Highest Income Category Research Articles

Socioeconomic Status and Its Relation to Hypertension in Rural Nepal.

Introduction Hypertension and its association with socioeconomic positions are well established. However, the gradient of these relationships and the mediating role of lifestyle factors among rural population in low- and middle-income countries such as Nepal are not fully understood. We sought to assess the association between socioeconomic factors (education, income, and employment status) and hypertension. Also, we assessed whether the effect of education and income level on hypertension was mediated by lifestyle factors. Methods This cross-sectional study was conducted among 260 participants aged ≥18 years attending a rural health center in Dolakha, Nepal. Self-reported data on demographic, socioeconomic, and lifestyle factors were collected, and blood pressure, weight, and height were measured for all study participants. Those with systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or administrating high blood pressure-lowering medicines were regarded as hypertensives. Poisson regression models were used to estimate the prevalence ratios and corresponding 95% confidence intervals to assess the association between socioeconomic factors and hypertension. We explored mediation, using the medeff command in Stata for causal mediation analysis of nonlinear models. Results Of the 50 hypertensive participants, sixty percent were aware of their status. The age-standardized prevalence of hypertension was two times higher for those with higher education or high-income category. Compared to low-income and unemployed groups, the prevalence ratio of hypertension was 1.33 and 2.26 times more for those belonging to the high-income and employed groups, respectively. No evidence of mediation by lifestyle factors was observed between socioeconomic status and hypertension. Conclusions Socioeconomic positions were positively associated with hypertension prevalence in rural Nepal. Further studies using longitudinal settings are necessary to validate our findings especially in low- and middle-income countries such as Nepal.

Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey.

Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-CoV-2. The Malaysian government has planned to procure COVID-19 vaccine through multiple agencies and companies in order to vaccinate at least 70% of the population. This study aimed to determine the knowledge, acceptance and perception of Malaysian adults regarding the COVID-19 vaccine. An online survey was conducted for two weeks in December 2020. A bilingual, semi-structured questionnaire was set up using Google Forms and the generated link was shared on social media (i.e., Facebook and WhatsApp). The questionnaire consisted of questions on knowledge, acceptance and perception of COVID-19 vaccine. The association between demographic factors with scores on knowledge about COVID-19 vaccine were analysed using the Mann-Whitney test for two categorical variables, and the Kruskal-Wallis test used for more than two categorical variables. A total of 1406 respondents participated, with the mean age of 37.07 years (SD = 16.05) years, and among them 926 (65.9%) were female. Sixty two percent of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score 4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine. High knowledge scores associated with higher education background, higher-income category and living with who is at higher risk of getting severe COVID-19. They were more likely to be willing to get vaccinated if they were in a lower age group, have higher education levels and were female. Even though knowledge about vaccine COVID-19 is inadequate, the majority of the respondents were willing to get vaccinated. This finding can help the Ministry of Health plan for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.

Association of Hospitalised Infection With Socioeconomic Status in Patients With Rheumatoid Arthritis Receiving Biologics or Tofacitinib: A Population-Based Cohort Study.

Objectives: Use of biologics or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) is associated with infection in patients with rheumatoid arthritis (RA). Socioeconomic status is substantial in infectious diseases; however, the impact of socioeconomic status on risk for infection in patients with RA receiving b/tsDMARD remains unclear.Methods: We used the 2003–2017 Taiwanese National Health Insurance Research Database to identify patients with RA receiving b/tsDMARDs. A Cox regression analysis was used to estimate the associations of covariates with the risk of hospitalised infection shown as hazard ratios (HRs) with 95% confidence interval (CIs).Results: We identified 7,647 RA patients who started their first bDMARD/tsDMARD treatment. Log-rank analyses demonstrated the association between age (p < 0.001), urbanisation (p = 0.001), the insured amount (p = 0.021), and the hospitalisation. Cox proportional regression analyses showed that age was independently associated with hospitalised infection in a dose–response manner, whereas a high-income category had an inverse association (HR 0.48, 95% CI 0.23–0.96). Hospitalisation for infection within 5 years was a strong risk factor (HR 5.63, 95% CI 1.91–16.62), and living in a rural area tended to be a risk factor (HR 1.76, 95% CI 0.98–3.14) for incident hospitalised infection.Conclusions: This study showed the crucial impacts of age, socioeconomic status, and history of infection on hospitalised infection in patients with RA receiving b/tsDMARDs. These findings highlight the largely ignored role of socioeconomic status in risk stratification among patients receiving b/tsDMARDs for RA.

Perceived Trust of E-Services, Perceived Usefulness and Adoption of E-Banking amongst the Students of University of Kelaniya: A Relational Study

This study examines the relationship of perceived usefulness and perceived trust of e-services on adopting e-banking in the context of Sri Lankan private commercial banks. Sample was drawn from the students of University of Kelaniya, those who are possessing e-banking facilities of private banks. Initially 500 questionnaires were distributed and 305 duly completed questionnaires were considered for the final data analysis process. Governing factors on perceived trust of e-services were identified by conducting principal component analysis. TAM has been extended by using the perceived trust of e-services. In order to test the hypotheses, correlation analysis followed by multiple regression analysis using hierarchical method along with diagnosis tests for outliers, residuals, influential cases, were performed whilst supplementary statistical tests, such as trend analysis and contrast test of ANOVA were also used for further analysis of demographic characteristics with special reference to respondents’ income levels. The empirical evidence supported two hypotheses indicating the positive relationships of perceived trust of e-services and perceived usefulness variables towards e-banking adoption. Furthermore, it was revealed that there are differences in adoption of e-banking with regard to several demographic variables. Third hypothesis stating the existence of differences in adoption of e-banking between lower income category customers and higher income category was also supported. Restricted sample selection and time restrictions are limitations. Nevertheless, extending of TAM in relation to present research context could be noted as the originality of the research. Findings would be beneficial for Sri Lankan bankers and banking application developers, alike. In conclusion, future research could be conducted in varied contexts in the field of technology adoption in search of novel findings.

The non-sovereign territories: Economic and environmental challenges of sectoral and geographic over-specialisation in tourism and financial services

This paper analyses the economic and geographic characteristics of the world’s principal non-sovereign territories in the context of the growth challenges facing small economies. These territories enjoy high degrees of policy autonomy within a complex array of relationships with their metropolitan countries. Seven of the ten metropolitan powers are European and account for 38 of the 49 inhabited non-sovereign territories. The territories’ distinct economic and geographic characteristics, notably small size and remoteness, have led to their adopting similar niche sectoral growth strategies to those of small sovereign states and a reliance upon tourism and financial services. In spite of the growth challenges faced, most of these territories have attained high levels of per capita gross national income, placing them in the World Bank High Income category. Global heating, economic crises and regional environmental shocks, along with growing international protectionist sentiments, however, raise critical questions regarding the continued viability of their traditional growth strategies, particularly their heavy reliance upon environmentally harmful long-haul air travel and cruise tourism. This paper bridges the gap between large-scale growth studies, which generally overlook non-sovereign entities, and single case studies to examine the determinants of the growth success of non-sovereign territories and their future growth challenges given the pressing need for both economic and environmental sustainability.

COVID-19 Vaccine Acceptance in the Democratic Republic of Congo: A Cross-Sectional Survey.

We investigated the level of willingness for COVID-19 vaccination in the Democratic Republic of Congo (DRC). Data were collected between 24 August 2020 and 8 September 2020 through an online survey. A total of 4131 responses were included; mean age of respondents was 35 years (standard deviation: 11.5); 68.4% were females; 71% had elementary or secondary school education. One fourth (24.1%) were convinced that COVID-19 did not exist. Overall, 2310 (55.9%) indicated they were willing to be vaccinated. In a multivariable regression model, belonging to the middle and high-income category (OR = 1.85, CI: 1.46–2.35 and OR = 2.91, CI: 2.15–3.93, respectively), being tested for COVID-19 (OR = 4.71, CI: 3.62–6.12; p < 0.001), COVID-19 community vaccine acceptance (OR = 14.45, CI: 2.91–71.65; p = 0.001) and acknowledging the existence of COVID-19 (OR = 6.04, CI: 4.42–8.23; p < 0.001) were associated with an increased willingness to be vaccinated. Being a healthcare worker was associated with a decreased willingness for vaccination (OR = 0.46, CI: 0.36–0.58; p < 0.001). In conclusion, the current willingness for COVID-19 vaccination among citizens of the DRC is too low to dramatically decrease community transmission. Of great concern is the low intention of immunization among healthcare workers. A large sensitization campaign will be needed to increase COVID-19 vaccine acceptance.

Socio Economic Factors Affecting The Use Of Solid Waste Produced In Kurunegala and Kundasale

Municipal Garbage Compost (M.S.W.C.) is popular with organic farming in the world. Nearly 100 authorities in Sri Lanka are involved in the production and the timing is right to identify the factors for using M.S.W.C. The cities of Kurunegala and Kundasale were selected to identify socio-economic factors that influence the use of M.S.W.C. Users (45) and non-users (35) M.S.W.C. selected using a simple random sampling method. Data collection was carried out using questionnaires and key informant interviews. The majority (51%) of M.S.W.C. users are in the 36-50 age category and 60% are in the high-income category. Hence, 47% of M.S.W.C. users are vegetable cultivators. The majority (84%) have higher knowledge about the supply of soil fertility nutrients and knowledge about production and application is at a moderate level. The Spearman correlation and multiple linear regression yields monthly income, agricultural land area, farming experience and knowledge of production methods and applications showed a significant relationship with the number of M.S.W.C. use. Discriminant function analysis yields knowledge about soil fertility, productivity, nutrient availability and attitudes about the benefits of using M.S.W.C. leading to M.S.W.C. users and non-users. Conducting interactive drama, multimedia and promotional videos to promote M.S.W.C.

AN EVALUATION ON OUTCOME OF OIL PALM REPLANTING SCHEME (TSSPK) AND NEW PLANTING SCHEME (TBSPK)

The Oil Palm Assistance Scheme for Replanting (TSSPK) and the New Planting (TBSPK) for Independent Smallholders (ISH) were inaugurated in 2011 as part of the 10th Malaysia Plan. It is a subset of the National Key Economic Area (NKEA) Oil Palm Commodities Entry Point Project 1 (EPP1). Among the assistance included in these schemes are the high-quality seedlings, agricultural inputs such as fertilisers and pesticides along with the cash fund for land preparation and cultivation of the seedlings. The smallholders who participated in these schemes were also given extension services by the MPOB extension agent (TUNAS) on various aspects of oil palm management. A total of 382 participants were involved and responded to the survey. The proportion of respondents are from Sabah (38.5%), Sarawak (38%), and Johor (23.6%). The study found that the average age of the participants mostly is 60 years old and above (40.1%), and 57.4% of participants were the owner of the oil palm plantation. The range of fresh fruit bunch (FFB) production harvested for the first and second year is between 0 - 4.6t/ha/year, which is slightly low due to the El Nino occurrence in 2016. A profit in income was recorded from the FFB sales after participating in the scheme. The low-income category recorded a decrease of 30.11% while the higher income category showed an increased between 2.66% to 16.59% after they joined the schemes. Some participants also implemented the integrated cash crops alongside the oil palm to generate income while waiting for the immature oil palm to produce yield. This study shows that most of the respondents complied with the Good Agriculture Practice (GAP) after joining the scheme. Most of the participants were pleased with the implementation of the schemes and services done by the TUNAS Officers and gave them an excellent rating. Several improvements are suggested such as agriculture input distribution, clustering the smallholders into cooperatives, continuity of GAP implementation, and comprehensive research in the future.

Determinants of Food Thermometer Use and Poultry Washing among Canadian Consumers

Previous surveys have found that few Canadians report using a food thermometer to check cooking doneness, and many report rinsing or washing poultry prior to cooking. A cross-sectional survey study was conducted to investigate the sociodemographic and psychosocial determinants of the reported use of these behaviors among Canadians. A questionnaire was developed, guided by the Theoretical Domains Framework, and pretested through 10 cognitive interviews. The questionnaire was administered in English and French on 18 November 2019, to an online panel of 524 Canadian consumers. Logistic and ordinal regression models were constructed to evaluate determinants of consumers' reported thermometer ownership (yes or no) and thermometer use and poultry washing frequencies (each measured on a 5-point Likert scale). Nearly two-thirds of respondents (64%; n = 333) reported owning a food thermometer. Thermometer ownership was more common among males (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.02, 2.15) and those with higher income categories. Nearly 45% of these respondents (n = 147) reported often or always using their thermometer to check cooking doneness. The frequency of engaging in this behavior was best determined by four psychosocial constructs: behavioral intentions, beliefs about consequences, self-efficacy, and habits. Nearly two-thirds of respondents (64%; n = 333) reported often or always washing their poultry before cooking it. This behavior was more frequently reported by males (OR = 1.51, 95% CI = 1.002, 2.28). It was also predicted by six psychosocial constructs: behavioral intentions, beliefs about consequences, self-efficacy, social influences, social responsibility, and habits. Habits had the largest influence on both behaviors. The study results can inform the development of more targeted food safety education and outreach initiatives to improve these behaviors among Canadians.

The role of innovation in the relationship between university–industry collaboration in R&amp;D and ISO 9001

PurposeThis study aims to investigate the relationship between university–industry collaboration (U-I-C) in research and development (R&amp;D) and quality management and explore how the relationship is mediated by innovation.Design/methodology/approachBased on panel data consisting of 109 countries spanning over a five year period (2013-2017) this study investigates, through structural equation modelling, how this relationship is mediated by innovation.FindingsThe main finding is that there are positive significant direct effects between U-I-C and innovation and between innovation and international organization for standardization (ISO) 9001. Furthermore, the strength and significance of these relations are highly affected by the classification of income in these countries, which ranges from high and upper-middle to lower-middle categories. This paper concludes that countries in the high-income category have higher achievement in U-I-C in R&amp;D, innovation and ISO 9001 when compared to the upper and lower-middle-income categories.Originality/valueThis paper demonstrates in the empirical study the value of collaboration in R&amp;D between government, industry and academia, as it can encourage scientific research and contribute to quality management and innovation. This research is one of the very few studies to assess the country’s income classification effect on U-I-C in R&amp;D, innovation and ISO 9001. It is recommended that more research is conducted on how countries not ranked in the high-income category could benefit from U-I-C in R&amp;D to enhance innovation and quality management.

Relationship between Contextual Factors, Psychosocial Factors and Hygienic Practices of Tribes in Liberia

This study determined the relationship between contextual factors, psychosocial factors and hygienic practices of the tribes of Liberia. Data were collected from six randomly selected tribes from three regions in Liberia. Convenient, stratified and random sampling techniques were employed to survey 390 household heads who were aged 15 years and above. A correlational design was used and data gathered were analyzed utilizing inferential statistics. Majority of the respondents were males aged 40 years and above and of the middle and high income category. Regression analysis revealed self-efficacy, social environment and cognitive factors as predictors of hygienic practices in terms of disposal of wastes, while self-efficacy, cognitive, policy implementation and cultural identity predicted handwashing. Additionally, social environment, self-efficacy, physical environment, cognitive and policy implementation predicted bathing practices. Respondents who had high income, high educational attainment and of the tribes C and E had a better practice on waste disposal. Those with high income and of the tribes D and C had a better handwashing practice, while those who had high income and of the A and E ethnic groups exhibited better bathing practices.

The determinants of non-smokers’ opinions about increased health insurance rates for smokers

Abstract Background The rates of obligatory health insurance available to Polish citizens do not depend on their health behaviours. However, there are opinions suggesting that the rates should be increased for those who show risky health behaviours. This study aimed at the assessment of determinants of non-smokers' opinions about the introduction of increased health insurance rates for smokers. Methods The analysis was carried out on the data originating from the telephone-based survey on the representative sample of 1000 adult Polish citizens. Responses from non-smokers in the moment of the study were retrieved from the data set. A dichotomised variable derived from the item asking about the opinion about increased insurance rates for smokers was used as a dependent variable in uni- and multivariate logistic regression models. Sociodemographic characteristics, health status, prior use of health care resources, and history of smoking were included as independent variables. Results The study sample included 779 respondents; of them 60.1% (n = 471) never and 0.39.9% (n = 308) smoked in the past. There were 45.0% and 34.4% of supporters of higher rates in these subgroups. Increased insurance rates were supported by older respondents (OR, 95%CI: 1.01,1,001-1.03) and those with higher income (2.17, 1.27-3.70, and 2.23, 1.34-3.71, for the comparisons of two higher income categories with referential category of net income &amp;lt;1500 PLN). Past smokers (0.51, 0.36-0.74), Internet users (0.49, 0.27-0.90), respondents admitted to hospital in preceding year (0.57, 0.36-0.91), and those who reached higher levels of education (0.49, 0.29-0.84, and 0.50, 0.28-0.90 for comparisons between persons with higher levels of education with those with the lowest level) expressed an opposite view. Conclusions Not only earlier experience of tobacco smoking but also higher education level, prior hospital admission and Internet use are related to lack of the acceptance for increased health insurance rates. Key messages Determinants of opinions about increased insurance rates may be counterintuitive. The use of health services or higher education levels are not associated with the support of higher rates for smokers.

Does religion promote pro-environmental behaviour? A cross-country investigation

ABSTRACT Religion is one of the most prominent social institutions in the world and is profoundly entangled with day to day activities of the majority of the population. However, the effect of religion on socio-economic and environmental dimensions of development is not yet well explored in literature. Thus, this study aims to investigate the influence of multiple indicators of religion on pro-environmental behaviour and attitudes, and whether its effect varies across different income categories of countries. To this end, we use the World Value Survey data from up to 212,995 respondents across 91 countries collected from 1989 to 2014. The results of the study show that religion induces pro-environmental behaviour. Religion promotes individuals' willingness to contribute money and dampens individuals' protest against contributing for environmental protection. Similarly, religion has a positive effect on ecological donation and participation in the environmental demonstration. Furthermore, the results of this study indicate that the effects of some of the religious indicators on stated willingness to contribute for environmental protection are more pronounced in low-income countries than countries in high-income categories. These results highlight the importance of religion on environmental protection and suggest that integrating religion into environmental policies and programs may yield better environmental outcomes.

Abstract A098: Socioeconomic and geographic predictors for radiotherapy quality disparities in the Mid-Southern U.S.

Abstract Background: Approximately half of cancer patients are prescribed radiotherapy (RT) during their care. RT noncompliance (NC) is a well-studied quality measure associated with inferior survival. Cancer outcomes in the Mid-South (West Tennessee, Mississippi Delta, Eastern Arkansas) rank well below other U.S. regions. The purpose of this study is to benchmark RT NC rates, define socioeconomic predictors of RT NC, and geographically map NC across a large Mid-Southern catchment region served by a single academic cancer referral center. Methods: Demographic, clinical, and treatment information were collected for all patients treated with RT at the University of Tennessee West Cancer Center from January 1, 2015 to December 31, 2017. RT NC was defined as delay in 2 or more treatments. “Critically high” RT NC was defined as delay in 5 or more treatments. Patients with Medicaid or no insurance were categorized as “At Risk.” Patient predicted income (PPI) was modeled using 2016 US Census data for patient residence zip code and grouped by thirds into three (low, middle, and high) income categories. RT NC was compared by insurance type, race, and PPI, analyzed for significance using Pearson's Chi square testing, and geomapped by patient residence zip code and urban and rural status. Results: A total of 3,754 patients were included, of whom 1,981 (52.8%) were Caucasian, 1,582 African American (42.2%), and 217 (5.7%) other. Insurance status was defined as Commercial, Medicare, or At Risk in 1,803 (48%), 1,508 (40%), and 443 (12%) patients, respectively. Overall, RT NC was seen in 962 patients (25.6%) and critically high RT NC was seen in 422 patients (11.2%). At-risk patients experienced more RT NC (36.2% v 25.1% p=&amp;lt;0.001) and more than double the critically high RT NC compared to patients with commercial insurance (20.3% v 9.6% p=&amp;lt;0.001). African American patients in our population experienced higher rates of RT NC and critically high RT NC compared to Caucasian patients ([30.5% v 22.0% p=&amp;lt;0.001] and [14.9% v 8.8% p=&amp;lt;0.001]). Compared to patients with high PPI (&amp;gt;67k), patients with low PPI (&amp;lt;$34k) experienced higher RT NC (20.2% v 31.7% p=&amp;lt;0.001) and critically high RT NC (7.3% v 15.7% p=&amp;lt;0.001). High RT NC rates were geographically associated with patients living in rural zip codes, with critically high RT NC rates in urban zip codes with low PPI. Conclusion: In our high-volume academic radiotherapy practice, RT noncompliance correlates significantly with uninsured or Medicaid coverage status, African American race, and low predicted income. Noncompliance disproportionately impacts rural patients and inner-urban patients with low predicted income. Further studies are needed to understand causative mechanisms requiring intervention to help close gaps in radiotherapy quality. Citation Format: Daniel V. Wakefield, Matthew Carnell, Austin P.H. Dove, Elena Delavega, Esra Ozdenerol, Maria Pisu, Michelle Y. Martin, David L. Schwartz. Socioeconomic and geographic predictors for radiotherapy quality disparities in the Mid-Southern U.S. [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A098.

Abstract 23: Income Disparity and Utilization of Cardiovascular Preventive Care Services in the Medical Expenditure Panel Survey (MEPS)

Background: Socioeconomic markers such as income level are associated with cardiovascular disease (CVD). However, the associations between income and utilization of CVD preventive services, such as receipt of lifestyle advice and screening for CVD risk factors in populations with and without established CVD are less well understood. Methods: We used data from the nationally representative Medical Expenditure Panel Survey (2006-2015). We included adults (≥18 years old) and divided the sample population into 2 groups: those with CVD (defined by self-reported and/or ICD9 diagnosis of CVD [coronary artery disease, stroke, heart failure, cardiac dysrhythmias and/or peripheral arterial disease]) and those without CVD. Participant responses were recorded by telephone survey. Additional information on health care utilization was collected from physicians, hospitals, and pharmacies. We categorized participants as high income (400% of federal poverty level [FPL]), middle income (200-400% of FPL), low income (125-200% of FPL) and poor/very low income (&lt;125% of FPL). We used logistic regression to compare likelihood of utilizing or receiving certain CVD risk preventive services among participants in different income groups, adjusting for demographics, comorbidities and other socioeconomic factors. Results: We included 185,081 participants without CVD (representing 194.6 million US adults without CVD, 48% female) and 32,862 participants with CVD (representing 37 million U.S. adults with CVD); 36% of individuals with CVD were in the high income category, 29% were middle income, 16% and 19% were in the low and poor/very low income group, respectively. Compared with high income adults, adults with low and poor/very low income were less likely to have cholesterol levels or blood pressure checked and receive counseling about diet modifications, exercise, or smoking cessation, regardless of CVD status ( Table ). Conclusion: Poor/very low income adults were much less likely to be screened for CVD risk factors or receive counseling for prevention of CVD than high income adults. More work must be done to reduce disparities in access to and utilization of CVD preventive services among adults in different income groups.

Patent Foramen Ovale Closure in hospitalized stroke patients in the United: Is there a racial disparity?

Background Racial disparity in stroke is well documented. Whether such disparity exists in the frequency of Patent Foramen Ovale (PFO) closure among patients with ischemic stroke (IS) is unclear. Objective To investigate the rate, trends, and racial determinants of PFO closure among hospitalized patients with ischemic stroke in the U.S. Methods The Nationwide Inpatient Sample was queried from 2006 to 2014 for patients older than 18-years of age with a primary discharge diagnosis of IS excluding those with a secondary discharge diagnosis of congenital heart diseases other than PFO. Patients were categorized by their PFO closure status. First, we determined the rate and 9-year trend in the rate of PFO closure. We then performed a logistic regression analysis to study the independent association between race and PFO closure. Results We identified a total of 1,028,565 patients with a primary discharge diagnosis of ischemic stroke, of whom 384 had PFO closure. In univariate analysis, PFO closure was more likely to be performed in younger patients, Hispanic patients, privately insured patients, those seen in large bed size academic center, and in patients in the high-income categories. We also observed that the rate of PFO closure decreased overtime overall and in all races, particularly after 2010. In multivariable logistic regression, Non-Hispanic Blacks were less likely to have PFO closure (OR: 0.51, 95%, CI: 0.35-0.74) when compared to Non- Hispanic Whites meanwhile the high rate of PFO closure in Hispanics observed in the univariate model was attenuated and did not reach statistical significance (OR: 1.57, CI: 0.90-2.72). Conclusions Although the rate of PFO closure has declined over time across all races after 2010, overall, Non-Hispanic Blacks were two times less likely to have a PFO closure after ischemic stroke than Non-Hispanic Whites after adjusting for demographic and socio-economic factors.

Socio Economic Factors Affecting the Use of Solid Waste Compost Produced in Kurunegala and Kundasale Municipalities.

Municipal Solid Waste Compost (MSWC) is popular with organic agriculture in the world. Nearly 100 authorities in Sri Lanka are involved in producing MSWC. Its timely needed to identify the factors affecting the use of MSWC. The Kurunegala and Kundasale municipalities were selected to identify the socio economic factors affecting the use of MSWC. The users (45) and non-users (35) of MSWC were selected using simple random sampling method. Data were collected using questionnaire and key informant interviews. Majority (51%) of the MSWC users were 36-50 years age category and 60% were high income category. Accordingly, 47% MSWC users were vegetable cultivators. Majority (84%) had a higher knowledge on soil fertility nutrient supply and knowledge on method of production and application was at a moderate level. Spearman correlation and multiple linear regression resulted monthly income, cultivated land extent, farming experience and knowledge on method of production and application showed significant relationship with the amount of MSWC use. Discriminant function analysis resulted knowledge on soil fertility, productivity , nutrient supply and attitude on advantage of using MSWC lead to discriminate the MSWC users and non users. Conducting interactive drama, multimedia and promotional videos to promote MSWC among farming community are recommended.

PENGURUSAN KEWANGAN PRASEKOLAH SWASTA

Early childhood services and education industry have grown steadily with a wide range of local and international franchise brands. This raises questions about the ability of private kindergartens and nurseries to compete in the market. The objective of this study is to analyze the basic aspects of the financial management of this institution and its ability to be viable and competitive. Data is obtained through questionnaires that are distributed to selected entrepreneurs and managers in the state of Selangor. Feedback from 52 institutions found that a large number of institutions have a sufficient number of children. Teachers are qualified but paid salaries on a low scale. Student management assistant is not provided due to small and varied size of classes. More kindergartens are in high-income categories compared to nurseries, but both institutional spendings are in lower categories. The registration fee varies between institutions but the kindergarten charges an additional fee at a higher rate compared to nurseries. There are preferential differences in operating expenses incurred between kindergartens and nurseries. Some recommendations to reduce the financial burden of private pre-school operators are discussed at the end of this article.

Is wealth associated with depressive symptoms in the United States?

PurposeThe aim of the study was to assess the relation between family wealth and depression in U.S. adults. MethodsParticipants were 5134 members of the 2015–2016 National Health and Nutrition Examination Survey who were aged 18 years or older and completed the depression screener. Using the Patient Health Questionnaire and household demographics interview data, we calculate the adjusted odds of depressive symptoms for persons with low relative to high family savings, using multivariable logistic regression. We estimate predicted probabilities of having depressive symptoms for low and high family savings groups at low, middle, and high family income categories. ResultsOverall, 57.4% of the total weighted population had low family savings (below $20,000), and 23.7% of the weighted population had depressive symptoms. Persons with low family savings had 1.49 times higher odds (95% confidence interval, 1.01–2.21) of having depressive symptoms than persons with high family savings, controlling for gender, age, race, education, marital status, family size, and family income. Predicted probabilities of depressive symptoms were higher for low family savings groups than high family savings groups at every income level. ConclusionsFamily wealth is associated with lower prevalence of current depressive symptoms in U.S. adults. Wealth may be an important determinant of population mental health, separate and independent from income.

Differences in performance of pomegranate growers under public and private extension services

The Pomegranate is cultivated as a commercial crop because of its high income generating capacity. The pomegranate needs a critical care at the production level and it enhances the need of consultancy service for the production. Hence, there are number of Private people working as consultants along with public extension personnel. The affordability of the growers to pay is a key factor for private extension in the area. The study was conducted in Hiriyuru, Chitradurga and Challakere taluks of Chitradurga district with a total sample size of 120 comprising 60 growers each under public extension and private extension systems. The “Ex-post fact” research design was used in the study. The 40 per cent of the growers were under medium adoption category in public extension services and under private extension service 40 per cent growers were found in high adoption category. The growers who were availed public extension services belonged to medium income category (43.33%). Whereas 45 per cent of growers from private extension service fall under high income category. The Benefit to cost ratio was highest in Challakere taluk (3.47) in case of private extension and in Public Extension the highest return was found in Hiriyuru (3.05). The results indicated that the farmers under private extension services obtained higher income by adoption of improved practices. This may be attributed to the facts that the private extension offer recent and competent technological information including marketing services on payment basis.