Households Representative Research Articles

Storage, Reuse and Disposal Practices of Home - Stored Medicines in Urban Households in Pune, India

Background: Improper home medicine storage is a global issue that leads to medicine wastage contributing to adverse effects. There have only been a few community-based research studies for in-home drug storage methods, reasons for use and its disposal ways among the consumers of India, until date. Methodology: A descriptive, cross-sectional study was done from April 2023 to June 2023. Data were collected by face-to-face interview of household representative using pretested structured questionnaire on medicines in households, their utilization, storage and disposal practices. Results: Most of the participants (78.3%) were educated to the level of graduation and above and their common reported source of procurement for stored medicines was doctor’s previous prescriptions (61.79%) where 42.5% of them stored medicines for anticipated future use. Commonly stored drugs in households were analgesics and antihistaminics and drugs for digestive system while only 5.3% stored antibiotics mostly for ongoing treatment. Unsafe storage practices like storing medicines without proper labelling (65%) and within reach of children (33.49%) were found in the study. Also, 42.45% participants reported to share stored medicines with family members and friends. Major practice for drug disposal was reported as throwing in household garbage (93.1%). Conclusion: In current study, 100% prevalence of in-home storage medication practices among the well-educated consumers without proper care taken for their use, storage and disposal which may pose a risk to the environment as well as humans.

Poor coverage of quality-adjusted antenatal care services: a population-level assessment by visit and source of antenatal care services in Bihar state of India

Despite the evidence on the poor quality of antenatal care (ANC) services, significant gap remains in the understanding of quality-adjusted coverage at the population-level for each ANC visit and by the source of ANC services, and in equity in this coverage. All births between July 2020 and June 2021 were listed from 261,124 households (91.5% participation) representative of the Bihar state. Mothers of all stillbirths and neonatal deaths, and of 25% random sample of livebirths who survived the neonatal period provided data on each ANC visit up to a maximum of first 4 ANC visits, including the source of ANC services and the services received (weight measurement, blood pressure checked, abdomen checked, urine sample taken, and blood sample taken). An ANC visit was deemed of quality if all of these services were received in that visit. We report the coverage of quality-adjusted ANC services (Q-ANC) for ANC visits 1-4 disaggregated by source of ANC services and wealth index (WI). Weighted proportions are reported to take into account the sampling design. A total of 30,412 births were reported by 29,517 women, and 7270 (82.1%) of the 8853 eligible women participated. Overall, 19,950 unique ANC visits from 6929 women were available for analysis, of which 41.7%, 13.8% and 44.5% were at Village Health and Nutrition Day (VNHD), public facility, and with a private provider, respectively. A total of 4409 (65.3%) of the 1st ANC visits were undertaken at VHND, with the proportion of private provider ANC visits increasing significantly from ANC visit 1 to ANC visit 4 (p<0.001). Q-ANC coverage considering all ANC visits was 20.9% (95% CI 20.7-21.2); and was 0.9% (95% CI 0.8-1.0), 29.9% (95% CI 29.2-30.7) and 36.9% (95% CI 36.5-37.4) for ANC visits in VHND, public facilities, and with private provider, respectively. Q-ANC coverage in the public facility was significantly lower in the 4th ANC visit (25.1%; 95% CI 23.4-26.9) as compared with visits 1 to 3, whereas it was the highest for 1st ANC visit with private provider (50.2%; 95% CI 49.2-51.1) and then dropped for visits 2 to 4. Irrespective of the source of ANC services, Q-ANC coverage increased significantly with increasing WI quartile for ANC visits 1 and 2, with WI quartile 3 women having significantly less coverage for ANC visit 3 compared to the rest, and no significant difference seen in the coverage of ANC 4 visit. Varied pattern of Q-ANC coverage by WI for each ANC visit was seen for public facility and private provider visits. With only 2 of 10 ANC visits deemed of adequate quality, sustainable delivery of quality ANC services are needed for every pregnant woman through-out the pregnancy irrespective of gestation period, number of ANC visit, and source of ANC services. The funding was provided by the India office of the Bill & Melinda Gates Foundation, USA.

Electricity consumption, subsidies, and policy inequalities in Mexico: Data from 100,000 households

This paper estimates electricity consumption and subsidies for each of the Mexican households surveyed in the ENCEVI and the ENIGH in 2018. Using information from the Mexican Utility Federal Electricity Commission (CFE, Comisión Federal de Electricidad), we expand these two datasets into a comprehensive source of electricity consumption for 100,000 households representative of all of Mexico. Our estimates show that large consumers receive large subsidies, with the top 20 % of the highest consuming households receiving 50 % of the subsidies. We also find that electricity consumption is determined by socio-economic status. In the extremely hot region, families in the highest income decile consume 57 %–66 % more than those in the lowest. For this reason, Mexicans in the highest income brackets benefit the most from subsidies; the average subsidy per household for those in the two highest income brackets is almost twice the average subsidy for those in the lowest bracket.

Does professionalizing maintenance unlock demand for more reliable water supply? Experimental evidence from rural Uganda

Professionalization is gaining prominence as a strategy to address the deficiencies in rural water supply reliability and financial sustainability in low- and middle-income countries that have persisted under community management policies. Yet there is little evidence regarding how much water users can and will pay for the higher reliability that professionalized services promise. What evidence exists largely relies on stated preference studies that do not confront water users with paying over time. We conducted a price experiment to measure effective demand (willingness and ability to pay) for a professional handpump maintenance and repair service among 113 water committees and 1,031 households representative of two districts in northern Uganda. We offered a one-year subscription using Becker-DeGroot-Marschak auctions with real money payments. The service largely delivered on its guarantee of fast repairs and satisfied most customers. Nonetheless, we found that just 4% of water committees paid any price for the full service period. None paid for more than one month at prices higher than our estimate of operating cost even though it represented less than 1% of annual household expenditure. Our findings contrast assertions from recent stated preference studies that increasing handpump reliability is a lynchpin to attracting higher payments from rural water users. Misaligned incentives that discourage water users, nonprofits and their donors, local governments, and political candidates from shifting to higher tariffs for maintenance seem to best explain why effective demand was low. Despite the low demand, we estimate that professionally maintaining the existing handpumps in the study districts would cost less in the long run than the de facto practice of letting these assets fail repeatedly and rehabilitating them. As Uganda and other countries embark on maintenance-oriented, post-community management rural water policies, funders, practitioners, and researchers will need to grapple with how to align institutional incentives for sustainable financing.

Effect of a conditional cash transference program on food insecurity in Mexican households: 2012-2016.

To estimate the effects of the social inclusion programme PROSPERA on food insecurity (FI) in Mexican households during 2012 and 2016. Quasi-experimental study using cross-sectional data from 2012 to 2016 National Household Income and Expenditure Survey - Socioeconomic Conditions Module (in Spanish, ENIGH-MCS). Data were used from a 2012 sample of 56888 Mexican households (representative of 31206819 households) and a 2016 sample of 70263 Mexican households (representative of 33445353 households). Severity of FI was estimated with the Mexican Food Security Scale (in Spanish, EMSA). The statistical analysis estimated a differences in differences (DD) model weighted by propensity score to compare program beneficiary and non-beneficiary households in 2012 than in 2016. We estimated the effect on households with and without children (< 18 years of age). We also compared this model to a DD model without propensity score weighting. Mexican households. FI among all beneficiary households decreased 8·0pp as compared to non-beneficiary households over the study period. In beneficiary households with children, this decrease was 6·0pp and for beneficiary households without children, this decrease was 12·9pp (for all, P-value < 0·001). The PROSPERA program had a positive effect on FI reduction at the household level through increasing food access, which usually improves nutritional outcomes in vulnerable Mexican populations.

Diarrhoeal diseases in Soweto, South Africa, 2020: a cross-sectional community survey

BackgroundIn South Africa, there are limited data on the burden of diarrhoea at a community level, specifically in older children and adults. This community survey estimated rates of and factors associated with diarrhoea across all ages and determined the proportion of cases presenting to healthcare facilities.MethodsHouseholds were enrolled from an existing urban health and demographic surveillance site. A household representative was interviewed to determine associated factors and occurrence of diarrhoea in the household, for all household members, in the past 2 weeks (including symptoms and health seeking behaviour). Diarrhoeal rate of any severity was calculated for < 5 years, 5–15 years and > 15 years age groups. Factors associated with diarrhoea and health seeking behaviour were investigated using binomial logistic regression.ResultsDiarrhoeal rate among respondents (2.5 episodes/person-year (95% CI, 1.8–3.5)) was significantly higher than for other household members (1.0 episodes/person-year (95% CI, 0.8–1.4); IRR = 2.4 (95% CI, 1.5–3.7) p < 0.001). Diarrhoeal rates were similar between age groups, however younger children (< 5 years) were more likely to present to healthcare facilities than adults (OR = 5.9 (95% CI, 1.1–31.4), p = 0.039). Oral rehydration solution was used in 44.8% of cases. Having a child between 5 and 15 years in the household was associated with diarrhoea (OR = 2.3 (95% CI, 1.3–3.9), p = 0.003) and, while 26.4% of cases sought healthcare, only 4.6% were hospitalised and only 3.4% of cases had a stool specimen collected. While the majority of cases were mild, 13.8% of cases felt they required healthcare but were unable to access it.ConclusionDiarrhoeal rate was high across all age groups in this community; however, older children and adults were less likely to present to healthcare, and are therefore underrepresented through facility-based clinical surveillance. Current diarrhoeal surveillance represents a fraction of the overall cases occurring in the community.

Non-communicable diseases among Palestinian refugees from Syria: a cross-sectional study on prevalence, case management, access to and utilisation of UNRWA Health Services

BackgroundAs of Feb 14, 2014, UNRWA had registered almost 53 000 Palestinian refugees from Syria (PRS) who had fled to Lebanon as the result of the conflict in Syria. Half of the PRS had gone to one of the 12 Palestinian camps, which are overcrowded and of poor infrastructure. Consequently, there is concern for the wellbeing of PRS; in particular, their health status and access to medical care. Little attention has been given to non-communicable diseases (NCDs) in the acute phases of emergencies. Therefore, an assessment of the prevalence of NCDs among PRS, as well as the patterns of use of available health care services by PRS, is warranted. MethodsA cross-sectional study was conducted in April, 2018, with 1100 PRS residing inside and outside refugee camps across all governorates of Lebanon. A listing of all PRS families was the sampling frame. A random sample of families was selected and contacted, and then one adult randomly selected from each family was approached for data collection. Pregnant women and participants who were too ill to participate were excluded. After obtaining informed verbal consent, we did face-to-face interviews to collect data on household details (such as type of settlement, source of income) and sociodemographic information, major NCDs (for the household representative), lifestyle behaviours, and health-care use. We invited all participants to UNRWA clinics for physical and biochemical measurements. The study protocol was approved by the Institutional Review Board of the American University of Beirut. FindingsWe surveyed 959 PRS (59% male [465], 82% married [785], mean age 43 years [SD 12]). A quarter of those interviewed had at least one NCD; the most prevalent were hypertension (23%; 221 of 959), rheumatic diseases (17%; 166), cardiovascular diseases (CVDs, 13%; 126), diabetes (13%; 124), and chronic respiratory diseases (CRDs) (10%; 100). All these NCDs were more prevalent among PRS inside camps than in those residing outside camps, except for diabetes. Most participants who had been diagnosed with NCDs were adhering to their prescribed medications (90–98%). However, of those reporting CVDs, only 56% (71 of 126) had attended at least one follow-up appointment, and of those reporting rheumatic diseases, only 33% (55 of 166) had attended at least one follow-up appointment. About half of participants reported that they checked their blood pressure (55%; 528 of 959) or blood glucose (45%; 430). 111 of 221 (50%) participants with hypertension monitored their blood pressure, and 78 of 124 (63%) participants with diabetes monitored their blood glucose. 133 participants attended UNRWA clinics for measurements; 40% (54) had obesity (>30 kg/cm2), 10% (13) had elevated blood pressure, 12% (16) had stage 1 hypertension, and 8% (10) had stage 2 hypertension. Most participants had normal glucose (67%; 89 of 133), cholesterol (65%; 87), triglyceride (58%; 77), and glycosylated haemoglobin levels (64; 85). A substantial proportion of participants who were tested had undiagnosed diabetes (14%; 33 of 108 reporting no diabetes), undiagnosed hypertension (23%; 19 of 81), uncontrolled diabetes (79% of participants with diabetes; 19 of 24), or uncontrolled hypertension (64% of participants with hypertension; 29 of 45). InterpretationFurther study is needed to understand why the prevalence of NCDs among PRS residing in Palestinian camps is higher than among those living outside, and to understand whether and why access to medicines is a problem, particularly outside camps. The burden of NCDs among PRS is high and their access to services is not optimal; therefore UNRWA should pay special attention to NCD services in this population. UNRWA should invest in efforts to increase awareness of free blood pressure and blood glucose monitoring services in its clinics, and could actively offer free testing in public areas inside camps. Doctors at UNRWA clinics should recommend that patients monitor their disease more frequently and educate them on how to do so. A limitation of the study was the low percentage of participants who attended UNRWA clinics for physical and biochemical measurements. FundingUNRWA.

Subjective Models of the Macroeconomy: Evidence from Experts and a Representative Sample

Using a sample of 2,200 households representative of the US population and a sample of more than 1,000 experts, we measure beliefs about how aggregate unemployment and in ation respond to different macroeconomic shocks. Expert predictions are quantitatively close to standard DSGE models and VAR evidence. While households' beliefs are directionally aligned with those of experts in the case of oil supply shocks and government spending shocks, they predict an opposite reaction of in ation to monetary policy and income tax shocks. A substantial fraction of deviations of household predictions can be explained by the use of a simple affective heuristic.

Choosing high-equity cosmetic brands in bad macroeconomic conditions: evidence from panel data

PurposeThis study investigates how price, promotion and consumer characteristics affect consumer choice of high over medium- and low-equity cosmetic brand under different macroeconomic conditions.Design/methodology/approachThe study uses purchase records from MarketingScan's Behaviour Scan panels (a GFK – Mediametrie Company) covering the period from 2008 to 2009. The panel analysed represents a sample of 2,149 households representative of the national population.FindingsResults indicate that regular price and relative brand price increase high-equity cosmetic brand choice over both low- and medium-equity brands, while reference price decreases it. Brand feature promotion activity and joint promotion positively affect high-equity cosmetic brand choice, whereas display promotion decreases it. In comparison to medium-equity cosmetic brands, gender and education slightly increase high-equity cosmetic brand choice, while age decreases it. Surprisingly, household income does not affect high-equity cosmetic brand choice. The effect of regular price decreases over worsening macroeconomic conditions. However, the effect of relative brand price decreases between low and moderate contraction periods, but increases between moderate and high contraction times. Feature promotion is effective only when the contraction is moderate, while the negative effect of display promotion is stable over time.Originality/valueThe paper underlines the moderating role of macroeconomic conditions on the relationship between pricing decisions as well as promotion activity and consumer choice of high-equity cosmetic brands.

A Community-Based Assessment of Knowledge and Practice of Breast Self-Examination and Prevalence of Breast Disease in Southwest Cameroon.

Introduction Despite the rising trend in breast cancer incidence and mortality across Sub-Saharan Africa, there remains a critical knowledge gap about the burden and patterns of breast disease and breast cancer screening practices at the population level. This study aimed to identify socioeconomic factors associated with knowledge and practice of breast self-examination (BSE) as well as assess the prevalence of breast disease symptoms among a mixed urban-rural population of women in the Southwest region of Cameroon. Methods We conducted a household-level community-based study in Southwest Cameroon between January and March 2017, using a three-stage cluster sampling framework. We surveyed 1287 households and collected self-reported data on 4208 female subjects, 790 of whom were household representatives. Each household representative provided information on behalf of all female household members about any ongoing breast disease symptoms. Moreover, female household representatives were questioned about their own knowledge and practice of BSE. Results Women demonstrated low frequency of knowledge of BSE, as 25% (n=201) of household representatives reported any knowledge of BSE; and among these only 15% (n=30) practiced BSE on a monthly basis. Age (aOR: 1.04), usage of Liquid Petroleum Gas fuel, a marker of higher socioeconomic status (aOR: 1.86), and speaking English as a primary language in the household (aOR: 1.59) were significant predictors of knowledge of BSE. Eleven women reported ongoing breast disease symptoms resulting in an overall prevalence of 2.3 cases of breast disease symptoms per 1000 women. Conclusions Socioeconomic disparities in access to health education may be a determinant of knowledge of BSE. Community-based strategies are needed to improve dissemination of breast cancer screening methods, particularly for women who face barriers to accessing care.

Subjective Models of the Macroeconomy: Evidence from Experts and a Representative Sample

Using a sample of 2,200 households representative of the US population and a sample of more than 1,000 experts, we measure beliefs about how aggregate unemployment and inflation respond to different macroeconomic shocks. Expert predictions are quantitatively close to standard DSGE models and VAR evidence. While households' beliefs are directionally aligned with those of experts in the case of oil supply shocks and government spending shocks, they predict an opposite reaction of inflation to monetary policy and income tax shocks. A substantial fraction of deviations of household predictions can be explained by the use of a simple affective heuristic

Hand washing behavior and associated factors in Vietnam based on the Multiple Indicator Cluster Survey, 2010–2011

BackgroundHandwashing is a cost-effective way of preventing communicable diseases such as respiratory and food-borne illnesses. However, handwashing rates are low in developing countries. Target 7C of the seventh Millennium Development Goals was to increase by half the proportion of people with sustainable access to safe drinking water and basic sanitation by 2015. Studies have found that better access to improved water sources and sanitation is associated with higher rates of handwashing.ObjectiveOur goal was to describe handwashing behaviour and identify the associated factors in Vietnamese households.DesignData from 12,000 households participating in the Vietnam Multiple Indicator Cluster Survey 2011 were used. The survey used a multistage sampling method to randomly select 100 clusters and 20 households per cluster. Self-administered questionnaires were used to collect data from a household representative. Demographic variables, the presence of a specific place for handwashing, soap and water, access to improved sanitation, and access to improved water sources were tested for association with handwashing behaviour in logistic regression.ResultsAlmost 98% of households had a specific place for handwashing, and 85% had cleansing materials and water at such a place. The prevalence of handwashing in the sample was almost 85%. Educational level, ethnicity of the household head, and household wealth were factors associated with handwashing practice (p<0.05). Those having access to an improved sanitation facility were more likely to practise handwashing [odds ratio (OR)=1.69, 95% confidence interval (CI): 1.37–2.09, p<0.001], as were those with access to improved water sources (OR=1.74, 95% CI: 1.37–2.21, p<0.001).ConclusionsHouseholds with low education, low wealth, belonging to ethnic minorities, and with low access to improved sanitation facilities and water sources should be targeted for interventions implementing handwashing practice. In addition, the availability of soap and water at handwashing sites should be increased and practical teaching programs should be deployed in order to increase handwashing rates.

Weight perceptions in a population sample of English adolescents: cause for celebration or concern?

Objectives:To examine the proportion of normal-weight adolescents who consider themselves to be too heavy (size overestimation), and the proportion of overweight or obese adolescents who consider themselves to be about the right weight or too light (size underestimation), in large population-based samples collected over 8 years in England.Methods:Data were from the Health Survey for England between 2005 and 2012: an annual survey of households representative of the English population. We analysed data from 4979 adolescents (2668 boys, 2311 girls) aged 13 to 15 years old whose weight status was defined as normal weight or overweight/obese based on body mass index standard deviation scores (BMI-SDS) derived from objective measurements of height and weight and using International Obesity Task Force standards. Weight perception was based on the adolescent's choice from the following descriptors: ‘about the right weight', ‘too heavy' or ‘too light'.Results:The majority of normal-weight adolescents (83% of boys, 84% of girls) correctly identified themselves as ‘about the right weight'. Overestimation was uncommon, with only 7% of normal-weight teens (4% of boys, 11% of girls) identifying themselves as ‘too heavy'. In contrast, only 60% of overweight/obese adolescents (53% of boys, 68% of girls) correctly identified themselves as ‘too heavy', whereas 39% (47% of boys, 32% of girls) underestimated, identifying themselves as ‘about the right weight' or ‘too light'. There were no significant changes in BMI-SDS or body size estimation over time (2005–2012).Conclusions:Overestimation of body weight among normal-weight adolescents is relatively uncommon; potentially a cause for celebration. However, almost half of boys and a third of girls with a BMI placing them in the overweight or obese BMI range perceived themselves to be about the right weight. Lack of awareness of excess weight among overweight and obese adolescents could be a cause for concern.

Assessment of Emergency Preparedness of Households in Israel for War--Current Status.

In recent decades, many efforts have been made, both globally and locally, to enhance household preparedness for emergencies. In the State of Israel in particular, substantial investment has been made throughout the years in preparing the population for one of the major threats to the civilian population--a rapidly deteriorating regional conflict that involves high-trajectory weapons (ie, rocket and missile fire) launched at the home front. The purpose of this study was to examine the current preparedness level of the Israeli public for this threat and determine the correlates of such preparedness with known factors. A telephone-based, random sampling of 503 households representative of the Israeli population was carried out during October 2013. The questionnaire examined the level of household preparedness as well as attitudes towards threat perception, responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the level of preparedness in the general population and to find correlates to this preparedness in attitudes and demographic variables. More than half of the sample reported complying with 50% or fewer of the actions recommended by the Israeli Home Front Command. Having an increased sense of preparedness and willingness to search for related information were positively correlated with actual household preparedness, and the latter was also found to be the most predictive variable of household preparedness. Although the overall household preparedness reported is mediocre, the level of preparedness found in this study suggests better preparedness of the population in Israel for its primary threat. The findings suggest that in order to promote preparedness of the Israeli public for war, emphasis should be put on increasing the public demand for information and encouraging people to evaluate their sense of preparedness.

English

(ProQuest: ... denotes formulae omitted.)IntroductionAs with the case of many industrialized countries, Austria faces a decreasing birth rate and an increasing life expectancy with the consequence of an ageing population. From 2013 to 2030 the share of older people (65 and more years) is expected to rise by 5.8 percentage points: from 18.2% to 24.0%. Simultaneously, the shares of young people (0-19 years) and the potential working population (20-64 years) will decline by 0.8 and 4.9 percentage points, respectively (Statistik Austria, 2013a). These demographic trends will not only be a test for the federal pension system and affect the labour market, but will also influence private consumption. In Austria, private consumption accounts for more than 50 % of GDP (53.6% in 2012; Statistik Austria, 2013b) and is therefore a crucial economic factor, which influences the production side and the demand of labour in an economy, additionally.The consumption behaviour of a household varies greatly by age due to differing preferences and needs with increasing age of the household members. The following paper aims to estimate potential effects of the demographic changes on the structure of private consumption in Austria. An extended Almost Ideal Demand System (AIDS) is estimated to receive age-specific demand equations for Austria as a whole as well as on regional level. The demand system is subsequently used to simulate potential effects of demographic changes (ageing, changing household size), as well as variations in income and prices on the structure of private consumption in Austria up to the year 2030.The paper is structured as follows: Part two gives an overview of the literature. In part three the estimated extended AIDS model and its specifications are defined. In part four data used for the analysis is described. The results of the model estimation, that is income elasticity for seven age groups and price elasticity, are presented in fifth part. Sixth part focuses on the scenarios and the potential effects of population ageing on private consumption in Austria. While scenario 1 shows the direct effects of the ageing of the population, in scenario 2 the changing household size as demographic trend is included, additionally. Scenarios 3 and 4 focus on potential changes in income, as well as prices, and its effects on private consumption. Finally, in chapter 7 a conclusion is given.Literature ReviewHouseholds have a limited income available and choose which goods and services to consume. Microeconomic consumer theory focuses on a household's decision on what and how much to consume. According to theory the choice of goods and services is determined by the preferences of the household, with the aim to maximize utility under the given income of the household and prices of the goods and services (Woeckener, 2006, p. 65ff). The preferences of a household are dependent on household specific characteristics as the size of the household, its composition or age structure, as well as regional or legal parameters and changes in time. Regarding demographic indicators, the consumption behaviour of a household varies greatly by age due to differing preferences and needs with increasing age of the household's representative. As an example, in general, young people will have higher expenditures in the field of education, while older people demand more goods and services in the health sector. Contrarily, work related expenditures (such as for transportation or clothing) are decreasing in retirement (Hurst, 2008). Furthermore, the consumption structure differs by age cohort due to the comparable historical, economical or societal framework people went through (Evans, Jamal and Foxall, 2009, p. 158ff).The differences in consumption by age are empirically shown by various studies. Foot and Gomez (2006) prove with data for Great Britain that the consumption structure of private households changes greatly by age. …

Burns in Sierra Leone: A population-based assessment

PurposeBurns remain disproportionately prevalent in developing countries. This study aims to describe the epidemiology of burns in Sierra Leone to serve as a baseline for future programs. MethodsA cluster randomized, cross-sectional, countrywide survey was conducted in 2012 in Sierra Leone. With a standardized questionnaire demographics and deaths during the previous 12 months of household members were assessed with the household representative. Thereafter, 2 randomly selected household members were interviewed, elucidating whether participants had ever had a burn in six body regions and determining burn mechanisms and patterns of health care seeking behavior. ResultsThis study included 1843 households and 3645 individuals. 3.98% (145/3645) of individuals reported at least one burn-injury. The highest proportions of burns were reported in the age groups 0–4 years old (23/426, 5.4%) and 5–14 years old (37/887, 4.17%). The majority of burns (129/145, 89.0%) were caused by a hot liquid/object and the upper, extremities were the most commonly burned body regions, with 36% (53/145) of cases. 21% (30/145) of individuals with burns sought care from a traditional healer. ConclusionsBurns are highly prevalent in Sierra Leone. Further research and resources should be allocated to the care and prevention of thermal injuries.

Mental disorders, disability and treatment gap in a protracted refugee setting

Studies have shown high levels of distress and mental disorder among people living in refugee camps, yet none has confirmed diagnosis through clinical reappraisal. To estimate the prevalence of mental disorders, related disability and treatment gap in adult refugees living in the Burj el-Barajneh camp. Randomly selected participants were screened by household representative (n = 748) and individual (n = 315) interviews; clinical reappraisal was performed on a subset (n = 194) of 326 selected participants. Weighted prevalence estimates and 95% confidence intervals were calculated. The prevalence of current mental disorders was 19.4% (95% CI 12.6-26.2); depression was the most common diagnosis (8.3%, 95% CI 4.4-12.2) and multiple diagnoses were common (42%) among the 88 persons with mental disorder. Lifetime prevalence of psychosis was 3.3% (95% CI 1.0-5.5). Mental disorders were associated with moderate to severe dysfunction (odds ratio = 8.8, 95% CI 4.5-17.4). The treatment gap was 96% (95% CI 92-100). A range of mental disorders and associated disability are common in this long-term refugee setting. Combined with an important treatment gap, findings support the current consensus-based policy to prioritise availability of mental health treatment in refugee camps, especially for the most severe and disabling conditions.

OP38 A Nationally Representative Study Exploring the Relationship between Sleep and Obesity in the United Kingdom

BackgroundThis study explored the potential role that sleep, and sleep improvement, might play in the aetiology of obesity, using data from the first wave of the Understanding Society (USoc) cohort...

A sociobehavioral wellness model of acupuncture use in the United States, 2007.

The purpose of this study was to provide updated and more comprehensive data on the correlates and patterns of acupuncture use in the United States, applying a sociobehavioral wellness model of utilization. Predisposing factors, enabling resources, need, and personal health practices were investigated. Patterns of recent usage, including assessing the reason for use based on treatment of a health condition, for wellness, or both, were examined. Also, for the first time, attitudes about acupuncture reported by previous users and never users were presented. Data from the 2007 National Health Interview Survey (NHIS), a cross-sectional, household survey representative of the U.S. civilian population, were used, which included the Complementary and Alternative Medicine supplement. Adults 18 and over (n=22,512) were analyzed. Bivariate prevalence estimates were obtained and logistic regression models were estimated. In addition, all analyses were weighted. The primary outcome measure was recent use of acupuncture, defined as any use in the past 12 months. In 2007, 6.8% of adults reported lifetime use of acupuncture and 1.5% reported use in the past 12 months. Multivariate results showed significant effects in the expected directions for multiple variables in each of the four domains of our conceptual model (predisposing factors, enabling resources, need, and personal health practices). Among recent users, close to half reported some mention of wellness as a reason for use. Musculoskeletal conditions and pain were the top health conditions treated and these users, to some extent, integrated conventional and acupuncture care. Negative attitudes or skepticism about acupuncture were not common reasons for nonuse among prior and never users. Application of a sociobehavioral wellness model to frame correlates and patterns of recent acupuncture use in the Unites States shows promise.

Medication Use in US Youth With Mental Disorders

To evaluate the prevalence, demographic and clinical correlates, and specificity of classes of psychotropic medications indicated for mental disorders. Cross-sectional survey. Direct household interviews of combined household and school samples representative of the general population of adolescents in the United States. Ten thousand one hundred twenty-three adolescents aged 13 to 18 years who participated in the National Comorbidity Survey Adolescent Supplement. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) mental disorders and neurodevelopmental disorders. Psychotropic medication use in the past 12 months. Among youth with any DSM-IV mental disorder, 14.2% reported that they had been treated with a psychotropic medication in the past 12 months. Strong associations emerged between specific disorders and classes of medications with evidence for efficacy. Antidepressants were most frequently used among those with primary mood disorders (14.1%); stimulant use was most common among those with attention-deficit/hyperactivity disorder (20.4%); and antipsychotic use was infrequent and mostly seen among those with serious developmental disorders. Less than 2.5% of adolescents without a 12-month mental disorder had been prescribed psychotropic medications, and most had evidence of psychological distress or impairment reflected in a previous mental disorder, subthreshold condition, or developmental disorder. Appropriate medication use was significantly more frequent among those in treatment in the mental health specialty sector than general medicine or other settings. These findings challenge recent concerns over widespread overmedication and misuse of psychotropic medications in US youth. In fact, these data highlight the need for greater recognition and appropriate treatment of youth with mental health disorders.