scholarly journals Disparities in baseline neurocognitive testing for student concussion management in Massachusetts high schools

2020 ◽  
Vol 6 (1) ◽  
pp. e000752
Author(s):  
Julia Campbell ◽  
Jonathan Howland ◽  
Courtney Hess ◽  
Kerrie Nelson ◽  
Robert A Stern ◽  
...  
Keyword(s):  
High Schools ◽  
Low Income ◽  
Economic Status ◽  
Secondary Analysis ◽  
Neurocognitive Testing ◽  
Student Body ◽  
Cross Sectional ◽  
Concussion Management ◽  
Health Related ◽  
Baseline Testing

PurposeThere is evidence of socioeconomic disparities with respect to the implementation of student-sports concussion laws nationally. The purpose of this study was to examine school sociodemographic characteristics associated with the provision of computerised baseline neurocognitive testing (BNT) in Massachusetts (MA) high schools, and to assess whether the scope of testing is associated with the economic status of student populations in MA.MethodsA cross-sectional secondary analysis of surveys conducted with MA athletic directors (n=270) was employed to investigate school characteristics associated with the provision of BNT. Correlation and regression analyses were used to assess whether the scope of testing is associated with the economic status of student populations in MA.ResultsThe scope of BNT was independently associated with the economic disadvantage rate (EDR) of the student population (β=−0.02, p=0.01); whether or not the school employs an athletic trainer (AT) (β=0.43, p=0.03); and school size (β=−0.54, p=0.03). In a multivariable regression model, EDR was significantly associated with the scope of baseline testing, while controlling for AT and size (β=−0.01, p=0.03, adj-R2=0.1135).ConclusionAmong public high schools in MA, disparities in the provision of BNT for students are associated with the economic characteristics of the student body. Schools that have a greater proportion of low-income students are less likely to provide comprehensive BNT. The clinical implications of not receiving BNT prior to concussion may include diminished quality of postconcussive care, which can have short-term and long-term social, health-related and educational impacts.

scholarly journals Exploring Athletic Trainers' Self-Confidence for Interpreting Results from Concussion Assessments

2019 ◽  
Vol 34 (5) ◽  
pp. 756-756
Author(s):  
N R D’Amico ◽  
T Covassin ◽  
N Murray ◽  
P Schatz ◽  
R J Elbin
Keyword(s):  
Online Survey ◽  
Management Practices ◽  
Athletic Trainers ◽  
Team Approach ◽  
Neurocognitive Testing ◽  
Cross Sectional ◽  
Certified Athletic Trainers ◽  
Concussion Management ◽  
Self Confidence ◽  
National Athletic Trainers Association

Abstract Purpose To explore athletic trainers' self-confidence for interpreting results from concussion assessments. Methods An online survey was administered via the National Athletic Trainers’ Association (NATA) membership listserv to a cross-sectional sample of 10,000 certified athletic trainers (ATCs) employed in high school and collegiate settings. The survey included: 1) ATC demographics (i.e., age, sex, years of experience); 2) ATC concussion management practices (i.e., previous concussion training, continuing education received on concussion, concussion assessments administered); and 3) a 4-point Likert scale (1=no confidence, 4=high confidence) assessing ATC self-confidence for interpreting results from concussion assessments. A total of 725 ATCs completed the survey yielding a response rate of 7.25%; 114 were excluded for missing data and 611 ATCs were included in final analyses. Sample demographics, ATC concussion management practices, and ATC self-confidence scores were examined with demographic statistics (i.e., means, standard deviations, frequencies, percentages) for 16 commonly used concussion assessments. Results The sample of ATCs (mean age 38.97±14.89 years) was predominately female (59.2%) and reported an average of 10.08±7.58 years of clinical experience. Clinical examinations (63.2%) and symptom scales (61.4%) were among the most frequent assessments with high ATC self-confidence for interpretation. Vestibular/oculomotor measures (27.2%) and computerized neurocognitive testing (26.2%) were among the most frequent assessments with low ATC self-confidence for interpretation. Conclusion Low ATC self-confidence scores for interpreting results from vestibular/oculomotor measures and computerized neurocognitive testing highlight the importance of incorporating a multi-disciplinary team approach and including sport neuropsychologists for the proper management of concussion.

Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors

2020 ◽  
Vol 23 (17) ◽  
pp. 3226-3235
Author(s):  
Reece Lyerly ◽  
Pasquale Rummo ◽  
Sarah Amin ◽  
Whitney Evans ◽  
Eliza Dexter Cohen ◽  
...  
Keyword(s):  
Rhode Island ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Economic Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Assistance Program ◽  
Logistic Regression Models ◽  
Populations At Risk ◽  
Nutrition Assistance

AbstractObjective:Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors.Design:In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits.Setting:An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits.Participants:This study describes current market customers at twelve market sites serving low-income seniors.Results:Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers.Conclusions:MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.

scholarly journals Birth weight and childhood obesity: effect modification by residence and household wealth

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Helen Andriani
Keyword(s):  
Birth Weight ◽  
Childhood Obesity ◽  
Rural Area ◽  
Low Income ◽  
Secondary Analysis ◽  
Household Wealth ◽  
Z Score ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Nationally Representative

Abstract Background There are both genetic and environmental factors which contribute to a child’s chances of being obese. When low birth weight (LBW) has been specifically evaluated relative to its association with childhood obesity, the results have produced conflicting findings. This study aims to describe the relationship between birth weight and childhood obesity and investigate the influence that residence and household wealth has on this relationship. Methods I performed a secondary analysis on the 2013 Riskesdas (or Basic Health Research), a cross-sectional, nationally representative survey of the Indonesian population. Height, weight, information regarding child’s birth weight, and basic characteristics of the study population were collected from parents with children aged 0 to 5 years (n = 63,237) in 2013. The exposure was child’s birth weight and the outcomes were child’s current weight, BMI z-score, and obesity. Data were analyzed by using multiple linear regression and multiple logistic regression. Results I found a significant increase in the weight, BMI z-score, and risk of childhood obesity to be associated with LBW. LBW children in rural area were associated with higher BMI z-score (mean ± standard error: 1.44 ± 0.02) and higher odds (odds ratio (95% confidence interval): 7.46 (6.77–8.23)) of obesity than those in urban area. LBW children from low class families were associated with higher BMI z-score (1.79 ± 0.04) and had higher odds (14.79 (12.47–17.54)) of obesity than those from middle class and wealthy families. Conclusions Effective prevention and intervention to childhood obesity as early as possible are imperative. As far as this study was concerned, efforts, policies, and targets are required to reduce the prevalence of LBW. Children born of LBW, who live in a rural area and from low income families, should be emphatically intervened as early as possible.

The Validity of ‘Recognition-Based’ Headache Diagnoses in Adolescents. Data from the Nord-TrØndelag Health Study 1995-97, Head-Hunt-Youth

Cephalalgia ◽  
2003 ◽  
Vol 23 (3) ◽  
pp. 223-229 ◽  
Author(s):  
J-A Zwart ◽  
G Dyb ◽  
LJ Stovner ◽  
T Sand ◽  
TL Holmen
Keyword(s):  
High Schools ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Health Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Semistructured Interviews ◽  
Health Related ◽  
Type Headache ◽  
Good Agreement

The aim of this study was to evaluate the validity of the headache diagnoses (migraine and tension-type headache) obtained from short interviews by nurses, where the subjects were asked to identify their headache(s) based on recognition of typical headache descriptions. All students in junior high schools and high schools aged 12-19 years in Nord-Tr⊘ndelag county, Norway, were invited to participate in the youth part of the Nord-Tr⊘ndelag Health Study ('Helseunders⊘kelsen i Nord-Tr⊘ndelag'-HUNT), 1995-1997. In this cross-sectional study a total of 8984 students (88%) completed a comprehensive questionnaire with different health-related items. Of these, 6149 were also interviewed by nurses about their headache complaints by giving them two alternative headache descriptions accordant with either migraine or tension-type headache (Head-HUNT-Youth). The headache diagnoses obtained from nurse interviews were validated in a stratified random sample enriched with headache subjects from the interviewed population. Out of 159 invited individuals, 112 (70%) participated in extensive semistructured interviews by neurologists. The overall chance-corrected agreement (K) was 0.76 (confidence interval (CI) 0.66-0.86), which is considered good. For migraine, the positive and negative predictive values were 89% and 90%, respectively, and the chance-corrected agreement (K) was 0.72 (CI 0.58-0.87). For tension-type headache, positive and negative predictive values were 83% and 91%, respectively, and chance-corrected agreement (K) was 0.74 (CI 0.62-0.87). There was good agreement between the headache diagnoses obtained from the short interviews by nurses and the extensive interviews by neurologists. Short interviews based on recognition of typical headache descriptions seem to be an alternative and efficient way to identify migraine and tension-type headache sufferers among adolescents. The method can be useful in epidemiological research, e.g. in estimation of headache prevalence.

scholarly journals Determinants of Health-Related Quality of Life in Rural Elderly People of the West of Iran: A Population-Based, Cross-Sectional Study

2019 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Marjan Hosseinpour ◽  
Mohammad Esmaeilpour Aghdam ◽  
Masumeh Piri ◽  
Farzad Maleki
Keyword(s):  
Quality Of Life ◽  
Economic Status ◽  
Population Based ◽  
Cross Sectional Study ◽  
Health Related Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Background and aims: World’s older population is growing, and attention is being directed to the improvement of their health-related quality of life (HRQoL). This article was conducted to investigate the HRQoL and associated factors in rural elderly residents in west of Iran. Methods: By using the multistage sampling method, 346 elders from rural areas of Shahindezh were enrolled in this population-based, cross-sectional study conducted in 2014. To assess the HRQoL of the elderly people, the Leiden-Padua (LEIPAD) questionnaire was used. The economic status was classified into 3 categories (good, moderate, and low) using the principal component analysis. Descriptive statistics, independent t test, ANOVA, and Spearman correlation coefficient were used to analyze data. Multivariate linear regression was performed to determine predictive factors. Results: The mean values and confidence intervals of total core scale and total moderator scale were 38.6 (36.7-40.6) and 31.2 (29.6-32.6), respectively. Univariate analysis showed age, marital status, economic status, occupation, income source, and ethnicity were associated with HRQoL (P<0.05). Multivariate analysis showed the married, the illiterate, widows/widowers and the divorced, people with low economic status, and the self-employed had low HRQoL with respect to total scale and total core scale models (P<0.05). Conclusion: HRQoL varies according to socioeconomic factors. Its determinants should be addressed in social and health policies designed to improve the health of older people, especially the most vulnerable groups.

scholarly journals Development Aid and Solidarity Work: East and West German Health Cooperation with Low-Income Countries, 1945 to 1970

Gesnerus ◽  
2017 ◽  
Vol 74 (2) ◽  
pp. 173-187
Author(s):  
Walter Bruchhausen ◽  
Iris Borowy
Keyword(s):  
Low Income ◽  
Economic Status ◽  
International Health ◽  
Development Aid ◽  
West Germany ◽  
Low Income Countries ◽  
Federal Republic Of Germany ◽  
Health Related ◽  
Strong Position ◽  
Scale Composition

Between 1949 and 1989, both the Federal Republic of Germany (FRG) in the West and the German Democratic Republic (GDR) in the East, engaged in health-related relations with low-income countries in the global South. The strong position of the churches in West Germany and the dominant position of the state in the East provided the preconditions for diverging international health activities, as did differences in ideology and economic status. Activities entailed similarities (an initial focus on clinical therapy and material donations) and differences (in scale, composition of actors and conceptualization). Programs evolved gradually, reacting to circumstances rather than a master plan. By the late 1960s, international health assistance was mainly organized as a component of “development aid” in the FRG, while regarded as “solidarity” in the GDR, in both cases designed to spur changes in recipient countries according to the respective Northern models as components of a perceived direct, global East-West confrontation.

scholarly journals Striving for equity: Life orientation resources in South African high schools

2021 ◽  
Vol 41 (1) ◽  
pp. 1-10
Author(s):  
André van Zyl ◽  
Elizabeth M. Webb ◽  
Jaqueline E. Wolvaardt
Keyword(s):  
High Schools ◽  
South African ◽  
Health Resources ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Life Orientation ◽  
Health Related ◽  
Printed Materials ◽  
Classroom Resources

As a school subject, life orientation (LO) aims to improve learner well-being, but a lack of classroom resources may be a barrier. We investigated whether classroom resources were equally available for LO educators in fully funded (no-fee) and partially funded (fee-paying) high schools in Tshwane South, South Africa. In this analytical cross-sectional study, LO representatives completed questionnaires about the availability of resources in their schools. Sixty-seven LO representatives completed the questionnaire. No-fee and fee-paying schools had the same availability of government resources and textbooks, but no-fee schools had less access to audio-visual equipment and printed materials. Representatives from both categories of schools were least satisfied with the availability of resources for the topic: Health. In contrast, they thought that the resources for non-health related topics such as career and skills-development were adequate. Representatives from no-fee schools were less satisfied with physical education resources (U (56) = -2.29, p = 0.02). The government’s efforts to redress inequity is evident in the availability of basic resources. However, a lack of health resources is a source of concern in a society that has a quadruple burden of disease.

scholarly journals Does bullying predict suicidal behaviors among in-school adolescents? A cross-sectional finding from Tanzania as an example of a low-income country

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Festo K. Shayo ◽  
Paul S. Lawala
Keyword(s):  
Suicide Attempt ◽  
Mental Health Professionals ◽  
Low Income ◽  
Suicide Ideation ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Suicidal Behaviors ◽  
Cross Sectional ◽  
Being Bullied

Abstract Background Bullying and suicidal behaviors are a silent public health problem among adolescents. Little is known about the link between bullying and suicidal behaviors in low-income countries such as Tanzania. In the current study, we estimated the prevalence of being bullied and determined its association with suicidal behaviors among in-school adolescents. Methods We performed a secondary analysis of the Tanzania Global School-based Student Health Survey (GSHS) conducted in 2014. This was the first nationally representative survey conducted to a sample of 3793 in-school adolescents. The primary independent variable was being bullied, while the outcome variables of interest were suicide ideation and suicide attempt. We used a chi-square χ2 test for group variables comparisons and multivariate logistic regression for statistical associations between independent and outcome variables. In our analysis, a p < 0.05 was considered statistically significant at 95% confidence intervals. Results The prevalence of being bullied among 3793 surveyed in-school adolescents was 27.0%. In an adjusted multivariate regression model, being bullied was independently associated with suicidal ideation and suicide attempt: [AOR; 1.9, 95% C.I; 1.5–2.4], and [AOR; 3.6, 95% C.I; 2.9–4.5] respectively, p < 0.001. Conclusions Bullying is prevalent and possibly a potential predictor of suicidal behaviors among in-school adolescents in Tanzania. There is a need for all educational stakeholders: teachers, parents, students, mental health professionals, and policymakers to design a program for mitigating the problem of bullying in schools.

scholarly journals Vitamin D status is associated with underweight and stunting in children aged 6–36 months residing in the Ecuadorian Andes

2017 ◽  
Vol 21 (11) ◽  
pp. 1974-1985 ◽  
Author(s):  
Rana R Mokhtar ◽  
Michael F Holick ◽  
Fernando Sempértegui ◽  
Jeffrey K Griffiths ◽  
Bertha Estrella ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sensitivity Analysis ◽  
Economic Status ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Vitamin D Status ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Urban Neighbourhoods ◽  
Low Serum

AbstractObjectiveThere is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting.DesignWe conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-ageZ-score≤−1) and stunting (defined as height-for-ageZ-score≤−2) were assessed using multivariate logistic regression.SettingChildren residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador.SubjectsChildren (n516) aged 6–36 months.ResultsMean serum 25(OH)D concentration was 58·0 (sd17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7).ConclusionsLow serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.

scholarly journals Prevalence and associated factors of postpartum depression among postpartum mothers in central region, Eritrea: a health facility based survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nahom Kiros Gebregziabher ◽  
Tesfit Brhane Netsereab ◽  
Yerusalem Gebremeskel Fessaha ◽  
Feven Andebrhan Alaza ◽  
Nardos Kidane Ghebrehiwet ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Central Region ◽  
Low Income ◽  
Screening Program ◽  
Unplanned Pregnancy ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Low Income Countries ◽  
Cross Sectional

Abstract Background Postpartum depression (PPD) is a mood disorder that occurs within the first 12 months after delivery. It affects 20 to 40% of women living in the low-income countries. In resource limited countries discovering the predictors of PPD is important as it allows close follow-up and targeted screening of at risk mothers. The objective of this study was to assess the magnitude and predictors of PPD among recently delivered mothers in Central Region of Eritrea. Methods This study used analytical cross-sectional study design to evaluate the magnitude of and factors associated with postpartum depression among 380 randomly selected mothers. The study was conducted in four primary health care facilities of Zoba Maekel (Central Region), Eritrea. A structured closed-ended questionnaire was used to capture the socio-demographic and maternity related information of the study participants. The standard Diagnostic and Statistical Manual of Mental Disorders Fifth Edition was used to assess depression. The dependent variable for this study was status of the mother with regard to PPD. The socio-demographic and maternity related variables of the mothers, presumed to influence the likelihood of developing postpartum depression, were the independent variables. Results In this study the prevalence of PPD was found to be 7.4%. Mother’s who are housewives were less likely to develop PPD (AOR = 0.24, 95% CI: 0.06–0.97; p = 0.046), whereas, mothers with perceived low economic status (AOR = 13.33, 95% CI: 2.66–66.78; p = 0.002), lack of partner support (AOR = 5.8, 95% CI: 1.33–25.29; p = 0.019), unplanned pregnancy (AOR = 3.39, 95% CI: 1.24–9.28; p = 0.017), maternal illness after delivery (AOR = 7.42, 95% CI: 1.44–34.2; p = 0.016), and reside in Southwest-Asmara (AOR = 6.35, 95% CI: 1.73–23.23; p = 0.05) had statistically significant higher odds of postpartum depression. Conclusions In the current study setting, factors that associated with PPD are grouped in to two domains; the woman’s potential to bear the forthcoming responsibility and the social support they get after delivery. The findings of this study imply the need to introduce an active screening program for PPD the health facilities as part of the postpartum care.

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