scholarly journals Comparison of Nutrients Intake among Pregnant Anemic & Non-Anemic Women

2021 ◽  
Author(s):  
Nouf Humayun ◽  
Shahid Bashir ◽  
Sidra Khalid
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Global Public Health ◽  
Vitamin B3 ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Nutrients Intake ◽  
Protein Rich ◽  
In Pregnancy

Background: Anemia, interpreted as a low blood hemoglobin values, was considered as a major health complication in the world.  However, anemia in pregnancy is a global public health problem in the developing countries, posing high risk of adverse results for expecting mothers as well as their fetus. The aim of study was to compare nutrients' intake among pregnant anemic & non-anemic women. Methods: A comparative cross-sectional study was conducted at Sir Ganga Ram Hospital, Lahore over a period of 4 months. The data were collected from 150 pregnant women, including 75 anemic and 75 non-anemic women, through pre-tested questionnaire using non-probability convenient sampling method. Data were tabulated and analyzed with help of SPSS version 21.0. Results: Analysis revealed that 34% of women had carbohydrate intake between 0-150 g/day, 44% had protein intake less than 50 g daily, and 36% had daily fat intake between 0-100 g/day. Moreover, 46.7% of the pregnant women were vitamins deficient, 51% were minerals deficient, 52% were iron deficient, 54.7% consumed tea with their meals, 44% had vitamin B3 intake less than 10 mg, 48% had vitamin C intake less than 50 mg, 48% had vitamin A intake between 0-500 RAE, 42% had calcium intake between 0-500 mg, and 31% had iron intake between 0-10 mg. Conclusion: The findings showed that nutrient intake of anemic pregnant women was not sufficient in the protein rich diet; they had high consumption of tea with their meals. Their overall energy intake and micronutrients were less than the required as per recommended dietary allowance in pregnancy.

Perceived Experiences of Community Violence Among Adolescents: A School Survey From Rio de Janeiro, Brazil

2021 ◽  
pp. 088626052110051
Author(s):  
Claudia L. de Moraes ◽  
Érika B. dos Santos ◽  
Michael E. Reichenheim ◽  
Stella R. Taquette ◽  
Luciane Stochero ◽  
...  
Keyword(s):  
Public Schools ◽  
Community Violence ◽  
Rio De Janeiro ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Global Public Health ◽  
Cross Sectional ◽  
Interpersonal Aggression ◽  
Adolescent Students ◽  
Management Actions

Community violence (CV) is a global public health problem due to its high frequency and severe consequences. Although CV is one of the leading causes of death among adolescents, little is known about the everyday CV situations that do not lead to death. This study aimed to estimate the frequency of exposure to and involvement in CV situations among adolescent students from public and private schools in the city of Rio de Janeiro, Brazil. This was a cross-sectional study of 693 individuals in their second year of high school selected through stratified multistage random sampling. Information about their exposure to and involvement in CV was collected through a self-completed multidimensional questionnaire in the classrooms. For approximately 30% of the adolescents, someone close to them had been murdered, and 40% had already seen the corpse of a victim of homicide. Seventeen percent reported having been directly involved in CV situations. Approximately 38%, 13%, and 25% had been victims of robberies, interpersonal aggression, and death threats to either themselves or their relatives, respectively. Many of these situations occurred more than once. In general, CV was more frequently reported by boys and by those who did not live with both parents. Adolescents from higher economic classes experienced more interpersonal aggression and felt a greater need to carry a gun. Those who belonged to the lower economic classes and studied in public schools were more exposed to lethal violence than other students. The results call attention to the very high percentage of adolescent students that are involved in CV situations as well as to the differences in violence rates among population subgroups. Such findings should be considered when planning CV prevention and management actions in schools and other socialization spaces for adolescents.

scholarly journals Prevalence and Associated Factors of Anemia among Muslim Students, Nakhon Si Thammarat, Thailand: A Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110134
Author(s):  
Chutima Rattanawan ◽  
Suraiya Cheloh ◽  
Asma Maimahad ◽  
Malatee Tayeh
Keyword(s):  
Public Health ◽  
Associated Factors ◽  
Public Health Problem ◽  
Economic Factor ◽  
Cross Sectional Study ◽  
School Age ◽  
Global Public Health ◽  
Related Factors ◽  
Cross Sectional ◽  
Prevalence Of Anemia

Anemia is a global public health problem. The prevalence of anemia among different ages, genders or ethnic groups must be clarified in order to solve problems. This study proposed to determine the prevalence and factors related to anemia among the Muslim school-age population in Nakhon Si Thammarat, Thailand. Socio-demographic and anthropometric data were collected by a structured questionnaire. Blood samples were collected from 200 school-age subjects. The thalassemia screening was performed with KKU-OF and KKU-DCIP reagents. The prevalence of anemia in this study was 36.5%, divided into males and females, 33.3% and 39.1%, respectively. The means of Hb, Hct, MCV, MCH, and MCHC in the anemic group were significantly lower. The positive results for KKU-OF or KKU-DCIP or both were 15.0%, 2.5%, and 1.0%, respectively. The result of positive OF test was a significantly independent factor for anemia. The number of family members was 5 to 7 and more than 7 persons are related factors for anemia in this study. In summary, the contribution of thalassemia and socio-economic factor are associated factors to anemia in this population. These findings should be addressed in public health strategies for the control of anemia of school-aged Muslims in the region.

scholarly journals Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi
Keyword(s):  
Sri Lanka ◽  
Data Collection ◽  
Pregnant Women ◽  
Associated Factors ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.

scholarly journals Domestic violence among pregnant women in Baghdad\Iraq 2018

2021 ◽  
Vol 63 (1) ◽  
pp. 31-35
Author(s):  
Hiba Raad Saeed ◽  
Besmah Mohamad Ali ◽  
Jawad K. AL-Diwan
Keyword(s):  
Domestic Violence ◽  
Pregnant Women ◽  
Family Relationships ◽  
Emotional Abuse ◽  
Protective Factor ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Number Of Children

Background: Domestic violence against women is a public health problem that affects more than one third of all women globally. It includes any physical, sexual or emotional abuse imposed upon women within family relationships. Several studies in Iraq demonstrated that domestic violence has been increasing over the past two decades. Objective: Determine the prevalence of domestic violence against pregnant women and factors associated with it. Patients and methods: A total of 345 pregnant women were included in a cross- sectional study conducted during the period from July - November 2018. They were selected through multistage random sampling from four Primary Health Care Centers in Baghdad. An Abuse Assessment Screen was used, with a known validity and reliability. Result: The overall prevalence of domestic violence was 37.1%. It was 9.0% during pregnancy. There were significant associations between domestic violence during pregnancy and the duration of marriage, husband’s age at marriage, husband’s consumption of alcohol and  the number of children. Conclusion: Pregnancy acts as a protective factor against domestic violence

scholarly journals Suggestive changes of human papillomavirus infection in students at a public university

2021 ◽  
Vol 106 (106(812)) ◽  
pp. 30-37
Author(s):  
J. Núñez ◽  
A. Romano ◽  
M. Medina ◽  
R.A. Cardozo
Keyword(s):  
Human Papillomavirus ◽  
Standard Procedure ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Low Grade ◽  
Global Public Health ◽  
Cross Sectional ◽  
Human Papillomavirus Infection ◽  
Papillomavirus Infection

Introduction: Sexually transmitted infections are a global public health problem. Objective: to analyze the results of cervical-vaginal cytologies with suggestive changes of Human Papillomavirus infection in students of the Faculty of Health Sciences of the University of Carabobo, who was attended the gynecology consultation of the Ambulatory “Nuestra Seora de la Luz” in 2016-2017. Method: descriptive, cross-sectional study. Population consisting of all students of the Faculty of Health Sciences who was attended the Gynecology Consultation at the Ambulatory mentioned above during the period under study. Non-probabilistic and intentional sample, inclusion criteria: age, acceptance to belong to the study by signing informed consent, and not suffering pathologies at the time of sampling or being pregnant. The collection of the information was carried out through the interview and subsequent cytological examination, and the cytological study was expressed according to the BETHESDA 2001 system. The sample for cervical-vaginal cytology was performed according to standard procedure. Results: average age of 21.43-2.47 years, 40.2% belonging to the low mean stratum, 9.2% smokers, sexarquia in ages 18-20 years in 52.6% of cases, 70% with 2 or 3 pairs. As for the cytology result, 9.2% was suggestive for Human Papillomavirus infection, while with the BETHESDA 2001 System, in the epithelial cell abnormalities section, 63.6% showed low-grade Human Papillomavirus -associated. Conclusions: in the sample, the suggestive changes to Human Papillomavirus infection, was higher than that found in other countries, whereas most interviewees presented risk factors to contract it, so emphasis on education is recommended conducting annual cytology to the at-risk population.

scholarly journals Gambaran Status Endemisitas Filariasis dan Faktor yang Terkait dengan Transmisi Sesaat Pasca Survei Transmission Assessment Survey (TAS-) 1 di Kabupaten Pidie, Aceh

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Nur Ramadhan ◽  
Yulidar Yulidar ◽  
Abidah Nur ◽  
Zain Hadifah ◽  
Yasir Yasir
Keyword(s):  
Public Health Problem ◽  
Evaluation Study ◽  
Cross Sectional Study ◽  
Global Public Health ◽  
Sectional Study ◽  
Selective Treatment ◽  
Related Factors ◽  
Cross Sectional ◽  
Assessment Survey ◽  
And Behavior

Abstract Filariasis is still a global public health problem both in the world and in Indonesia. Aceh is include in one of the provinces with the most clinical cases in Indonesia. The aimed of this study was to determine the description of endemicity status and Related Factors to Instantaneous Transmissions period after Transmission Assessment Survey (TAS) 1 in Pidie district. This research is part of the filariasis elimination evaluation study in Indonesia (Multicenter Filariasis Study) Litbangkes Office Center, Ministry of Health in 2017. The research design was cross sectional study. The study was conducted from February to November 2017. The selected research sites were Buloh and Kambuk Payapi Village in Pidie district. Data was collected by interviewin respondent to obtained information about people's knowledge, attitudes and behavior related to filariasis. In addition, finger blood tests were also conducted on respondents who had been interviewed. The number of respondents by finger blood was 627 and 714 were interviewed. The risk of filariasis transmission still occurred with the finding of 10 positive cases of microfilaria as many as 10 people in Kambuk Payapi village  with B.malayi species. The average filarial density was 86.84 / μl blood.  Respondent’s knowledge about filariasis is still low, community attitudes towads the prevention and treatment of filariasis was positive. Only a portion of respondents were involved in mass treatment. Selective treatment and strengthening synergy across sectors and programs must be increased so that elimination of  filariasis can be achieved. In addition, it is necessary to increase public knowledge through various health promotion media to improve community behaviour to achieve  elimination of filariasis. Abstrak Filariasis masih menjadi masalah kesehatan baik di dunia maupun di Indonesia. Aceh termasuk dalam salah satu provinsi dengan kasus klinis kronis terbanyak di Indonesia. Tujuan penelitian ini adalah mengetahui gambaran status endemisitas filariasis dan faktor yang berpengaruh dengan transmisi setelah Transmission Assessment Survey (TAS) 1 di Kabupaten Pidie. Penelitian ini merupakan bagian dari studi evaluasi eliminasi filariasis di Indonesia (studi Multicenter Filariasis) Badan Litbangkes Kementerian Kesehatan tahun 2017. Desain penelitian adalah cross sectional study. Penelitian dilakukan dari Februari-November 2017. Tempat penelitian adalah di desa Buloh dan desa Kambuk Payapi di Kabupaten Pidie. Pengumpulan data dilakukan wawancara responden untuk mendapatkan informasi tentang pengetahuan, sikap, dan perilaku masyarakat terkait filariasis. Selain itu juga dilakukan pemeriksaan darah jari malam hari pada responden yang sudah diwawancarai.  Jumlah responden yang diperiksa darah jari 627 responden dan yang diwawancarai 714.  Resiko penularan filariasis masih terjadi dengan masih ditemukannya kasus positif mikrofilaria sebanyak 10 orang di desa Kambuk Payapi dengan spesies B.malayi. Rata-rata kepadatan filaria adalah 86,84/µl darah. Pengetahuan responden tentang penyebab filariasis masih rendah, sikap masyarakat terhadap upaya pencegahan dan pengobatan filariasis sudah positif. Namun demikian hanya sebagian responden yang ikut terlibat dalam pengobatan masal. Pengobatan selektif dan memperkuat sinergi lintas sektos dan lintas program harus ditingkatkan agar eliminasi filariasis dapat dicapai. Selain itu diperlukan peningkatan pengetahuan masyarakat melalui berbagai media promosi kesehatan untuk meningkatkan prilaku masyarakat untuk mencapai eliminasi filariasis.  

scholarly journals KESAHIHAN DIAGNOSTIK HEMOGLOBIN RETIKULOSIT UNTUK DETEKSI DEFISIENSI ZAT BESI DI KEHAMILAN (Diagnostic Validity of Reticulocyte Hemoglobin for Iron Deficiency Detection in Pregnancy)

2018 ◽  
Vol 21 (3) ◽  
pp. 285
Author(s):  
Tri Ratnaningsih ◽  
Budi Mulyono ◽  
Sutaryo Sutaryo ◽  
Iwan Dwiprahasto
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Transferrin Saturation ◽  
Diagnostic Validity ◽  
Third Trimester ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Roche Diagnostics ◽  
Edta Tube ◽  
In Pregnancy

Entering the second trimester of pregnancy, more iron is required due to the increase in erythrocyte mass, plasma volume andthe development of fetus as well as chorion. Iron is needed the most in the third trimester. The existing hematological iron stageparameters can only detect iron deficiency in the latest stage. The aim of this study was to know the assessment validity of Ret-Heexamination as a new parameter to diagnose iron deficiency in pregnant women with anemia, as well as a screening tool for those interm pregnancy without anemia. The research design was cross sectional. The subjects were women in term pregnancy, gathered fromPKU Muhammadiyah Hospital, Bantul Yogyakarta from May to November 2013. A seven (7) mL blood sample was taken from thecubital vein of the subjects. Two mL of the sample was tested for routine hematological examination using an EDTA tube, while theRet-He was assessed using an automatic hematological instrument Sysmex XT-2000-i (Symex Corporation, Kobe, Japan). The serumof the remaining five (5) mL was used to check the serum iron and TIBC to obtain the saturation value (Tsat) using Cobas analyzerC501 (Roche Diagnostics, Germany), while the serum ferritin (SF) was examined using Minividas. The subjects were classified into two(2) groups based on the Hb levels, namely: anemia (Hb<11 g/dL) and those who did not (Hb≥11 g/dL). Furthermore, they were alsoclassified into two (2) groups based on transferrin saturation values: iron deficient (Tsat <9%) and normal (Tsat ≥9%). From 291subjects, 59 (20.3%) were found to have anemia and 232 (79.7%) did not. The cut off value of Ret-He to diagnose iron deficiency inpregnant women with anemia was 29.8 pg (82% sensitivity and 72% specificity). Meanwhile, the cut-off value of Ret-He for irondeficiency screening in pregnant women without anemia was 29.8 pg, with a sensitivity and specificity of 92% and 87% respectively.The Ret-He holds a good diagnostic validity to detect iron deficiency in pregnancy, with or without anemia.

scholarly journals Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

2017 ◽  
Vol 6 (3) ◽  
pp. 781
Author(s):  
Radha K. R. ◽  
Nishu Sugunan ◽  
Resmy C. R.
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

scholarly journals Hubungan Tekanan Darah Ibu Hamil Aterm Dengan Berat Badan Lahir di RSUP Dr. M. Djamil Padang

2013 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Feby Andammori ◽  
Nur Indrawaty Lipoeto ◽  
Yusrawati Yusrawati
Keyword(s):  
Blood Pressure ◽  
Pregnant Woman ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Record ◽  
Cross Sectional Study ◽  
T Test ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

AbstrakTinggi rendahnya tekanan darah sistolik dan diastolik dalam kehamilan mempunyai pengaruh terhadap berat badan lahir. Penelitian ini bertujuan untuk mengidentifikasi hubungan tekanan darah ibu hamil aterm dengan berat badan lahir di RSUP dr M. Djamil Padang. Metode penelitian : Penelitian yang dilakukan merupakan survei analitik dengan menggunakan studi komparatif dengan design penelitian Cross Sectional Study. Penelitian menggunakan data sekunder yang diambil dari sub bagian Rekam Medik (Medical Record) RSUP dr. M. Djamil Padang bulan Januari 2010 – Desember 2012 dengan jumlah sampel 34 orang ibu hamil yang tidak hipertensi dan 34 orang ibu hamil yang mengalami hipertensi dalam kehamilannya. Hasil penelitian : Ditemukan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang tidak mengalami hipertensi pada kehamilannya adalah 3.408 (SD 307) gram dan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang mengalami hipertensi pada kehamilannya adalah 2.799 (SD 413) gram. Dari hasil uji analisis Independent Sample T-test diperoleh hasil ditemukan adanya hubungan tekanan darah ibu hamil dengan berat badan lahir di RSUP dr. M. Djamil Padang p = 0,00 (p < 0,05). Kesimpulan : Pemeriksaan kehamilan secara teratur penting untuk mengantisipasi adanya peningkatan tekanan darah ibu hamil yang dapat berpengaruh terhadap berat bayi lahir.Kata kunci: tekanan darah, berat badan lahir, ibu hamilAbstractHigh and low level of systolic and diastolic blood pressure in pregnancy has impact to birth weight. This research is purposed to identify the relation between aterm pregnant blood pressure and birth weight.Methods : This research is analytical survey which used comparative study with Cross Sectional Study design. This research used secondary data taken from Medical Record in RSUP dr. M. Djamil Padang since Januari 2010 until December 2012 with number of samples are 34 pregnant women who have not hypertension and 34 pregnant women who have hypertension in pregnancy.The results: Research found that average of birth weight from non-hypertension pregnant woman is about 3,408 (SD 307) gr and average of birth weight from hypertension pregnant woman is about 2,799 (SD 413) gr. The result from Independent sample T-test analysis found that there is a relation between blood pressure in pregnancy with birth weight at RSUP dr. M.Djamil Padang p = 0.00 (p<0.05).Conclusion: Regular antenatal care is important to anticipate an increase in maternal blood pressure can affect birth weight.Keywords: blood pressure, birth weight, pregnant women

scholarly journals Prevalence of Anxiety in Pregnancy during COVID 19 pandemic in Shree Birendra Hospital, Chhauni

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shailaja Khadka ◽  
Sumana Thapa ◽  
Ratna Khatri ◽  
Rosy Malla ◽  
Sumana Thapa ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Low Grade ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ethical Approval ◽  
Almost All ◽  
In Pregnancy

Aim: To determine the prevalence of anxiety in pregnancy during COVID19 pandemic in Shree Birendra Hospital, Chhauni Method: It is a cross sectional study conducted at Shree Birendra Hospital Chhauni from July to October 2020 following the ethical approval from IRC. All the pregnant women from first to last trimester attending outdoor visit were included; they were asked to fill up Beck Anxiety Index form. The level of anxiety was compared with demographic data like age, race, parity, and period of gestation, education and occupation. Data were analyzed by using SPSS 20 software. Results: A total of 385 presumably uninfected pregnant women were surveyed in 20-40 (28.45±3.95) years age group from 4 to 41 (27.15±9.4) weeks of pregnancy and 55.6% were multipara. Low-grade anxiety was found 99.5% (BAI= 3.06±3.66). Conclusions: Low-grade anxiety was found in almost all pregnant women during covid pandemic and there was no significant difference by demographic variables.

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