan, Kristin L.; Mirabile, Scott P.

2008-01-01

Hurricane Katrina dramatically altered the level of social and environmental stressors for the residents of the New Orleans area. The Family Stress Model describes a process whereby felt financial strain undermines parents' mental health, the quality of family relationships, and child adjustment. Our study considered the extent to which the Family…

24 CFR 982.516 - Family income and composition: Regular and interim examinations.

Science.gov (United States)

2010-04-01

... VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.516 Family income and composition: Regular and... assistance payment. (For a voucher tenancy, the housing assistance payment shall be calculated in accordance... the housing assistance payment resulting from an interim redetermination. (2) At the effective date of...

Marginal Effects of a Gross Income Increase for a Single Parent Family in Six European Countries

DEFF Research Database (Denmark)

Willumsen, Marie

the contributions to the combined marginal rate, the marginal effective tax rate, METR, using the OECD term, from taxation, payment for childcare, tapering of housing benefits and sometimes child benefits, when the income varies from a low level to a high level for a single parent family. Six countries are included......High marginal tax rates constitute an issue in several countries because they are supposed to create barriers for increased labour supply. It is, however, often the case that relatively low income families with children face substantially higher combined marginal rates than even the highest...

CDM pilot project to stimulate market for family-hydro for low-income households

International Nuclear Information System (INIS)

2004-01-01

Over 100,000 low-income households living in rural, rice-farming regions of Vietnam and China rely upon family-hydro (between 100 and 200W) as the only affordable means of obtaining electricity. These systems are used for domestic lighting, radio and, in some cases, televisions. The units are small, cheap and are usually installed and owned by a single family. Funding from the CDM could be utilised in order to reduce the cost of good quality equipment to provide low-income households living in isolated off-grid locations with an affordable and sustainable electricity supply which can meet their needs for lighting, educational, productive and recreational uses. Therefore research was needed to determine the level of carbon emission reductions resulting from their use. The successful acceptance by the Prototype Carbon Fund (PCF) of the methodology of establishing the benchmark developed during this project could then be used as a precedent by other project developers in the future, thus being of long-term support to the emerging family-hydro industry. (author)

Race, Poverty and SAT Scores: Modeling the Influences of Family Income on Black and White High School Students' SAT Performance

Science.gov (United States)

Dixon-Roman, Ezekiel J.; Everson, Howard T.; McArdle, John J.

2013-01-01

Background: Educational policy makers and test critics often assert that standardized test scores are strongly influenced by factors beyond individual differences in academic achievement such as family income and wealth. Unfortunately, few empirical studies consider the simultaneous and related influences of family income, parental education, and…

Newborn well-child visits in the home setting: a pilot study in a family medicine residency.

Science.gov (United States)

Lakin, Ashley; Sutter, Mary Beth; Magee, Susanna

2015-03-01

The purpose of our study was to pilot a home visit program targeting neonates conducted by family medicine residents. While the literature shows that home visit programs are successful at preventing adverse outcomes for young children, such as improving parenting practices and promoting breastfeeding, no data exist about newborn home visits conducted by resident physicians. Residents conducted newborn home visits precepted by a family medicine faculty member from June 2012--May 2013. Subjects were recruited from the residency continuity practice and randomized to receive two home visits (which replaced two office visits) or routine office-based newborn care. All participants were surveyed using the validated WHOQOL-BREF quality of life scale and a patient satisfaction instrument. Metrics were also obtained from the electronic medical record. Mothers and resident physicians completed an open-ended questionnaire about their experience. All patients, whether receiving office-based or home-based care, rated their care highly. Significant differences were seen in usage of acute care in the first 6 months of life, and mothers in the home visit group trended toward initiating breastfeeding at a higher rate. The home visit group ranked their quality of life higher across all domains when compared to the control group, approaching statistical significance in two domains. Residents providing home visits reported increased connectedness to patients and improved confidence in anticipatory guidance delivery. Home visits are valuable for families with newborns, in terms of minimizing acute care service usage, breastfeeding promotion, and perhaps increasing maternal perceptions of well-being. A home visit program has the potential to enhance resident education and the doctor-patient relationship.

Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting as Pathways to Disruptions in Cortisol

Science.gov (United States)

Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

2012-01-01

This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the…

Anxiety and depression levels among multidisciplinary health residents

Directory of Open Access Journals (Sweden)

Daniela Salvagni Rotta

2016-01-01

Full Text Available Objective: to assess symptoms of anxiety and depression of professionals of Multidisciplinary Health Residence Programs. Methods: this is a cross-sectional study, performed with fifty professionals, using three instruments: one for socioeconomic and demographic data, and the Beck’s Anxiety and Depression Scale. Results: predominance of females (92.0%, average age 26 years old, single (88.0%, family income from two to five salaries (56.0% satisfied with the work (82.0% and thought about quitting the program (56.0% showed anxiety (50.0% and depression (28.0%. Conclusion: there was an association between anxiety and depression in multidisciplinary residents, which points to the need for rethinking strategies for identifying these symptoms and control of stress factors for the promotion of mental health.

Evaluating the pin money hypothesis: the relationship between women's labour market activity, family income and poverty in Britain.

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Harkness, S; Machin, S; Waldfogel, J

1997-01-01

"In this paper we evaluate the hypothesis that the over-representation of women amongst the low paid is of little importance because women's earnings account for only a small proportion of total family income. Data from the [United Kingdom] General Household Survey (GHS), together with attitudinal evidence from three cross-sectional data sources, indicate that women's earnings are in fact an important and growing component of family income. The majority of the growth in the share of women's earnings occurs as a result of changing family labour structures; women's earnings are playing an increasingly important role in keeping their families out of poverty." excerpt

Development of a New South Dakota Rural Family Medicine Residency Program.

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Heisler, Jean; Huber, Thomas; Huntington, Mark K

2017-11-01

The healthcare workforce is a priority in South Dakota. It has been estimated that 8,000 additional healthcare workers beyond those in practice in 2010 will be needed by 2020. In 2016, the South Dakota Department of Health included in its budget funds for the development of a new Rural Family Medicine Residency Training Program as one of the steps toward addressing the physician component of these workforce needs. This new program has just received its accreditation and is recruiting the inaugural class of resident physicians for the spring of 2018. This article provides a concise overview of the program's initial development. Copyright© South Dakota State Medical Association.

[Self-rated health in adults: influence of poverty and income inequality in the area of residence].

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Caicedo, Beatriz; Berbesi Fernández, Dedsy

2015-01-01

To evaluate the influence of income inequality and poverty in the towns of Bogotá, Colombia, on poor self-rated health among their residents. The study was based on a multipurpose survey applied in Bogotá-Colombia. A hierarchical data structure (individuals=level1, locations=level 2) was used to define a logit-type multilevel logistic model. The dependent variable was self-perceived poor health, and local variables were income inequality and poverty. All analyses were controlled for socio-demographic variables and stratified by sex. The prevalence of self-reported fair or poor health in the study population was 23.2%. Women showed a greater risk of ill health, as well as men and women with a low educational level, older persons, those without work in the last week and persons affiliated to the subsidized health system. The highest levels of poverty in the city increased the risk of poor health. Cross-level interactions showed that young women and men with a low education level were the most affected by income inequality in the locality. In Bogotá, there are geographical differences in the perception of health. Higher rates of poverty and income inequality were associated with an increased risk of self-perceived poor health. Notable findings were the large health inequalities at the individual and local levels. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Income inequality and self-reported health in a representative sample of 27 017 residents of state capitals of Brazil.

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Massa, K H C; Pabayo, R; Chiavegatto Filho, A D P

2018-02-01

The association between income inequality and health has been analyzed predominantly in developed countries with modest levels of inequality. The study aimed to analyze the association between income inequality and self-reported health (SRH) in the adult population of the 27 Brazilian capitals. Individuals aged 18 years or older from the National Health survey residing in Brazilian capitals in 2013 were analyzed (n = 27 017). Bayesian multilevel models were applied after controlling for individual factors and area-level socioeconomic characteristics. We found a significant association between income inequality and SRH, even after controlling for individual and contextual factors. The results indicate greater odds of poor SRH among those living in areas with medium (OR = 1.31, 95% CI: 1.17-1.47) and high income inequality level (OR = 1.39, 95% CI: 1.24-1.56). Income inequality remained significantly associated with SRH, even after controlling for other contextual socioeconomic characteristics, such as local illiteracy rate, violence and per capita income. The study highlights the importance of the individual and contextual characteristics associated with SRH. Our findings suggest that city-level income inequality can have a detrimental effect on individual health, over and above other contextual socioeconomic characteristics and individual factors. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Role of expendable income and price in food choice by low income families.

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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.

Review of quality assessment tools for family planning programmes in low- and middle-income countries.

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Sprockett, Andrea

2017-03-01

Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this literature review was to identify widely used public domain quality assessment tools with existing or potential application in clinic-based family planning programmes. Using PubMed, PopLine, Google Scholar and Google, key terms such as ‘quality assessment tool’, ‘quality assessment method’, ‘quality measurement’, ‘LMIC’, ‘developing country’, ‘family planning’ and ‘reproductive health’ were searched for articles, identifying 20 relevant tools. Tools were assessed to determine the type of quality components assessed, divided into structure and process components, level of application (national or facility), health service domain that can be assessed by the tool, cost and current use of the tool. Tools were also assessed for shortcomings based on application in a low- and middle-income clinic-based family planning programme, including personnel required, re-assessment frequency, assessment of structure, process and outcome quality, comparability of data over time and across facilities and ability to benchmark clinic results to a national benchmark. No tools met all criteria, indicating a critical gap in quality assessment for low- and middle-income family planning programmes. To achieve Universal Health Coverage, agreed on in the Sustainable Development Goals and to improve system-wide healthcare quality, we must develop and widely adopt a standardized quality assessment tool.

Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

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McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

2011-12-01

An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

Personal finances of urology residents in Canada.

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Teichman, J M; Tongco, W; MacNeily, A E; Smart, M

2000-12-01

We examined how Urology residents in Canada manage their personal finances. A survey instrument was designed to elicit information on demographics, expenses, savings and incomes. The questionnaire was completed by 40 Urology residents attending the 2000 Queen's Urology Exam Skills Training (QUEST) program. Twenty-eight residents (70%) had educational debt (median debt $50 000). Seventeen residents (45%) paid credit card interest charges within the last year. Four residents (10%) maintained an unpaid credit card balance > $7500 at 17% annual interest rate. Twenty-six residents (67%) contributed to Registered Retirement Savings Program (RRSP) accounts. Seventeen residents (44%) contributed to non-RRSP retirement accounts. Nineteen residents (50%) budgeted expenses. Median resident income was $45 000. Thirteen residents (34%) had cash reserves < $250. Many residents save little, and incur substantial debt over and above educational loans. Many residents would benefit from instruction concerning prudent financial management. Residents should be informed of the consequences of low saving and high debt.

Parental Mathematics Homework Involvement of Low-Income Families with Middle School Students

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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…

Maternal Correlates of Growth in Toddler Vocabulary Production in Low-Income Families

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Pan, Barbara Alexander; Rowe, Meredith L.; Singer, Judith D.; Snow, Catherine E.

2005-01-01

This study investigated predictors of growth in toddlers' vocabulary production between the ages of 1 and 3 years by analyzing mother-child communication in 108 low-income families. Individual growth modeling was used to describe patterns of growth in children's observed vocabulary production and predictors of initial status and between-person…

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

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Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

2017-10-01

The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

Early Childhood Caries and Body Mass Index in Young Children from Low Income Families

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Maria Goretti Queiroz

2013-03-01

Full Text Available The relationship between early childhood caries (ECC and obesity is controversial. This cross-sectional survey investigated this association in children from low-income families in Goiania, Goias, Brazil and considered the role of several social determinants. A questionnaire examining the characteristics of the children and their families was administered to the primary caregiver during home visits. In addition, children (approximately 6 years of age had their height, weight, and tooth condition assessed. The primary ECC outcome was categorized as one of the following: caries experience (decayed, missing, filled tooth: “dmft” index > 0, active ECC (decayed teeth > 0, or active severe ECC (decayed teeth ≥ 6. Descriptive, bivariate and logistic regression analyses were conducted. The participants in the current study consisted of 269 caregiver-child dyads, 88.5% of whom were included in the Family Health Program. Caregivers were mostly mothers (67.7%, were 35.3 ± 10.0 years old on average and had 9.8 ± 3.1 years of formal education. The mean family income was 2.3 ± 1.5 times greater than the Brazilian minimum wage. On average, the children in the current study were 68.7 ± 3.8 months old. Of these, 51.7% were boys, 23.4% were overweight or obese, 45.0% had active ECC, and 17.1% had severe ECC. The average body mass index (BMI of the children was 15.9 ± 2.2, and their dmft index was 2.5 ± 3.2. BMI was not associated with any of the three categories of dental caries (p > 0.05. In contrast, higher family incomes were significantly associated with the lack of caries experience in children (OR 1.22, 95%CI 1.01–1.50, but the mother’s level of education was not significantly associated with ECC.

Pathways between acculturation and health behaviors among residents of low-income housing: the mediating role of social and contextual factors.

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Allen, Jennifer Dacey; Caspi, Caitlin; Yang, May; Leyva, Bryan; Stoddard, Anne M; Tamers, Sara; Tucker-Seeley, Reginald D; Sorensen, Glorian C

2014-12-01

Acculturation may influence health behaviors, yet mechanisms underlying its effect are not well understood. In this study, we describe relationships between acculturation and health behaviors among low-income housing residents, and examine whether these relationships are mediated by social and contextual factors. Residents of 20 low-income housing sites in the Boston metropolitan area completed surveys that assessed acculturative characteristics, social/contextual factors, and health behaviors. A composite acculturation scale was developed using latent class analysis, resulting in four distinct acculturative groups. Path analysis was used to examine interrelationships between acculturation, health behaviors, and social/contextual factors, specifically self-reported social ties, social support, stress, material hardship, and discrimination. Of the 828 respondents, 69% were born outside of the U.S. Less acculturated groups exhibited healthier dietary practices and were less likely to smoke than more acculturated groups. Acculturation had a direct effect on diet and smoking, but not physical activity. Acculturation also showed an indirect effect on diet through its relationship with material hardship. Our finding that material hardship mediated the relationship between acculturation and diet suggests the need to explicate the significant role of financial resources in interventions seeking to promote healthy diets among low-income immigrant groups. Future research should examine these social and contextual mediators using larger, population-based samples, preferably with longitudinal data. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Family medicine residents’ perceived level of comfort in treating common sports injuries across residency programs in the United States

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Amoako AO

2015-03-01

Full Text Available Adae O Amoako,1 Agyenim B Amoako,2 George GA Pujalte3 1Department of Family and Community Medicine, Penn State Hershey Medical Center, Hershey, PA, USA; 2Department of Family Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA; 3Sports Medicine, Divisions of Primary Care, and Orthopedics, Mayo Clinic Health System, Waycross, GA, USA Background and objective: Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. Methods: This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Results: Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7% compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8% respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively. Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, <0.0001, and 0.0001, respectively; comfort level, P=0.0016, <0.0001, 0.0897, and 0.0010, respectively. Conclusion: Medical education background, factors that affect training, and an interest in sports medicine contribute to residents' knowledge and comfort

Solar project description for Zien Mechanical Contractors-I single family residence, Milwaukee, Wisconsin

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Beers, D.

1980-02-01

The Zien Mechanical site is a single family residence located in Milwaukee, Wisconsin. The home has two separate solar energy systems: an air system for space heating and cooling; a liquid system to preheat the potable hot water. The space heating and cooling system design and operation modes are described. The space heating system is designed to apply approximately 44 percent of the space heating requirements for the 1388 square foot residence. Engineering drawings are provided and the performance evaluation instrumentation is described.

How Entrustment Is Informed by Holistic Judgments Across Time in a Family Medicine Residency Program: An Ethnographic Nonparticipant Observational Study.

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Sagasser, Margaretha H; Fluit, Cornelia R M G; van Weel, Chris; van der Vleuten, Cees P M; Kramer, Anneke W M

2017-06-01

Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands. Seven supervisor-resident pairs participated. During two days, one researcher observed first-year residents' patient encounters, debriefing sessions, and supervisor-resident educational meetings and interviewed them separately afterwards. Data were collected and analyzed using iterative, phenomenological inductive research methodology. The entrustment process developed over three phases. Supervisors based their initial entrustment on prior knowledge about the resident. In the ensuing two weeks, entrustment decisions regarding independent patient care were derived from residents' observed general competencies necessary for a range of health problems (clinical reasoning, decision making, relating to patients); medical knowledge and skills; and supervisors' intuition. Supervisors provided supervision during and after encounters. Once residents performed independently, supervisors kept reevaluating their decisions, informed by residents' overall growth in competencies rather than by adhering to a predefined set of tasks. Supervisors in family medicine residency training took a holistic approach to trust, based on general competencies, knowledge, skills, and intuition. Entrustment started before training and developed over time. Building trust is a mutual process between supervisor and resident, requiring a good working relationship.

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

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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.

Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

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Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

2001-01-01

Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

Access to housing subsidies, housing status, drug use and HIV risk among low-income U.S. urban residents

Directory of Open Access Journals (Sweden)

Dickson-Gomez Julia

2011-11-01

Full Text Available Abstract Background Much research has shown an association between homelessness and unstable housing and HIV risk but most has relied on relatively narrow definitions of housing status that preclude a deeper understanding of this relationship. Fewer studies have examined access to housing subsidies and supportive housing programs among low-income populations with different personal characteristics. This paper explores personal characteristics associated with access to housing subsidies and supportive housing, the relationship between personal characteristics and housing status, and the relationship between housing status and sexual risk behaviors among low-income urban residents. Methods Surveys were conducted with 392 low-income residents from Hartford and East Harford, Connecticut through a targeted sampling plan. We measured personal characteristics (income, education, use of crack, heroin, or cocaine in the last 6 months, receipt of welfare benefits, mental illness diagnosis, arrest, criminal conviction, longest prison term served, and self-reported HIV diagnosis; access to housing subsidies or supportive housing programs; current housing status; and sexual risk behaviors. To answer the aims above, we performed univariate analyses using Chi-square or 2-sided ANOVA's. Those with significance levels above (0.10 were included in multivariate analyses. We performed 2 separate multiple regressions to determine the effects of personal characteristics on access to housing subsidies and access to supportive housing respectively. We used multinomial main effects logistic regression to determine the effects of housing status on sexual risk behavior. Results Being HIV positive or having a mental illness predicted access to housing subsidies and supportive housing, while having a criminal conviction was not related to access to either housing subsidies or supportive housing. Drug use was associated with poorer housing statuses such as living on the

The effect of dual accreditation on family medicine residency programs.

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Mims, Lisa D; Bressler, Lindsey C; Wannamaker, Louise R; Carek, Peter J

2015-04-01

In 1985, the American Osteopathic Association (AOA) Board of Trustees agreed to allow residency programs to become dually accredited by the AOA and Accreditation Council for Graduate Medical Education (ACGME). Despite the increase in such programs, there has been minimal research comparing these programs to exclusively ACGME-accredited residencies. This study examines the association between dual accreditation and suggested markers of quality. Standard characteristics such as regional location, program structure (community or university based), postgraduate year one (PGY-1) positions offered, and salary (PGY-1) were obtained for each residency program. In addition, the faculty to resident ratio in the family medicine clinic and the number of half days residents spent in the clinic each week were recorded. Initial Match rates and pass rates of new graduates on the ABFM examination from 2009 to 2013 were also obtained. Variables were analyzed using chi-square and Student's t test. Logistic regression models were then created to predict a program's 5-year aggregate initial Match rate and Board pass rate in the top tertile as compared to the lowest tertile. Dual accreditation was obtained by 117 (27.0%) of programs. Initial analyses revealed associations between dually accredited programs and mean year of initial ACGME program accreditation, regional location, program structure, tracks, and alternative medicine curriculum. When evaluated in logistic regression, dual accreditation status was not associated with Match rates or ABFM pass rates. By examining suggested markers of program quality for dually accredited programs in comparison to ACGME-only accredited programs, this study successfully established both differences and similarities among the two types.

Geographical Mobility, Income, Life Satisfaction and Family Size Preferences: An Empirical Study on Rural Households in Shaanxi and Henan Provinces in China.

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Chen, Jiangsheng; Yang, Hong

Employing data from the China rural-urban mobility survey conducted in 2010, this study investigates the influence of family demographic characteristics on the income, life satisfaction, and potential for rural-urban mobility at the rural household level of two provinces of China: Shaanxi and Henan. A larger labor force in a rural household was found to reduce a family's ability or inclination to move to a city. The findings reveal that family size negatively affects the average income per family member and reduces the marginal income of the labor force and that minor children can improve the life satisfaction of family members. We conclude that a larger family size does not translate to more benefits for a rural household. Family size preference is found to be a reflection of parents' concerns about elderly care and is deemed to be unfavorable for urbanization in P. R. China.

Family income trajectory during childhood is associated with adolescent cigarette smoking and alcohol use.

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Poonawalla, Insiya B; Kendzor, Darla E; Owen, Margaret Tresch; Caughy, Margaret O

2014-10-01

Although childhood socioeconomic disadvantage has been linked with adolescent tobacco and alcohol use in cross-sectional research, less is known about the influence of changes in socioeconomic status during childhood. Upward socioeconomic mobility may attenuate the negative influence of earlier socioeconomic disadvantage on health, while downward mobility may counter the health benefits of earlier socioeconomic advantage. This study evaluated the influence of common trajectories of family income during childhood on smoking and alcohol use during adolescence. Data utilized were part of the 15-year longitudinal Study of Early Child Care and Youth Development. A 5-class trajectory model (two stable, one downward, and two upward income trajectories) was developed previously with this sample (N=1356). Logistic regression analyses were conducted to determine whether children of the more disadvantaged income trajectories were more likely to engage in tobacco and alcohol use at age 15 relative to those of the most advantaged trajectory. Family income trajectory was significantly associated with ever-smoking (p=.02) and past-year alcohol use at age 15years (p=.008). Children from the less advantaged trajectories were more likely to have ever-smoked than children of the most advantaged trajectory (all p'schildhood socioeconomic disadvantage influences adolescent smoking, while downward socioeconomic mobility influences adolescent alcohol use. Copyright © 2014 Elsevier Ltd. All rights reserved.

Biking practices and preferences in a lower income, primarily minority neighborhood: Learning what residents want.

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Lusk, Anne C; Anastasio, Albert; Shaffer, Nicholas; Wu, Juan; Li, Yanping

2017-09-01

This paper examines if, in a lower-income minority neighborhood, bicycling practices and bicycle-environment preferences of Blacks and Hispanics were different from Whites. During the summer of 2014, surveys were mailed to 1537 households near a proposed cycle track on Malcolm X Boulevard in Roxbury, MA. On the Boulevard, intercept surveys were distributed to cyclists and observations noted about passing cyclist's characteristics. Data were analyzed from 252 returned-mailed surveys, 120 intercept surveys, and 709 bicyclists. White (100%), Hispanic (79%), and Black (76%) bicyclists shown pictures of 6 bicycle facility types in intercept surveys perceived the cycle track as safest. More White mailed-survey respondents thought bikes would not be stolen which may explain why more Hispanics (52%) and Blacks (47%) preferred to park their bikes inside their home compared with Whites (28%), with H/W B/W differences statistically significant ( p  bike compared with Whites (75%). Minority populations are biking on roads but prefer cycle tracks. They also prefer to park bikes inside their homes and bicycle with family and friends. Wide cycle tracks (bicycling with family/friends) and home bike parking should be targeted as capital investments in lower-income minority neighborhoods.

26 CFR 1.871-3 - Residence of alien seamen.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Residence of alien seamen. 1.871-3 Section 1.871... (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-3 Residence of alien seamen. In order to determine whether an alien seaman is a resident of the United States for purposes of the income...

Race-ethnic, family income, and education differentials in nutritional and lipid biomarkers in US children and adolescents: NHANES 2003-2006.

Science.gov (United States)

Kant, Ashima K; Graubard, Barry I

2012-09-01

Children from ethnic minority and low-income families in the United States have higher rates of poor health and higher mortality rates. Diet, an acknowledged correlate of health, may mediate the known race-ethnic and socioeconomic differentials in the health of US children. The objective was to examine the independent association of race-ethnicity, family income, and education with nutritional and lipid biomarkers in US children. We used data from the NHANES 2003-2006 to examine serum concentrations of vitamins A, D, E, C, B-6, and B-12; serum concentrations of folate, carotenoids, and lipids; and dietary intakes of corresponding nutrients for 2-19-y-old children (n = ~2700-7500). Multiple covariate-adjusted regression methods were used to examine the independent and joint associations of race-ethnicity, family income, and education with biomarker status. Non-Hispanic blacks had lower mean serum concentrations of vitamins A, B-6, and E and α-carotene than did non-Hispanic whites. Both non-Hispanic blacks and Mexican Americans had higher mean serum vitamin C, β-cryptoxanthin, and lutein + zeaxanthin but lower folate and vitamin D concentrations compared with non-Hispanic whites. In comparison with non-Hispanic whites, non-Hispanic blacks were less likely to have low serum HDL cholesterol or high triglycerides. Family income and education predicted few biomarker or dietary outcomes, and the observed associations were weak. Moreover, modification of race-ethnic differentials by income or education (or vice versa) was noted for very few biomarkers. Race-ethnicity, but not family income or education, was a strong independent predictor of serum nutrient concentrations and dietary micronutrient intakes in US children and adolescents.

Trends in Disparities in Low-Income Children's Health Insurance Coverage and Access to Care by Family Immigration Status.

Science.gov (United States)

Jarlenski, Marian; Baller, Julia; Borrero, Sonya; Bennett, Wendy L

2016-03-01

To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status. We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care. All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P = .06), a 9 percentage point greater increase in having a personal doctor or nurse (P Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Literacy, Education, and Inequality: Assimilation and Resistance Narratives from Families Residing at a Homeless Shelter

Science.gov (United States)

Jacobs, Mary M.

2014-01-01

In this article, I draw on data from my qualitative dissertation study of the literacy practices of five families who resided in a homeless shelter to complicate the relationship between literacy, education, and inequality. Homelessness is examined through the lens of sponsorship to understand the differential access the families have to powerful…

24 CFR 1000.108 - How is HUD approval obtained by a recipient for housing for non low-income Indian families and...

Science.gov (United States)

2010-04-01

... recipient for housing for non low-income Indian families and model activities? 1000.108 Section 1000.108... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.108 How is HUD approval obtained by a.... Assistance to non low-income Indian families must be in accordance with § 1000.110. Proposals may be...

Personal Empowerment in the Study of Home Internet Use by Low-Income Families.

Science.gov (United States)

Bier, Melinda; Gallo, Michael; Nucklos, Eddy; Sherblom, Stephen; Pennick, Michael

1997-01-01

Describes a United States Department of Commerce (National Telecommunications and Information Administrations, NTIA, 1995) study of home Internet use by Low-income families. The study investigated the barriers, benefits (empowerment), and perceived worth of the Internet and concluded that home Internet access enabled powerful emotional and…

The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

Science.gov (United States)

Bern-Klug, Mercedes

2008-01-01

Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

After Mexico Implemented a Tax, Purchases of Sugar-Sweetened Beverages Decreased and Water Increased: Difference by Place of Residence, Household Composition, and Income Level.

Science.gov (United States)

Colchero, M Arantxa; Molina, Mariana; Guerrero-López, Carlos M

2017-08-01

Background: In January 2014, Mexico implemented a tax on sugar-sweetened beverage (SSB) purchases of 1 peso/L. Objective: We examined the heterogeneity of changes in nonalcoholic beverage (SSB and bottled water) purchases after the tax was implemented by household income, urban and rural strata, and household composition. Methods: We used 4 rounds of the National Income and Expenditure Surveys: 2008, 2010, 2012, and 2014. Changes in purchases in per capita liters per week were estimated with the use of 2-part models to adjust for nonpurchases. We compared absolute and relative differences between adjusted changes in observed purchases in 2014 with expected purchases in 2014 based on prior trends (2008-2012). The models were adjusted for sociodemographic characteristics of the households, place of residence, and lagged gross domestic product per capita. Results: We found a 6.3% reduction in the observed purchases of SSBs in 2014 compared with the expected purchases in that same year based on trends from 2008 to 2012. These reductions were higher among lower-income households, residents living in urban areas, and households with children. We also found a 16.2% increase in water purchases that was higher in low- and middle-income households, in urban areas, and among households with adults only. Conclusions: SSB purchases decreased and water purchases increased after an SSB tax was imposed in Mexico. The magnitude of these changes was greater in lower-income and urban households. © 2017 American Society for Nutrition.

Examining trust in health professionals among family caregivers of nursing home residents with advanced dementia.

Science.gov (United States)

Boogaard, Jannie A; Werner, Perla; Zisberg, Anna; van der Steen, Jenny T

2017-12-01

In a context of increasing emphasis on shared decision-making and palliative care in dementia, research on family caregivers' trust in health professionals in advanced dementia is surprisingly scant. The aim of the present study was to assess trust in nursing home health professionals of family caregivers of nursing home residents with advanced dementia, and possible correlates, such as family caregivers' satisfaction, involvement in care, care burden and patients' symptom burden. A cross-sectional study was carried out using structured questionnaires administered through the telephone. Generalized estimating equation analyses with adjustment for nursing home clustering were applied to assess the most important associations with family caregivers' trust. A total of 214 family caregivers of persons with dementia residing in 25 nursing homes participated in the study. The majority of the participants (67%) were women and adult children (75%). The majority of the family caregivers trusted physicians, nurses and nurses' aides at a moderate-to-high level. Approximately half to one-third reported moderate-to-low levels of trust. Higher levels of trust were associated with more positive care outcomes, such as higher family satisfaction with care and more positive evaluations of physician-family communication. The present study showed the importance of family caregivers trusting nursing home health professionals for their experiences as caregivers. Although causation cannot be established, increased family caregivers' trust in nursing home health professionals by improving communication and exchange of information might provide a good basis for providing optimal palliative care in advanced dementia. Geriatr Gerontol Int 2017; 17: 2466-2471. © 2017 Japan Geriatrics Society.

Associations among parental feeding styles and children's food intake in families with limited incomes

OpenAIRE

Liu Yan; Nicklas Theresa A; Fisher Jennifer O; Hughes Sheryl O; Hoerr Sharon L; Shewchuk Richard M

2009-01-01

Abstract Background Although general parenting styles and restrictive parental feeding practices have been associated with children's weight status, few studies have examined the association between feeding styles and proximal outcomes such as children's food intake, especially in multi-ethnic families with limited incomes. The purpose of this study was to evaluate the association of parental feeding styles and young children's evening food intake in a multiethnic sample of families in Head S...

Development and evaluation of brochures for fall prevention education created to empower nursing home residents and family members.

Science.gov (United States)

Schoberer, Daniela; Eglseer, Doris; Halfens, Ruud J G; Lohrmann, Christa

2018-06-01

In this study, we describe the development of evidence- and theory-based fall prevention educational material and its evaluation from the users' perspectives. To reduce risk factors for falling in nursing homes, nursing staff must enact multifactorial fall prevention intervention programmes. A core component of these programmes is to educate residents and their family members, both verbally and in a written form. However, users can only benefit from educational material if it is based on current scientific evidence, easy to understand and process and customised. We followed a structured procedure during the development process, while considering various aspect of quality. To assess the understandability and usefulness of the resulting educational materials, we conducted a qualitative content analysis study. The educational materials development process incorporated several iterative steps including a systematic literature search and the application of frameworks for designing and writing the materials. To evaluate the material, we performed six focus group discussions separately with residents, family members and nursing staff from two nursing homes (total of 32 participants). Residents' brochures included clear information on avoiding external risks as well as coping strategies after a fall event. Family members' brochures were more comprehensive, including both concrete tips and outlining the advantages and disadvantages of interventions. Residents and family members had no difficulties understanding the material and tried to apply the content to their individual situations. Nursing staff commented on some ambiguities and incongruities relating to current nursing care practice. By involving users in the development of evidence-based educational materials, nursing staff can achieve a high acceptance rate for the materials and motivate users to address the topic. The involvement of users is essential for developing educational material that meets users' needs

Parent-Child Interactions Among Low-Income Mexican American Parents and Preschoolers: Do Clinic-Referred Families Differ From Nonreferred Families?

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McCabe, Kristen; Yeh, May; Lau, Anna; Argote, Carolina Bertely; Liang, June

2009-01-01

This study compared low-income Mexican American parents of young children referred for behavior problems to their nonreferred counterparts on an observational measure of parent-child interactions. Referred Mexican American parents demonstrated more negative behaviors than their nonreferred counterparts in both nondirective and highly directive situations. However, no differences were found at moderate levels of directiveness. The most and least directive situations in the Dyadic Parent-Child Interaction Coding System best differentiated referred from nonreferred Mexican American families, and families differed more in their negative behaviors than positive behaviors. Many of the parenting behaviors that have been found to differ between referred and nonreferred Caucasian families were also observed to differ between their Mexican American counterparts. PMID:20171330

Factors influencing healthy lifestyle changes: a qualitative look at low-income families engaged in treatment for overweight children.

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Cason-Wilkerson, Rochelle; Goldberg, Shauna; Albright, Karen; Allison, Mandy; Haemer, Matthew

2015-04-01

Childhood obesity disproportionately affects low-income minority populations, yet there is a paucity of literature about effective interventions in this population. This study sought to understand the experience of low-income majority Hispanic families engaged in obesity treatment. We conducted six focus groups (2=English, 4=Spanish) with families who completed a community-based, family-oriented obesity treatment program, using standard qualitative focus group interview methods. Transcripts were recorded, transcribed, and analyzed for thematic content. Two coders using the software program ATLAS.ti (v.7.0; Scientific Software Development GmbH, Berlin, Germany) coded each transcript independently; reflexive team analysis with three study team members was used to reach a consensus. Participants (n=37) indicated high program satisfaction. Parents reported buying less junk/fast food, increased consumption of fruits and vegetables, preparing and eating more meals as a family, and increasing their families' physical activity (PA). Four barrier and facilitator themes emerged. Barrier themes were time and financial cost, parent's lack of time and energy, influence of family members, and challenges regarding physical environment. Facilitator themes were skill building around healthy eating and parenting, family involvement, and long-term health concerns. Unanticipated findings, parents reported, were that changes resulted in children sleeping better, feeling happier, and less irritability. Despite low-income families experiencing barriers to lifestyle changes to manage obesity, they made positive dietary changes and increased PA by learning specific skills and including the whole family in those changes. Additionally, some unexpected benefits were noted, including improved sleep, less irritability, and children appearing happier. Future studies should consider using these parent-identified outcomes as secondary measures of program effectiveness.

The association of childhood asthma with mental health and developmental comorbidities in low-income families.

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Arif, Ahmed A; Korgaonkar, Purva

2016-01-01

The objective of the study was to determine the relationship of childhood asthma with mental health and developmental indicators in low-income families. Parents/guardians of approximately 400 children, aged 2-14 years, were recruited from a charity hospital serving low income neighborhoods in the outskirts of Karachi, Pakistan. Mothers of children were interviewed in their local language by a trained nurse. Eight self-reported comorbidities were grouped into two constructs based on factor analysis and conveniently labeled as mental health (anxiety, attention and behavioral problems) and developmental problems (learning, developmental delay, hearing impairment, sleep and speech problems). Data were analyzed using multiple logistic regression, adjusted for age, sex, presence of older siblings, number of people in the household, child birth weight, presence of mold, and family history of asthma or hay fever. Children with asthma had 18 times greater odds of mental health problems (adjusted OR = 18.0, 95% CI: 9.2, 35.1) as compared to children without asthma. The odds of developmental problems were more than 14 times greater for children with asthma (adjusted OR = 14.3, 95% CI: 7.8, 26.1) as compared to children without asthma. This study found mental and developmental adverse consequences of childhood asthma in low-income families. Identifying and treating asthma at an early age could reduce the burden of comorbidities in this population.

Residency education through the family medicine morbidity and mortality conference.

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Kim, Curi; Fetters, Michael D; Gorenflo, Daniel W

2006-09-01

The value of the morbidity and mortality conference (M&MC) has received little examination in the primary care literature. We sought to understand the educational content of M&MCs by examining data from a family medicine training program. Archived morbidity and mortality conference data (July 2001-July 2003) were retrieved from two University of Michigan family medicine adult inpatient services (one community based and one university based). We used chi-square and t test to compare demographic variables and adverse events between hospital sites. We qualitatively analyzed written comments about adverse events. Both family medicine services shared similar diagnoses, patient volume, length of stay, and gender distribution of patients, but the community hospital had an older average patient age (67.9 years versus 52.9 years) and a higher outpatient complication rate. Analysis of the qualitative data revealed patterns of adverse events, such as an association between avoidable admissions and inadequate pain control, that could be improved through educational intervention. Although family medicine residents' experiences in university and community hospitals were comparable, there were differences in patient populations and case complexity. Modifying the M&MC format could enhance its effectiveness as an educational tool about adverse events.

26 CFR 1.871-4 - Proof of residence of aliens.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Proof of residence of aliens. 1.871-4 Section 1... (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-4 Proof of residence of aliens... alien within the United States has acquired residence therein for purposes of the income tax. (b...

Process Evaluation of a Parenting Program for Low-Income Families in South Africa

Science.gov (United States)

Lachman, Jamie M.; Kelly, Jane; Cluver, Lucie; Ward, Catherine L.; Hutchings, Judy; Gardner, Frances

2018-01-01

Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3-8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists,…

School Readiness among Low-Income Black Children: Family Characteristics, Parenting, and Social Support

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Bono, Katherine E.; Sy, Susan R.; Kopp, Claire B.

2016-01-01

This study focuses on the associations between family variables and academic and social school readiness in low-income Black children. Analyses drew from the National Institute for Child Development (NICHD) Study of Early Child Care and Youth Development dataset. The participants included 122 children and their mothers. Data collection occurred…

Health financing and integration of urban and rural residents' basic medical insurance systems in China.

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Zhu, Kun; Zhang, Luying; Yuan, Shasha; Zhang, Xiaojuan; Zhang, Zhiruo

2017-11-07

China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems. Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents. URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade. The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund

Examining neighborhood and interpersonal norms and social support on fruit and vegetable intake in low-income communities.

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Dulin, Akilah; Risica, Patricia M; Mello, Jennifer; Ahmed, Rashid; Carey, Kate B; Cardel, Michelle; Howe, Chanelle J; Nadimpalli, Sarah; Gans, Kim M

2018-04-05

We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants included 290 residents in four low-income subsidized housing sites who were ≥ 18 years of age, English and/or Spanish speaking, and without medical conditions that prevented consumption of F&V. Linear regression models examined associations of norms and social support with F&V intake after adjustments for sociodemographic characteristics. In the analysis, neighborhood social support for F&V was associated with a 0.31 cup increase in F&V intake (95% CI = 0.05, 0.57). The family norm for eating F&V and family social support for eating F&V were associated with a 0.32 cup (95% CI = 0.13, 0.52) and 0.42 cup (95% CI = 0.19, 0.64) increase in F&V intake, respectively. To our knowledge, no other studies have examined neighborhood, family, and peer norms and social support simultaneously and in relation to F&V intake. These findings may inform neighborhood interventions and community-level policies to reduce neighborhood disparities in F&V consumption.

Food and nutritional insecurity in families of an agroextrative community in the state of Ceará

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Sandra Maria de Oliveira

2017-10-01

Full Text Available This study sought to present a food insecurity situation experienced by families living in the Terra Nova community of the municipality of Massapê in the State of Ceará, Brazil. It is a quantitative study with transversal approach. A questionnaire was used to evaluate the socio-demographic characteristics, along with the Brazilian Scale of Food Insecurity - BSFI - with 15 food insecurity questions at different levels of intensity. We searched 28 families and obtained information on family income, socioeconomic status, housing, basic sanitation, schooling and food consumption. The prevalence of food insecurity in households with residents aged over 18 was 75%, 25% mild, 50% moderate and 0% severe.  For households with at least one resident under the age of 18, the prevalence of food insecurity was 100%, being 41.67% mild, 50% moderate and 8.33% severe.  More than a half of the families (75% lived with up to ½ minimum wage per month. The majority of families (82,15 reported being beneficiaries of an income transfer program, in this case, Bolsa Família. The results show that although there are public policies to combat hunger in Brazil, there are still many families residing, mainly in the Northeast, who live in situations of social vulnerability. Therefore, it is necessary and essential to create and implement structuring actions that can reverse this situation, both regarding food production, as well as access to food of sufficient quality and quantity to address such deficiencies.

What if Member States Subjected Non-Resident Taxpayers to Unlimited Income Taxation whilst Granting Double Tax Relief under a Netherlands-Style Tax Exemption?

NARCIS (Netherlands)

M.F. de Wilde (Maarten)

2011-01-01

textabstractIn this article, the author seeks to illustrate, through examples dealing with cross-border business losses, what the result would be if Member States were to subject non-resident taxpayers to unlimited income taxation whilst granting double tax relief under a Netherlands-style tax

Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study

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Schneider Craig

2007-04-01

Full Text Available Abstract Background As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs developed for the program. Methods The direct observation (DO and treatment plan (TP evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP. The OSCE I was implemented first in 2005 (n = 6, revised and then implemented with a second class of IFM participants in 2006 (n = 7. OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6. Data from the initial implementation of these tools are described using descriptive statistics. Results Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies. Conclusion As these tools are refined further they will be of value both in improving

Influence of Parental Education and Family Income on Children's Education in Rural Uganda

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Drajea, Alice J.; O'Sullivan, Carmel

2014-01-01

This article investigates the effect of parents' literacy levels and family income in Uganda on the quality and nature of parents' involvement in their children's primary education. A mixed-methods study with an ethnographic element was employed to explore the views and opinions of 21 participants through a qualitative approach. Methods for data…

Low-Income Children, Their Families and the Great Recession: What Next in Policy?

Science.gov (United States)

Aber, Lawrence; Chaudry, Ajay

2010-01-01

Children and youth vary in their developmental health due to differences in family economic security and exposure to toxic stress. The economic downturn has increased the challenges facing low-income children. The American Recovery and Reinvestment Act of 2009 (ARRA) and the President's first budget made significant down-payments on investments in…

Prediction of postpartum weight in low-income Mexican-origin women from childhood experiences of abuse and family conflict

Science.gov (United States)

Luecken, Linda J.; Jewell, Shannon L.; MacKinnon, David P.

2016-01-01

Objective The postpartum period represents a crucial transition period in which weight gain or loss can affect lifetime obesity risk. This study examined the prevalence of obesity and the influence of childhood abuse and family conflict on postpartum weight among low-income Mexican-origin women. Depressive symptoms and partner support were evaluated as mediators. Methods At a prenatal assessment, low-income Mexican-origin women (N=322; mean age = 27.8; SD = 6.5) reported on childhood abuse and family conflict. Weight was measured seven times between 6 weeks and 2 years postpartum and calculated as body mass index (BMI). Regression and growth models were used to estimate the impact of childhood abuse, childhood family conflict, partner support, and depressive symptoms on weight and weight change. Results Higher family conflict predicted higher weight across the first (β = .12, p = .037) and second (β = .16, p = .012) postpartum years. Family conflict (β = .17; p = .018) and low partner support (β = −.16, p = .028) also predicted increasing weight in the first year. Partner support partially mediated the effect of childhood abuse on weight change in the first year (p = .031). Depressive symptomatology mediated the effects of childhood abuse and family conflict on weight status in the second year (abuse: p = .005; conflict: p = .023). Conclusions For low-income Mexican-origin women with a history of childhood abuse or high family conflict, depression and low partner support may be important targets for obesity prevention efforts in the postpartum period. PMID:27583713

Family income trajectory during childhood is associated with adiposity in adolescence: a latent class growth analysis.

Science.gov (United States)

Kendzor, Darla E; Caughy, Margaret O; Owen, Margaret Tresch

2012-08-05

Childhood socioeconomic disadvantage has been linked with obesity in cross-sectional research, although less is known about how changes in socioeconomic status influence the development of obesity. Researchers have hypothesized that upward socioeconomic mobility may attenuate the health effects of earlier socioeconomic disadvantage; while downward socioeconomic mobility might have a negative influence on health despite relative socioeconomic advantages at earlier stages. The purpose of the current study was to characterize trajectories of family income during childhood, and to evaluate the influence of these trajectories on adiposity at age 15. Data were collected as part of the Study of Early Child Care and Youth Development (SECCYD) between 1991 and 2007 at 10 sites across the United States. A latent class growth analysis (LCGA) was conducted to identify trajectories of family income from birth to 15 years of age. Analyses of covariance (ANCOVAs) were conducted to determine whether measures of adiposity differed by trajectory, while controlling for relevant covariates. The LCGA supported a 5-class trajectory model, which included two stable, one downward, and two upward trajectories. ANCOVAs indicated that BMI percentile, waist circumference, and skinfold thicknesses at age 15 differed significantly by trajectory, such that those who experienced downward mobility or stable low income had greater adiposity relative to the more advantaged trajectories. Conversely, upwardly mobile children and those with consistently adequate incomes had similar and more positive outcomes relative to the most disadvantaged trajectories. Findings suggest that promoting upward socioeconomic mobility among disadvantaged families may have a positive impact on obesity-related outcomes in adolescence.

[Patient safety culture in family and community medicine residents in Aragon].

Science.gov (United States)

Rodríguez-Cogollo, R; Paredes-Alvarado, I R; Galicia-Flores, T; Barrasa-Villar, J I; Castán-Ruiz, S

2014-01-01

having an appropriate patient safety culture is the first recommendation to improve it. The aim of this article is to determine the safety culture in family medicine residents and then to identify improvement strategies. an online cross-sectional survey of residents in family medicine teaching units of Aragon using the translated, validated and adapted to Spanish, Medical Office Survey on Patient Safety Culture (MOSPS) questionnaire. The results were grouped in 12-dimensional responses for analysis, and the mean value of each dimension was calculated. Perceptions were described by Percentages of Positive (PRP) and Negative Responses (PRN) to each dimension. positive results were seen in «the Patient Care Tracking/Follow-up». There were significant differences in the «Information Exchange With Other Settings», «Staff Training» and «Overall Perceptions of Patient Safety and Quality». Study participants viewed «Work Pressure and Pace» negatively. the institutions providing health services, as well as their staff, are increasingly aware of the importance of improving Patient Safety, and the results of this study allowed us to present information that helps identify weaknesses, and to design initiatives and strategies to improve care practices. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

What if Member States Subjected Non-Resident Taxpayers to Unlimited Income Taxation whilst Granting Double Tax Relief under a Netherlands-Style Tax Exemption?

OpenAIRE

Wilde, Maarten

2011-01-01

textabstractIn this article, the author seeks to illustrate, through examples dealing with cross-border business losses, what the result would be if Member States were to subject non-resident taxpayers to unlimited income taxation whilst granting double tax relief under a Netherlands-style tax exemption method.

BOUNCE: A community-based mother–daughter healthy lifestyle intervention for low-income Latino families

Science.gov (United States)

The primary purpose of this study was to assess the efficacy of a family-based exploratory community study titled BOUNCE (Behavior Opportunities Uniting Nutrition, Counseling, and Exercise), to increase physical fitness and activity in low-income Latino mothers and daughters. The BOUNCE study consis...

Racial Inequality Trends and the Intergenerational Persistence of Income and Family Structure

OpenAIRE

Bloome, Deirdre

2014-01-01

Racial disparity in family incomes remained remarkably stable over the past 40 years in the United States despite major legal and social reforms. Previous scholarship presents two primary explanations for persistent inequality through a period of progressive change. One highlights continuity: because socioeconomic status is transmitted from parents to children, disparities created through histories of discrimination and opportunity denial may dissipate slowly. The second highlights change: be...

24 CFR 92.203 - Income determinations.

Science.gov (United States)

2010-04-01

... accordance with § 92.252(h): (i) Examine the source documents evidencing annual income (e.g., wage statement... annual income; or alternatively, the statement must indicate the current dollar limit for very low- or low-income families for the family size of the tenant and state that the tenant's annual income does...

Residents' and preceptors' perceptions of the use of the iPad for clinical teaching in a family medicine residency program.

Science.gov (United States)

Archibald, Douglas; Macdonald, Colla J; Plante, Judith; Hogue, Rebecca J; Fiallos, Javier

2014-08-20

As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants' responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad's contribution to teaching/learning compared to preceptors. iPad's interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing knowledge through workshops led by more skillful i

ENRICHMENT PROGRAM FOR ACADEMICALLY TALENTED JUNIOR HIGH SCHOOL STUDENTS FROM LOW INCOME FAMILIES.

Science.gov (United States)

PRESSMAN, HARVEY

A PROPOSAL FOR AN ENRICHMENT PROGRAM FOR ACADEMICALLY TALENTED JUNIOR HIGH SCHOOL STUDENTS FROM LOW-INCOME FAMILIES IN CERTAIN AREAS OF BOSTON IS PRESENTED. BASIC ASSUMPTIONS ARE THAT THERE IS AND OBVIOUS AND PRESSING NEED TO GIVE EXTRA HELP TO THE ABLE STUDENT FROM A DISADVANTAGED BACKGROUND, AND THAT A RELATIVELY BRIEF ENRICHMENT EXPERIENCE FOR…

Provincial-level spatial statistical modelling of the change in per capita disposable Family Income in Spain, 1975-1983

Directory of Open Access Journals (Sweden)

Daniel A. Griffith

1998-02-01

Full Text Available Computational simplifications for a space-time autoregressive response model specification are explored for the change in Spain's per capita disposable family income between 1975 and 1983. The geographic resolution for this analysis is the provincial partitioning of part of the Iberian peninsula into Spain's 47 coterminous provinces coupled with its 3 island clusters provinces. In keeping with the Paelinckian tradition of spatial econometrics, exploration focuses on both new spatial econometric estimators and model specifications that emphasize the capturing of spatial dependency effects in the mean response term. One goal of this analysis is to differentiate between spatial, temporal, and space-time interaction information contained in the per capita disposable family income data. A second objective of the application is to illustrate the utility of extending computational simplifications from the spatial to the space-time domain. And a third purpose is to gain some substantive insights into the economic development of one country in a changing Europe. A serendipitous outcome of this investigation is a detailed analysis of locational information latent in Spain's regionally disaggregated per capita disposable family income.

Housing ownership and affordability among low-income society in the poorest sub-district of Semarang, Central Java, Indonesia

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Indrianingrum, Lulut

2017-03-01

The Government has intervened to deal with various affordable public housing programs, as well as financing programs for Low Income society in Indonesia. The characteristics of this society in each region are so diverse, that made the housing programs for this social segment uneasy in reaching the right target. Regulation of Housing and Settlement No. 2/2001 has mandated that the State are obliged to implement a habitable public housing for people, especially for the low income society. The purpose of this study is exploring the low-income residents' preferences and affordability of home ownership for their families in the poorest sub-district of Semarang. Aspects of studies include family conditions, financing, location, housing type and price. The research used a descriptive method to analyze a set of questionnaire data, distributed to low income residents in Sub district Tanjungmas, which isthe poorest sub district in Semarang. The results showed that the respondents developed a vision of home ownership by saving their money for the allocated housing budget and taking a bank installment. They tended to plan to get a house in their current neighborhood or nearby or anywhere else with the same price range. They really understood that, in order to get a better home and neighborhood they have to pay for higher prices. Therefore, their housing criteria or standards were set based on the quality of life in their current residential area, and should be located in a township (kampung).

Bolsa Família (Family Grant) Programme: an analysis of Brazilian income transfer programme

NARCIS (Netherlands)

L. Mourao (Luciana); A. Macedo de Jesus (Anderson)

2012-01-01

markdownabstract__Abstract__ Income transfer programmes are common in various countries and play an important role in combating poverty. This article presents a review of the results of the Bolsa Família (Family Grant) Programme, implemented in Brazil by the government of Lula da Silva in

Obesity risk in children: The role of acculturation in the feeding practices and styles of low-income Hispanic families

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Parent feeding has been associated with child overweight/obesity in low-income families. Because acculturation to the United States has been associated with increased adult obesity, our study aim was to determine whether acculturation was associated with feeding in these populations. Low-income Hisp...

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

Science.gov (United States)

Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

2016-01-01

A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

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Neily Zakiyah

Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary

Quali-quantitative study of nutritional status and eating patterns in children aged 1-3 years from low-income families in two population groups with different productive activities (Buenos Aires, Argentina, 2007-2008

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Lorena Pasarin

2016-06-01

Full Text Available The aim of this article is to describe the nutritional status and eating patterns of children aged 1-3 years from low-income families who reside in areas with different productive activities: primary production and production of goods and services. A descriptive cross-sectional study was performed with a qualitative and quantitative methodology, evaluating anthropometric and biochemical nutritional status, food intake, economic and demographic characteristics, dietary practices and representations. The results show that children from areas of primary production had a lower prevalence of anemia and iron deficiency. They also had a higher consumption of energy, calcium, zinc, vitamin A and protein and a greater diversity and quality in food consumption. We can conclude that the geographical context of families closer to sources of primary production favors interaction with individuals outside of the family, expanding both the informal social network and access to better quality nutritional food.

Knowledge and misconceptions about immunizations among medical students, pediatric, and family medicine resident.

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Tañón, Vilmarie; Borrero, Clarimar; Pedrogo, Yasmín

2010-01-01

Previous research has indicated that, despite being the most trusted source of health information, medical students, residents and other health related professionals lack accurate and current knowledge regarding immunization practices. To evaluate medical students and primary care resident knowledge about immunizations. Self-administered survey given to students from four medical schools, Pediatrics residents (2 training programs) and Family Medicine residents (2 programs). Data was analyzed using Statistix 8.0. One-way ANOVA test was used to compare means, and a p-value less than 0.05 was considered statistically significant. Participants (N=376) included 3rd (64%) and 4th (18%) year medical students and a homogenous distribution of 1st, 2nd and 3rd year residents. The mean percent of correct answers about immunizations was 61%. The participants showed poor knowledge about indications (62% correct answers), contraindications (46% correct answers) and myths (71% correct answers). Knowledge about immunizations correlated with higher levels of education (p immunizations followed by books (48%) and the internet (36%). They referred poor exposure to immunizations in clinical settings. Most medical students do not have the expected knowledge about immunization indications and contraindications. Residents were not proficient in immunization contraindications. Both groups had an adequate understanding about vaccination myths. Efforts towards ensuring adequate exposure to immunizations education during training years are needed in order to eliminate one of the barriers to adequate immunizations in children.

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

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Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

1996-06-01

To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p sexual harassment to someone (p sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

Biking practices and preferences in a lower income, primarily minority neighborhood: Learning what residents want

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Anne C. Lusk

2017-09-01

Full Text Available This paper examines if, in a lower-income minority neighborhood, bicycling practices and bicycle-environment preferences of Blacks and Hispanics were different from Whites. During the summer of 2014, surveys were mailed to 1537 households near a proposed cycle track on Malcolm X Boulevard in Roxbury, MA. On the Boulevard, intercept surveys were distributed to cyclists and observations noted about passing cyclist's characteristics. Data were analyzed from 252 returned-mailed surveys, 120 intercept surveys, and 709 bicyclists. White (100%, Hispanic (79%, and Black (76% bicyclists shown pictures of 6 bicycle facility types in intercept surveys perceived the cycle track as safest. More White mailed-survey respondents thought bikes would not be stolen which may explain why more Hispanics (52% and Blacks (47% preferred to park their bikes inside their home compared with Whites (28%, with H/W B/W differences statistically significant (p < 0.05. More Hispanic (81% and Black (54% mailed-survey respondents thought they would bicycle more if they could bicycle with family and friends compared with Whites (40%. Bicyclists observed commuting morning and evening included Blacks (55%, Whites (36% and Hispanics (9%. More Whites (68% wore helmets compared with Hispanics (21% and Blacks (17% (p < 0.001. More Blacks (94% and Hispanics (94% rode a mountain bike compared with Whites (75%. Minority populations are biking on roads but prefer cycle tracks. They also prefer to park bikes inside their homes and bicycle with family and friends. Wide cycle tracks (bicycling with family/friends and home bike parking should be targeted as capital investments in lower-income minority neighborhoods.

Family Income, Parent Education, and Perceived Constraints as Predictors of Observed Program Quality and Parent Rated Program Quality

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Torquati, Julia C.; Raikes, Helen H.; Huddleston-Casas, Catherine A.; Bovaird, James A.; Harris, Beatrice A.

2011-01-01

Observed child care quality and parent perceptions of child care quality received by children in poor (below Federal Poverty Line, FPL), low-income (between FPL and 200% of FPL), and non-low-income families were examined. Observations were completed in 359 center- and home-based child care programs in four Midwestern states and surveys were…

Developing an integrated evidence-based medicine curriculum for family medicine residency at the University of Alberta.

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Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna

2008-06-01

There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.

Impact of family and gender on career goals: results of a national survey of 4586 surgery residents.

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Viola, Kate V; Bucholz, Emily; Yeo, Heather; Piper, Crystal L; Piper, Crystal; Bell, Richard H; Sosa, Julie Ann

2010-05-01

To determine how marriage, children, and gender influence US categorical general surgery residents' perceptions of their profession and motivations for specialty training. Cross-sectional national survey administered after the January 2008 American Board of Surgery In-service Training Examination. Two hundred forty-eight US general surgery residency programs. All US categorical general surgery residents. We evaluated demographic characteristics with respect to survey responses using the chi(2) test, analysis of variance, and multivariate logistic regression. Interaction terms between variables were assessed. Perceptions of respondents regarding the future of general surgery and the role of specialty training in relation to anticipated income and lifestyle. The survey response rate was 75.0% (4586 respondents). Mean age was 30.6 years; 31.7% were women, 51.3% were married, and 25.4% had children. Of the respondents, 28.7% believed general surgery is becoming obsolete (30.1% of men and 25.9% of women; P = .004), and 55.1% believed specialty training is necessary for success (56.4% of men and 52.7% of women; P = .02). Single residents and residents without children were more likely to plan for fellowship (59.1% single vs 51.9% married, P Marital status, children, and gender appear to have a powerful effect on general surgery residents' career planning.

Visual impairment in urban school children of low-income families in Kolkata, India.

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Ghosh, Sambuddha; Mukhopadhyay, Udayaditya; Maji, Dipankar; Bhaduri, Gautam

2012-01-01

To evaluate pattern of visual impairment in school children from low-income families in Kolkata, India, an institutional cross-sectional study was conducted among 2570 children of 10 primary schools. Ocular examination including refraction was done and pattern of visual impairment and refractive error was studied. The age range was 6-14 years. Refractive error was seen in 14.7%. Only 4 children were already wearing correction. Myopia and hypermetropia was present in 307 (11.9%) and 65 (2.5%) children, respectively. Visual acuity of less than 6/12 in better eye was present in 109 (4.2%) and 5 (0.2%) children pre- and post-correction, respectively. Eighteen children had amblyopia. Although prevalence of refractive error in this group is less compared to school children of all income categories reported from other cities of India, it is more compared to school children of all income categories from the same city. Refractive error mostly remains uncorrected in this group.

Family income trajectory during childhood is associated with adiposity in adolescence: a latent class growth analysis

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Kendzor Darla E

2012-08-01

Full Text Available Abstract Background Childhood socioeconomic disadvantage has been linked with obesity in cross-sectional research, although less is known about how changes in socioeconomic status influence the development of obesity. Researchers have hypothesized that upward socioeconomic mobility may attenuate the health effects of earlier socioeconomic disadvantage; while downward socioeconomic mobility might have a negative influence on health despite relative socioeconomic advantages at earlier stages. The purpose of the current study was to characterize trajectories of family income during childhood, and to evaluate the influence of these trajectories on adiposity at age 15. Methods Data were collected as part of the Study of Early Child Care and Youth Development (SECCYD between 1991 and 2007 at 10 sites across the United States. A latent class growth analysis (LCGA was conducted to identify trajectories of family income from birth to 15 years of age. Analyses of covariance (ANCOVAs were conducted to determine whether measures of adiposity differed by trajectory, while controlling for relevant covariates. Results The LCGA supported a 5-class trajectory model, which included two stable, one downward, and two upward trajectories. ANCOVAs indicated that BMI percentile, waist circumference, and skinfold thicknesses at age 15 differed significantly by trajectory, such that those who experienced downward mobility or stable low income had greater adiposity relative to the more advantaged trajectories. Conversely, upwardly mobile children and those with consistently adequate incomes had similar and more positive outcomes relative to the most disadvantaged trajectories. Conclusions Findings suggest that promoting upward socioeconomic mobility among disadvantaged families may have a positive impact on obesity-related outcomes in adolescence.

Effectiveness of a Formal Mentorship Program in Family Medicine Residency: The Residents’ Perspective

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Marie Andrades

2013-01-01

Full Text Available Introduction. Mentoring is a recognized form of teaching learning strategy in postgraduate medical education. This paper describes the effectiveness of a formal mentorship program from the residents’ perspective after a year of implementation. Methods. The Aga Khan University Family Medicine Residency Program is the first program in Pakistan to our knowledge to implement formal mentorship for all four years of residency. A mentorship program was developed, implemented, and evaluated a year later using a rating scale. The 10-point Likert scale consisted of questions on academics, clinical work, research, administrative issues, and personal/social issues. Results. The response rate was 95% (. Eighty percent ( were women. Satisfaction level in seeking help was the highest for academics (75%. Residents scored mentorship as low in helping to tackle their personal problems (20%. Barriers reported in rapport building with mentor were time constraints and gender difference. The most useful attributes of the mentor which helped rapport building were accessibility, active listening, support for emotional needs, and trustworthiness. Conclusion. Mentoring has a role in trainees’ personal and professional growth especially when their needs are addressed. The effectiveness of the mentorship program in residency can improve if the residents are allowed to choose their own mentors.

Family income, parental education and internalizing and externalizing psychopathology among 2-3-year-old Chinese children: the mediator effect of parent-child conflict.

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Zhang, Xiao

2014-02-01

Using a sample of 156 Chinese children aged 2-3 years and their parents, this study examined the effects of socio-economic status, specifically family income and parental education, on the children's internalizing and externalizing psychopathology and whether these effects were mediated by mother-child and father-child conflict. Results indicated that family income, maternal education and paternal education all negatively predicted externalizing symptoms. Income also negatively predicted internalizing symptoms among boys but not girls. Maternal education negatively predicted internalizing symptoms among girls but not boys. The effects of income on psychopathology were fully mediated by mother-child and father-child conflict. In contrast, the effects of education were not mediated or only partially mediated by conflict. Findings are discussed in the framework of the family stress model. © 2013 International Union of Psychological Science.

What Health and Aged Care Culture Change Models Mean for Residents and Their Families: A Systematic Review.

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Petriwskyj, Andrea; Parker, Deborah; Brown Wilson, Christine; Gibson, Alexandra

2016-04-01

A range of commercialized programs are increasingly being adopted which involve broad culture change within care organizations to implement person-centered care. These claim a range of benefits for clients; however, the published evidence for client and family outcomes from culture change is inconclusive and the evidence for these specific models is difficult to identify. The purpose of this review was to identify and evaluate the peer-reviewed evidence regarding consumer outcomes for these subscription-based models. The review followed the Joanna Briggs Institute procedure. The review considered peer-reviewed literature that reported on studies conducted with health and aged care services, their staff, and consumers, addressed subscription-based person-centered culture change models, and were published in English up to and including 2015. The review identified 19 articles of sufficient quality that reported evidence relating to consumer outcomes and experience. Resident outcomes and family and resident satisfaction and experiences were mixed. Findings suggest potential benefits for some outcomes, particularly related to quality of life and psychiatric symptoms, staff engagement, and functional ability. Although residents and families identified some improvements in residents' lives, both also identified problematic aspects of the change related to staff adjustment and staff time. Outcomes for these models are at best comparable with traditional care with limited suggestions that they result in poorer outcomes and sufficient potential for benefits to warrant further investigation. Although these models may have the potential to benefit residents, the implementation of person-centered principles may affect the outcomes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

26 CFR 1.871-2 - Determining residence of alien individuals.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Determining residence of alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-2 Determining residence of alien individuals. (a) General. The term nonresident alien individual means an individual whose...

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis

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Ana Cristina Lindsay

2017-08-01

Full Text Available Latinos are the largest minority population group in the United States (U.S., and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44. Participants (n = 147 were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish administered by bilingual interviewers. About one-third (34% of participants were classified as having obesity (BMI ≥ 30 kg/m2, 28.3% had elevated depressive symptoms (CES-D ≥ 16, and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR = 2.80, 95% confidence interval (CI: 1.24–6.33. Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09. Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis.

Science.gov (United States)

Lindsay, Ana Cristina; Greaney, Mary L; Wallington, Sherrie F; Wright, Julie A; Hunt, Anne T

2017-08-02

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15-44). Participants ( n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers' Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m²), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24-6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02-1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when

Work-family conflict, health services and medication use among dual-income couples in Europe.

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Christiaens, Wendy; Bracke, Piet

2014-03-01

Combination pressure or work-life imbalance is linked to adverse health. However, it remains unclear how work-family conflict is related to healthcare utilisation. Does work-family conflict function as a barrier or as a facilitator in relation to the use of health services and prescription medication? Lack of time may prevent people from visiting a doctor when they feel unwell. However, combination pressure can also be expected to intensify the use of health services, as the need for a quick fix is prioritised. Further, do women and men differ in their susceptibility to medicalisation and time pressure resulting from work-life imbalance? This article investigates the use of health services and prescription medication of dual-income couples with children, based on data from 23 countries in the European Social Survey round 2 (N(women) = 3755; N(men) = 3142). It was found that medical services and prescription medications are used more frequently in dual-income couples experiencing work-to-family spillover, but for women only this is irrespective of their self-reported health. Family-to-work spillover does not result in increased health service or medication use for either men or women. While women opt for a medical response to work-life imbalance, men's reluctance to seek formal health support is confirmed. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Early resident-to-resident physics education in diagnostic radiology.

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Kansagra, Akash P

2014-01-01

The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Relationship Between Family, Parent, and Child Characteristics and Intimate-Partner Violence (IPV) Among Ukrainian Mothers.

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Burlaka, Viktor; Grogan-Kaylor, Andrew; Savchuk, Olena; Graham-Bermann, Sandra A

2017-07-01

To assess the prevalence of intimate partner violence (IPV) in a sample of Ukrainian mothers of schoolchildren, and to examine the relationship between IPV and family, parent, and child characteristics utilizing multilevel models. Mothers of children aged 9-16 (n = 278, 93.5% Ukrainians) answered the Revised Conflict Tactics Scale (CTS2) assessing IPV. We also examined the relationship between IPV and maternal age, education, employment and marital status, family income, and rural or urban residence. Eighty-one percent of women reported psychological violence and 58% reported physical assault. On average, women reported 66 instances of IPV during the last year. Multilevel modeling revealed that lower maternal education, unemployment, not living with the husband or partner, and urban residency were associated with higher IPV victimization. Younger age and family income were not significantly related to IPV. IPV was a significant social problem in the present sample of Ukrainian mothers of school age children. Future policy and violence prevention programming should focus on supporting academic and employment opportunities for women, particularly for those living in urban areas.

The Well-Being of Maryland Parents and Their Children: Differences by Income Status and Family Structure. Research Brief. Publication #2009-22

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Wertheimer, Richard; Moore, Kristin Anderson; Kahn, Jordan

2009-01-01

Research studies based on statistics for the United States as a whole have documented differences in child and family well-being between children in low-income families and children in more affluent families and between children in single-parent families and children in two-parent families. However, researchers have not explored differences in…

Income Inequality and Income Taxation in Canada: Trends in the Census 1980-2005

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Kevin Milligan

2013-08-01

Full Text Available Faced with rising fiscal pressures and discontent over income inequality, many countries, Canada among them, are searching for remedies. Income tax systems offer an effective way of changing economic destinies, so it’s only natural for governments to regard tax policy as a panacea. The first step to a solution is to understand how income tax influences existing inequality. This paper provides an overview of trends in pre- and post-tax income distribution in Canada from 1980-2005, by drawing on a more comprehensive data source than those found in many existing studies — Canadian census data. The results are in broad agreement: money has been steadily accumulating in the top half of the income distribution since 1980, with the trend quickening after 1995. This is just as true for family after-tax incomes as it is for individual market incomes even after the impact of the income tax system is taken into account. Over the 25-year period studied, the Gini coefficient rose from 0.352 to 0.404 for pre-tax income, and from 0.312 to 0.349 for after-tax income, while the proportion of the increase undone by taxation fell to a low of 2 per cent after 1995, as the Canadian tax system became less redistributive. However, some progressive aspects remain. Improvements to refundable tax credits in the late 1990s led to a 20 per cent decline in the number of families falling under the Low-Income Cut-Off. Canada’s income tax system hasn’t kept pace with climbing pre-tax inequality, but it continues to be a useful aftertax equalizer for low-income families.

The relationship between diet and perceived and objective access to supermarkets among low-income housing residents

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Caspi, Caitlin E.; Kawachi, Ichiro; Subramanian, S.V.; Adamkiewicz, Gary; Sorensen, Glorian

2013-01-01

In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in “food deserts,” or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in “food deserts,” as the average distance to a supermarket was 0.76 km (range 0.13–1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures. PMID:22727742

Impact of income and income inequality on infant health outcomes in the United States.

Science.gov (United States)

Olson, Maren E; Diekema, Douglas; Elliott, Barbara A; Renier, Colleen M

2010-12-01

The goal was to investigate the relationships of income and income inequality with neonatal and infant health outcomes in the United States. The 2000-2004 state data were extracted from the Kids Count Data Center. Health indicators included proportion of preterm births (PTBs), proportion of infants with low birth weight (LBW), proportion of infants with very low birth weight (VLBW), and infant mortality rate (IMR). Income was evaluated on the basis of median family income and proportion of federal poverty levels; income inequality was measured by using the Gini coefficient. Pearson correlations evaluated associations between the proportion of children living in poverty and the health indicators. Linear regression evaluated predictive relationships between median household income, proportion of children living in poverty, and income inequality for the 4 health indicators. Median family income was negatively correlated with all birth outcomes (PTB, r = -0.481; LBW, r = -0.295; VLBW, r = -0.133; IMR, r = -0.432), and the Gini coefficient was positively correlated (PTB, r = 0.339; LBW, r = 0.398; VLBW, r = 0.460; IMR, r = 0.114). The Gini coefficient explained a significant proportion of the variance in rate for each outcome in linear regression models with median family income. Among children living in poverty, the role of income decreased as the degree of poverty decreased, whereas the role of income inequality increased. Both income and income inequality affect infant health outcomes in the United States. The health of the poorest infants was affected more by absolute wealth than relative wealth.

Why poverty remains high: the role of income growth, economic inequality, and changes in family structure, 1949-1999.

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Iceland, John

2003-08-01

After dramatic declines in poverty from 1950 to the early 1970s in the United States, progress stalled. This article examines the association between trends in poverty and income growth, economic inequality, and changes in family structure using three measures of poverty: an absolute measure, a relative measure, and a quasi-relative one. I found that income growth explains most of the trend in absolute poverty, while inequality generally plays the most significant role in explaining trends in relative poverty. Rising inequality in the 1970s and 1980s was especially important in explaining increases in poverty among Hispanics, whereas changes in family structure played a significant role for children and African Americans through 1990. Notably, changes in family structure no longer had a significant association with trends in poverty for any group in the 1990s.

Preparing Residents for Teaching Careers: The Faculty for Tomorrow Resident Workshop.

Science.gov (United States)

Lin, Steven; Gordon, Paul

2017-03-01

Progress toward growing the primary care workforce is at risk of being derailed by an emerging crisis: a critical shortage of family medicine faculty. In response to the faculty shortage, the Society of Teachers of Family Medicine (STFM) launched a 2-year initiative called "Faculty for Tomorrow" (F4T). The F4T Task Force created a workshop designed to increase residents' interest in, and prepare them for, careers in academic family medicine. We aimed to evaluate the effectiveness of this workshop. Participants were family medicine residents who preregistered for and attended the F4T Resident Workshop at the 2016 STFM Annual Spring Conference. The intervention was a full-day, 9-hour preconference workshop delivered by a multi-institutional faculty team. Participants were asked to complete a questionnaire before and immediately after the workshop. Data collected included demographics, residency program characteristics, future career plans, self-reported confidence in skills, and general knowledge relevant to becoming faculty. A total of 75 participants attended the workshop. The proportion of those who were "extremely likely" to pursue a career in academic family medicine increased from 58% to 72%. Participants reported statistically significant improvements in their confidence in clinical teaching, providing feedback to learners, writing an effective CV, knowledge about the structure of academic family medicine, and knowledge about applying for a faculty position. The STFM F4T Resident Workshop was effective at increasing participants' interest in academic careers, as well as self-reported confidence in skills and knowledge relevant to becoming faculty. The data collected from participants regarding their career plans may inform future interventions.

Mothers’ Depression and Stress, Severity of Autism among Children and Family Income

OpenAIRE

Athari, Pegah; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia; Ghaedi, Leila; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia

2013-01-01

This study was conducted to investigate the relationship between mothers’ depression and stress compared with severity of autism in children and the effect of family income on the relationship between these two latter variables. Levels of depression and stress among mothers (n=250) were measured based on Depression Anxiety and Stress Scale of 42 items (DASS¬-42). The severity of autism among children was assessed by Autism Behavior Checklist (ABC) according to children’s teachers reports (n=2...

Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

Directory of Open Access Journals (Sweden)

Angela D. Liese

2017-09-01

Full Text Available Low-income areas in which residents have poor access to healthy foods have been referred to as “food deserts.” It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI. We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc. with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m2. The vast majority of study participants shopped at supermarkets (61% or supercenters/warehouse clubs (27%. Shopping at a supercenter or warehouse club as one’s primary store was significantly associated with a 2.6 kg/m2 higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m2 lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should

Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

Science.gov (United States)

Liese, Angela D.; Ma, Xiaonan; Hutto, Brent; Sharpe, Patricia A.; Bell, Bethany A.; Wilcox, Sara

2017-01-01

Low-income areas in which residents have poor access to healthy foods have been referred to as “food deserts.” It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI). We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc.) with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m2. The vast majority of study participants shopped at supermarkets (61%) or supercenters/warehouse clubs (27%). Shopping at a supercenter or warehouse club as one’s primary store was significantly associated with a 2.6 kg/m2 higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m2 lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should consider assessing

Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina.

Science.gov (United States)

Liese, Angela D; Ma, Xiaonan; Hutto, Brent; Sharpe, Patricia A; Bell, Bethany A; Wilcox, Sara

2017-09-16

Low-income areas in which residents have poor access to healthy foods have been referred to as "food deserts." It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI). We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc.) with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m². The vast majority of study participants shopped at supermarkets (61%) or supercenters/warehouse clubs (27%). Shopping at a supercenter or warehouse club as one's primary store was significantly associated with a 2.6 kg/m² higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m² lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should consider assessing

Lifestyle medicine course for family medicine residents: preliminary assessment of the impact on knowledge, attitudes, self-efficacy and personal health.

Science.gov (United States)

Malatskey, Lilach; Bar Zeev, Yael; Tzuk-Onn, Adva; Polak, Rani

2017-09-01

The WHO estimates that by 2020 two-thirds of the diseases worldwide will be the result of unhealthy lifestyle habits. Less than half of primary care physician graduates feel prepared to give lifestyle behaviour counselling. Our objective was to evaluate the impact of lifestyle medicine (LM) course on self-reported knowledge, attitudes, self-efficacy and health behaviour of family medicine residents. Based on the Israeli syllabus for the study of LM, we delivered five face to face 20 H courses. Pre/post data were collected by knowledge, attitudes, self-efficacy and personal health survey: RESULTS: A total of 112 family medicine residents participated in one of the five courses, of which 91 (81.3%) filled both pre and post surveys. Participates showed an improvement in self-reported knowledge and capacity to manage patients in regard to smoking, weight management and physical activity. An improvement was noted in personal health behaviour of overweight participant's in regard to self-reported physical activity. A comprehensive LM syllabus based course has a positive impact on family medicine residents LM counselling abilities. We suggest that LM course should be considered as a potential permanent addition to the family medicine residency programme. 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/.

Family planning advice and postpartum contraceptive use among low-income women in Mexico.

Science.gov (United States)

Barber, Sarah L

2007-03-01

In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

Does longer duration of breastfeeding prevent childhood asthma in low-income families?

Science.gov (United States)

Arif, Ahmed A; Racine, Elizabeth F

2017-08-01

The objective of this study was to examine the relationship of breastfeeding duration with childhood asthma among low-income families in Karachi, Pakistan. Mothers/caregivers of 200 children with asthma and an equal number of children without asthma were interviewed about breastfeeding duration. Based on the responses, 6 different binary variables were constructed: breastfeeding 3 months or less, 6 months or less, 9 months or less, 12 months or less, 18 months or less, and 24 months or less. Asthma status of the child was determined by clinical examination by a primary care physician. Data was analyzed using multiple logistic regression method, adjusted for age and sex of the child, household income, parental ethnicity, number of older siblings, family history of asthma or hay fever, presence of mold, parental smoking, number of people in the household, and body mass index of the child. The average duration of breastfeeding was 21.4 months (SD = 7.33 months). Breastfeeding for at least 24 months was associated with increased odds of asthma (aOR = 1.77, 95%CI: 0.99, 3.16). Whereas breastfeeding for 12 months or less, and to some extent 18 months or less, was protective against childhood asthma. There was some evidence this protective effect may be delayed in children with a family history of asthma or hay fever. This study found breastfeeding for 12 months or less may have a protective effect against asthma. The protective effect weans down after 18 months, and if continued 24 months or more may place the child at-risk of asthma.

Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance.

Science.gov (United States)

Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M

2017-10-11

This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.

On Noncooperative Capital Income Taxation in Open Economies

OpenAIRE

Kenneth Kletzer

1990-01-01

This paper discusses the strategic use of capital income taxation and lump-sum fiscal policies for gaining national advantage in an integrated world capital market. Each fiscal authority seeks to maximize a social welfare function defined over the utilities of home country residents incorporating national redistributing objectives. A national optimum policy is to impose a non-discriminatory source-based capital income tax or subsidy along with an optimal lump-sum tax and transfer plan. Reside...

Income Inequality and Intergenerational Income Mobility in the United States

Science.gov (United States)

Bloome, Deirdre

2015-01-01

Is there a relationship between family income inequality and income mobility across generations in the United States? As family income inequality rose in the United States, parental resources available for improving children’s health, education, and care diverged. The amount and rate of divergence also varied across US states. Researchers and policy analysts have expressed concern that relatively high inequality might be accompanied by relatively low mobility, tightening the connection between individuals’ incomes during childhood and adulthood. Using data from the Panel Study of Income Dynamics, the National Longitudinal Survey of Youth, and various government sources, this paper exploits state and cohort variation to estimate the relationship between inequality and mobility. Results provide very little support for the hypothesis that inequality shapes mobility in the United States. The inequality children experienced during youth had no robust association with their economic mobility as adults. Formal analysis reveals that offsetting effects could underlie this result. In theory, mobility-enhancing forces may counterbalance mobility-reducing effects. In practice, the results suggest that in the US context, the intergenerational transmission of income may not be very responsive to changes in inequality. PMID:26388653

Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

Directory of Open Access Journals (Sweden)

Chang LF

2007-06-01

Full Text Available Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.Results: Findings from this chart review include: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative.Discussion: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway

Science.gov (United States)

Zachrisson, Henrik D.; Dearing, Eric

2015-01-01

The sociopolitical context of Norway includes low poverty rates and universal access to subsidized and regulated Early Childhood Education and Care (ECEC). In this context, the association between family income dynamics and changes in early child behavior problems was investigated, as well as whether high-quality ECEC buffers children from the…

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

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Nykänen, Esa-Pekka A; Dunning, Hanna E; Aryeetey, Richmond N O; Robertson, Aileen; Parlesak, Alexandr

2018-04-07

The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural acceptability for families living in extreme and moderate poverty (food budget under USD 1.9 and 3.1 per day respectively). Energy-appropriate FBs minimized for cost, following Food Balance Sheets (FBS), lacked key micronutrients such as iodine, vitamin B12 and iron for the mothers. Nutritionally adequate FBs were achieved in all settings when optimizing for a diet cheaper than USD 3.1. However, when delimiting cost to USD 1.9 in rural areas, wild foods had to be included in order to meet nutritional adequacy. Optimization suggested to reduce roots, tubers and fruits and to increase cereals, vegetables and oil-bearing crops compared with FBS. LP is a useful tool to design culturally acceptable diets at minimum cost for low-income Ghanaian families to help advise national authorities how to overcome the double burden of malnutrition.

Perceived spatial stigma, body mass index and blood pressure: a global positioning system study among low-income housing residents in New York City

Directory of Open Access Journals (Sweden)

Dustin T. Duncan

2016-05-01

Full Text Available Previous research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI, and blood pressure among a sample of low-income housing residents in New York City (NYC. Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample. Global positioning systems (GPS tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051, as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01 and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004. In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR=1.32, 95%CI: 1.1, 1.4, P=0.02 and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007. However, we found no differences in spatial mobility (based GPS data among participants who reported living in neighborhoods with and without spatial stigma (P>0.05. Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals

Geographical Income Polarization

DEFF Research Database (Denmark)

Azhar, Hussain; Jonassen, Anders Bruun

inter municipal income inequality. Counter factual simulations show that rising property prices to a large part explain the rise in polarization. One side-effect of polarization is tendencies towards a parallel polarization of residence location patterns, where low skilled individuals tend to live...

Two-year outcomes of the Early Risers prevention trial with formerly homeless families residing in supportive housing.

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Gewirtz, Abigail H; DeGarmo, David S; Lee, Susanne; Morrell, Nicole; August, Gerald

2015-04-01

This article reports 2-year outcomes from a cluster randomized, controlled trial of the Early Risers (ER) program implemented as a selective preventive intervention in supportive housing settings for homeless families. Based on the goals of this comprehensive prevention program, we predicted that intervention participants receiving ER services would show improvement in parenting and child outcomes relative to families in treatment-as-usual sites. The sample included 270 children in 161 families, residing in 15 supportive housing sites; multimethod, multi-informant assessments conducted at baseline and yearly thereafter included parent and teacher report of child adjustment, parent report of parenting self-efficacy, and parent-child observations that yielded scores of effective parenting practices. Data were modeled in HLM7 (4-level model accounting for nesting of children within families and families within housing sites). Two years' postbaseline, intent-to-treat (ITT) analyses indicated that parents in the ER group showed significantly improved parenting self-efficacy, and parent report indicated significant reductions in ER group children's depression. No main effects of ITT were shown for observed parenting effectiveness. However, over time, average levels of parenting self-efficacy predicted observed effective parenting practices, and observed effective parenting practices predicted improvements in both teacher- and parent-report of child adjustment. This is the first study to our knowledge to demonstrate prevention effects of a program for homeless families residing in family supportive housing. (c) 2015 APA, all rights reserved).

Motherhood during residency training: challenges and strategies.

Science.gov (United States)

Walsh, Allyn; Gold, Michelle; Jensen, Phyllis; Jedrzkiewicz, Michelle

2005-07-01

To determine what factors enable or impede women in a Canadian family medicine residency program from combining motherhood with residency training. To determine how policies can support these women, given that in recent decades the number of female family medicine residents has increased. Qualitative study using in-person interviews. McMaster University Family Medicine Residency Program. Twenty-one of 27 family medicine residents taking maternity leave between 1994 and 1999. Semistructured interviews. The research team reviewed transcripts of audiotaped interviews for emerging themes; consensus was reached on content and meaning. NVIVO software was used for data analysis. Long hours, unpredictable work demands, guilt because absences from work increase workload for colleagues, and residents' high expectations of themselves cause pregnant residents severe stress. This stress continues upon return to work; finding adequate child care is an added stress. Residents report receiving less support from colleagues and supervisors upon return to work; they associate this with no longer being visibly pregnant. Physically demanding training rotations put additional strain on pregnant residents and those newly returned to work. Flexibility in scheduling rotations can help accommodate needs at home. Providing breaks, privacy, and refrigerators at work can help maintain breastfeeding. Allowing residents to remain involved in academic and clinical work during maternity leave helps maintain clinical skills, build new knowledge, and promote peer support. Pregnancy during residency training is common and becoming more common. Training programs can successfully enhance the experience of motherhood during residency by providing flexibility at work to facilitate a healthy balance among the competing demands of family, work, and student life.

Family income and young adolescents’ perceived social position: associations with self-esteem and life satisfaction in the UK Millennium Cohort Study

Science.gov (United States)

Bannink, Rienke; Pearce, Anna

2016-01-01

Background Self-esteem and life satisfaction are important aspects of positive mental health in young people, and both are socially distributed. However, the majority of evidence is based on socioeconomic characteristics of the family. As children enter adolescence and gain independence, perceptions of their own social position are likely to influence mental health. Design and objectives Using data on 11-year-olds from the UK Millennium Cohort Study, we investigated associations of both family income and young adolescents’ perception of their social position with self-esteem and life satisfaction. We hypothesised that there would be differences in the impact of perceived social position on positive mental health when investigating the full scale scoring distribution or the bottom of the distribution. Therefore, we estimated proportional odds for having greater positive mental health (across the distribution of scores) and ORs for poor outcomes (lowest 10% scores). Results The likelihood of greater self-esteem and life satisfaction increased with income; similarly, the risk of having poor self-esteem and life satisfaction increased as income decreased. Young adolescents who perceived their family as poorer than their friends (instead of about the same) were less likely to have greater self-esteem and life satisfaction and were more likely to have poor outcomes. Young adolescents who perceived their family as richer were more likely to have poor self-esteem, but were not less likely to have greater self-esteem. For life satisfaction, young adolescents who perceived their families as richer were less likely to have greater and more likely to have poor life satisfaction. Conclusions Policies to redistribute income in families with children are likely to benefit the mental health of young people. However, it is also important to consider the impact of social comparison on young people's mental health as they enter adolescence. PMID:26957529

Agricultural and residential pesticides in wipe samples from farmworker family residences in North Carolina and Virginia.

OpenAIRE

Quandt, Sara A; Arcury, Thomas A; Rao, Pamela; Snively, Beverly M; Camann, David E; Doran, Alicia M; Yau, Alice Y; Hoppin, Jane A; Jackson, David S

2004-01-01

Children of farmworkers can be exposed to pesticides through multiple pathways, including agricultural take-home and drift as well as residential applications. Because farmworker families often live in poor-quality housing, the exposure from residential pesticide use may be substantial. We measured eight locally reported agricultural pesticides and 13 pesticides commonly found in U.S. houses in residences of 41 farmworker families with at least one child < 7 years of age in western North Caro...

Family obligation values as a protective and vulnerability factor among low-income adolescent girls.

Science.gov (United States)

Milan, Stephanie; Wortel, Sanne

2015-06-01

Adolescents' beliefs about family obligation often reflect cultural variations in their family context, and thus are important for understanding development among diverse youth. In this study, we test hypotheses about the role of family obligation values in risk behavior and mental health in a sample of 194 low-income adolescent girls (mean age = 15.2; 58% Latina, 28% African-American/Black). We hypothesized that family obligation values can be both a protective and vulnerability factor, depending on the type of outcome and the presence of other risk factors. Across the sample, higher family obligation values tended to occur with indicators of positive family functioning (e.g., more frequent communication, less maternal hostility) based on mother and adolescent reports. As hypothesized, family obligation values moderated the relationship between established risk factors and adjustment in distinct ways, such that high family obligation values decreased risk in some domains (i.e., a protective factor) but increased risk in other domains (i.e., a vulnerability factor). Specifically, high family obligation values diminished the relationship between peer norms for risky behavior (sex and substance use) and individual engagement in those behaviors. At the same time, high family obligation values magnified the relationship between exposure to negative life events and poor mental health (PTSD and depressive symptoms). The results suggest that family obligation is an important but complex aspect of development among diverse adolescent girls.

Family Obligation Values as a Protective and Vulnerability Factor among Low-Income Adolescent Girls

Science.gov (United States)

Milan, Stephanie; Wortel, Sanne

2014-01-01

Adolescents’ beliefs about family obligation often reflect cultural variations in their family context, and thus are important for understanding development among diverse youth. In this study, we test hypotheses about the role of family obligation values in risk behavior and mental health in a sample of 194 low-income adolescent girls (Mean age = 15.2; 58% Latina, 28% African-American/Black). We hypothesized that family obligation values can be both a protective and vulnerability factor, depending on the type of outcome and the presence of other risk factors. Across the sample, higher family obligation values tended to occur with indicators of positive family functioning (e.g., more frequent communication, less maternal hostility) based on mother and adolescent reports. As hypothesized, family obligation values moderated the relationship between established risk factors and adjustment in distinct ways, such that high family obligation values decreased risk in some domains (i.e., a protective factor) but increased risk in other domains (i.e., a vulnerability factor). Specifically, high family obligation values diminished the relationship between peer norms for risky behavior (sex and substance use) and individual engagement in those behaviors. At the same time, high family obligation values magnified the relationship between exposure to negative life events and poor mental health (PTSD and depressive symptoms). The results suggest that family obligation is an important but complex aspect of development among diverse adolescent girls. PMID:25351163

Introducing Family Tax Splitting in Germany: How Would It Affect the Income Distribution, Work Incentives and Household Welfare?

OpenAIRE

Viktor Steiner; Katharina Wrohlich

2007-01-01

We analyze the effects of three alternative proposals to reform the taxation of families relative to the current German system of joint taxation of couples and child allowances: a French-type family splitting and two full family splitting proposals. The empirical analysis of the effects of these proposals on the income distribution and on work incentives is based on a behavioral micro-simulation model which integrates an empirical household labor supply model into a detailed tax-benefit model...

Family cohesion moderates the relationship between acculturative stress and depression in Japanese adolescent temporary residents.

Science.gov (United States)

Roley, Michelle E; Kawakami, Ryoko; Baker, Jessica; Hurtado, Gabriela; Chin, Andrew; Hovey, Joseph D

2014-12-01

Acculturative stress is a risk factor for depression, and may be important in the risk for depression among acculturating Japanese adolescents. However, little to no research has been published on the mental health of acculturating Japanese adolescents. Further, although family cohesion has been shown to be protective against depression across ethnic groups, no prior research has examined family cohesion as a protective factor for Japanese adolescents. To examine these relationships, 26 Japanese temporary resident adolescents and 76 parents in the Midwest were recruited to participate. Moderate to strong correlations between acculturative stress, depression, likelihood for and seriousness of family conflict were found. A regression analysis found that likelihood for family conflict moderated the relationship between acculturative stress and depression. Findings broaden our understanding of the role of acculturative stress and family conflict on depression risk for Japanese adolescent immigrants.

Levels and trends in the income mobility of U.S. families, 1977 - 2012

OpenAIRE

Bradbury, Katharine L.

2016-01-01

Much of America's promise is predicated on economic mobility - the possibility that people can move up and down the economic ladder during their lifetimes. Mobility is of particular consequence when economic disparities are increasing. Using panel data and mobility concepts and measures adapted from the literature, this paper examines 10-year income mobility levels and trends for U.S. working-age families during the time span 1977 - 2012. According to many measures, mobility, already limited ...

Mental Health and Family Functioning as Determinants of A Sedentary Lifestyle among Low-Income Women with Young Children

Science.gov (United States)

Li, Kaigang; Davison, Kirsten K.; Jurkowski, Janine M.

2012-01-01

This cross-sectional study examined mental health and family environmental factors related to a sedentary lifestyle, including lack of leisure-time physical activity (LTPA) and high levels of television viewing, among low-income mothers/female guardians of preschool-aged children. A self-administered questionnaire was completed by 131 mothers in 2010. Primary outcome measures included television viewing time (minutes/day) and LTPA (3 hours). Additionally, 36% of women engaged in less than the recommended 150-minute LTPA per week. Hierarchical multiple regression analyses indicated that greater depressive symptoms (B = 76.4, p<.01) and lower family functioning (B = 33.0, p < .05) were independently related to greater television viewing when controlling for other variables. No independent factors were identified for lack of LTPA when controlling for other covariates. Findings suggest that health promotion efforts to promote an active lifestyle among low-income women with young children should address mental health and family functioning factors, especially depressive symptoms. PMID:22860706

Immigration and the distribution of incomes

OpenAIRE

Blau, Francine D.; Kahn, Lawrence M.

2012-01-01

We review research on the impact of immigration on income distribution. We discuss routes through which immigration can affect income distribution in the host and source countries, including compositional effects and effects on native incomes. Immigration may affect the composition of skills among the residents of a country. Moreover, immigrants can, by changing relative factor supplies, affect native wage and employment rates and the return to capital. We then provide evidence on the level a...

Communication from the Legal Service and the HR Department: 2005 INCOME TAX DECLARATION

CERN Document Server

2006-01-01

1) Avis d'impôt sent by the French Centre des Impôts Members of the personnel residing in France have received (or are about to receive) a document issued by their local Centre des Impôts (CDI) entitled «Avis d'impôt - Impôt sur les revenus de 2005». The document states in particular that: 'The declaration form you have filed indicates no income for 2005. Please note that this avis d'impôt does not constitute substantiation of the absence of any income. You have been in receipt of income from international organisations or diplomatic or consular missions that is exempt from taxation in France. Indicate this income at the bottom of this avis d'impôt.'1) This document must not be returned to your CDI. It is intended for French administrative bodies and agencies wishing to obtain information on your tax position in France. If a French body or agency (e.g. the Family Allowances Fund) requests you to provide it with information on the income you have declared to the tax authorities, you must indicate i...

Income inequality in today's China.

Science.gov (United States)

Xie, Yu; Zhou, Xiang

2014-05-13

Using multiple data sources, we establish that China's income inequality since 2005 has reached very high levels, with the Gini coefficient in the range of 0.53-0.55. Analyzing comparable survey data collected in 2010 in China and the United States, we examine social determinants that help explain China's high income inequality. Our results indicate that a substantial part of China's high income inequality is due to regional disparities and the rural-urban gap. The contributions of these two structural forces are particularly strong in China, but they play a negligible role in generating the overall income inequality in the United States, where individual-level and family-level income determinants, such as family structure and race/ethnicity, play a much larger role.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

OpenAIRE

Wilson Mark C; Mustafa Reem; Gunukula Sameer; Akl Elie A; Symons Andrew; Moheet Amir; Schünemann Holger J

2010-01-01

Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United Stat...

Does early-life family income influence later dental pain experience? A prospective 14-year study.

Science.gov (United States)

Ghorbani, Z; Peres, M A; Liu, P; Mejia, G C; Armfield, J M; Peres, K G

2017-12-01

The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions. © 2017 Australian Dental Association.

The profile of the Greek 'XXL' family.

Science.gov (United States)

Christoforidis, Athanasios; Batzios, Spyros; Sidiropoulos, Haralampos; Provatidou, Maria; Cassimos, Dimitris

2011-10-01

To identify Greek families in which all members were overweight or obese (XXL families) and to describe their profile with regard to their socio-economic status and their eating behaviours and practices. A prospective cohort study. The metropolitan area of Kavala. We recruited children aged 11 and 12 years from twelve primary schools, and their parents, from volunteers. Auxologic measurements of the children included height and weight. A structured questionnaire pertaining to information on the socio-economic status of the family, anthropometric values and educational status of parents, dietary habits and the availability of various food products and beverages at home, as well as dietary intake, physical activity, time spent sleeping and time spent watching television, was filled in by one of the parents of each child. A total of 331 families finally participated. In sixty-one families (18·43 %) both parents and child were either overweight or obese (XXL family), and in seven of these families all members were obese. Only twenty-eight families (8·46 %) had all members with a normal BMI. The XXL family was associated with lower educational status of both parents, whereas a higher percentage of XXL families resided in rural areas and had lower income. Skipping breakfast and spending more than 3 h in front of a screen every day were more frequently observed in XXL families. With regard to the availability of various food products and beverages at home, no significant differences were observed between XXL families and the rest of the studied families. Greek XXL families have lower educational status and lower annual income.

College Costs and Family Income: The Affordability Issue at UC and CSU. Report 11-02

Science.gov (United States)

Jones, Jessika

2011-01-01

Rising costs are putting an education at California's public universities out of reach for many Californians. Eroding state funding for higher education has meant that more costs are passed on to students and their families in the form of increased fees. Room and board and other costs have grown much faster than inflation. Incomes have not kept…

A model for scale up of family health innovations in low-income and middle-income settings: a mixed methods study.

Science.gov (United States)

Bradley, Elizabeth H; Curry, Leslie A; Taylor, Lauren A; Pallas, Sarah Wood; Talbert-Slagle, Kristina; Yuan, Christina; Fox, Ashley; Minhas, Dilpreet; Ciccone, Dana Karen; Berg, David; Pérez-Escamilla, Rafael

2012-01-01

Many family health innovations that have been shown to be both efficacious and cost-effective fail to scale up for widespread use particularly in low-income and middle-income countries (LMIC). Although individual cases of successful scale-up, in which widespread take up occurs, have been described, we lack an integrated and practical model of scale-up that may be applicable to a wide range of public health innovations in LMIC. To develop an integrated and practical model of scale-up that synthesises experiences of family health programmes in LMICs. We conducted a mixed methods study that included in-depth interviews with 33 key informants and a systematic review of peer-reviewed and grey literature from 11 electronic databases and 20 global health agency web sites. We included key informants and studies that reported on the scale up of several family health innovations including Depo-Provera as an example of a product innovation, exclusive breastfeeding as an example of a health behaviour innovation, community health workers (CHWs) as an example of an organisational innovation and social marketing as an example of a business model innovation. Key informants were drawn from non-governmental, government and international organisations using snowball sampling. An article was excluded if the article: did not meet the study's definition of the innovation; did not address dissemination, diffusion, scale up or sustainability of the innovation; did not address low-income or middle-income countries; was superficial in its discussion and/or did not provide empirical evidence about scale-up of the innovation; was not available online in full text; or was not available in English, French, Spanish or Portuguese, resulting in a final sample of 41 peer-reviewed articles and 30 grey literature sources. We used the constant comparative method of qualitative data analysis to extract recurrent themes from the interviews, and we integrated these themes with findings from the

Family Resources as Protective Factors for Low-Income Youth Exposed to Community Violence.

Science.gov (United States)

Hardaway, Cecily R; Sterrett-Hong, Emma; Larkby, Cynthia A; Cornelius, Marie D

2016-07-01

Exposure to community violence is a risk factor for internalizing and externalizing problems; however, resources within the family can decrease the likelihood that adolescents will experience internalizing and externalizing problems as a result of such exposure. This study investigates the potential moderating effects of kinship support (i.e., emotional and tangible support from extended family) and parental involvement on the relation between exposure to community violence (i.e., witnessing violence and violent victimization) and socioemotional adjustment (i.e., internalizing and externalizing problems) in low-income adolescents. The sample included 312 (50 % female; 71 % African American and 29 % White) low-income youth who participated in a longitudinal investigation when adolescents were age 14 (M age = 14.49 years) and again when they were 16 (M age = 16.49 years). Exposure to community violence at age 14 was related to more internalizing and externalizing problems at age 16. High levels of kinship support and parental involvement appeared to function as protective factors, weakening the association between exposure to violence and externalizing problems. Contrary to prediction, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems. The results from this study suggest that both kinship support and parental involvement help buffer adolescents from externalizing problems that are associated with exposure to community violence.

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'…

Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income, Latino Children of Predominantly Immigrant Families: A Qualitative Study.

Science.gov (United States)

Lindsay, Ana Cristina; Wallington, Sherrie F; Lees, Faith D; Greaney, Mary L

2018-05-14

Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and maintains dietary and physical activity (PA) habits that ultimately impact weight status. Previous research suggests the parents are central to creating a home environment that facilitates or hinders the development of children’s early healthy eating and PA habits. Therefore, the purpose of this study was to explore low-income Latino parents’ beliefs, parenting styles, and parenting practices related to their children’s eating and PA behaviors while at home. Qualitative study using focus group discussions (FGDs) with 33 low-income Latino parents of preschool children 2 to 5 years of age. FGDs were transcribed verbatim and analyzed using thematic analysis. Data analyses revealed that most parents recognize the importance of healthy eating and PA for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. This study provides information about how the home environment may influence low-income Latino preschool children’s eating and PA habits, which may be useful for health promotion and disease prevention efforts targeting low-income Latino families with young children, and for developing home-based and parenting interventions to prevent and control childhood obesity among this population group. Pediatric healthcare providers can play an important role in facilitating communication, providing education, and offering guidance to low-income Latino parents that support their children’s development of early healthy eating and PA habits, while taking into account daily life barriers faced

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.