scholarly journals Demographic, occupational and societal risk exposures to physical injuries in a rural community in Western Kenya: a 12-week longitudinal study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053161
Author(s):  
Reagan Ngoge Chweya ◽  
Susan Njoki Mambo ◽  
John Mwangi Gachohi
Keyword(s):  
Rural Setting ◽  
Middle Aged ◽  
Western Kenya ◽  
Survey Tool ◽  
Household Level ◽  
Individual Level ◽  
Independent Variables ◽  
Physical Injuries ◽  
Societal Risk ◽  
Study Participants

ObjectiveWe studied factors associated with the weekly occurrence of physical injuries in a rural setting to determine injury-related burden and risk exposures.DesignProspective cohort study.SettingSuna-West subcounty, Migori County, Western Kenya.Participants390 study participants (subjects) cluster sampled from 92 households, recruited and followed up for 12 weeks, between August and October 2019.MethodsWe collected data weekly on occurrence of injuries, individual-level and household-level independent variables using a standard interviewer-administered questionnaire adapted from the WHO survey tool for injuries. Analyses related occurrence of injuries and independent variables using a multilevel Poisson regression model, adjusting for age and sex.Outcome measuresQuantifying injury-related burden and patterns by demographic, occupational and societal risk exposures.ResultsWe documented 44 injuries, coming from 38 subjects dwelling in 30 of the 92 study households. On average, each study subject and household experienced 1.2 and 1.5 episodes of injuries across the 12 study weeks. Open wounds and bruises were the most frequent injuries commonly reported among middle-aged (18–54 years) and young (5–17 years) subjects at 32.2 and 7.6 episodes per 1000-person week, respectively. The common cause of injuries among young, middle-aged and old subjects (>54 years) were falls, road accidents and person-related assault or being hit by an object, each at 15.2, 18.9, and 11.4 episodes per 1000-person week, respectively. Subjects not domesticating animals (incidence rate ratio (IRR)=7.6, 95% CI 1.4 to 41.7) and those making a visit outside the local subcounty of residence (IRR=2.2, 95% CI 1.5 to 3.1) were at higher risk of reporting injuries.ConclusionWe provide evidence of a higher burden of physical injuries associated with demographic, occupational and societal risk exposures with the most injuries resulting from falls. Further studies could better define granular characteristics constituting these factors.

scholarly journals Understanding Food Waste, Food Insecurity, and the Gap between the Two: A Nationwide Cross-Sectional Study in Saudi Arabia

Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 681
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Ali F. Duhaim ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Food Insecurity ◽  
Food Waste ◽  
Cross Sectional ◽  
Household Level ◽  
Individual Level ◽  
Factors Associated ◽  
Household Factors ◽  
Cooked Food ◽  
The Individual

Background: Food waste and food insecurity may co-exist in various balances in developing and developed countries. This study aimed to explore the levels of food waste and food insecurity, the factors associated with them, and their relationships at the household and individual levels in Saudi Arabia. Methods: This study was a nationwide cross-sectional survey conducted via computer-assisted phone interviews in January 2021. Quota sampling was utilized to generate balanced distributions of participants by gender across all the administrative regions of Saudi Arabia. Data collection included household demographics, food waste and disposal, the Food Insecurity Experience Scale (FIES), and the Household Food Insecurity Access Scale (HFIAS). Results: Out of the 2807 potential participants contacted, 2454 (87.4%) completed the interview. The mean age was 31.4 (SD = 11.7; range = 18–99) and 50.1% were female. The weighted prevalence of uncooked food waste in the last four weeks was 63.6% and the cooked food waste was 74.4%. However, the food insecurity weighted prevalence at the individual level (FIES) was 6.8%. In terms of food insecurity at the household level (HFIAS), 13.3% were in the “severely food insecure” category. Moreover, this study found that “moderately food insecure” households were associated with an increased likelihood to waste uncooked food (relative risk (RR) = 1.25), and the “mildly food insecure” (RR = 1.21) and “moderately food insecure” (RR = 1.17) households were associated with an increased likelihood to waste cooked food. However, “food secure” households were associated with a decreased likelihood to waste cooked food (RR = 0.56). Finally, this study identified four household factors associated with food waste and three household factors that were associated with “severe food insecurity.” Conclusions: This first national coverage study to explore food waste and food insecurity at the individual level and household level, identified household factors associated with food waste and food insecurity and identified new associations between food waste and food insecurity in Saudi Arabia. The associations found between food waste and food insecurity are potential areas of intervention to reduce both food waste and food insecurity at the same time, toward achieving the Sustainable Development Goal (SDG) targets related to food waste and food security.

scholarly journals C-factor: a summary measure for systemic arterial calcifications

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lieke M. Kuiper ◽  
M. Kamran Ikram ◽  
Maryam Kavousi ◽  
Meike W. Vernooij ◽  
M. Arfan Ikram ◽  
...  
Keyword(s):  
Cox Regression ◽  
Intraclass Correlation ◽  
Principal Component ◽  
Arterial Calcification ◽  
Standard Deviation Increase ◽  
Single Measure ◽  
Individual Level ◽  
Enhanced Ct ◽  
Study Participants ◽  
Overall Mortality

Abstract Background Arterial calcification, the hallmark of arteriosclerosis, has a widespread distribution in the human body with only moderate correlation among sites. Hitherto, a single measure capturing the systemic burden of arterial calcification was lacking. In this paper, we propose the C-factor as an overall measure of calcification burden. Methods To quantify calcification in the coronary arteries, aortic arch, extra- and intracranial carotid arteries, and vertebrobasilar arteries, 2384 Rotterdam Study participants underwent cardiac and extra-cardiac non-enhanced CT. We performed principal component analyses on the calcification volumes of all twenty-six possible combinations of these vessel beds. Each analysis’ first principal component represents the C-factor. Subsequently, we determined the correlation between the C-factor derived from all vessel beds and the other C-factors with intraclass correlation coefficient (ICC) analyses. Finally, we examined the association of the C-factor and calcification in the separate vessel beds with cardiovascular, non-cardiovascular, and overall mortality using Cox–regression analyses. Results The ICCs ranged from 0.80 to 0.99. Larger calcification volumes and a higher C-factor were all individually associated with higher risk of cardiovascular, non-cardiovascular, and overall mortality. When included simultaneously in a model, the C-factor was still associated with all three mortality types (adjusted hazard ratio per standard deviation increase (HR) > 1.52), whereas associations of the separate vessel beds with mortality attenuated substantially (HR < 1.26). Conclusions The C-factor summarizes the systemic component of arterial calcification on an individual level and appears robust among different combinations of vessel beds. Importantly, when mutually adjusted, the C-factor retains its strength of association with mortality while the site-specific associations attenuate.

The utility of household Grocery Purchase Quality Index scores as an individual diet quality metric

2020 ◽  
pp. 1-28
Author(s):  
Haley Wynne Parker ◽  
Carolina de Araujo ◽  
Anne N. Thorndike ◽  
Maya Vadiveloo
Keyword(s):  
Diet Quality ◽  
Quality Index ◽  
Secondary Analysis ◽  
Weighted Kappa ◽  
Healthy Eating Index ◽  
Bachelor's Degree ◽  
Dietary Recommendations ◽  
Household Level ◽  
Individual Level ◽  
Grocery Purchase

Abstract The validated Grocery Purchase Quality Index (GPQI) reflects concordance between household grocery purchases and US dietary recommendations. However, it is unclear whether GPQI scores calculated from partial purchasing records validly reflect individual-level diet quality. Within the 9-month randomized controlled Smart Cart study examining the effect of targeted coupons on grocery purchase quality (n=209), this secondary analysis examined concordance between the GPQI (range 0-75, scaled to 100) calculated from 3-months of loyalty-card linked partial (≥50%) household grocery purchasing data and individual-level Healthy Eating Index (HEI) scores at baseline and 3-months calculated from food frequency questionnaires. HEI and GPQI concordance was assessed with overall and demographic-stratified partially-adjusted correlations; covariate-adjusted percent score differences, cross-classification, and weighted kappa coefficients assessed concordance across GPQI tertiles (T). Participants were mostly middle-aged (55.4(13.9) years), female (90.3%), from non-smoking households (96.4%), without children (70.7%). Mean GPQI (54.8(9.1)%) scores were lower than HEI scores (baseline: 73.2(9.1)%, 3-months: 72.4(9.4)%), and moderately correlated (baseline r=0.41 vs. 3-month r=0.31, p<0.001). Correlations were stronger among participants with ≤ bachelor’s degree, obesity, and children. Concordance was highest in T3. Participants with high (T3) vs. low (T1) GPQI scores had 7.3-10.6 higher odds of having HEI scores >80% at both timepoints. Weighted kappas (k=0.25) indicated moderate agreement between scores. Household-level GPQI derived from partial grocery purchasing data were moderately correlated with self-reported intake, indicating their promise for evaluating diet quality. Partial purchasing data appears to moderately reflect individual diet quality and may be useful in interventions monitoring changes in diet quality.

Prevalence and clustering of diarrhoea within households in India: some evidence from NFHS-4, 2015–16

2020 ◽  
Vol 53 (1) ◽  
pp. 108-120 ◽  
Author(s):  
Bevin Vijayan ◽  
Mala Ramanathan
Keyword(s):  
Water Supply ◽  
Diarrhoeal Disease ◽  
Household Level ◽  
Individual Level ◽  
Under Five ◽  
Safe Water ◽  
Chi Squared ◽  
Improved Sanitation ◽  
Nationally Representative ◽  
Water Supply And Sanitation

AbstractDiarrhoeal disease is one of the major causes of morbidity and mortality in children and is usually measured at individual level. Shared household attributes, such as improved water supply and sanitation, expose those living in the same household to these same risk factors for diarrhoea. The occurrence of diarrhoea in two or more children in the same household is termed ‘diarrhoea clustering’. The aim of this study was to examine the role of improved water supply and sanitation in the occurrence of diarrhoea, and the clustering of diarrhoea in households, among under-five children in India. Data were taken from the fourth round of the National Family and Health Survey (NFHS-4), a nationally representative survey which interviewed 699,686 women from 601,509 households in the country. If any child was reported to have diarrhoea in a household in the 2 weeks preceding the survey, the household was designated a diarrhoeal household. Household clustering of diarrhoea was defined the occurrence of diarrhoea in more than one child in households with two or more children. The analysis was done at the household level separately for diarrhoeal households and clustering of diarrhoea in households. The presence of clustering was tested using a chi-squared test. The overall prevalences of diarrhoea and clustering of diarrhoea were examined using exogenous variables. Odds ratios, standardized to allow comparison across categories, were computed. The household prevalence of diarrhoea was 12% and that of clustering of diarrhoea was 2.4%. About 6.5% of households contributed 12.6% of the total diarrhoeal cases. Access to safe water and sanitation was shown to have a great impact on reducing diarrhoeal prevalence and clustering across different household groups. Safe water alone had a greater impact on reducing the prevalence in the absence of improved sanitation when compared with the presence of improved sanitation. It may be possible to reduce the prevalence of diarrhoea in households by targeting those households with more than one child in the under-five age group with the provision of safe water and improved sanitation.

scholarly journals Urban–Rural Disparities in the Magnitude and Determinants of Stunting among Children under Five in Tanzania: Based on Tanzania Demographic and Health Surveys 1991–2016

2021 ◽  
Vol 18 (10) ◽  
pp. 5184
Author(s):  
Wenjun Zhu ◽  
Si Zhu ◽  
Bruno F. Sunguya ◽  
Jiayan Huang
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Household Level ◽  
Individual Level ◽  
Child Stunting ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Individual

Our study aims to examine the disparity of under-5 child stunting prevalence between urban and rural areas of Tanzania in the past three decades, and to explore factors affecting the rural–urban disparity. Secondary analyses of Tanzania Demographic and Health Surveys (TDHS) data drawn from 1991–1992, 1996, 1999, 2004–2005, 2009–2010, and 2015–2016 surveys were conducted. Under-5 child stunting prevalence was calculated separately for rural and urban children and its decline trends were examined by chi-square tests. Descriptive analyses were used to present the individual-level, household-level, and societal-level characteristics of children, while multivariable logistic regression analyses were performed to examine determinants of stunting in rural and urban areas, respectively. Additive interaction effects were estimated between residence and other covariates. The results showed that total stunting prevalence was declining in Tanzania, but urban–rural disparity has widened since the decline was slower in the rural area. No interaction effect existed between residence and other determinants, and the urban–rural disparity was mainly caused by the discrepancy of the individual-level and household-level factors between rural and urban households. As various types of determinants exist, multisector nutritional intervention strategies are required to address the child stunting problem. Meanwhile, the intervention should focus on targeting vulnerable children, rather than implementing different policies in rural and urban areas.

scholarly journals How well do different dietary and nutrition assessment tools match? Insights from rural Kenya

2018 ◽  
Vol 22 (3) ◽  
pp. 391-403 ◽  
Author(s):  
Andrea Fongar ◽  
Theda Gödecke ◽  
Antony Aseta ◽  
Matin Qaim
Keyword(s):  
Food Consumption ◽  
Food Access ◽  
Dietary Diversity ◽  
Assessment Tools ◽  
Dietary Quality ◽  
Anthropometric Measures ◽  
Household Level ◽  
Individual Level ◽  
Rural Kenya

AbstractObjectiveVarious indicators and assessment tools exist to measure diets and nutrition. Most studies eventually rely on one approach. Relatively little is known about how closely results match when different tools are used in the same context. The present study compares and correlates different indicators for the same households and individuals to better understand which indicators can be used as proxies for others.DesignA survey of households and individuals was carried out in Kenya in 2015. Seven-day food consumption and 24 h dietary recalls were administered at household and individual level, respectively. Individual height and weight measures were taken. Different indicators of food access (energy consumption, household dietary diversity scores), dietary quality (individual dietary diversity scores, micronutrient intakes) and nutrition (anthropometric indicators) were calculated and correlated to evaluate associations.SettingRural farm households in western Kenya.ParticipantsData collected from 809 households and 1556 individuals living in these households (782 female adults, 479 male adults, 295 children aged 6–59 months).ResultsAll measures of food access and dietary quality were positively correlated at individual level. Household-level and individual-level dietary indicators were also positively correlated. Correlations between dietary indicators and anthropometric measures were small and mostly statistically insignificant.ConclusionsDietary indicators from 7d food consumption recalls at the household level can be used as proxies of individual dietary quality of children and male and female adults. Individual dietary diversity scores are good proxies of micronutrient intakes. However, neither household-level nor individual-level dietary indicators are good proxies of individual nutritional status in this setting.

Neighborhood Influences on Physical Activity in Middle-Aged and Older Adults: A Multilevel Perspective

2005 ◽  
Vol 13 (1) ◽  
pp. 87-114 ◽  
Author(s):  
Fuzhong Li ◽  
K. John Fisher ◽  
Adrian Bauman ◽  
Marcia G. Ory ◽  
Wojtek Chodzko-Zajko ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Behavior ◽  
Research Literature ◽  
Middle Aged ◽  
New Paradigm ◽  
Individual Level ◽  
Neighborhood Influences ◽  
Environment Variables ◽  
Multilevel Perspective

Over the past few years, attention has been drawn to the importance of neighborhood influences on physical activity behavior and the need to consider a multilevel analysis involving not only individual-level variables but also social-and physical-environment variables at the neighborhood level in explaining individual differences in physical activity outcomes. This new paradigm raises a series of issues concerning systems of influence observed at different hierarchical levels (e.g., individuals, neighborhoods) and variables that can be defined at each level. This article reviews research literature and discusses substantive, operational, and statistical issues in studies involving multilevel influences on middle-aged and older adults’ physical activity. To encourage multilevel research, the authors propose a model that focuses attention on multiple levels of influence and the interaction among variables characterizing individuals, among variables characterizing neighborhoods, and across both levels. They conclude that a multilevel perspective is needed to increase understanding of the multiple influences on physical activity.

scholarly journals Cohort Profile: The China Multi-Ethnic Cohort (CMEC) Study

2020 ◽  
Author(s):  
Xing Zhao ◽  
Feng Hong ◽  
Jianzhong Yin ◽  
Wenge Tang ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Disease Incidence ◽  
Data Access ◽  
Population Based ◽  
Baseline Survey ◽  
Individual Level ◽  
Long Term Storage ◽  
Level Data ◽  
The Individual ◽  
Study Participants

AbstractCohort purposeThe China Multi-Ethnic Cohort (CMEC) is a community population-based prospective observational study aiming to address the urgent need for understanding NCD prevalence, risk factors and associated conditions in resource-constrained settings for ethnic minorities in China.Cohort BasicsA total of 99 556 participants aged 30 to 79 years (Tibetan populations include those aged 18 to 30 years) from the Tibetan, Yi, Miao, Bai, Bouyei, and Dong ethnic groups in Southwest China were recruited between May 2018 and September 2019.Follow-up and attritionAll surviving study participants will be invited for re-interviews every 3-5 years with concise questionnaires to review risk exposures and disease incidence. Furthermore, the vital status of study participants will be followed up through linkage with established electronic disease registries annually.Design and MeasuresThe CMEC baseline survey collected data with an electronic questionnaire and face-to-face interviews, medical examinations and clinical laboratory tests. Furthermore, we collected biological specimens, including blood, saliva and stool, for long-term storage. In addition to the individual level data, we also collected regional level data for each investigation site.Collaboration and data accessCollaborations are welcome. Please send specific ideas to corresponding author at: [email protected].

Abstract P266: Change in the Association Between Serum Lipids and Coronary Heart Disease among Middle-Aged Adults: Observational Data from the Pre- and Post-Statin Era.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lisandro D Colantonio ◽  
Vera Bittner ◽  
Emily B Levitan ◽  
Shia Kent ◽  
Monika M Safford ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Racial Differences ◽  
Serum Lipids ◽  
Current Analysis ◽  
Middle Aged ◽  
Chd Risk Factors ◽  
Middle Aged Adults ◽  
Study Participants ◽  
Statin Use

Dyslipidemia is a major risk factor for coronary heart disease (CHD) and is usually treated with statins. Few observational studies have examined associations between lipids and CHD in the era of widespread statin use. The objective of the current analysis was to contrast the association between serum lipids and incident coronary heart disease (CHD) among middle-aged adults before and after statin use became widespread. Methods: We analyzed data from 14,590 Atherosclerosis Risk In Communities (ARIC) study participants who were recruited in 1987-1989 (pre-statins), and 13,196 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants (9,578 not taking statins) who were recruited in 2003-2007 (post-statins). Our analysis was restricted to participants 45 to 64 years of age without a history of CHD at baseline. Total and HDL cholesterol (HDL-C) and fasting triglycerides (TG) were measured at baseline and used to calculate LDL-C, non-HDL-C, total-to-HDL-C ratio and total-to-TG ratio. Each lipid parameter was categorized into four levels based on REGARDS quartile cut-points. Results: In ARIC, participants with higher LDL-C were more likely to have diabetes and use antihypertensive medication, whereas these CHD risk factors were progressively less common at higher LDL-C in REGARDS participants not taking statins. Over a maximum 7 years of follow up, 513 and 278 incident CHD events occurred among ARIC and REGARDS participants, respectively. After multivariable adjustment, higher categories of each lipid marker (lower categories of HDL-C) were associated with a higher hazard ratio (HR) for CHD among ARIC participants, but not among REGARDS participants not taking statins (figure). No association between lipid markers and CHD was observed among REGARDS participants taking statins. DISCUSION: The current analysis suggests that the widespread preferential use of statins among high risk individuals may have obscured the association between lipids and incident CHD.

scholarly journals Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples

2019 ◽  
Author(s):  
Courtney A Polenick ◽  
Kira S Birditt ◽  
Angela Turkelson ◽  
Benjamin C Bugajski ◽  
Helen C Kales
Keyword(s):  
Depressive Symptoms ◽  
Marital Quality ◽  
Chronic Conditions ◽  
Later Life ◽  
Well Being ◽  
Middle Aged ◽  
Older Couples ◽  
Individual Level ◽  
The Individual ◽  
Over Time

Abstract Objectives Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms. Methods The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006–2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner’s baseline report of negative marital quality and number of chronic conditions in each wave. Results Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions. Discussion Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.

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