scholarly journals What’s important to you? Socioeconomic inequalities in the perceived importance of health compared to other life domains

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sanne E. Verra ◽  
Maartje P. Poelman ◽  
Andrea L. Mudd ◽  
Emely de Vet ◽  
Sofie van Rongen ◽  
...  
Keyword(s):  
Low Income ◽  
Educational Level ◽  
Latent Class ◽  
Financial Strain ◽  
Future Research ◽  
Life Domains ◽  
Perceived Importance ◽  
Long Life ◽  
Higher Educational ◽  
Future Focus

Abstract Background Pressing issues, like financial concerns, may outweigh the importance people attach to health. This study tested whether health, compared to other life domains, was considered more important by people in high versus low socioeconomic positions, with future focus and financial strain as potential explanatory factors. Methods A cross-sectional survey was conducted in 2019 among N=1,330 Dutch adults. Participants rated the importance of two health-related domains (not being ill, living a long life) and seven other life domains (e.g., work, family) on a five-point scale. A latent class analysis grouped participants in classes with similar patterns of importance ratings. Differences in class membership according to socioeconomic position (indicated by income and education) were examined using structural equation modelling, with future focus and financial strain as mediators. Results Three classes were identified, which were defined as: neutralists, who found all domains neutral or unimportant (3.5% of the sample); hedonists, who found most domains important except living a long life, work, and religion (36.2%); and maximalists, who found nearly all domains important, including both health domains (60.3%). Of the neutralists, 38% considered not being ill important, and 30% considered living a long life important. For hedonists, this was 92% and 39%, respectively, and for maximalists this was 99% and 87%, respectively. Compared to belonging to the maximalists class, a low income predicted belonging to the neutralists, and a higher educational level and unemployment predicted belonging to the hedonists. No mediation pathways via future focus or financial strain were found. Conclusions Lower income groups were less likely to consider not being ill important. Those without paid employment and those with a higher educational level were less likely to consider living a long life important. Neither future focus nor financial strain explained these inequalities. Future research should investigate socioeconomic differences in conceptualisations of health, and if inequalities in the perceived importance of health are associated with inequalities in health. To support individuals dealing with challenging circumstances in daily life, health-promoting interventions could align to the life domains perceived important to reach their target group and to prevent widening socioeconomic health inequalities.

scholarly journals Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005–2018

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2530
Author(s):  
Navika Gangrade ◽  
Janet Figueroa ◽  
Tashara M. Leak
Keyword(s):  
National Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
High Income ◽  
Future Research ◽  
Nutrition Examination Survey ◽  
Middle Income ◽  
Low Socioeconomic ◽  
Health And Nutrition ◽  
Income Ratio

Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.

scholarly journals Are Nanobiosensors an Improved Solution for Diagnosis of Leishmania?

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 491
Author(s):  
Sona Jain ◽  
Wanessa Santana ◽  
Silvio S. Dolabella ◽  
André L. S. Santos ◽  
Eliana B. Souto ◽  
...  
Keyword(s):  
Low Income ◽  
Neglected Tropical Diseases ◽  
Diagnostic Techniques ◽  
Cross Reactivity ◽  
Low Income Countries ◽  
Future Research ◽  
Immunological Tests ◽  
Diagnostic Approaches ◽  
Signal Improvement ◽  
Adequate Management

Leishmaniasis is one of the deadliest neglected tropical diseases affecting 12–15 million people worldwide, especially in middle- and low-income countries. Rapid and accurate diagnosis of the disease is important for its adequate management and treatment. Several techniques are available for the diagnosis of leishmaniasis. Among these, parasitological and immunological tests are most widely used. However, in most cases, the utilized diagnostic techniques are not good enough, showing cross-reactivity and reduced accuracy. In recent years, many new methods have been reported with potential for improved diagnosis. This review focuses on the diagnosis of Leishmania exploring the biosensors and nanotechnology-based options for their detection. New developments including the use of nanomaterials as fluorophores, fluorescence quenchers as reducing agents and as dendrimers for signal improvement and amplification, together with the use of aptamers to replace antibodies are described. Future research opportunities to overcome the current limitations on the available diagnostic approaches are also discussed.

scholarly journals The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215338
Author(s):  
Jamilah Meghji ◽  
Stefanie Gregorius ◽  
Jason Madan ◽  
Fatima Chitimbe ◽  
Rachael Thomson ◽  
...  
Keyword(s):  
Low Income ◽  
Disease Onset ◽  
Treatment Completion ◽  
Well Being ◽  
Urban Setting ◽  
Financial Strain ◽  
First Episode ◽  
Health Seeking ◽  
Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

scholarly journals Scoping review protocol: bladder cancer in Nigeria: what are the gaps in clinical care and research?

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041894
Author(s):  
Joyce Kibaru ◽  
Pinky Kotecha ◽  
Abdulkarim Muhammad Iya ◽  
Beth Russell ◽  
Muzzammil Abdullahi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Scoping Review ◽  
Low Income ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Cochrane Library ◽  
Future Research ◽  
Scoping Reviews ◽  
Local Risk

IntroductionBladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC.Methods and analysisThis review will be conducted according to Arksey and O’Malley scoping review methodology framework. The following electronic databases will be searched: Medline (using the PubMed interface), Ovid Gateway (Embase and Ovid), Cochrane library and Open Grey literature. Two independent reviewers will screen titles and abstracts and subsequently screen full-text studies for inclusion, any lack of consensus will be discussed with a third reviewer. Any study providing insight into the epidemiology or treatment pathway of BC (RCTs, observations, case series, policy paper) will be included. A data chart will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A consultation process will be carried out with a multidisciplinary team of Nigerian healthcare professionals, patients and scientists.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. By highlighting the key gaps in the literature, this review can provide direction for future research and clinical guidelines in Nigeria (and other low-income and middle-income countries), where BC is more prevalent due to local risk factors and healthcare settings.

scholarly journals Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amber L. Pearson ◽  
Kimberly A. Clevenger ◽  
Teresa H. Horton ◽  
Joseph C. Gardiner ◽  
Ventra Asana ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Low Income ◽  
Spatial Data ◽  
Vigorous Physical Activity ◽  
Future Research ◽  
Cardiometabolic Health ◽  
Multilevel Regression ◽  
Critical Pathway ◽  
Perceived Safety

Abstract Introduction Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one’s neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. Methods In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. Results In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = − 2.34, p = 0.017), depression scores (β = − 4.22, p = 0.006), and BMI (β = − 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. Conclusion Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity—via stress reduction and concomitant effects on cardiometabolic health.

scholarly journals Discrepancies between Global Forest Net Primary Productivity Estimates Derived from MODIS and Forest Inventory Data and Underlying Factors

2021 ◽  
Vol 13 (8) ◽  
pp. 1441
Author(s):  
Jin Han Park ◽  
Jianbang Gan ◽  
Chan Park
Keyword(s):  
Low Income ◽  
Primary Productivity ◽  
Carbon Stock ◽  
Forest Cover ◽  
Net Primary Productivity ◽  
Estimation Methods ◽  
Future Research ◽  
Important Indicator ◽  
Sequestration Potential ◽  
Carbon Losses

The net primary productivity (NPP) of a forest is an important indicator of its potential for the provision of ecosystem services such as timber, carbon, and biodiversity. However, accurately and consistently quantifying global forest NPP remains a challenge in practice. We converted carbon stock changes using the Global Forest Resources Assessment (FRA) data and carbon losses associated with disturbances and timber removals into an NPP equivalent measurement (FRA NPP*) and compared it with the NPP derived from the MODIS satellite data (MOD17 NPP) for the world’s forests. We found statistically significant differences between the two NPP estimates, with the FRA NPP* being lower than the MOD17 NPP; the differences were correlated with forest cover, normalized difference vegetation index (NDVI), and GDP per capita in countries, and may also stem from the NPP estimation methods and scopes. While the former explicitly accounts for carbon losses associated with timber removals and disturbances, the latter better reflects the principles of photosynthesis. The discrepancies between the two NPP estimates increase in countries with a low income or low forest cover, calling for enhancing their forest resource assessment capacity. By identifying the discrepancies and underlying factors, we also provide new insights into the relationships between the MOD17 NPP and global forest carbon stock estimates, motivating and guiding future research to improve the robustness of quantifying global forest NPP and carbon sequestration potential.

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

scholarly journals Community intervention strategies to reduce the impact of financial strain and promote financial well-being: a comprehensive rapid review

2021 ◽  
Vol 28 (1) ◽  
pp. 42-50
Author(s):  
Nicole M. Glenn ◽  
Lisa Allen Scott ◽  
Teree Hokanson ◽  
Karla Gustafson ◽  
Melissa A. Stoops ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Community Intervention ◽  
Well Being ◽  
Small Sample ◽  
Financial Strain ◽  
Rapid Review ◽  
Research Centre ◽  
Future Research ◽  
The Impact

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May–September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.

scholarly journals Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Lung Ultrasound ◽  
New Technology ◽  
Healthcare Providers ◽  
Ease Of Use ◽  
Local Context ◽  
Future Research ◽  
Successful Implementation ◽  
Pneumonia Diagnosis

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.

scholarly journals Energy, macronutrient and fatty acid intake of French elderly community dwellers and association with socio-demographic characteristics: data from the Bordeaux sample of the Three-City Study

2007 ◽  
Vol 98 (5) ◽  
pp. 1046-1057 ◽  
Author(s):  
Catherine Féart ◽  
Marthe A. Jutand ◽  
Sophie Larrieu ◽  
Luc Letenneur ◽  
Cécile Delcourt ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Dietary Intake ◽  
Low Income ◽  
Educational Level ◽  
Dietary Habits ◽  
Dietary Assessment ◽  
The Elderly ◽  
Demographic Characteristics ◽  
Age Related ◽  
Total Fat

Few data are available regarding dietary habits of the elderly, in particular about fatty acid consumption, whereas these are major risk or protective factors of several age-related diseases. The aim of the present study was to characterise the dietary intake of a French elderly population in terms of energy, macronutrients and fatty acids based on their socio-demographic characteristics. The study population (age range 67·7–94·9 years) consisted of 1786 subjects from Bordeaux (France), included in the Three-City cohort. Dietary assessment was performed by a 24 h recall, allowing the estimation of energy, protein, carbohydrate, total fat, SFA, MUFA and PUFA intakes. Socio-demographic characteristics (age, sex, marital status, educational level and income), practice of sports and BMI were registered. Total energy intake (EI) was lower in women and in older participants ( ≥ 85 years) but higher in single subjects. Higher EI was associated with higher income, but not with educational level. Mean contribution of macronutrients to EI (protein 18 %, carbohydrate 46 % and total fat 31 %) was higher in women than men, except for alcohol. The oldest individuals consumed less protein and more mono- and disaccharides. Excess saturated fat intake (43 % of total fat), associated with a relative deficit in MUFA consumption (36 % of total fat), was observed. The mean 18 : 2n-6 : 18 : 3n-3 ratio was 9.9 and decreased with higher educational level. The present results suggest that being female, older age, being widowed and low income level could be considered as risk factors of inadequate dietary intake.

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