Low Socioeconomic Circumstances Research Articles

Can we identify the prevalence of perinatal mental health using routinely collected health data?: A review of publicly available perinatal mental health data sources in England.

Perinatal mental health (PMH) conditions affect around one in four women, and may be even higher in women from some ethnic minority groups and those living in low socioeconomic circumstances. Poor PMH causes significant distress and can have lifelong adverse impacts for some children. In England, current prevalence rates are estimated using mental health data of the general population and do not take sociodemographic variance of geographical areas into account. Services cannot plan their capacity and ensure appropriate and timely support using these estimates. Our aim was to see if PMH prevalence rates could be identified using existing publicly available sources of routine health data. A review of data sources was completed by searching NHS Digital (now NHS England), Public Health England and other national PMH resources, performing keyword searches online, and research team knowledge of the field. The sources were screened for routine data that could be used to produce prevalence of PMH conditions by sociodemographic variation. Included sources were reviewed for their utility in accessibility, data relevance and technical specification relating to PMH and sociodemographic data items. We found a PMH data 'blind spot' with significant inadequacies in the utility of all identified data sources, making it impossible to provide information on the prevalence of PMH in England and understand variation by sociodemographic differences. To enhance the utility of publicly available routine data to provide PMH prevalence rates requires improved mandatory PMH data capture in universal services, available publicly via one platform and including assessment outcomes and sociodemographic data.

Childhood social adversity and clustering of health risk behaviours during early adolescence in a population-based birth cohort

ObjectivesThis study aimed to prospectively explore the association between early lifetime exposure to psychosocial adversity and engagement in health risk behaviours (HRBs) during early adolescence. Study designThis was a prospective study. MethodsThis study used data from the baseline (2005–2006), third (2016–2017) and fourth waves (2018–2020) of the Generation XXI birth cohort. Socio-economic circumstances (SECs) at baseline, adverse childhood experiences (ACEs; e.g. abuse, neglect, household dysfunction) at age 10 years and HRBs (i.e. alcohol consumption, smoking, physical exercise level, sedentary behaviours, sleep duration and eating behaviours) at age 13 years were measured. Patterns of HRBs were obtained using latent class analysis. Latent class regression analysis was used to estimate the likelihood of being engaged in HRBs according to the extent of exposure to ACEs (i.e. 0 ACEs, 1–3 ACEs, 4–5 ACEs and ≥6 ACEs) and negative family SECs. ResultsAdolescents whose mothers had a low level of education (adjusted odds ratio [aOR] = 2.72 [95% confidence interval {CI}, 2.33–3.18]), low occupational status (aOR = 3.21 [95% CI, 2.68–3.85]) and low income (aOR = 2.70 [95% CI, 2.23–3.28]) were more likely to be engaged in HRBs than their peers with higher SECs. Adolescents who experienced more ACEs were at a significantly increased risk of involvement in HRBs (aOR = 1.86 [95% CI, 1.33–2.63] for 4–5 ACEs vs aOR 2.41 [95% CI, 1.72–3.43] for ≥6 ACEs). No significant gender differences were observed. ConclusionsAdolescents from families with low SECs were more likely than their more affluent counterparts to be engaged in HRBs. Furthermore, more ACEs contributed to widening health inequalities.

The association between social functioning and health literacy among rural Southeastern African Americans with hypertension.

African Americans living in low socioeconomic circumstances are at high risk of poor health outcomes; this is particularly true for those with hypertension. Many African Americans with chronic hypertension living in the rural impoverished Southeastern USA have low health literacy and are socially isolated. These factors are known to have a negative impact on health outcomes, but it is possible that social support may overcome some of the effect of low health literacy. Since little has been reported about this association, we examined the association between social functioning and health literacy in a rural African American population in the Southeast USA. We used baseline data from participants in the Southeastern Collaboration to Improve Blood Pressure Control, a pragmatic trial that recruited rural African Americans with persistently uncontrolled hypertension and collected survey data. Overall, 33.5% of the 1221 person sample reported social isolation, 26.0% reported low instrumental support, 36.0% reported low emotional support, and 63.4% had inadequate health literacy. All three domains of low social functioning were significantly associated with low health literacy, and this effect was robust to multivariable adjustment for sociodemographics and cognitive functioning for social isolation (adjusted odds ratio 1.62, 95% confidence intervals 1.20-2.20). In conclusion, the majority of this sample living in the NC and AL Black Belt had high social functioning but inadequate health literacy. Tests of interventions to improve social support, especially social isolation, may be warranted to overcome low health literacy in this high-risk rural population.

Parent wellbeing, family screen time and socioeconomic status during early childhood predict physical activity of Aboriginal and Torres Strait Islander children at ages 8-13.

Physical activity is holistically linked to culture and wellbeing among Aboriginal and Torres Strait Islander peoples, the First Nation Peoples of Australia. Socioecological correlates of high physical activity among Indigenous children include living in a remote area and low screen time but little is known about early life determinants of physical activity. This paper examines sociodemographic, family, community, cultural, parent social and emotional wellbeing determinants of physical activity among Aboriginal and Torres Strait Islander children. Longitudinal cohort study. The Longitudinal Study of Indigenous Children, the largest First Nations child cohort study in the world, primarily collects data through parental report. Multiple logistic regression analyses examined Wave 1 (age 0-5 years) predictors of achieving ≥1 h/day of physical activity at Wave 9 (aged 8-13 years). Of the 1181 children, 596 (50.5 %) achieved ≥1 h of physical activity every day. Achieving ≥1 h/day of physical activity at Wave 9 was associated with the following Wave 1 determinants: high parent social and emotional wellbeing (resilience; adjusted odds ratio 1.87 (95 % confidence interval: 1.32-2.65)), living in remote (odds ratio 3.66 (2.42-5.54)), regional (odds ratio 2.98 (2.13-4.18)) or low socioeconomic areas (odds ratio 1.85 (1.08-3.17)), main source of family income not wages/salaries (odds ratio 0.66 (0.46-0.97)), and if families played electronic games (odds ratio 0.72 (0.55-0.94)). To achieve high physical activity levels among Aboriginal and Torres Strait Islander children, high parental culture specific social and emotional wellbeing and low family screen time in early life may compensate for apparently low socio-economic circumstances, including living in remote areas.

Enablers and barriers to effective parenting within the first 1000 days of life

Abstract Background The first 1000 days is the period between conception and a child’s second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities. Methods This study was conducted in low socio-economic communities of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis. Results Two main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner’s support, the negative impact of technology, and lack of access to services. Conclusions Enablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner’s support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities. Key messages • Effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. • There is a need to develop policies and interventions to promote effective parenting within the first 1000 days in low socio-economic communities.

Enablers and barriers to effective parenting within the first 1000\xa0days: an exploratory study of South African parents and primary caregivers in low socio-economic communities

BackgroundThe first 1000 days is the period between conception and a child’s second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities.MethodsThis study was conducted in communities in South Africa considered low socio-economic communities in the Western Cape Province of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis.ResultsTwo main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, unemployment/job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner’s support, the negative impact of technology, and lack of access to services.ConclusionEnablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner’s support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities.

Knowledge about Anemia in Pregnancy among Females Attending Primary Health Care Centers in Baghdad

BACKGROUND: In pregnancy, several physiological changes occur that lead to decrease in the level of hemoglobin. Anemia during pregnancy is a major public health concern in underdeveloped nations, with a high rate of morbidity and death among pregnant women. Inadequate prenatal care, a lack of information about the nutritional requirements of pregnant women, and general low socioeconomic circumstances all contribute to these high rates of morbidity and death. As pregnant women’s and husbands’ education levels increased, the frequency and severity of anemia decreased in the investigated community of pregnant women. AIM: This study aims to find out the level of knowledge about anemia in pregnancy among adult females attending primary health care centers (PHCCs) and to find out if there is any association between sociodemographic characteristics of adult females and knowledge about anemia in pregnancy. METHODS: A cross-sectional study with analytic component conducted in four PHCCs in Al-Adhamiya Health District during a period of 4 months from December 1, 2020, to April 1, 2021. It included 400 females aged between 18 and 45 years attending the selected PHCCs for any complaint. The data had been collected through the distribution of well-designed questionnaire including two parts: Participants’ sociodemographic characteristics and knowledge parts. RESULTS: In this study, overall knowledge score of the participants about anemia in pregnancy showed that 60% had fair knowledge. There were statistically significant associations between knowledge score and age of females, marital status, educational level, occupation, and parity. CONCLUSION: The majority of Iraqi adult females have fair and acceptable levels of knowledge about anemia in pregnancy. Younger age, being single, low educational level, unemployed, and low parity were associated with worst level of knowledge.

Pengaruh Pendidikan Kesehatan terhadap Tingkat Pengetahuan Remaja tentang Bahaya Pernikahan Dini

In the current era of globalization, many adolescent problems occur resulting in early marriage behavior such as lack of adolescent knowledge, self-desire due to feelings of love, low socioeconomic circumstances, low education, free association, lack of parental care, and negative influence of mass media/information. One of the factors that influence the incidence of early marriage is knowledge. A lack of knowledge about sexual and reproductive health information and education in adolescents causes them to lack the skills to make informed and safe decisions about sexual and reproductive risks, thus enabling premarital sex and leading to early marriage. The factors that can influence the increase in knowledge are information received such as health education. This study aims to determine the effect of health education on the level of knowledge of adolescents about the dangers of early marriage based on data through the literature review method. Using the literature review method. Search journals using an academic database, namely Google Scholar which was published in 2017-2021 using Indonesian and English. Research design Eksperimental. There are 6 journals that state the influence of health education on the level of knowledge of adolescents about the dangers of early marriage is shown from the results of experimental tests after being given health education experienced a significant increase in knowledge. The provision of Health Education greatly affects the knowledge of someone who previously did not know to know, therefore education about early marriage should continue to be given to adolescents in order to avoid the negative impact of early marriage.

Maternal experiences of caring for preterm infants in a vulnerable South African population.

BackgroundCaring for a preterm infant is known to be a stressful experience as these infants are at a high risk of medical sequelae and developmental delays. Early intervention is imperative for the best developmental outcome for the infant. Such interventions are often delivered through the mother or primary caregiver; however, healthcare professionals are seldom aware of all the factors that influence maternal well-being, potentially influencing her ability to provide optimal care.AimTo explore the experiences of a group of vulnerable women, namely, isiXhosa-speaking mothers of preterm infants living in low socio-economic circumstances in the Western Cape province of South Africa, regarding having, caring for and feeding their preterm infants within the first 6 months of the infant’s life.SettingA follow-up clinic for preterm infants and their mothers at a public tertiary hospital in Cape Town, South Africa.MethodsThe study employed a qualitative, cross-sectional design that was explorative and contextual in nature. A discussion schedule was used to guide 15 in-depth interviews with mothers that were later thematically analysed.ResultsSocial support and religion positively influenced maternal coping. The infant’s medical stability was the main concern for mothers and concerns regarding the infant’s development did not arise. Prematurity influenced mothers’ decisions to use traditional medicines and hospital care affected some traditional practices.ConclusionThe study findings highlighted the influence of traditional and religious beliefs, the importance of the cultural education of medical staff members and a support system to improve maternal experiences.ContributionThe findings provide insights into maternal experiences with implications for healthcare practitioners’ continued education in an ethnically diverse setting.

International Adoption: A Review and Update.

1. Judith Kim Eckerle, MD*,† 2. Megan Marie Bresnahan, OTR/L† 3. Maria Kroupina, PhD, LP*,† 4. Dana Ernest Johnson, MD, PhD*,† 5. Cynthia Ruth Howard, MD, MPHTM*,† 1. *Department of Pediatrics, University of Minnesota, Minneapolis, MN 2. †MHealth Fairview University of Minnesota Masonic Children’s Hospital, Minneapolis, MN * Abbreviations: Ab : : antibody ACE : : adverse childhood experience CDC : : Centers for Disease Control and Prevention CXR : : chest radiography IA : : international adoptee TB : : tuberculosis 1. Key information for accurate assessment of the preadoption referral. 2. Determining immunization status and planning catch-up strategy. 3. Updated screening protocol for and treatment of latent tuberculosis infection. 4. Evaluation of developmental delays in the context of international adoption. 5. Screening for risk factors indicating the need for referral to child mental health and developmental specialists. After completing this article, readers should be able to: 1. Review the basic components of an adoption referral file and know when to consult an international adoption medicine expert. 2. Perform the initial medical assessment of a newly arrived international adoptee, including evaluation of the efficacy of previous immunizations and planning of catch-up immunization based on new recommendations. 3. Screen for tuberculosis and treat latent tuberculosis infection based on recent Centers for Disease Control and Prevention (CDC) guidelines. 4. Understand the multiple areas of a developmental baseline of adopted children and assess for catch-up needs. 5. Identify the child with multiple risk factors and/or parental or family stressors who needs a referral to an adoption-competent mental health specialist. Although interest in intercountry adoption continues to be high, the numbers of international adoptions have changed dramatically since the peak in 2004 when 45,483 international adoptees (IAs) were placed in families worldwide. By 2017, the number dropped 79% to 9,387. In the United …

Early socioeconomic circumstances and adverse childhood experiences in 10-year-old children

Abstract Background Evidence showed that adverse childhood experiences (ACEs) are associated with the development of disease later in life and premature death. Examining the occurrence of these experiences at early ages would contribute to intervene and therefore to reduce health inequalities. This study aimed to assess the prevalence of ACEs among 10-year-children and to examine its association with early socioeconomic circumstances. Methods At the fourth wave of the population-based birth cohort Generation XXI, from Porto, Portugal, 5153 children completed a self-report questionnaire on 9 experiences related to household dysfunction and physical and emotional abuse. Socioeconomic circumstances included household income, maternal and paternal education, and history of parental unemployment. Logistic regression was performed to calculate the Odds Ratios (OR) and 95% Confidence Intervals (95%CI). Results A high prevalence of physical and emotional abuse was reported by children from low socioeconomic circumstances. A graded relationship between socioeconomic circumstances and cumulative ACEs was observed, for instance, low household income was associated with increased number of ACEs (one event [OR = 1.10; 95%CI: 0.89-1.36], two events [OR = 1.41; 95%CI: 1.15-1.73], three events [OR = 1.67; 95%CI: 1.34-2.06], and four or more events [OR = 2.05; 95%CI: 1.64-2.55]). Also, living with one parent or none of them increased the likelihood of reporting multiple ACEs (OR = 5.50; 95%CI: 4.23-7.13). Conclusions Children from low socioeconomic circumstances were more likely to report multiple adverse experiences in the first decade of life. These findings support that children from less advantaged environments might be at a higher risk of co-occurrence of adverse experiences during their childhood. Key messages Prevalence of ACEs is high among 10-year-old children and is associated with low socioeconomic circumstances. Social inequalities in children should be prioritized by public health policy.

Social determinants of adolescent smoking over three generations.

Aim: We studied how multigenerational socioeconomic circumstances influence adolescents' smoking. Previous studies have shown that low academic achievement as well as parents' low socioeconomic circumstances are associated with adolescents' smoking, but there are few studies on grandparents' influence on their grandchildren's smoking. For the chain of three generations, we hypothesised that high socioeconomic circumstances of both parents and grandparents decrease the probability of smoking and adolescents' own education and circumstances contribute to this association. We further investigated the role of intergenerational social mobility. Method: Survey data from 1979 to 1997 on 12- to 18-year-old Finns (n=54,487) were linked with 1970-2009 registry-based data of their grandparents, parents and themselves. Socioeconomic circumstances among parents and grandparents were measured by socioeconomic status, education and material resources and among adolescents by academic achievement, educational orientation, family structure and parental smoking. Logistic regression analysis was used to study the associations. Results: Associations of adolescent smoking with grandparental socioeconomic circumstances were weak and mediated through parental circumstances. Parental smoking and divorce and living in a non-intact family increased smoking. Adolescents' low academic achievement and orientation to low education level were the most important predictors of smoking. Upward intergenerational social mobility between fathers and children decreased the risk of smoking, whereas downward mobility increased it. Conclusions: The influence of grandparents' low socioeconomic circumstances on grandchildren's smoking is mediated through parents' socioeconomic circumstances. Low academic achievement in adolescence is a strong predictor of smoking and adolescents orient towards the group of their future education level, not that of their parents.

Socioeconomic circumstances and incidence of chronic obstructive pulmonary disease (COPD) in an urban population in Sweden

The association between socioeconomic circumstances and incidence of chronic obstructive pulmonary disease (COPD) was investigated in an urban population in Sweden. The study included all 40–89 year-old inhabitants in Malmö, Sweden (N = 117,479) without previous hospitalization due to COPD, who were followed over 14 years for COPD related hospital admissions. The Malmö Preventive Project (MPP) cohort (n = 27,358) with information on biological and lifestyle factors was also used to study the association between socioeconomic circumstances and COPD. The Swedish hospital discharge register was used to record incidence of COPD hospitalizations. A total of 2,877 individuals (47.5% men) were discharged from hospital with COPD as the primary diagnosis during follow-up in Malmö. Low annual income (hazard ratio (HR): 2.23; 95%CI: 1.97–2.53, P < 0.001) and rented (vs. self-owned) housing (HR: 1.41; 1.30–1.52, P < 0.001) were associated with a higher risk for COPD. In addition, compared to married subjects, divorced (HR: 1.61; 1.46–1.78, P < 0.001) and widowed (HR: 1.30; 1.16–1.46, P < 0.001) individuals had an increased risk for hospitalization due to COPD. Low income, low occupation and being divorced or widowed were similarly associated with COPD in the MPP cohort, after adjustments for smoking, FEV1, BMI, age and sex. However, socioeconomic circumstances were not associated with COPD in analyses restricted to never smokers. Low socioeconomic circumstances were associated with an increased risk of COPD after adjustments for biological and lifestyle risk factors including smoking status. However, this relationship was not significant in those who never smoked.

Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand

ObjectivesPaediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, we used a novel solution‐focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non‐obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13–17) living in socioeconomically deprived neighbourhoods. MethodsSixty‐eight parents and adolescents from 30 families were recruited and interviewed, resulting in 15 obese and 15 healthy weight adolescents participating in the study. ResultsOur findings showed that, despite living in low socioeconomic circumstances, parents were able to alter their micro‐environments to prevent obesity in their children. Parents with healthy weight adolescents had food rules in the home and monitored their children's eating and television viewing time. ConclusionsAn appreciative inquiry approach to obesity research can uncover resiliency factors within families that can be applied to obesity prevention and treatment programs. Implications for public healthAppreciative inquiry methodology is a promising alternative qualitative research strategy for developing health interventions for low‐income ethnic minority communities.

Abstract 43: Access to Care, Income, Education and Coronary Heart Disease Outcomes in the Reasons for Geographic and Racial Differences in Stroke Study

Background: We have shown that individuals aged &lt;65 years with the combination of low income (INC) and low education (EDU) are at high risk of coronary heart disease (CHD). Access to healthcare is often cited as a major contributor to this relationship, but few studies have examined these relationships for combinations of INC and EDU. We hypothesize that he association between INC+EDU categories and incident CHD is mediated by insurance status, rural residence, and living in a health professional shortage area (HPSA). Methods: We used data from 24,666 participants free of CHD at baseline in the national prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study of black and white participants aged &gt; 45 years recruited between 2003-2007. Low INC (&lt;$35,000) and low EDU (&lt;high school graduation) were used to define four groups (Table column headings). Cox proportional hazards models examined the mediating effects of having health insurance, rural residence, and HPSA residence on the association between combinations of INC-EDU and CHD, stratified on age 65. Results: A total of 1,046 events occurred over mean follow-up 6.4±2.3 years. For those &lt;65, low INC+EDU and low INC+high EDU were associated with higher risk for CHD (Table). In unadjusted models, HPSA residence was not significantly associated with CHD incidence for either younger or older participants, but having health insurance (HR 0.74 [95% CI 0.55-0.99]) and rural residence (HR 1.41 [95% CI 1.14-1.73]) were significantly associated with CHD for younger but not older participants. There was no evidence of mediation by access to care variables (Table). Conclusion: Access to care variables did not mediate the relationship between low INC, especially low INC+EDU, and CHD observed in younger REGARDS participants. Access to care as reflected in health insurance or rural or HPSA residence may not play a major role in the higher risk for CHD in middle aged adults living in low socioeconomic circumstances.

Assessment of experiences of survivors of cerebro-vascular accidents and their caregivers functioning at home in the Oshana region of Namibia

&lt;p&gt;In the wake of a cerebro-vascular accident, survivor and caregiver are often apprehensive about being on their own at home; this is particularly so for those living in low socioeconomic circumstances in the rural areas of Namibia. The situation is aggravated by the fact that there is no structured system of home visits by health workers that could assist caregivers in their daily tasks. Phenomenological interviews were therefore conducted to explore how these caregivers cope with providing home care to the survivors of such accidents. The findings that emerged were categorised into four themes, namely, survivors were unable to provide self-care and were dependent on others for help, the altered role function and performance of survivors, negative emotions because of altered self-esteem, and disrupted social interaction. These experiences together illustrate that some survivors are unable to take care of themselves at all and depend completely on their caregivers for help.&lt;/p&gt;

Spatiotemporal variation and social determinants of suicide in China, 2006-2012: findings from a nationally representative mortality surveillance system.

Suicide in China has declined since the 1990s. However, there has been limited investigation of the potential spatiotemporal variation and social determinants of suicide during subsequent periods. Annual suicide counts from 2006 to 2012 stratified by county, 5-year age group (⩾15 years) and gender were obtained from the Chinese Disease Surveillance Points system. Trends and geographic differentials were examined using multilevel negative binomial regression models to explore spatiotemporal variation in suicide, and the role of key sociodemographic factors associated with suicide. The suicide rate (per 100 000) in China decreased from 14.7 to 9.1, 2006-2012. Rates of suicide were higher in males than females and increased substantially with age. Suicide rates were higher in rural areas compared with urban areas; however, urban-rural disparities reduced over time with a faster decline for rural areas. Within both urban and rural areas, higher rates of suicide were evident in areas with lower socio-economic circumstances (SEC) [rate ratio (RR) 1.85, 95% confidence interval (CI) 1.31-2.62]. Suicide rates varied more than twofold (median RR 2.06) across counties, and were highest in central and southwest regions of China. A high proportion of the divorced population, especially for younger females, was associated with lower suicide rates (RR 0.60, 95% CI 0.46-0.79). Geographic variations for suicide should be taken into account in policy making, particularly for older males living in rural areas and urban areas with low SEC. Measures to reduce disparities in socio-economic level and alleviate family relation stress are current priorities.

Human wound myiasis caused by Phormia regina and Sarcophaga haemorrhoidalis in Minia Governorate, Egypt.

Myiasis is the parasitic infestation of human by the larvae (maggots) of dipterous fly that grow within the host while feeding on its tissue. Cutaneous myiasis is the most considerably encountered clinical form. Moreover, wound (traumatic) myiasis is the main clinical manifestation of cutaneous myiasis. In this research, we aimed to study the type of infesting larvae that are responsible for wound myiasis in the patients in Minia city, Egypt. Three cases of wound myiasis have been noticed among 280 patients with wounds at different parts of bodies. Two of them were diabetic patients. The third one had a history of hypertension with right side hemiplegia 2years ago. All of them were elderly. The larvae removed from cases 1 and 3 were identified macroscopically and microscopically as the third-stage larvae of Sarcophaga haemorrhoidalis. The larvae removed from case 2 were the third-stage larvae of Phormia regina, which is very rare worldwide. In addition to the open and obsolete wound, diabetes mellitus and low socio-economic circumstances were shown to be attributed as important predisposing risk factors that led to the occurrence of myiasis in these patients.

Health Promotion in a Low-income Primary School: Children with and Without DCD Benefit, but Differently

ABSTRACTPoor motor performance and reduced physical fitness are characteristic of children with Developmental Coordination Disorder (DCD). These features have also been identified more frequently among children living in low socio-economic circumstances. Aims: To evaluate the outcomes of a nine-week health promotion program (HPP) on the motor performance and fitness levels of children (6–10 years) with and without DCD attending a low-income primary school. Methods: The HPP was designed and implemented by undergraduate physiotherapy students using guidelines from the World Health Organization School Health Initiative and their physiotherapy curriculum. Children with DCD (n = 22) and a control group without DCD (n = 19) participated in the evaluation. Motor skill, functional strength, aerobic capacity, and anaerobic power were measured at baseline and after nine weeks. Results: Both groups of children improved on all measures at the conclusion of the HPP. Children with DCD showed greater improvement than the control group in motor performance and the control group showed greater improvement on one of the anaerobic fitness outcomes. Conclusions: A school-based HPP that focuses on increasing opportunities for physical activity may be effective in improving motor performance in children with DCD and can increase fitness levels in general.

Adaptation of Char Livelihood in Flood and River Erosion Areas through Indigenous Practice: A Study on Bhuapur Riverine Area in Tangail

In Bangladesh, flood and river erosion is a very common event and it has been occurred since 1988 and its process is till going on. The study was conducted in two char villages of the Jamuna River in the Bhuapur upazila of Tangail districts, namely Khanurbari and Shushua char from July to December 2011. The empirical data and findings were procured by the application of social survey, focus group discussion and field observation. The study explored the people’s indigenous survival techniques and assessed variation in people’s ability to adopt with floods and river erosion in those char villages. The result of the study showed that the people in char land with high flood proneness and low socio-economic circumstances were more likely to fail to adopt with impacts compared to people in areas with high and sudden flooding. The char people use their indigenous knowledge to adapt through this diverse situation. The study explores a negative fact that without any organizational support, the people of char have to formulate and undertake various adaptation techniques in their own way. Finally, the study recommended some suggestions for the policy planners and implementers for the future development of char areas in Bangladesh. It emphasizes the importance of the government and the non-governmental organizations to take their own responsibilities in the devastating situation of the flood and riverbank erosion. DOI: http://dx.doi.org/10.3329/jesnr.v7i1.22138 J. Environ. Sci. & Natural Resources, 7(1): 13-19 2014