Home Maintenance Research Articles

Status of Women during Dogra Rule in Kashmir: Review

The present research is an attempt to provide a historical overview to understand the position of women during dogra rule in Kashmir. The history of Jammu and Kashmir reveals that women enjoyed high status as elsewhere in India but there was a marked decline in the position of women in Kashmir. Women are identified with silence and deprivation. It is from 5th five year plan onwards that the role of women is recognized. Women also contributed a lot in the Kashmir economy. Besides, preparation of food and housekeeping, they also do the work of grinding the grain and maintenance of home since ages. The study is of Dogra rule and highlights the brutality done with the women in Kashmir. The attempt is to explore the women’s condition and exploitation she had gone through during Dogra rule in Kashmir.

Changes in Consumption amid COVID-19: Zip-Code Level Evidence from the U.S.

Using monthly zip-code level data on credit card transactions covering 16 U.S. cities, this paper investigates changes in consumption at local commercial places during the coronavirus disease 2019 (COVID-19). Since using aggregate-level data can suppress valuable information on consumption patterns coming from zip codes, the main contribution is achieved by estimating common factors across zip codes that are controlled for factors that are zip-code and time specific as well as those that are zip-code and sector specific. Whereas raw data for the median zip code suggest that spending on all sectors (except for grocery) has decreased amid COVID-19, the estimation results based on common factors across zip codes rather show that relative consumption of products and services that can be consumed at home (e.g., grocery, pharmacy, home maintenance) has increased up to 56% amid COVID-19 compared to the previous year, whereas relative consumption of products and services that cannot be consumed at home (e.g., fuel, transportation, personal care services, restaurant) has decreased up to 51%. Similarly, after controlling for the corresponding factors, online shopping has relatively increased up to 21%, while its expenditure share has relatively increased by up to 16% compared to the pre-COVID-19 period.

Ambiguities of energy poverty and the search for “hidden energy transfers”. A review of energy vulnerability narratives

Several gaps in the conceptual and empirical knowledge of energy poverty have developed during recent years. This article aims to depict these inconsistencies, as well as to undertake a brief analysis of the current state of the practices and policies that build around this concept. The way energy use in household consumption contributes or not to the development and reproduction of energy poverty will be addressed though a short analysis of how different definitions employed succeed to measure energy deprivation, as well as of how these definitions are engaged as practicalities in different social contexts. To meet this purpose, I use data from European Quality of Life Survey 2003–2016, Eurostat, and EU Buildings Database, and I also focus on narratives around energy vulnerability, traced in several policy documents. This is relevant in order to highlight gaps and ambiguities that will illustrate the links between the macrosocial layouts of the geographical and political distribution of energy for residential consumption and the scaled-down realities of energy consumption in households. Patterns of energy use are influenced by access to adequate and sufficient energy sources for home maintenance and for increasing housing quality, as well as by the other variables related to the dynamics of knowledge of efficient energy sources, the evolution of the purpose of energy policies, and the holding of energy assessment strategies for household consumption. Furthermore, to advance the understanding of energy poverty mechanisms, as well as practices around energy use, a new concept of “hidden energy transfers” is proposed as an analytical tool that highlights the social embeddedness of energy, particularly how social connectedness is vital for the energy deprived households. As demonstrated, the concept builds upon previous studies and can address a more inclusive and contextual understanding of coping strategies around energy deprivation and energy poverty, that considers not only behaviours within the household, but also those outside of it. Keywords: energy poverty; energy justice; energy vulnerability; hidden energy transfers; energy literacy.

Accidental adult deaths involving ladders: A forensic perspective.

A retrospective study was undertaken of autopsy cases at the Forensic Science South Australia state mortuary over a 20-year period from January 1999 to December 2018 for all cases aged ≥18 years where a ladder was mentioned in the death scene description and/or police reports. Twelve cases were identified, all of whom were male, with an average age of 56 years (range 21–83 years). The most frequent cause of death was a fall from a ladder ( n = 8; 66%), followed by electrocution ( n = 4; 33%). The falls were associated with deaths from blunt injuries, impalement and laceration. The age range of those who fell was 47–83 years (average 66 years). The three of the four deaths associated with electrocutions involved contact with power lines or live electrical wires; the remaining case involved a sharp metal ladder base cutting through a live power lead. The age range of those who were electrocuted was 21–43 years (average 35 years) – significantly younger than those who had died from falls ( p < 0.05). The increase in mean age of the population with increasing popularity of home maintenance activities may result in more cases of lethal falls involving ladders presenting for forensic assessment.

Heritage language policies of the Iranian diaspora in New Zealand

ABSTRACT The present study investigates immigrant parents’ family language policies in regards to their children’s heritage language development and maintenance by utilizing Spolsky’s theoretical model on which research on family language policy (FLP) considerably draw. Following the three core components of the FLP model, Iranian parents’ beliefs, practices and efforts in relation to their children’s home language (i.e. Persian/Farsi) acquisition and maintenance are investigated. The data were collected through semi-structured interviews with twenty-five parents of Persian-English bilinguals (6–18 year old) in New Zealand. The findings reveal that although the parents hold positive beliefs towards the family language acquisition and maintenance, there are discrepancies between their language ideologies and family language practices. In light of these inconsistencies between parents’ beliefs and their actual family language practices and efforts to preserve the heritage language, we argue that to raise their children bilingually, immigrant parents should not only have strong beliefs towards family language acquisition and maintenance, but also their everyday practices and efforts should be in line with their beliefs.

Improving Oral Health Through Curriculum Framework Innovation in Supportive Care and Home Maintenance

Journal of Dental EducationVolume 83, Issue 8 p. 863-864 Guest Editorial Improving Oral Health Through Curriculum Framework Innovation in Supportive Care and Home Maintenance Lily T. Garcia DDS, MS, FACP, Corresponding Author Lily T. Garcia DDS, MS, FACP Professor and Associate Dean for Education [email protected] The University of Iowa College of Dentistry & Dental ClinicsDirect correspondence to Dr. Lily T. Garcia, The University of Iowa College of Dentistry & Dental Clinics, DSB N310, Iowa City, IA 52242-1010; [email protected].Search for more papers by this authorDonald A. Curtis DMD, FACP, Donald A. Curtis DMD, FACP Professor Division of Prosthodontics, School of Dentistry, University of California, San FranciscoSearch for more papers by this authorKent L. Knoernschild DMD, MS, FACP, Kent L. Knoernschild DMD, MS, FACP Director of Advanced Education Program in Prosthodontics Department of Restorative Dentistry, College of Dentistry, University of Illinois at ChicagoSearch for more papers by this authorStephen D. Campbell DDS, MMSc, FACP, Stephen D. Campbell DDS, MMSc, FACP Professor Department of Restorative Dentistry, College of Dentistry, University of Illinois at ChicagoSearch for more papers by this author Lily T. Garcia DDS, MS, FACP, Corresponding Author Lily T. Garcia DDS, MS, FACP Professor and Associate Dean for Education [email protected] The University of Iowa College of Dentistry & Dental ClinicsDirect correspondence to Dr. Lily T. Garcia, The University of Iowa College of Dentistry & Dental Clinics, DSB N310, Iowa City, IA 52242-1010; [email protected].Search for more papers by this authorDonald A. Curtis DMD, FACP, Donald A. Curtis DMD, FACP Professor Division of Prosthodontics, School of Dentistry, University of California, San FranciscoSearch for more papers by this authorKent L. Knoernschild DMD, MS, FACP, Kent L. Knoernschild DMD, MS, FACP Director of Advanced Education Program in Prosthodontics Department of Restorative Dentistry, College of Dentistry, University of Illinois at ChicagoSearch for more papers by this authorStephen D. Campbell DDS, MMSc, FACP, Stephen D. Campbell DDS, MMSc, FACP Professor Department of Restorative Dentistry, College of Dentistry, University of Illinois at ChicagoSearch for more papers by this author First published: 01 August 2019 https://doi.org/10.21815/JDE.019.082Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume83, Issue8August 2019Pages 863-864 RelatedInformation

Ljudska prava u siromaštvu

U povijesnoj osnovi europskih integracija, kao i u fazi pristupanja svake nove članice, leži nada u bolje sutra, u gospodarski napredak države i pojedinca. U radu se istražuje u kojoj je mjeri siromaštvo poticaj migriranju radne snage u potrazi za kvalitetnijom i sigurnijom egzistencijom unutar EU-a. Materijalna dobra osobe, obitelji i države pretpostavka su ostvarenja ljudskih prava. U radu se istražuju podatci Eurostata o stanju u RH nakon petogodišnjeg članstva u EU-u. Budući da su migracije radne snage potaknute materijalnom oskudicom, na razini Europske unije neizbježno dolazi do relociranih obitelji, ali i imovine. Zbog nade u povratak i obiteljskih veza koje se održavaju ovisno o tradiciji i osjećaju pripadnosti nacionalnom identitetu, nesumnjivo dolazi do usporednih bračno-imovinskih ili partnerskih režima. Uredbama EU-a iz 2016. godine uspostavlja se mehanizam pojačane suradnje u imovinskim učincima braka i registriranih partnerstava. Istražuju se uzroci i nastoje se predvidjeti posljedice sve brojnijih transnacionalno relociranih obitelji.

A retrospective analysis of the use of tap water iontophoresis for focal hyperhidrosis at a district general hospital: the patients’ perspective

Objective: Tap water iontophoresis as a treatment for focal hyperhidrosis is given as an initial series of treatments in hospital, followed by home maintenance treatments. Our study assessed quality of life and perception of hyperhidrosis with the use of iontophoresis.Materials and methods: All patients treated with iontophoresis at our hospital from 2012 to 2017 were retrospectively assessed (n = 82, mean age 34 years; 60% female). Fifty of the 82 patients (mean age 34 years; 60% female) had a pre-treatment DLQI (mean 12.6). Twenty-three of these patients (mean age 33 years; 60% female) had a paired pre- and post-treatment DLQI recorded. The average DLQI pre-treatment was 14.1 and post-treatment was 2.2. Therefore, the average reduction (improvement) was 11.9 (p < .05).Results: Thirty-eight of the 82 patients (46%) completed a telephone interview (mean age 35 years; 65% female). Of this cohort, 24 had an improvement in HDSS following treatment, and the remaining 14 patients had no change. Nine patients (24%) bought their own iontophoresis machine. In these patients, there was a higher average improvement in HDSS (1.8), compared to the total interviewed cohort (1.0).Conclusion: In conclusion, tap water iontophoresis can result in a significant improvement in perceived severity of hyperhidrosis and quality of life.

Care For America's Elderly And Disabled People Relies On Immigrant Labor.

As the US wrestles with immigration policy and caring for an aging population, data on immigrants' role as health care and long-term care workers can inform both debates. Previous studies have examined immigrants' role as health care and direct care workers (nursing, home health, and personal care aides) but not that of immigrants hired by private households or nonmedical facilities such as senior housing to assist elderly and disabled people or unauthorized immigrants' role in providing these services. Using nationally representative data, we found that in 2017 immigrants accounted for 18.2percent of health care workers and 23.5percent of formal and nonformal long-term care sector workers. More than one-quarter (27.5percent) of direct care workers and 30.3percent of nursing home housekeeping and maintenance workers were immigrants. Although legal noncitizen immigrants accounted for 5.2percent of the US population, they made up 9.0percent of direct care workers. Naturalized citizens, 6.8percent of the US population, accounted for 13.9percent of direct care workers. In light of the current and projected shortage of health care and direct care workers, our finding that immigrants fill a disproportionate share of such jobs suggests that policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans.

Patient-Specific, Risk-Based Prevention, Maintenance, and Supportive Care: A Need for Action and Innovation in Education.

To develop a competency-based curriculum framework for prevention, supportive care, and maintenance for use in educational and patient care programs and to seek consensus on an overarching competency statement that embraces these critical learning and patient care concepts. A preliminary survey of current preventive and maintenance practices in U.S. dental and prosthodontic programs was completed and summarized with quantitative analysis. The American College of Prosthodontists organized a one-day consensus workshop with 14 participants from various U.S. dental schools with diverse backgrounds to develop a curriculum framework. The curriculum framework was used in the development of a joint competency statement using an iterative, online consensus process of debate and feedback. The preliminary survey helped frame the initiative and identify potential educational needs and gaps. Consensus was achieved for a recommended competency statement: "Graduates must be competent in promoting oral health through risk assessment, diagnosis, prevention, and management of the hard tissue, soft tissue, and prostheses, and as part of professional recall and home maintenance."This competency statement complements the proposed curriculum framework designed around 3 domains-caries prevention, periodontal supportive care, and prosthesis supportive care-with a set of recommended learning objectives. Commission on Dental Accreditation (CODA) learning standards do not outline patient-customized, evidence-based recall and home maintenance programs that highlight prevention of dental caries, periodontal supportive care, prosthesis maintenance, and patient education.The proposed competency-based curricular framework serves as an initial step in addressing student learning and patient care within the context of a recall system and home maintenance program while offering schools the needed flexibility for implementation within their curriculum.

Synthetic 2018 data report of the French Language Peritoneal Dialysis and Home Hemodialysis Registry (RDPLF)

The RDPLF was created in 1986 and collects the main data of peritoneal dialysis of French patients and of various French-speaking countries. The database is structured in several modules: a compulsory core module including a follow-up of comorbidities, assistance, infections, survival, transplantation, and optional modules following more specific aspects: nursing, catheter, anemia, nutrition, heart failure. In addition, since 2012 patients treated at home in hemodialysis are also followed. This article presents a summary of the main characteristics of patients in the RDPLF in 2018. It highlights important differences in practices and patient profiles between francophone countries. Daily low dialysate flow rate hemodialysis is predominant in the new centers and sometimes begins to appear as a transitional mode that allows home maintenance for patients who cannot continue on peritoneal dialysis.

Ukrainian Undeclared Work Survey: First Findings

This paper presents the first findings of the Ukrainian Undeclared Work Survey (UUDWS) that was conducted in the end of 2017. UUDWS is a direct method that aims to estimate the size and the nature of the undeclared work in Ukraine. This is the first survey of its kind in Ukraine and it takes into account both the demand and the supply side of the undeclared work in Ukraine. Our findings reveal that about 7 % of the respondents admitted having worked undeclared in the past 12 months, whereas about 46 % know someone who works undeclared, and every third respondent estimated that at least 50 % of the population of Ukraine work undeclared. The majority of the undeclared workers are between 35 to 54 years old, live in urban areas, and consider themselves asunemployed, employees, and self-employed. The main undeclared activities provided include home maintenance or home improvement services, selling farm produced food, gardening, car repairs, and selling goods/services associated with their hobbies. Among the main reasons for working undeclared are difficulties to find a regular job, seasonal nature of the work, common practice to work undeclared, the fact that the State does not do anything for people, and mutual benefit from undeclared work. The results contend that Ukrainian employees have low protection in terms of their salary, as a significant part is paid in the “envelope”. Finally, informal work generates on average a lower income than the formal one. In our research in progress, we address the perceptions and acceptance of undeclared work in Ukraine, as well as assess its main determinants.Article received 30.04.2018

OLDER ADULTS AS CAREGIVERS: HOW DOES IT IMPACT THEIR CONSUMPTION PATTERNS?

AbstractOlder adults have become the emerging force for providing informal caregiving to their parents, grandchildren, or both when needed. To investigate the association between the intensity of caregiving provision and household consumption patterns, this study uses China Health and Retirement Longitudinal Study 2011 and 2013 survey data and a difference-in-differences method. Results show that 39.1% of older adults (n=13,098; age 55 or older) in China were informal caregivers in 2013, and the average caregiving time was 16.44 hours/week. Older adults who provided caregiving for more than 40 hours spent significantly more on food, clothing, and transportation, but less on home maintenance, healthcare services, education, and leisure. Interestingly, rural elders becoming more intensive caregivers spent on average 396 yuan more on tobacco and alcohol in 2013 than in 2011. Future policies and programs should pay more attention to financial burdens and time-use impacts for older caregivers.

The impact of home energy efficiency interventions and winter fuel payments on winter- and cold-related mortality and morbidity in England: a natural equipment mixed-methods study

BackgroundEngland, and the UK more generally, has a large burden of winter- and cold-related mortality/morbidity in comparison with nearby countries in continental Europe. Improving the energy efficiency of the housing stock may help to reduce this, as well as being important for climate change and energy security objectives.ObjectivesTo evaluate the impact of home energy efficiency (HEE) interventions on winter- and cold-related mortality/morbidity, including assessing the impact of winter fuel payments (WFPs) and fuel costs.DesignA mixed-methods study – an epidemiological time-series analysis, an analysis of data on HEE interventions, the development and application of modelling methods including a multicriteria decision analysis and an in-depth interview study of householders.SettingEngland, UK.ParticipantsThe population of England. In-depth interviews were conducted with 12 households (2–4 participants each) and 41 individuals in three geographical regions.InterventionsHEE interventions.Main outcome measuresMortality, morbidity and intervention-related changes to the home indoor environment.Data sourcesThe Homes Energy Efficiency Database, mortality and hospital admissions data and weather (temperature) data.ResultsThere has been a progressive decline in cold-related deaths since the mid-1970s. Since the introduction of WFPs, the gradient of association between winter cold and mortality [2.00%, 95% confidence interval (CI) 1.74% to 2.28%] per degree Celsius fall in temperature is somewhat weaker (i.e. that the population is less vulnerable to cold) than in earlier years (2.37%, 95% CI 0.22% to 2.53%). There is also evidence that years with above-average fuel costs were associated with higher vulnerability to outdoor cold. HEE measures installed in England in 2002–10 have had a relatively modest impact in improving the indoor environment. The gains in winter temperatures (around +0.09 °C on a day with maximum outdoor temperature of 5 °C) are associated with an estimated annual reduction of ≈280 cold-related deaths in England (an eventual maximum annual impact of 4000 life-years gained), but these impacts may be appreciably smaller than those of changes in indoor air quality. Modelling studies indicate the potential importance of the medium- and longer-term impacts that HEE measures have on health, which are not observable in short-term studies. They also suggest that HEE improvements of similar annualised cost to current WFPs would achieve greater improvements in health while reducing (rather than increasing) carbon dioxide emissions. In-depth interviews suggest four distinct householder framings of HEE measures (as home improvement, home maintenance, subsidised public goods and contributions to sustainability), which do not dovetail with current ‘consumerist’ national policy and may have implications for the uptake of HEE measures.LimitationsThe quantification of intervention impacts in this national study is reliant on various indirect/model-based assessments.ConclusionsLarger-scale changes are required to the housing stock in England if the full potential benefits for improving health and for reaching increasingly important climate change mitigation targets are to be realised.Future workStudies based on data linkage at individual dwelling level to examine health impacts. There is a need for empirical assessment of HEE interventions on indoor air quality.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 6, No. 11. See the NIHR Journals Library website for further project information.

COST-EFFECTIVENESS OF HOME OXYGEN THERAPY-HOME MECHANICAL VENTILATION (HOT-HMV) FOR TREATMENT OF COPD WITH CHRONIC HYPERCAPNIC RESPIRATORY FAILURE FOLLOWING AN ACUTE EXACERBATION OF COPD IN THE US

SESSION TITLE: Improving Care in COPD SESSION TYPE: Original Investigations PRESENTED ON: 10/08/2018 01:30 PM - 02:30 PM PURPOSE: In the UK trial of HOT-HMV, delayed time to readmission was reported in patients (pts) with persistent hypercapnia following a life-threatening exacerbation of COPD requiring acute non-invasive ventilation (NIV) (Murphy et al., JAMA 2017). The health economic impact of HOT-HMV in the US has been previously reported using costs for a respiratory assist device with a -$50,856 /quality-adjusted life year (QALY) (Criner et al ATS 2018). The current study reports the incremental cost-effectiveness (CE) of HOT-HMV with a home ventilator device. METHODS: The analysis included pt-level use of equipment (O2 concentrator, home NIV device, maintenance and support), from the intent-to-treat analysis of an open-label parallel-group randomized clinical trial. Pts with a hospitalization due to a COPD exacerbation requiring acute NIV with persistent hypercapnia 2-4 weeks following resolution of respiratory acidosis were enrolled. Pts in the control arm were permitted to have HMV added to HOT if the primary end-point (hospital readmission) was met & if pre-set safety criteria were breached (e.g. persistent acidosis & inability to wean from NIV). The analysis included medical resource utilization (MRU) of patient-level evaluation of equipment (oxygen concentrator & ventilator NIV device, including maintenance & support), patient-reported medication, physician office visits, & hospital admissions due to exacerbations. Trial data were used to develop an economic model from the US payer perspective. Costs were calculated by multiplying observed MRU by standard unit costs (2018$) & summed at the pt level. QALYs were measured based on patient health utilities calculated with US coefficients & EuroQOL EQ-5D data from the trial. One-way sensitivity and bootstrap analyses with 1,000 iterations were completed. RESULTS: 28/59 HOT pts & 36/57 HOT-HMV pts completed the 12-month study; 17 pts allocated to HOT received additional HMV. Rehospitalization w/i 30 days was 58.3% lower in the intervention group. The base-case incremental cost/QALY gained was $24,375, suggesting HOT-HMV is cost-effective with the higher cost of a home ventilator. Total costs were $32,330 for HOT-HMV & $30,447 for HOT alone. HOT-HMV patient costs were $11,973 for devices, $10,910 for doctor visits, $758 for medication, & $8,689 for exacerbations; corresponding costs for HOT alone were $3,383, $15,179, $1,087, & $10,798. One-way sensitivity analysis suggests that the home ventilator device cost has the greatest impact on cost/QALY. A bootstrap analysis indicates the probability for HOT-HMV being more expensive & more effective is 60.4%. CONCLUSIONS: These data support the cost-effectiveness of HOT-HMV using a home ventilator device for treatment in the U.S. CLINICAL IMPLICATIONS: In addition to the clinical effectiveness of HOT-HMV as previously reported, these data support the cost effectiveness of HOT-HMV using a home ventilator device for treatment. DISCLOSURES: no disclosure on file for Bernd Brüggenjürgen; Advisory Committee Member relationship with GSK, BI, Chiesi, Pulmonx, BTG, Novartis, Mereo Please note: $1001 - $5000 Added 03/01/2018 by Gerard Criner, source=Web Response, value=Consulting fee Consultant relationship with GSK, BI, novartis, Mereo, Prometic, Pulmonx, BTG, Pneumrx Please note: $1001 - $5000 Added 06/01/2018 by Gerard Criner, source=Web Response, value=Consulting fee Consultant relationship with Resmed and Philips Please note: >$100000 Added 03/16/2018 by Lauren Fusfeld, source=Web Response, value=Consulting fee Employee relationship with Boston Healthcare Associates Please note: >$100000 Added 03/03/2018 by Thomas Goss, source=Web Response, value=Grant/Research SupportRemoved 03/03/2018 by Thomas Goss, source=Web Response Employee relationship with Boston Healthcare Associates Please note: >$100000 Added 03/03/2018 by Thomas Goss, source=Web Response, value=SalaryRemoved 03/03/2018 by Thomas Goss, source=Web Response Consultant relationship with ResMed Please note: $20001 - $100000 Added 03/03/2018 by Thomas Goss, source=Web Response, value=Grant/Research Support Consultant relationship with Philips Respironics Please note: $20001 - $100000 Added 03/03/2018 by Thomas Goss, source=Web Response, value=Grant/Research Support Consultant relationship with Resmed Please note: $5001 - $20000 Added 03/05/2018 by Qing Gu, source=Web Response, value=Grant/Research Support no disclosure on file for Nicholas Hart; Speaker/Speaker's Bureau relationship with Philips respironics Please note: $1-$1000 Added 03/15/2018 by Patrick Murphy, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with ResMed Please note: $1-$1000 Added 03/15/2018 by Patrick Murphy, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Breas Please note: $1-$1000 Added 03/15/2018 by Patrick Murphy, source=Web Response, value=Honoraria

Using the health belief model to identify communication opportunities to prevent Chagas disease in Southern Ecuador.

BackgroundChagas disease (CD) is a life-threatening illness caused by the protozoan parasite Trypanosoma cruzi, which is transmitted by triatomine bugs. Triatomine bugs inhabit poorly constructed homes that create multiple hiding spots for the bugs. Modifying the actual structure of a home, along with the homeowners’ practices, can reduce triatomine infestation. This research was designed to collect culturally-relevant information to develop a health campaign to decrease risk of CD transmission by promoting home maintenance and better hygiene in rural communities of southern Ecuador.Methods and main findingsThe Health Belief Model (HBM) guided focus group discussions and the interpretation of the results. Four focus groups ranging from 4 to 10 participants were conducted between May and June 2014 in three communities of Loja province in Southern Ecuador. A thematic analysis was used to identify within the data related to perceptions of susceptibility, severity, benefits, barriers and self-efficacy related to CD and its prevention. The results provide clear guidance for the development of Chagas-prevention messages.ConclusionData obtained emphasize the importance of standardizing messages presented to the communities for CD prevention. Messages should provide more information on the protective nature of the behaviors promoted for CD prevention; overcoming barriers such as cost and convenience, and build on facilitating factors, including community members’ interest on quality of life, protection of their families, and relationship with the land.

Home maintenance expenditures and income fluctuations

In this paper, I study the role of a household’s expenditures on durables in its smoothing strategy for consumption. I ask, “Do homeowners spend less on maintaining their homes when they earn less than expected?” To answer this question, I estimate the elasticity of home maintenance expenditures to transitory earnings. The results show that households do smooth consumption by reducing home maintenance expenditures when transitory earnings are negative, but do not do so by spending more when transitory earnings are positive. Households that are mobility constrained do use home maintenance expenditures as a smoothing strategy, but those that are not constrained do not. The results also show an asymmetry by gender: Males reduce maintenance expenditures for negative transitory earnings while females increase these expenditures for positive transitory earnings.

Vulnerability of caregivers of people with a neurodegenerative disease: a synthesis.

The aging of the population and the increasing of the neurodegenerative pathologies encourage the current policies in health to further promote the home maintenance for dependent elderly people. Therefore, informal caregivers provide a substantial assistance to the medical team by monitoring home care. These volunteer caregivers who play an essential role in the survival of our health system however may expose to dangers of systematic assistance. In order to better understand the plural risks which caregivers are likely to face, this paper proposes a critical analysis of the consequences of caregiving on health and quality of life and summarizes factors that contribute to vulnerability - protection of caregivers. It seems caregivers will present very heterogeneous reactions in the way they are considering the care situation. Facing to many difficulties encountered, caregivers are dealing with their skills and adopt personal coping strategies. There is thus a wide range of fragility profiles and needs among caregivers. Better taking into account the multiple components of aid relationships paves the way toward possible new care perspectives by recognizing the specific needs of each caregiver with respect for its uniqueness. In this way only, we can effectively contribute to challenge one of the important and actual social issue: the prevention of global exhaustion of caregivers of people with neurodegenerative disease.

Examining age-related differences in functional domain impairment following traumatic brain injury.

To examine differences in the functional recovery trajectories between younger and older adults with mild-moderate traumatic brain injury (TBI) in the first year postinjury as well as health-related quality of life. Observational cohort. Level one trauma centre in the State of Washington. Adults with mild-moderate TBI (N=34; younger adults, n=19, and older adults, n=15). None. Functional Status Examination (FSE) and health-related quality of life (HRQOL; SF-12v2). Older adults consistently showed significantly worse functional performance than younger adults following TBI in the following FSE domains: mobility, ability to travel, home maintenance and overall functional status. For both groups, preinjury physical health was significantly correlated with ability to travel and social integration at 12-month postinjury. Older participants' preinjury physical and mental health had significant and negative correlation with their functional status. Our study provides insights and implications into adults' specific functional impairments following TBI, and which domains have persistent deficits. Early intervention and rehabilitation should focus on improving older adults' physical functioning and mobility. Our study may also inform future research and design of post-TBI interventions for older adults.

Long-Term Follow-Up of Individual Development Accounts: Evidence from the ADD Experiment

This report presents findings from the fourth wave of the American Dream Demonstration (ADD) experimental study of Individual Development Accounts (IDAs). The ADD was a set of 14 privately funded local IDA programs initiated in the late 1990s. It was the first large-scale test of IDAs in the United States and used a variety of research methods in order to learn about IDAs. One of these programs, in Tulsa, Oklahoma, was implemented as a random assignment experiment. This report is based on a 10-year follow study of impacts at the Tulsa site.In total, 1,103 low-income participants were surveyed at baseline and randomly assigned to either the treatment or control group. Treatment group members received access to an IDA as well as financial education and case management. The IDA provided matched withdrawals at a 2:1 rate for home purchase and a 1:1 rate for home repair, small business investment, post-secondary education, or retirement savings. Participants who made the maximum matchable deposits throughout the 3 years of the program could accumulate $6,750 (plus interest) for a home purchase or $4,500 (plus interest) for the other qualified uses.In examining the five allowable uses, the study finds some impacts of IDAs on education, especially for males, and on home maintenance and repair 10-years after the program. However, we find no impact on homeownership, businesses, and retirement savings in the follow-up study. The positive findings for education and home maintenance and repair may suggest that IDAs are best suited to support asset purchases that can be accomplished incrementally over a period of time. Targeting IDAs for education and home maintenance and repair may be more effective than applying them to “all-or-nothing” purchases like a house.