Female Beneficiaries Research Articles

Frequency of Disparities in Laboratory Testing After Statin Initiation in Subjects ≥65 Years

Laboratory testing is important for the safety of older adults initiating statins, but there has been little examination of laboratory testing disparities by race/ethnicity, age, gender, Medicaid eligibility, and multimorbidity. The study's purpose was to examine disparities in guideline-concordant baseline laboratory testing and abnormal laboratory values among a retrospective cohort of 76,868 Medicare fee-for-service beneficiaries from 10 states in the eastern United States who had dyslipidemia and initiated a statin from July 1 to November 30, 2011. Guideline-concordant assessment of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was defined as evidence of an outpatient claim for either test within 180days before or 14days after the date of the index statin fill. In 2011, baseline laboratory testing rates were 89.3% for ALT and 88.8% for AST. Older adults were somewhat more likely to have ALT and AST testing if they were dually enrolled in Medicaid (relative risk 1.01, 95% confidence interval [CI] 1.00 to 1.02) or had multiple chronic conditions (relative risk 1.03, 95% CI 1.00 to 1.06 for 2 to 3 conditions; odds ratio [OR] 1.08, 95% CI 1.05 to 1.11 for 4 to 5 conditions; OR 1.14, 95% CI 1.11 to 1.17 for 6+ conditions), compared with 0 to 1 conditions. Non-Hispanic blacks were less likely to receive baseline testing (OR 0.97, 95% CI 0.96 to 0.98) than non-Hispanic Whites, and male beneficiaries were somewhat less likely to receive testing than female beneficiaries (OR 0.99, 95% CI 0.98 to 0.99). Abnormal values were rare. In conclusion, ALT and AST assessment after statin initiation was commonly done as recommended, and there were negligible disparities in testing rates for beneficiaries.

Does oncology patient-reported healthcare experience vary by site of care (SOC)?

71 Background: Patients with cancer are increasingly receiving chemotherapy infusions in a hospital outpatient (HO) as compared to the physician practice setting (PO). Previous research has focused on SOC differences in economic measures, such as healthcare costs, in commercially insured populations. This study investigates SOC differences in patients’ reported healthcare experience for a mostly Medicare population. Methods: A convenience sample of 2,604 Humana members with cancer of the breast, lung, colon/rectum or NHL/CLL and treated in 2014 received a survey by mail to capture patient reported healthcare experiences. We implemented the Consumer Assessment of Health Care Providers and Systems (CAHPS) for Cancer Care survey’s 5 domains (“affective” communication, shared decision making, patient self-management, exchanging information and access to care and information) and ad hoc travel and wait time questions. Average composite scores for each CAHPS domain were weighted and adjusted by age and health status (1 = excellent - 5 = poor). Differences in responses were tested using chi-square and t-tests. Results: The response rate was 25.0% (N = 651). Survey respondents were mostly female (75.0%) and Medicare beneficiaries (87.9%) with a mean age of 68.7. HO patients reported slightly worse health status than PO patients (2.9 vs 3.0, p= 0.028) CAHPS for cancer domain scores indicated a similar patient perceived experience across all domains except for access to care and information (1-3 scale): HO = 2.6 vs PO = 2.5, p= 0.007. This difference was driven mainly by items related to contacting the health care team for certain symptoms and after hours care. More HO patients traveled > 30 minutes for treatment (39.0% vs 25.9%, p= 0.004) and reported wait times > 15 minutes (72.2% vs 63.8%, p= .054). Patient perceived acceptability of these travel and wait times were similar (HO: 61.9% vs PO: 66.7%, p= .782 and HO: 60.4% vs PO: 63.1%, p= .919). Conclusions: Analysis of the new CAHPS for cancer care survey showed comparable patient perceived experiences by site of care. However, access to the health care team for certain symptoms and after hours care was better for HO patients, though HO patients also had longer travel and waiting time.

Women, Apiculture and Development: Evaluating the Impact of a Beekeeping Project on Rural Women’s Livelihoods

Apiculture is often cited as a possible method of empowering rural women. Beekeeping generates a product with high market potential, while being more easily adapted to constraints of low credit and limited land access than other agricultural activities. Beekeepers in Romania are predominantly male, however studies have shown a growing popularity of the activity among women In 2008 and 2011, Heifer International introduced beekeeping to rural families in SAƒlaj County, Romania, encouraging equal participation among women and men. By “passing on the gift”, the project was also extended in some villages in Cluj county. The goal of the present study was to assess the projects’ impact on female beneficiaries several years later. The methodology used was surveying via a quantitative and qualitative questionnaire. The sample size was 30 women, from nine villages of the SomeE™ River Valley involved in the project. The results of the research shown that women continue to practice subsistence farming and beekeeping remains small-scale. However, improvements in household revenues and women’s participation are observed. Production is focused mainly on honey, which is sold through informal channels. Women welcome the idea of further diversification through value-added products, and further training to improve market access could provide additional benefits. Families consume more honey and the women acknowledge nutritional benefits. The Heifer principle of “passing on the gift” helped build connections among local women beekeepers. The study offers advice and best practices for future apicultural development projects. It reminds practitioners of the importance of activities that facilitate women’s empowerment and agency in rural community development.

Rural-Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia.

Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer's disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 contiguous, geographically similar states with large rural areas and aged populations. We used Centers for Medicare and Medicaid Services Public Use Files data from 2007 to 2013 to assess prevalence of ADRD at the county level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of age-eligible residents enrolled in Medicare, and percent of residents under age 65 enrolled in Medicare in our adjusted models, we found that 2013 ADRD diagnostic prevalence was 11% lower in rural counties (95% CI: 9%-13%). Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results.

The Incidence of Breast Cancer among Disabled Kansans with Medicare

BACKGROUND: Breast cancer disparities by disability status are poorly understood. While previous studies have shown increased odds of late stage at diagnosis, it is unclear whether the incidence of breast cancer varies by disability status. METHODS: To assess cancer incidence and stage at diagnosis among disabled and nondisabled Medicare beneficiaries in Kansas, a retrospective cohort study was conducted using linked Medicare enrollment and Kansas Cancer Registry data from 2007 to 2009. Disability status was determined by the indicator for the original reason for Medicare eligibility. RESULTS: Among the 651,337 Medicare beneficiaries included in the cohort, there were 2,384 cases of breast cancer. The age-adjusted incidence was 313 per 100,000 among female beneficiaries with disabilities and 369 per 100,000 among nondisabled female beneficiaries. The adjusted incidence rate ratio was 0.93 (95% CI 0.73-1.18). When assessing stage at diagnosis, there was no difference in the odds of late stage at diagnosis by disability status (OR = 1.02; 95% CI 0.68-1.50). CONCLUSION: No significant difference in incidence or stage at diagnosis was identified among this cohort. The use of Medicare eligibility to define disability status presented a number of limitations. Future studies should seek alternate definitions of disability to assess disparities in breast cancer incidence, including definitions using Medicare claims data.

The Design of Conditional Cash Transfers: Experiences from Argentina's Universal Child Allowance

Conditional cash transfers (CCTs) have spread rapidly in developing countries in the past decade. While there is extensive literature assessing their impacts health, education and other outcomes, little attention has been paid to beneficiaries' subjective experiences of CCT design. This article addresses this issue by exploring how beneficiaries of Argentina's flagship CCT, the Universal Child Allowance, perceive the programme's unique design features. We find male and female beneficiaries tend to support targeted transfers to female carers, and that confusion about payment schedules has important implications for beneficiary engagement. Analysis of these findings offers useful insights into how CCT programme design may affect outcomes.

A Critical Analysis of the Laws of Inheritance in the Southern States of Nigeria

AbstractThis article critically examines the customary laws of inheritance in the communities of southern Nigeria. It argues that the rules are skewed against female beneficiaries, both wives and children. It also argues that courts faced with such customs should subject them to the repugnancy test contained in the Evidence Act 2004, the Constitution of the Federal Republic of Nigeria 1999 and other international conventions to which Nigeria is party, as do the courts in Ghana, South Africa and Botswana.

Landscape Analysis of Nutrition-sensitive Agriculture Policy Development in Senegal.

Unlocking the agricultural potential of Africa offers a genuine opportunity to address malnutrition and drive development of the continent. Using Senegal as a case study, to identify gaps and opportunities to strengthen agricultural policies with nutrition-sensitive approaches. We carried out a systematic analysis of 13 policy documents that related to food production, agriculture, food security, or nutrition. Next, we collected data during a participatory analysis with 32 national stakeholders and in-depth interviews with 15 national experts of technical directorates of the different ministries that deal with agriculture and food production. The current agricultural context has various elements that are considered to enhance its nutrition sensitivity. On average, 8.3 of the 17 Food and Agriculture Organization guiding principles for agriculture programming for nutrition were included in the policies reviewed. Ensuring food security and increasing dietary diversity were considered to be the principal objectives of agricultural policies. Although there was considerable agreement that agriculture can contribute to nutrition, current agricultural programs generally do not target communities on the basis of their nutritional vulnerability. Agricultural programs were reported to have specific components to target female beneficiaries but were generally not used as delivery platforms for nutritional interventions. The findings of this study indicate the need for a coherent policy environment across the food system that aligns recommendations at the national level with local action on the ground. In addition, specific activities are needed to develop a shared understanding of nutrition and public health nutrition within the agricultural community in Senegal.

MP81-20 THE LONG-TERM SAFETY, TRENDS AND RE-INTERVENTIONS IN THE SURGICAL MANAGEMENT OF STRESS URINARY INCONTINENCE

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology1 Apr 2015MP81-20 THE LONG-TERM SAFETY, TRENDS AND RE-INTERVENTIONS IN THE SURGICAL MANAGEMENT OF STRESS URINARY INCONTINENCE Bilal Chughtai, Adrien Bernstein, Jessica Buck, Jialin Mao, Abby Isaacs, Richard Lee, Alexis Te, Steven Kaplan, and Art Sedrakyan Bilal ChughtaiBilal Chughtai More articles by this author , Adrien BernsteinAdrien Bernstein More articles by this author , Jessica BuckJessica Buck More articles by this author , Jialin MaoJialin Mao More articles by this author , Abby IsaacsAbby Isaacs More articles by this author , Richard LeeRichard Lee More articles by this author , Alexis TeAlexis Te More articles by this author , Steven KaplanSteven Kaplan More articles by this author , and Art SedrakyanArt Sedrakyan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2898AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Stress urinary incontinence (SUI) can greatly decrease a women's quality of life, and prevalence reports vary greatly indicating that up to 35% of women suffer from this condition. We determined short-term safety and long-term re-interventions following surgical treatment of stress urinary incontinence among female Medicare beneficiaries. METHODS We analyzed a 5% national random sample of Medicare claims from 2000 to 2011 of female beneficiaries who underwent sling or bulking procedures, based on CPT-4 and ICD-9 procedure codes. Individual patient's first sling or bulking procedure in the claim was identified. 90-day adverse events and re-interventions during the follow-up period were captured using ICD-9 diagnosis, procedure and CPT-4 codes. Statistical analysis for categorical data was performed to determine differences in distribution of patient demographics and comorbidities. Outcomes including 90-day adverse events and re-interventions were compared between treatment groups. Time to event was used to determine freedom from re-intervention after therapy. RESULTS We identified 21,134 and 3,475 patients undergoing sling and bulking procedures between 2000 and 2011. There was a 29.7% increase in sling procedures and 59.5% decrease in bulking procedures from 2000 to 2011. 90-day adverse events of both procedures were rare, with exception of mild risk of urinary retention (Sling 11.3%, Bulk 8.4%). Smaller proportion of patients receiving slings had re-interventions compared to those who had bulking therapy. 53.2% sling patients and 76.3% bulking patients who had subsequent procedures received same procedure at first re-intervention. CONCLUSIONS Both sling and bulking procedures are safe in terms of short-term performance. Patients who received initial treatment of bulking agent injection are more likely to have re-interventions. Patients who had re-interventions tend to repeat the therapy instead of converting to another procedure. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1036 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bilal Chughtai More articles by this author Adrien Bernstein More articles by this author Jessica Buck More articles by this author Jialin Mao More articles by this author Abby Isaacs More articles by this author Richard Lee More articles by this author Alexis Te More articles by this author Steven Kaplan More articles by this author Art Sedrakyan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Academic Staff Attrition at African Universities

tries, with 23 countries receiving significant funding for systemic change. Nearly one-third million students benefited directly, including more than 1,000 female scholarship beneficiaries. The assessment also found that the foundations invested more on higher education than would have been possible without the partnership. One leading initiative is in the area of information and communications technology identified as a priority intervention at a joint workshop with the UN Economic Commission for Africa. With an initial investment of more than $5 million, the partnership commissioned the African Virtual University to consolidate bandwidth demand from several universities and negotiate its acquisition from satellite companies at a significantly lower cost. No single foundation would have had the network and the human resources to start and sustain this effort over time. PHEA has also attracted the attention of other foundations and agencies. The William and Flora Hewlett Foundation and the Andrew W. Mellon Foundation formally joined the partnership in April 2005. The six foundations have pledged to continue the partnership though 2010 and to invest $200 million over the next five years, expanding the number of beneficiary countries to include Kenya, Egypt, and Madagascar. Four special initiatives will receive joint support: (a) provision of broadband and utilization of information and communication technology to improve access to information and production of knowledge in African universities; (b) development of research on higher education innovations, institutional transformation,

Prevalence and Incidence of Epilepsy in an Elderly and Low-Income Population in the United States.

Background and PurposeThe purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States.MethodsArizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged ≥65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for ≥12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence.ResultsThe estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05).ConclusionsThis patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status.

Have We Finally Achieved Actuarial Fairness of Social Security Retirement Benefits and Will it Last?

This paper develops a framework to analyze the actuarial adjustments faced by American workers who claim Social Security benefits before or after their Full Retirement Age (FRA). We derive the conditions under which these adjustments are “actuarially fair” (or “neutral”) and develop measures to characterize the deviation from the fair form. Fair adjustment schedules are increasing at an increasing rate in take-up age and become flatter as longevity rises. We document that the actuarial fit has improved across generations. Our baseline 3% discount rate scenario estimates that the current schedule deviates from its fair form by less than 1% for average-mortality beneficiaries, compared to 5.1% and 4.0% for male and female beneficiaries in 1980, respectively. The improvement is largely due to the increases in the Delayed Retirement Credit. For men, gains in life expectancy combined with the increase in the FRA also contributed to the improved fit. We predict that the designated increase in the FRA to age 67 will have little effect on the actuarial fit. We investigate schedules reflecting (further) increases in the retirement ages, as recommended by the President’s 2010 Fiscal Commission, and propose alternatives. We also discuss results from the analysis of the adjustments to spousal and widow(er) benefits.

Gendered Impact of Microcredit in Mali: An Evaluation by Propensity Score Matching

Microfinance in Mali has a positive impact on poverty alleviation in total and higher on female than on male beneficiaries.

English

The main purpose of the study was to assess the impact of Plan Ghana&rsquo;s Microfinance Scheme on the livelihoods of female beneficiaries in the Lower Manya Krobo Municipality of the Eastern Region of Ghana. A descriptive survey design was adopted and 180 sample size was used. The study showed that the scheme had improved beneficiaries&rsquo; lives tremendously in areas of health, child education, personal development, and business sustainability. The study also recommended that Plan Ghana intensifies the training programme for its clients. &nbsp; Key words: Lower Manya- Krobo, microfinance, Plan Ghana, poverty reduction.

Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica.

To determine whether there was a difference in wealth and cardiovascular disease (CVD) risk between microcredit loan beneficiaries and community-matched non-beneficiaries (controls). Seven hundred and twenty-six households of microcredit loan beneficiaries were matched with 726 controls by age, sex and community. A standardised interviewer administered questionnaire was used to collect data on health and household expenditure. Weights, heights, waist circumference and blood pressure measurements were taken for an adult and one child (6-16 years) from each household. Amongst adults, there was no difference in the prevalence of pre-hypertension and hypertension. More male (68.1% vs. 47.8%) and female beneficiaries (84.5% vs. 77.9%) were overweight/obese. More male (17.2% vs. 7.1%; P < 0.05) and female beneficiaries (68.5% vs. 63.3%; P < 0.05) exhibited substantially increased risk for CVD. Children of beneficiaries displayed higher mean BMI-for-age z-scores than their control peers: males 0.56 [95% CI 0.40-0.72] vs. 0.18 [95% CI 0.02-0.35] (P < 0.001) and females 0.66 [95% CI 0.52-0.80] vs. 0.42 [95% CI 0.29-0.56] (P < 0.001). Based on BMI-for-age z-scores, children of beneficiaries had greater odds of being overweight/obese (OR = 1.46; 95% CI 1.18-1.82) Beneficiaries were economically better off; their mean total annual expenditure and house ownership were significantly higher than controls (P < 0.001). Microcredit financing is positively associated with wealth acquisition but worsened cardiovascular risk status.

Detection and treatment rates for perinatal depression in a state Medicaid population.

The purpose of this investigation was to assess detection and treatment rates for perinatal depression among women enrolled in the California State Medicaid (Medi-Cal) program in comparison to female beneficiaries of reproductive age who did not give birth during the same study period. Investigators conducted a retrospective longitudinal cohort analysis of women between the ages of 18 and 39 years old who were continuously enrolled in the Medi-Cal fee-for-service program between January 2006 and December 2009. The perinatal cohort consisted of women with evidence of a live birth occurring between October 2007 and March 2009. The control cohort consisted of women in the same age group and health plan without evidence of pregnancy during this time frame. The primary outcome of this investigation was diagnosis of depression during 3 contiguous 9-month time frames: immediately prior to presumed conception, during pregnancy, and throughout the postpartum period. Secondary outcomes included within-group and cohort comparisons of treatment patterns (antidepressant or psychotherapy). A multivariable analysis of demographic factors predicting depression diagnosis or treatment was conducted as well. A total of 6030 women was identified in the perinatal cohort, and 56,709 women were included in the control group. The perinatal cohort was significantly less likely than nonpregnant controls to receive a diagnosis of depression both during pregnancy (prevalence=1.6% vs 3.5%; OR=0.45; 95% CI=0.35-0.55) and postpartum (2.2% vs 3.6%; OR=0.59; 95% CI=0.50-0.71). Similar differences were noted in antidepressant prescribing patterns apparent during these 2 time frames. A subgroup analysis of women who received a depression diagnosis revealed that only 48% of the perinatal cohort was provided any treatment during pregnancy (vs 72% of the control group; p<0.0001) or postpartum (57% vs 73%; p<0.0001). Specific demographic factors predicting a lower prevalence of depression detection or treatment included Hispanic descent, age <25 years, or primary residence in an rural setting. Depression was often overlooked and undertreated among women who are pregnant or postpartum in comparison to services delivered to similar nonpregnant controls. Significant disparities in the healthcare received by certain subpopulations of perinatal women suggest that research into barriers to care and subsequent interventions are warranted.

Service delivery effectiveness of microcredit-driven non-government organizations in alleviating poverty: a study on Bangladesh

This paper develops and validates a three-dimensional multi-item scale for non-government organizations (NGOs) that captures features related to ‘credibility,’ ‘confidence,’ and ‘convenience’ dimensions of effective service delivery in reducing poverty in rural Bangladesh. The methodology is based on 355 samples collected by the author from 68 randomly chosen villages in Bangladesh during September–December 2011. Results of the regional analysis show that male beneficiaries preferred to have improvement in the items related to ‘confidence and convenience’ dimensions such as worker’s skill, transparency in the transaction process, location, and business hours of NGOs. On the other hand, female beneficiaries expect to see changes in items that belong to the ‘credibility’ dimension such as speed of making decision, regularity in sharing information, and regular meeting with the managers.

Women's perceptions of the Girinka (one cow per poor family) programme, poverty alleviation and climate resilience in Rwanda

abstractThe Girinka ‘one cow per poor family’ programme has been implemented in Rwanda since 2006 to contribute towards poverty reduction, reduction of child malnutrition as well as to promote climate resilience among poor rural families. Under the programme, every family whose local community confirms it meets national criteria of being poor receives one dairy cow. Impacts of the Girinka programme on female beneficiaries for increasing livelihood options and enabling food security in the drought-prone Bugesera District as well as its potential contribution to climate resilience were assessed. The specific focus was whether the Girinka programme assists female beneficiaries to better cope with climate change in Bugesera District. The key consideration is the extent to which interventions reduce women's vulnerability to climate change impacts. Both quantitative and qualitative research methods were used in this study. One hundred and thirty three female beneficiaries were interviewed and four focus group discussions held. The key findings of the study show that the one cow per poor family resulted in expanded land use, improved household nutrition and food security. Changes in agricultural practices resulting from the use of green fertiliser contributed to climate change resilience, increased crop production and generated income for poor rural women. The study reveals that while the government energy policy prioritises biogas energy production and the use of cow dung for biogas energy generation to reduce deforestation and greenhouse gas emissions in the atmosphere for climate resilience, few respondents in the study could afford to buy biodigesters. Direct benefits for women who are responsible for energy and the collection of wood for their households are not yet being reaped and depend on affordable biodigesters. The main problems reported by respondents were inadequate veterinary services for care of the cow, the frequent search for water sources during droughts and insufficient land to grow fodder.

Trends in urodynamics in U.S. female medicare beneficiaries, 2000-2010.

To document variations and temporal trends in the use of urodynamics (UDS) in female U.S. Medicare beneficiaries. Using a 5% sample of U.S. Medicare utilization records, we identified female beneficiaries who had undergone UDS studies between 2000 and 2010 by the presence of Common Procedural Terminology codes for cystometrogram in claims from the Carrier file. We abstracted data for each patient on age, race, residence, ICD9 diagnoses, dates of service, and provider specialty. We calculated rates per 100,000 beneficiaries with data available from the enrollment files (i.e., Denominator files) and reported the numbers and rates per 100,000 by year. During this period, 1.4 million female U.S. Medicare beneficiaries underwent UDS, of which 6% were videourodynamics. Seventy four percent of UDS were associated with a diagnosis of any urinary incontinence, with 50% specific for stress incontinence. The annual rates of UDS increased by 29%, from 422 in 2000 to 543 in 2010 per 100,000. Similar increases were seen across age groups, geographic regions and racial/ethnic groups. The rate of UDS performed by gynecologists increased by 144% over the study period, while that of urologists decreased by 3%. In 2010, gynecologists performed 35% and urologists 58% of all UDS. The use of UDS in the female Medicare program increased substantially between 2000 and 2010, with some variation across demographics and marked variation across provider specialty.

Gender Dimension to Farmers’ Perception of the National Fadama Development Project Phase III in Kogi State

The study evaluated the perception of farmers of the Third National Fadama Project in Kogi state with particular interest on the gender dimension. A multistage random sampling technique was used in selecting the respondents while structured interview schedule was used for data collection. Samples of 20 farmers were selected in 5 local government areas to give a total of 100 respondents. Data were analyzed with frequency, percentages, mean, standard deviation and t-test. The result indicates that the mean membership composition of the groups by gender was about 5 for both male and female. The major source of information for the male was radio (90.1) while for the female was Buyers (75.9). The test of difference (t-test) shows that the male and female differ significantly on 2 activities and did not differ significantly on 10 activities. The result also shows that the male and female beneficiaries do not differ significantly in their attitudes to project (P< 0.05) with only one item having significant difference. There were only 2 being untimely disbursement and Lack of ready market to sell the increased output as a result of securing productive asset out the 20 possible constraints where the male and female participant differ (P< 0.05). These 2 constraints are Untimely disbursement of inputs (t=4.53 p<0.05) and Lack of ready market to sell the increased output as a result of securing productive asset (t= 5.59, p<0.05). The study therefore concluded that there is no significant disparity in the perception of the Third National Fadama Project in Kogi State based on gender and as such recommends that intervention programmes should be gender sensitive. Keywords: Gender, Fadama Development Project