Annual Family Income Research Articles

Socio-economic status and husbandry practices of indigenous goat rearing community in Bangladesh

The research was conducted of a indigenous goat rearing community named “Deshi Chaagol Palon Mohila Somoby Somity Ltd” at three villages namely Pachpai, Borochala and Gangatia under Bhaluka Upazilla, Mymensingh district. Fifty (50) farmers were selected randomly in the study area to conduct baseline survey with help of well organized questionnaire which developed through Participatory Rural Appraisal (PRA). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 17.0. Among livestock, 31 % goat, 29% chicken and 28% cattle were reared in the project areas. 49% goats were solid Black and 36% were Black Boiragi. The profession of the farmer was agriculture (80%). The education level of the farmers was 32% illiterate and 36% were also completed primary education (1-5 class). The average family size, annual income and land size were 4.28±0.15, 83910.00±4330.61 Tk. and 45.78±6.12 decimal, respectively. Farmer’s goat rearing experience was 11.70±1.05 years. Maximum farmers (76%) were reared their goats by semi-intensive systems. Development of data based on socio-economic status of farmers during this study might help in decision making on evaluation of performance of goat at farmer’s community.
 Asian Australas. J. Biosci. Biotechnol. 2018, 3 (1), 11-16

Perceived Discrimination among Black Youth: An 18-Year Longitudinal Study.

Background: Recent research has suggested vulnerability to perceived racial discrimination (PRD) as a mechanism behind high levels of depression seen in high socioeconomic status (SES) Black males. To better understand the effects of gender and SES on shaping experiences of PRD among Black youth in the United States, we used data from the Family and Community Health Study (FACHS) to explore the trajectory of PRD in Black youth by gender, SES, and place. Methods: Data came from FACHS, 1997–2017, which followed 889 children aged 10–12 years old at Wave 1 (n = 478; 53.8% females and n = 411; 46.2% males) for up to 18 years. Data were collected in seven waves. The main predictors of interest were gender, SES (parent education and annual family income), age, and place of residence. Main outcomes of interest were baseline and slope of PRD. Latent growth curve modeling (LGCM) was used for data analysis. Results: Gender, SES, place, and age were correlated with baseline and change in PRD over time. Male, high family income, and younger Black youth reported lower PRD at baseline but a larger increase in PRD over time. Youth who lived in Iowa (in a predominantly White area) reported higher PRD at baseline and also an increase in PRD over time. High parental education was not associated with baseline or change in PRD. Conclusion: In the United States, Black youth who are male, high income, and live in predominantly White areas experience an increase in PRD over time. Future research is needed on the interactions between gender, SES, and place on exposure and vulnerability of Black youth to PRD. Such research may explain the increased risk of depression in high SES Black males.

Catastrophic costs of treating drug resistant TB patients in a tertiary care hospital in India

Private healthcare is choice of point of care for 70% of Indians. Multidrug resistant tuberculosis (MDR-TB) treatment is costly and involves duration as long as 2 years. To estimate costs to patients undergoing treatment for MDR-TB. A health-economics questionnaire was administered to 50 consecutive patients who successfully completed ambulatory private treatment for MDR-TB. Direct costs included drug costs, investigations, consultation fees, travel costs, hospitalisation and invasive procedures and cost prior to presentation to us. Indirect costs included loss of income. Of our cohort of 50 patients, 36 had pulmonary TB while 14 had extra-pulmonary TB (EPTB). 40 had MDR-TB and 10 had XDR-TB. There were 15 males and 35 females. Mean age was 30 years (range 16-61 years). Treatment cost for pulmonary MDR-TB averaged $5723 while it averaged $8401 for pulmonary XDR-TB and $5609 for EPTB. The major expense was due to drug costs (37%) while consultation fees were only 5%. Annual individual income for the cohort ranged from $0 to $63,000 (mean $11,430). On average, the cost of treatment ranged from 2.56% to 180.34% of the annual family income. 34/50 (68%) had total costs greater than 20% of annual family income and 39/50 (78%) had total costs greater than 10% of annual family income. The number of patients with total costs >40% of total family income was 22. MDR-TB in the private sector results in "catastrophic health costs". Financial and social support is essential for patients undergoing treatment for MDR-TB.

Assessing Coping Strategies in Response to Drought: A Micro Level Study in the North-West Region of Bangladesh

Drought is an extreme and frequent event in the north-west region of Bangladesh and it adversely affects the livelihood of the farming community. Identifying the coping strategies that farmers use in the face of drought is crucial in order to understand how farmers minimize the effects of drought on their production, especially in the face of climatic changes that may impact the occurrence of extreme weather events. The purpose of this study was to assess farmers’ coping strategies for droughts by identifying which strategies are used and the influencing factors. A mixed methods approach using qualitative and quantitative data was employed. Preliminary data were collected using structured interviews and focus group discussions in which the findings were triangulated in order to design a questionnaire. The study respondents were 100 farmers operating in north-west Bangladesh. The findings were analyzed using descriptive statistics, coefficient of correlation, multiple linear and step-wise regressions. The results reveal that the respondents have limited drought coping strategies, even though the region is prone to frequent droughts. Among the fourteen identified drought coping strategies, the use of deep tube wells for irrigation water was the most widely reported and the farmers perceived it as the most important coping strategy. Shallow tube wells closely followed as the second most commonly used coping strategy reported by the respondents. Among the identified coping strategies, the least practiced was the use of treadle pumps. The findings from the study showed that age, education, farm size, annual family income, extension media contact, and organization participation were significantly associated with the choice of coping strategy that the farmers employed. Additionally, farm size, age, and education were identified as influential factors that affected the farmers’ choice of which drought coping strategies to use. The study identified important issues for policy makers engaged with governmental programs that aim to enhance the farmers’ drought coping mechanisms. The methods employed and the results of this study could be usefully applied in other districts of Bangladesh, or other areas of the world suffering from the negative effects of drought on agricultural production.

Abstract 2: Financial Toxicity From Out-of-pocket Annual Health Expenditures in Low-income Adults With Atherosclerotic Cardiovascular Disease in the United States

Background: Health insurance is effective in preventing financial hardship from unexpected major healthcare events. However, to determine whether vulnerable patients are adequately protected from longitudinal health care costs, it is also essential to assess the financial impact of cumulative out of-pocket (OOP) healthcare expenses for common chronic conditions like ASCVD, particularly for low-income families. Methods: Using the Medical Expenditure Panel Survey (2006-2015), we assessed the annual inflation-adjusted OOP expenses, inclusive of insurance premiums, for all patients with ASCVD (coronary, cerebral, or peripheral vascular disease). We assessed these expenses at a family-level, i.e. for families with ≥1 members with ASCVD, and compared against annual family incomes. Low-income families were defined by an income <200% of the federal poverty limit. OOP expenses of >20% and >40% of family income defined high, and catastrophic health expenses, respectively. Survey methods were used to obtain national estimates. Results: We identified 22521 adults (≥18y) with ASCVD, represented in 20600 families in MEPS. They correspond to an annual estimated 23 million or 9.9% of US adults, and 21 million or 15% of all US families. Of these, 39% were low-income. The median annual family OOP expenses were $2450 (IQR 725, 5343), and income was $39765 (IQR 19080, 77635). Overall, OOP expenses represented a median 6.4% (IQR: 1.3, 19.1) of income in low-income, and 5.5% (IQR 2.6, 10.4) in mid/high income families. Low-income families had over 3-fold and 9-fold higher odds than mid/high income families of expenses of >20% of income (24.1% vs 8.1%, OR 3.6 [3.2, 4.1]), and >40% of income (11.2% vs 1.4%, OR 9.2 [7.5, 11.2]) (Fig A). While more low-income families gained insurance coverage (90% in 2006 to 93% in 2015), those with insurance had higher rates of OOP expenses than those without insurance (Fig B/C) or any mid/high income insurance subgroups. Conclusion: 1 in 4 low-income families with a member with ASCVD experience a high financial burden, and 1 in 10 experience a catastrophic healthcare expense, even with insurance coverage. Underinsurance of low-income families has improved minimally. To alleviate economic disparities, policy interventions must extend focus to improving the quality of coverage for low-income families.

National surveillance of 2,3,7,8-substituted polychlorinated dibenzo-p-dioxins/furans in soil in Taiwan

In this study, the polychlorinated dibenzo-p-dioxin/furan (PCDD/F) levels in 381 soil samples coming from different background areas (n = 238) and contaminated areas (n = 143) in Taiwan were investigated from 2011 to 2015 using high resolution gas chromatograph/high resolution mass spectrometry (HRGC/HRMS). The contaminated areas showed higher PCDD/F contamination as compared to the background areas (1230 vs 749 pg/g dry weight (dw)); 14.0 vs 6.25 pg WHO2005-TEQ/g dw). The lowest levels were recorded in the outlying islands (1.28 pg WHO2005-TEQ/g dw). PCDD/F congener distribution profiles in the background and contaminated areas as well as on the islands varied. OCDD was the dominant congener in almost all locations, including the northern background (87.7%) and central contaminated (74.2%) areas. Other dominant species included OCDF and 1,2,3,4,6,7,8-HpCDD. Levels of PCDD/F-TEQs in Taiwanese soils, including the background areas, were higher than in some developing countries and regions with global background levels due to high industrialization except for the contaminated areas. Geographic differences in dioxin-contaminated soils were also shown in this study. Higher soil dioxin-TEQs were observed in locations with high populations and population densities. Despite the limitations, the economic status of Taiwan represented by the annual averaged family income (AAFI) was positively correlated to soil dioxin-TEQs.

English

Small-scale farmers’ adaptation decision in the face of climate variability and change (CVC) depends largely on their ability to perceive the impacts of CVC as well as their degree of vulnerability to these impacts. This research looks at the factors that influence small-scale farmers’ adaptation decision faced with climate variability and change, with particular focus on Mbengwi Central Sub-Division, North-West Region of Cameroon. The study made use of household surveys to identify the impacts, determine vulnerability and assess the factors influencing small-scale farmers’ adaptation decision. Data obtained from household surveys was analyzed using descriptive statistics (bar charts, percentage indices) and inferential statistics (Mann-Whitney test, Chi-Square, and the Binomial Logistic (BNL) regression model). Data analysis was done on Microsoft Excel 2007 and the Statistical Package for Social Sciences (SPSS) 17.0. Results showed that, following small-scale farmers’ perceptions, crop productivity decline was the main impact of CVC (96.7%) and poverty the principal cause of vulnerability to CVC (98.3%). Mann-Whitney test results revealed that there was a significant difference between farmers’ adaptation decision and six hypothesized continuous explanatory variables (age, household size, farm size, number of farms, annual family income, farm experience) (p<0.01). Chi-square test results revealed that there was a significant difference between farmers adaptation decision and some hypothesized discontinuous explanatory variables (perception of extreme weather events, access to weather information, access to extension services, access to credit, membership in farming groups and distance to markets) (p<0.01). Results of the BNL regression model showed that the main determinants of small-scale farmers’ adaptation decision in the study area were age of household head, farm size and access to weather information (p<0.05).   Key words: Climate variability and change, small-scale farmers, impacts, vulnerability, adaptation decision, North-West Region of Cameroon.

Factors Determining the Membership of Farmer’s in Producer Organization (PO) a Study in the Assam State of India

Aim of this study to document the factors that influence farmer’s participation in producer organizations. To address these issues, the Government of Assam decided to mobilize farmers in the form of Producer organization (PO). Producer organization meant for effective management of agriculture in a specific crop field. The history of Producer Organizations indicates that after performing successfully for a period of time it almost defunct. For sustainability of Producer Organizations, factors influencing its membership pattern need to be studied. Therefore, this study was conducted in Jorhat District of Assam to address this issue. Total 240 respondents were selected (120 members and 120 non-members of Producer Organizations) by using multistage sampling technique. The instrument for data collection was questionnaire that consists of two sections. Section one contained Individual level information i.e. Age, Education, Gender, Caste, Organizational participation, Extent of public extension contact. Section two had Family level/ house hold information i.e. Primary source of income, Size of the family, annual family income, Size of operational land holding. The t test indicated that there were significant difference between age, operational land holding, the extent of government extension contact, the primary source of income and annual family income of members’ and non-members’ means in these characteristics, both the groups were heterogeneous. From forward stepwise regression analysis, it was found that extension contact, operational land holding, annual family income and caste influences the membership pattern of Producer Organization. These variables together explained 67.50 per cent (Adjusted R2 =0.675) of the variance of effective factors on farmer’s membership pattern toward producer organizations. The study recommended that extension machinery should give emphasise on these factors and manipulate these factors for enrolling more farmers.

Moderating effects of age, income and internet usage on Online Brand Community (OBC)-induced purchase intention

PurposeThe purpose of this paper is to understand the customer attitude and perception towards the online brand communities (OBCs) and purchase intention (PI). The paper also analyses the moderating effects of age, income and internet usage on the relationship among the proposed variables.Design/methodology/approachThe study employed a multi-analytical approach through the use of structural equation modelling and neural networks to test the proposed framework. The information was obtained from 236 respondents using a web-based questionnaire survey. Further, moderation analysis, with age, annual family income and weekly internet usage as moderating variables, was conducted on the structural model.FindingsThe results of the analysis demonstrate that the multi-group moderating effect for different groups within age, income and internet usage have significant differences for the relationships between the independent variables content perception, perceived usefulness, critical mass, brand attachment and attitude towards brand and the dependent variable, PI.Originality/valueThe study is one of its kind to understand and analyse the role of moderating variables (age, income and internet usage) on OBC-induced PI.

Declines in adult blood lead levels in New York City compared with the United States, 2004–2014

ObjectivesTo assess changes in lead exposure in the New York City (NYC) adult population over a 10-year period and to contrast changes with national estimates, overall, and by socio-demographics and smoking status. MethodsWe used measurements of blood lead levels (BLLs) from NYC resident adults who participated in the NYC Health and Nutrition Examination Surveys (HANES) in 2004 and 2013–2014. We compared estimates of geometric means (GM), 95th percentiles, and prevalence of BLL ≥ 5 µg/dL overall and by subgroups over time, with adults who participated in the National HANES (NHANES) 2001–2004 and 2011–2014. ResultsThe GM BLLs among NYC adults declined from 1.79 µg/dL in 2004 to 1.13 µg/dL in 2013–2014 (P < .0001). The declines over this period ranged from 30.1% to 43.2% across socio-demographic groups and smoking status (P < .0001 for all comparisons), and were slightly greater than declines observed nationally. The drop in prevalence of elevated BLLs (≥ 5 µg/dL) was also greater in NYC (4.8–0.5%), compared with NHANES (3.8–2.0%). By 2013–2014, NYC adults with lower annual family income (< $20,000) no longer had higher GM BLLs relative to those with higher incomes (≥ $75,000), a disparity improvement not observed nationally. Likewise, GM BLLs and 95th percentiles for non-Hispanic black adults in NYC were lower than GM BLLs for non-Hispanic white adults. Non-Hispanic Asian adults had the highest GM BLLs compared with other racial/ethnic groups, both in NYC in 2013–14 and nationally in 2011–2014 (1.37 µg/dL, P = .1048 and 1.22 µg/dL, P = .0004, respectively). ConclusionThe lessening of disparity in lead exposure across income groups and decreasing exposure at the high end of the distribution among non-Hispanic black and Asian adults in NYC suggest that regulatory and outreach efforts have effectively targeted these higher exposure risk groups. However, Asian adults still had the highest average BLL, suggesting a need for enhanced outreach to this group. Local surveillance remains an important tool to monitor BLLs of local populations and to inform initiatives to reduce exposures in those at highest risk.

Analysis of blood glucose fluctuation and its influencing factors in patients with type 2 diabetes

Objective To figure out the status of blood glucose fluctuations in patients with type 2 diabetes mellitus (T2DM) and explore its influencing factors. Methods A total of 105 T2DM cases were subjected to multiple surveys with questionnaires pertaining to general patient information, diabetes self-management, medical responses and social support as well as rating scales for the Pittsburg Sleep Quality Index and positive and negative emotions. Furthermore, the continuous glucose monitoring system (CGMS, Medtronic) was used to examine their blood sugar dynamics. Results The outcome of dynamic blood sugar monitoring showed, the standard deviation of blood glucose (SDBG) concentration was (2.41±0.91) mmol/L, the mean amplitude of glycemic excursion (MAGE) per day was (4.01±1.86) mmol/L, the median of glycemic excursion (LAGE) was 5.3 mmol/L, the median of the M-value was 5.13 mmol/L, the median for the means of daily difference (MODD) was 1.84 mmol/L and the median for low blood glucose indexes(LBMI) was 1.08 mmol/L. According to the results derived from multiple stepwise regression analyses, which used blood sugar fluctuation parameters as the variances. The results showed that: annual family income, glycosylated hemoglobin A1c (HbA1c), and diabetes self-management were shown to account for 51.5% of total SDBG variations; HbA1c, diabetes self-management, annual family income, social support and obedience could account for 76.3% of total MAGE variations; HbA1c, negative emotions and annual family income could account for 63.8% of total LAGE variations; HbA1c, annual family income, diabetes self-management and educational status could account for 52.3% of total M-value variations; HbA1c, negative emotions, diabetes self-management, annual family income and sleep quality could account for 48.0% of total MODD variations; HbA1c, annual family income and gender could account for 20.4% of total LBMI variation. Conclusions The T2DM patients, by contrast, demonstrated greater blood sugar fluctuations. HbA1c, annual family income, diabetes self-management, sleep quality, negative emotions and obedience were the main determinants that affect such fluctuations. Key words: Diabetes mellitus, type 2; Blood glucose fluctuation; Influencing factors

Illegal drug use and its correlates in San Juan, Puerto Rico

BackgroundData on the prevalence and correlates of illegal drug use in Puerto Rico are now almost 20 years old. ObjectivesThis study sought to estimate the 12-month prevalence of illegal and non-prescribed medical drug use in San Juan, Puerto Rico and identify sociodemographic correlates of use. MethodsData are from a random household sample of 1510 individuals, 18–64 years of age in San Juan, Puerto Rico. ResultsThe 12-month prevalence of any illegal or non-prescribed drug use was 16.5%. Prevalence among men (20.7%) was higher than among women (12.9%; chi2 = 16.308; df = 1; p < .01). Prevalence for specific drugs ranged from 11.2% for marijuana to 0.2% for methadone. Resultsof the multiple logistic regression analysis showed that male gender (OR = 1.67, 95CI = 1.21–2.3; p < .01), age 18–29 (OR = 2.39; 95CI = 1.35–4.23; p < .01), age 30–39 (OR = 1.93; 95CI = 1.01–3.69; p < .05), low (OR = 2.03; 95CI = 1.36–3.02; p < .001) and medium (OR = 1.50; 95CL = 1.01–2.23; p < .05) family cohesion/pride, and no religious preference (OR = 1.99; 95CI = 1.23–3.22; p < .01) increased the odds of drug use. Annual family income of $40,000–$60,000 (OR = 0.45; 95CI = 0.21–0.93; p < .05) and $60,001 and more (OR = 0.35; 95CI = 0.13–0.94; p > .05) were negatively associated with drug use compared to annual income up to $10,000. ConclusionsAs in many other places in the U.S., drug use in San Juan, Puerto Rico is high, affecting about 1 in 6 adults in the population. The highest prevalence is for marijuana use, which cannot be medically prescribed and of which recreational use is illegal on the island.

Mental health status in railway female workers and its occupational influencing factors

Objective: To investigate the mental health status of railway female workers and related influencing factors, and to provide a scientific strategy for labor protection regulations in railway female workers. Methods: Cluster sampling was used to select 5033 female workers from Jinan, Nanning, Qinghai-Tibet, and Wuhan railway systems in China from January to August, 2016. A uniform reproductive health questionnaire, as well as the Symptom Checklist-90 (SCL-90) , was used to investigate their general information (age, marital status, education level, and family income) , work type (day shift, night shift, or work on shift) , work position, and the presence or absence of exposure to occupational hazardous factors. The score on each factor of SCL-90 and the positive rate of mental health status were calculated. Results: The positive rate of mental health status was 10.6% in railway female workers. The workers exposed to occupational hazardous factors had a significantly higher positive rate of mental health status than those not exposed to occupational hazardous factors (14.20% vs 8.02%, P<0.01) . There were significant differences in the positive rate of mental health status between workers with different ages, marital status, education levels, histories of abortion, or annual family income levels (P<0.01) . The scores of somatization (1.54±0.62) and horror (1.28±0.47) in SCL-90 were significantly higher than the Chinese adult norm (P<0.01) . The multivariate logistic regression analysis showed that exposure to occupational hazardous factors, night shift, overwork, and carrying heavy objects were associated with mental health problems (OR=1.797, 95%CI: 1.393-2.318; OR=0.641, 95%CI: 0.498-0.827; OR=0.586, 95%CI: 0.439-0.783; OR=0.580, 95%CI: 0.378-0.890) . Conclusion: Railway female workers have lower levels of mental health than the general population and are under significant occupational stress. Exposure to occupational hazardous factors, night shift, overwork, and carrying heavy objects are associated with the development of mental health problems in railway female workers.

Childhood socioeconomic status and lifetime health behaviors: The Young Finns Study

BackgroundDifferences in health behaviors partly explain the socioeconomic gap in cardiovascular health. We prospectively examined the association between childhood socioeconomic status (SES) and lifestyle factors in adulthood, and the difference of lifestyle factors according to childhood SES in multiple time points from childhood to adulthood. Methods and resultsThe sample comprised 3453 participants aged 3–18 years at baseline (1980) from the longitudinal Young Finns Study. The participants were followed up for 31 years (N = 1675–1930). SES in childhood was characterized as reported annual family income and classified on an 8-point scale. Diet, smoking, alcohol intake and physical activity were used as adult and life course lifestyle factors. Higher childhood SES predicted a healthier diet in adulthood in terms of lower consumption of meat (β ± SE −3.6 ± 0.99,p < 0.001), higher consumption of fish (1.1 ± 0.5, p = 0.04) and higher diet score (0.14 ± 0.044, p = 0.01). Childhood SES was also directly associated with physical activity index (0.059 ± 0.023, p = 0.009) and inversely with the risk of being a smoker (RR 0.90 95%CI 0.85–0.95, p < 0.001) and the amount of pack years (−0.47 ± 0.18, p = 0.01). Life course level of smoking was significantly higher and physical activity index lower among those below the median childhood SES when compared with those above the median SES. ConclusionsThese results show that childhood SES associates with several lifestyle factors 31 years later in adulthood. Therefore, attention could be paid to lifestyle behaviors of children of low SES families to promote cardiovascular health.

Associations among maternal pre-pregnancy body mass index, gestational weight gain and risk of autism in the Han Chinese population

BackgroundAutism is a neurodevelopmental disorder with an unclear etiology. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have been suggested to play a role in the etiology of autism. The current study explores the associations among maternal pre-pregnancy BMI, GWG and the risk of autism in the Han Chinese population.MethodsDemographic information, a basic medical history and information regarding maternal pre-pregnancy and pregnancy conditions were collected from the parents of 705 Han Chinese children with autism and 2236 unrelated typically developing children. Binary logistic regressions were conducted to calculate the odds ratio (OR) for the relationship among pre-pregnancy BMI, GWG and the occurrence of autism. The interaction between pre-pregnancy BMI and GWG was analyzed by performing stratification analyses using a logistic model.ResultsAfter adjusting for the children’s gender, parental age and family annual income, excessive GWG was associated with autism risk in the entire sample (OR = 1.327, 95% CI: 1.021–1.725), whereas the relationship between maternal pre-pregnancy BMI and autism was not significant. According to the stratification analyses, excessive GWG increased the risk of autism in overweight/obese mothers (OR = 2.468, 95% CI: 1.102–5.526) but not in underweight or normal weight mothers.ConclusionsThe maternal pre-pregnancy BMI might not be independently associated with autism risk. However, excessive GWG might increase the autism risk of offspring of overweight and obese mothers.

Epidemiological investigation of Helicobacter pylori infection in Lhasa region

Objective To investigate current status and the influencing factors of Helicobacter pylori (H.pylori) infection in Lhasa region. Methods From November 2015 to July 2016, a questionnaire survey was conducted among 1 000 individuals in Lhasa region and H. pylori infection was detected by 13C urea breath test. Chi-square test and multivariate Logistic regression analysis were performed for statistical analysis. Results Among 1 000 individuals, 576 (57.60%) cases were infected by H. pylori. The H. pylori infection rate in people less than 60 years old was 59.32% (538/907), which was higher than that of people no less than 60 years old (40.86%, 38/93), and the difference was statistically significant (χ2=11.765, P<0.01). The higher the education level, the lower the infection rate of H. pylori (χ2=16.381, P=0.001). The difference in the infection rate of H. pylori in different occupations was statistically significant (χ2=28.699, P<0.01). The infection rate of H. pylori was lowest in mental workers (45.77%, 119/260) and was highest in heavy labor worker (79.35%, 123/155), and the difference was statistically significant (χ2=44.985, P<0.01). The lower the family annual income, the higher the infection rate of H. pylori (χ2=84.472, P<0.01). Raw meat intake (odd ratio (OR)=1.725, 95% confidence interval (CI) 1.192 to 2.249), dietary taste (OR=1.316, 95%CI 1.056 to 1.564) and sharing dishware (OR=2.723, 95%CI 1.973 to 3.431) were positively correlated with H. pylori infection (all P<0.01), and family income was negatively correlated with H. pylori infection (OR=3.205, 95%CI 2.358 to 4.056, P<0.01). Conclusion The infection rate of H. pylori decreased in Lhasa region compared to that of 10 years ago, which may be due to the improved dietary habit as well as social-economic condition. Key words: Helicobacter pylori; Epidemiology; Lhasa region

Tobacco Product Use Among Military Veterans - United States, 2010-2015.

In 2015, an estimated 18.8 million U.S. adults were military veterans (1). Although the prevalence of tobacco-attributable conditions is high among veterans (2), there is a paucity of data on use of tobacco products, other than cigarettes, in this population. To monitor tobacco product use among veterans, CDC analyzed self-reported current (i.e., past 30-day) use of five tobacco product types (cigarettes, cigars [big cigars, cigarillos, or little cigars], roll-your-own tobacco, pipes, and smokeless tobacco [chewing tobacco, snuff, dip, or snus]) from the National Survey on Drug Use and Health (NSDUH). Overall, 29.2% of veterans reported current use of any of the assessed tobacco products. Cigarettes were the most commonly used tobacco product (21.6%), followed by cigars (6.2%), smokeless tobacco (5.2%), roll-your-own tobacco (3.0%), and pipes (1.5%); 7.0% of veterans currently used two or more tobacco products. Within subgroups of veterans, current use of any of the assessed tobacco products was higher among persons aged 18-25 years (56.8%), Hispanics (34.0%), persons with less than a high school diploma (37.9%), those with annual family income <$20,000 (44.3%), living in poverty (53.7%), reporting serious psychological distress (48.2%), and with no health insurance (60.1%). By age and sex subgroups, use of any of the assessed tobacco products was significantly higher among all veteran groups than their nonveteran counterparts, except males aged ≥50 years. Expanding the reach of evidence-based tobacco control interventions among veterans could reduce tobacco use prevalence in this population.

Microcredit Could Influence Empowerment of Women. A Quantitative Study in Chittagong, Bangladesh

This paper will explore some of the ways in which microcredit have improved the empowerment of women in Chittagong, Bangladesh in terms of change in annual family income, change in health conditions change in decision-making ability and change in purchasing capacity. This was a quantitative research and using a survey method. Data was collected from a sample of 113 borrowers of microcredit loans. The AMOS software developed for analyzing the Structure Equation Modeling (SEM) and SPSS was used. The findings revealed that decision making capacity and family income have a significant impact towards empowerment of women. The findings supported the results from some earlier studies and also bring out several new ideas such as the importance of family income. The findings have significantly contributed to the advancement of knowledge in the empowerment of women borrowers in Chittagong, Bangladesh. The implications were in the areas of encouraging poor women to increase their self-esteem and self-worth, and thereby empower them. It is recommended that microcredit lending be continued and suitable policies and legislation be implemented to ensure successful implementation. The results of this study will add to the current body of knowledge as well as assist in creating foundational solutions to ensure successful outcomes arising from microcredit loans in Bangladesh.

890: Exclusive formula feeding among socioeconomically disadvantaged (SED) women: a necessity rather than a choice?

SED women are comparatively less likely to breastfeed. Many breastfeeding (BF) educational interventions assume SED women choose formula feeding because of limited knowledge of BF benefits or poor social support. We compared patient-reported reasons for BF cessation between SED women who chose exclusive formula feeding and SED women who chose to supplement BF with formula. This cross-sectional study occurred in 2016 at a single, university-based tertiary care center, which is designated a Baby Friendly Hospital. SED women without a BF contraindication who delivered non-anomalous singletons were recruited at scheduled appointments within 6 months of delivery. Consenting women completed a validated BF survey. Study outcomes included reasons for formula initiation and BF cessation. We compared outcomes in women who exclusively formula fed to those who supplemented BF with formula. 149 women completed the survey; of these, 47 (31.5%) chose to supplement BF with formula, and 51 (34.3%) chose exclusive formula feeding. Compared to those who chose BF with formula supplementation, women who chose exclusive formula feeding were more likely to have an annual family income of <$25,000 but were otherwise similar in age, ethnicity, and level of education. On a 1-4 scale, with 4 denoting more importance, women who chose exclusive formula feeding were more likely to rate their desire or need to return to work or school (4 (3,4) versus 3 (1,4), p<0.001) or to leave the baby for a few hours at a time (4 (1,4) versus 1 (1,3); p<0.001) as very important reasons for not BF on PPD2. Conversely, women who chose exclusive formula feeding reported being less likely to start formula due to their concern the baby was still hungry after BF (13.7% versus 36.2%, p=0.01). There was no difference between groups in BF problems such as pain or difficulty latching. The majority of SED women feed their infants formula by PPD2. This decision appears driven more by logistical necessity than by a lack of BF knowledge or personal problems with BF. These data suggest BF educational interventions should target strategies to continue BF when returning to work or school.

Evaluation of a Commercial Telehealth Weight Loss and Management Program

Objective: This study assesses the effectiveness of the Bright Line Eating Boot Camp (BLE: BC), an eight-week telehealth weight management program. Methods: Data come from participants in the BLE: BC research program. The final sample (n=5,374) contained primarily white adults (92.8%), females (95.2%), and individuals who reported high socioeconomic status (96.0% had completed at least some college and 47.4% reported an annual family income of at least $100,000). We focus in this manuscript on the primary outcomes of percent weight loss and change in body mass index from baseline. Secondary outcomes include program satisfaction and perceptions of healthy eating. Results: Approximately 95% of participants lost weight between baseline and completion of the BLE: BC. During the eight weeks, average percent weight loss was 7.8 (SD=7.5) and body mass index declined by an average of 2.6 (SD=2.3). Spearman’s correlation tests show that participants who reported expending more effort and participating more in the program reported greater percent weight loss (rs=0.39, p<0.001 and rs=0.34, p<0.001, respectively) and larger reduction in body mass index (rs=0.36, p<0.001 and rs=0.33, p<0.001, respectively). The majority of participants (88.6%) reported being satisfied with the program and 90.4% reported that healthy eating became easier. Conclusion: The results of this study support the efficacy of the BLE: BC as a fully online, telehealth weight loss program. Future studies should assess the long-term weight loss and maintenance of BLE: BC participants and endeavor to specify mechanisms for the observed weight change. Although we acknowledge limitations in generalizability of the results due to the lack of a comparison group and selection bias in the sample, the results show clinically-significant weight loss among the majority of BLE: BC participants.