Household Residents Research Articles

Chatbot for Social Need Screening and Resource Sharing With Vulnerable Families: Iterative Design and Evaluation Study.

Health outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution. This study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources. This research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot's design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported. Among the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot's capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot. Chatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.

Socioeconomic inequalities in underweight children: a cross-sectional analysis of trends in West Africa over two decades

ObjectiveTo study trends in socioeconomic inequalities in underweight children in West Africa, and specifically to analyse the concentration index of underweight inequalities and measure inequalities in the risk of being...

National Trends and Prevalence of Atopic Dermatitis and Pandemic-Related Factors among Korean Adults, 2007–2021

Introduction: Previous studies have variably reported inconclusive trends in the prevalence of atopic dermatitis (AD) among adults, and there are limited data on the impact of the COVID-19 pandemic. We aimed to investigate the national trends and age-stratified prevalence of AD among adults from 2007 to 2021 in South Korea, focusing mainly on the impact of the COVID-19 pandemic-related factors. Methods: A nationwide cross-sectional study was conducted using the Korea National Health and Nutrition Examination Survey data from 2007 to 2021. Overall and age-stratified prevalence for AD were assessed using weighted beta coefficients or odds ratios. Results: A total of 83,566 adults over 20 years (male, 49.40%) were included. During the observation period, the prevalence of AD was stable in the overall population from 2.61% (95% CI, 2.29–2.93) in 2007–2009 to 2.15% (1.68–2.63) in 2020 and 2.38% (1.81–2.95) in 2021. However, the weighted prevalence of AD in adults aged 40–59 years old decreased during the pre-pandemic era, and the prevalence of AD in adults aged above 60 years significantly decreased during the pandemic, with a significant decline observed after the initial outbreak. From age-stratification analysis, the adults aged 40–59 years showed a significant increase after the pandemic outbreak which was evident in specific variables: individuals with rural residence, lower education, and lower household income quartiles. Adults aged above 60 years showed a significant decrease in the slope after the outbreak, evident in specific variables: individuals of female, rural residence, lower education, and lower household income quartiles. Conclusion: We observed a stable overall prevalence of AD throughout the 15-year observation period. However, the age-stratified analysis suggested significantly different trends according to age-stratified groups and the impact of the COVID-19 pandemic on the prevalence of AD.

Do Oral Cholera Vaccine and Water, Sanitation, and Hygiene Combine to Provide Greater Protection Against Cholera? Results From a Cluster-Randomized Trial of Oral Cholera Vaccine in Kolkata, India.

Oral cholera vaccine (OCV) and incremental improvements in household water, sanitation, and hygiene (WASH) within cholera-endemic areas can reduce cholera risk. However, we lack empiric evaluation of their combined impact. We evaluated a cluster-randomized, placebo-controlled trial of OCV (Shanchol) in Kolkata, India. The study population included 108 777 individuals, and 106 879 nonpregnant individuals >1 year of age were eligible to receive 2 doses of OCV or placebo. We measured cholera risk in all household members assigned to OCV vs placebo and in all members of households with "Better" vs "Not Better" WASH, where WASH was classified according to validated criteria. Protection was measured by Cox proportional hazard models. Residence in an OCV household was associated with protective effectiveness (PE) of 54% (95% CI, 42%-64%; P < .001) and was similar regardless of Better (PE, 57%; 95% CI, 26%-75%; P = .002) or Not Better (PE, 53%; 95% CI, 40%-64%; P < .001) household WASH. Better WASH household residence was associated with PE of 30% (95% CI, 5%-48%; P = .023) and was similar in OCV (PE, 24%; 95% CI, -26% to 54%; P = .293) and placebo (PE, 29%; 95% CI, -3% to 51%; P = .069) households. When assessed conjointly, residence in OCV households with Better WASH was associated with the greatest PE against cholera at 69% (95% CI, 49%-81%; P < .001). These findings suggest that the combination of a vaccine policy and improved WASH reduces cholera risk more than either would alone, although the magnitude of either intervention was not affected by the other. Future randomized trials investigating OCV and WASH interventions separately and together are recommended to further understand the interaction between OCV and WASH.

Trend and determinants of minimum dietary diversity consumption change among children aged 6-23 months in Ethiopia from 2011 to 2019: A multivariate decomposition analysis.

Sustainable Development Goals 2 target 2.2 aimed to end all forms of malnutrition by 2030. However, the prevalence of inadequate minimum dietary diversity (MDD) is high in Ethiopia and the evidence of trends and determinants of MDD consumption change among children over time is limited. Therefore, this study aimed to determine trends and determinants of MDD consumption change among children aged 6 to 23 months in Ethiopia from 2011-2019 Demographic and Health Survey (DHS) data. The study used the data on nationally representative weighted samples of 6,971, 7,467, and 3,154 children aged 6-23 months from the 2011, 2016, and 2019 rounds of the DHS. Trend and Multivariate Decomposition analysis was conducted to determine MDD consumption change from 2011-2016, and 2016-2019 into two components: one that was explained by differences in the level of the determinants (endowment), and the other component was explained by differences in the effect of the covariates on the outcome (coefficient effects). The trends analysis showed that adequate MDD consumption significantly increased from 2% to 10.41% from 2011 to 2016 but decreased from 10.41% to 7.11% from 2016 to 2019 in Ethiopia. The compositional and behavioral change factors like maternal age, occupational status of parents, sex of the household head, wealth index, residence, and sex of child statistically contributed to changes in MDD consumption from 2011 to 2016, and from 2016 to 2019 at p-value <0.05. The trend of minimum dietary diversity consumption among children aged 6 to 23 months in Ethiopia increased from 2011-2016 and decreased from 2016-2019 in the last decade. The study revealed that the changes in behavioral response and population composition contributed to MDD consumption change among children in Ethiopia. The finding highlights the urgent need for targeted interventions and policies to address the issue of MDD consumption change among young children due to population structure changes like wealth status, residence, and behavioral response related to employment, household head, and sex of the child in Ethiopia. Therefore, efforts should be geared to reduce poverty and improve maternal employment status, particularly for women, by producing equitable economic opportunities.

PREVALENCE OF UROLITHIASIS TYPES AND FACTORS OF STONE FORMATION AMONG LOCAL RESIDENTS OF SOUTH WAZIRISTAN

Background: Kidney stone disease (KSD), a widespread public health issue around the globe, is caused by the confluence of demography, contact with the environment, eating choices, and hereditary factors. Aims: The current study examined the prevalence of urolithiasis types and factors of stone formation among residents of Waziristan since a rising water consumption (&gt;3 l everyday) is frequently advised by doctors to avoid kidney disease. Methods: From 110 renal stone individuals ages 18 to 55. There were 25 women and 85 men in Waziristan, and data on a household residence, daily water intake, and origin of water supply were gathered. Drinking water samples were taken twice a year from the case (high stone frequency) and control (zero stone epidemiologic) locations using the correct techniques. Potential of hydrogen (pH), acidity, total dissolved solutes (TDS), electrical conductivity (EC), and salinity were all measured in the samples collected. To see if there had been any statistically meaningful variations among the case and control regions, mean estimates of the examined variables were evaluated. Findings: 53.6% of the patients, we found, drank less than 3 L of water each day. Testing of samples from drinking water reveals calcium oxalate (CaOx) (94%) and struvite (3%), as well as 3% uric acid (UA). TDS levels were around 650 ppm. It was determined that every water sample was fit for human drinking. According to the findings, urolithiasis is quite prevalent in Waziristan and has a wide range of risk variables. Conclusions: The most important factor in the development of KSD is the purity of the water, not the quantity drank. Stone formation is influenced by genetic factors as well as higher overall solute concentrations. Supporting and advancing awareness initiatives that focus on the key urolithiasis risk variables is crucial.

AN URBAN HOUSEHOLD LIVING WAGE: AN EMPIRICAL OVERVIEW

As Malaysia is rapidly progressing towards the status of a high-income nation, it is imperative that all of its residents strive for at least a minimally decent standard of living. Keeping a comfortable standard of living is becoming increasingly challenging for many families as the cost of living continues to rise. The goal of this research is to learn how much is the living wage for the household residing in Kota Kinabalu need to get by. In this research, a "household" is a person or a group of people, whether they are related or not, who live in the same house and make financial decisions together. This research used the Anker Formula to determine a fair living wage. This research adopts a quantitative approach for data collecting by distributing self-designed questionnaires to respondents in and around Kota Kinabalu. The results of the study reveal that the total living wage required by households with varied numbers of full-time workers varies modestly. Overall, a worker in the Kota Kinabalu area needs RM 2393.06 a month as a living wage to maintain a minimum acceptable standard of living. Literature demonstrates that the cost of housing, food, transportation, communication, healthcare, education, household size, the number of full- time workers, and savings all play important roles in determining a family's ability to make ends meet. Authorities should place greater weight on these considerations when determining the minimum wage legislation, especially in densely populated areas like Kota Kinabalu, Sabah.

Assessment of municipal solid waste from households in Khulna city of Bangladesh

Waste management is a major concern for both developed and developing countries, with a particular focus on household waste because it makes up a significant proportion of municipal waste. The aim of this study is to assess the state of solid waste management practice in Khulna, as well as to characterize and quantify municipal solid waste as a step toward effective management. To collect information on the existing waste management methods, structured questionnaires were used to conduct surveys of household residents. In this study, whole wards (31 wards) of Khulna City Corporation (KCC) were clustered in 9 groups and selected one ward from each group. To analyze household waste, 75 households from each ward were selected and collected waste for 7 days. The selected household was categorized into five different socioeconomic strata such as low-income, lower-middle-income, middle-income, higher-middle-income and higher-income families. Besides, the assessment was carried out on the production and characterization of household waste that was produced in KCC. The waste samples were quantified, separated and characterized in the laboratory. Results reveal that biodegradable waste is the most prominent type and its percentage is about 81 %. The amount of waste production is positively correlated with income level. The waste generation rate of households for high-income families was 0.652 kg/cap/day while this rate got almost half for a low-income family and its value is o.312 kg/cap/day. Source separation of waste plays a vital role to reduce plastic leakage to the SDP. The result shows the proportion of plastic in mixed waste and source-separated waste after sorting by the waste collector was 4.04 % and 2.99 %, respectively. Survey results show that 42.96 % of respondents think that the source-separated waste should be collected during the period of 12pm to 02pm. A proposed management process was developed for household waste based on the output of this study.

Association Among Household Water, Sanitation, and Hygiene (WASH) Status and Typhoid Risk in Urban Slums: Prospective Cohort Study in Bangladesh.

Typhoid fever, or enteric fever, is a highly fatal infectious disease that affects over 9 million people worldwide each year, resulting in more than 110,000 deaths. Reduction in the burden of typhoid in low-income countries is crucial for public health and requires the implementation of feasible water, sanitation, and hygiene (WASH) interventions, especially in densely populated urban slums. In this study, conducted in Mirpur, Bangladesh, we aimed to assess the association between household WASH status and typhoid risk in a training subpopulation of a large prospective cohort (n=98,087), and to evaluate the performance of a machine learning algorithm in creating a composite WASH variable. Further, we investigated the protection associated with living in households with improved WASH facilities and in clusters with increasing prevalence of such facilities during a 2-year follow-up period. We used a machine learning algorithm to create a dichotomous composite variable ("Better" and "Not Better") based on 3 WASH variables: private toilet facility, safe drinking water source, and presence of water filter. The algorithm was trained using data from the training subpopulation and then validated in a distinct subpopulation (n=65,286) to assess its sensitivity and specificity. Cox regression models were used to evaluate the protective effect of living in "Better" WASH households and in clusters with increasing levels of "Better" WASH prevalence. We found that residence in households with improved WASH facilities was associated with a 38% reduction in typhoid risk (adjusted hazard ratio=0.62, 95% CI 0.49-0.78; P<.001). This reduction was particularly pronounced in individuals younger than 10 years at the first census participation, with an adjusted hazard ratio of 0.49 (95% CI 0.36-0.66; P<.001). Furthermore, we observed an inverse relationship between the prevalence of "Better" WASH facilities in clusters and the incidence of typhoid, although this association was not statistically significant in the multivariable model. Specifically, the adjusted hazard of typhoid decreased by 0.996 (95% CI 0.986-1.006) for each percent increase in the prevalence of "Better" WASH in the cluster (P=.39). Our findings demonstrate that existing variations in household WASH are associated with differences in the risk of typhoid in densely populated urban slums. This suggests that attainable improvements in WASH facilities can contribute to enhanced typhoid control, especially in settings where major infrastructural improvements are challenging. These findings underscore the importance of implementing and promoting comprehensive WASH interventions in low-income countries as a means to reduce the burden of typhoid and improve public health outcomes in vulnerable populations.

Investigating Deferral Rates in Cochlear Implantation: How Often Do Candidates Defer and Why?

Evaluate the rate at which cochlear implant (CI) candidates decline surgery and identify associated factors. Retrospective cohort study. Tertiary referral center. Four hundred ninety-three CI candidates from July 1989 to December 2020 with complete demographic and socioeconomic data. Diagnostic. Age, sex, race, marital and employment status, median household income percentile, distance-to-CI-center, and residence in a medically underserved county. Of the 493 CI candidates included, 80 patients (16.2%) declined surgery. Based on chart checking, the most common reason patients did not receive the implant was due to loss of follow-up (38%). African American patients were 73% less likely to undergo implantation compared with White patients (odds ratio [OR], 0.27 [0.11-0.68]; p = 0.005). Asian patients were 95% less likely to undergo implantation (OR, 0.05 [0.009-0.25]; p = 0.0003) compared with White patients. For every 1-year age increase, patients were 4% less likely to undergo implantation (OR, 0.96 [0.94-0.98]; p < 0.0001) and for every 10-year age increase, the patients were 33% less likely. Compared with their single counterparts, married patients were more likely to undergo implantation (OR, 1.87 [1.12-3.15]; p = 0.02). No differences were observed when comparing implanted and nonimplanted CI candidates in sex, employment status, distance-to-CI-center, or median family income percentile. A χ2 test of independence showed no association between receiving CIs and living in medically underserved counties ( χ2 = 2; N = 493; 0.3891; p = 0.53). Not infrequently, CI candidates decline surgery. Although demographic factors (race, age, and marital status) were associated with the cochlear implantation decision, socioeconomic factors (median family income and residence in a medically underserved community) were not. Perhaps cultural components of a patient's race have a larger impact on whether or not the patients get implanted.

Analysis of Factors Associated with Household Waste Production in Antang Landfiil, Tamangapa Village, Manggala District

The Antang Final Disposal Site is a reality of life that not many people look into. The Makassar city rubbish dump is the final point for all rubbish trucks in the center of the city. Thus, the Antang Final Disposal Site becomes a center for landfills where it may take years to manage all the collected waste. Apart from being a place to collect rubbish, the Antang Final Disposal Site is also a place to earn a fortune for those who live there. Not a few depend on their profession as garbage collectors. Starting from the head of the family to their children and wives. The aim of this research is to determine the relationship between factors and household production waste at the Antang Tamangapa Final Disposal Site, Makassar City. Based on the results of the research and discussion previously stated, it can be concluded that there is a significant relationship between the variables of number of family members or household residents (p=0.029&lt;0.05, OR=2.941), socio-economic status (p=0.035&lt;0 .05, OR=2.909) with household waste production variables.

An Approach to Assessing the State of Organic Waste Generation in Community Households Based on Associative Learning

The purpose of this work is to substantiate the approach to assessing the state of organic waste generation by households of a given community, which is based on passive production observations and intellectual analysis of statistical data, which ensures consideration of the factors and features of organic waste generation, as well as the development of qualitative models for forecasting their receipt. To achieve the goal, the following tasks were solved: the analysis of the state of organic waste generation by households in the EU countries was performed; an approach to assessing the state of organic waste generation by households of a given community is proposed; based on the use of the proposed approach, and models for assessing the state of organic waste generation of households in a given community were substantiated. The hypothesis of the study is to substantiate and use an approach to assessing the generation of organic waste by households in individual communities, based on the method of association learning and search for association rules, which will identify factors that have a significant impact on the volume of organic waste generated by households, the consideration of which will improve the accuracy of forecasting models and improve the quality of management of the processes of collection and processing of this waste in communities. The research methodology used allows for the use of data mining, probability theory, mathematical statistics, machine learning technology, and the Associative Rule Learning (ARL) method. Based on the use of a reasonable algorithm, they identify key trends and relationships between the factors of organic waste generation in communities in different countries, which is the basis for creating accurate models for predicting the volume of collection and processing of this waste in communities. The study found that the largest number of households produced organic waste per capita in the range of 0.14–0.25 kg/person. At the same time, most households have from two to four residents and are located on the adjoining territory from 350 m2 to 680 m2. Based on the method of learning associative rules, it was found that there are no close correlations between individual factors that determine the daily volume of organic waste generation by households per capita. The highest correlation coefficient between the type of housing and the income level of household residents is 0.13. The number of residents and the occupied area of the adjacent territory have the greatest impact on the daily volume of organic waste generated by households per capita. The substantiated associative rules of relationships, as well as the diagrams of relationships between factors, have helped to identify those factors that have the greatest impact on the volume of organic waste generation. They are the basis for creating accurate models for predicting the volume of collection and planning the processing of this waste in communities. Based on the proposed approach, Python 3.9 software was developed. It makes it possible to quickly carry out calculations and perform a quantitative assessment of the state of organic waste generation by households of a given community according to the specified rules of association between the volumes of organic waste generation and their factors. The results of the study are the basis for the further development of models for accurate forecasting of the collection and planning of the processing of organic waste from households in communities.

Better Existing Water, Sanitation, and Hygiene Can Reduce the Risk of Cholera in an Endemic Setting: Results From a Prospective Cohort Study From Kolkata, India.

Global cholera control efforts rely heavily on effective water, sanitation, and hygiene (WASH) interventions in cholera-endemic settings. Using data from a large, randomized controlled trial of oral cholera vaccine conducted in Kolkata, India, we evaluated whether natural variations in WASH in an urban slum setting were predictive of cholera risk. From the control population (n = 55 086), baseline WASH data from a randomly selected "training subpopulation" (n = 27 634) were analyzed with recursive partitioning to develop a dichotomous ("better" vs "not better") composite household WASH variable from several WASH features collected at baseline, and this composite variable was then evaluated in a mutually exclusive "validation population" (n = 27 452). We then evaluated whether residents of better WASH households in the entire population (n = 55 086) experienced lower cholera risk using Cox regression models. Better WASH was defined by a combination of 4 dichotomized WASH characteristics including safe source of water for daily use, safe source of drinking water, private or shared flush toilet use, and always handwashing with soap after defecation. Residence in better WASH households was associated with a 30% reduction in risk of cholera over a 5-year period (adjusted hazard ratio, 0.70 [95% confidence interval, .49-.99]; P = .048). We also found that the impact of better WASH households on reducing cholera risk was greatest in young children (0-4 years) and this effect progressively declined with age. The evidence suggests that modest improvements in WASH facilities and behaviors significantly modify cholera risk and may be an important component of cholera prevention and elimination strategies in endemic settings. Clinical Trials Registration. NCT00289224.

Prevalence of bacteriologically-confirmed pulmonary tuberculosis in urban Blantyre, Malawi 2019-20: Substantial decline compared to 2013-14 national survey.

Recent evidence shows rapidly changing tuberculosis (TB) epidemiology in Southern and Eastern Africa, with need for subdistrict prevalence estimates to guide targeted interventions. We conducted a pulmonary TB prevalence survey to estimate current TB burden in Blantyre city, Malawi. From May 2019 to March 2020, 115 households in middle/high-density residential Blantyre, were randomly-selected from each of 72 clusters. Consenting eligible participants (household residents ≥ 18 years) were interviewed, including for cough (any duration), and offered HIV testing and chest X-ray; participants with cough and/or abnormal X-ray provided two sputum samples for microscopy, Xpert MTB/Rif and mycobacterial culture. TB disease prevalence and risk factors for prevalent TB were calculated using complete-case analysis, multiple imputation, and inverse probability weighting. Of 20,899 eligible adults, 15,897 (76%) were interviewed, 13,490/15,897 (85%) had X-ray, and 1,120/1,394 (80%) sputum-eligible participants produced at least one specimen, giving 15,318 complete cases (5,895, 38% men). 29/15,318 had bacteriologically-confirmed TB (189 per 100,000 complete-case (cc) / 150 per 100,000 with inverse weighting (iw)). Men had higher burden (cc: 305 [95% CI:144-645] per 100,000) than women (cc: 117 [95% CI:65-211] per 100,000): cc adjusted odds ratio (aOR) 2.70 (1.26-5.78). Other significant risk factors for prevalent TB on complete-case analysis were working age (25-49 years) and previous TB treatment, but not HIV status. Multivariable analysis of imputed data was limited by small numbers, but previous TB and age group 25-49 years remained significantly associated with higher TB prevalence. Pulmonary TB prevalence for Blantyre was considerably lower than the 1,014 per 100,000 for urban Malawi in the 2013-14 national survey, at 150-189 per 100,000 adults, but some groups, notably men, remain disproportionately affected. TB case-finding is still needed for TB elimination in Blantyre, and similar urban centres, but should focus on reaching the highest risk groups, such as older men.

Multimorbidity and complex multimorbidity in Brazilians with severe obesity

To investigate the prevalence of multimorbidity and complex multimorbidity and their association with sociodemographic and health variables in individuals with severe obesity. This is a baseline data analysis of 150 individuals with severe obesity (body mass index ≥ 35.0 kg/m2) aged 18–65 years. The outcomes were multimorbidity and complex multimorbidity. Sociodemographic, lifestyle, anthropometric and self-perceived health data were collected. Poisson multiple regression was conducted to identify multimorbidity risk factors. The frequency of two or more morbidities was 90.7%, three or more morbidities was 76.7%, and complex multimorbidity was 72.0%. Living with four or more household residents was associated with ≥ 3 morbidities and complex multimorbidity. Fair and very poor self-perceived health was associated with ≥ 2 morbidities, ≥ 3 morbidities and complex multimorbidity. A higher BMI range (45.0–65.0 kg/m2) was associated with ≥ 2 morbidities and ≥ 3 morbidities. Anxiety (82.7%), varicose veins of lower limbs (58.7%), hypertension (56.0%) were the most frequent morbidities, as well as the pairs and triads including them. The prevalence of multimorbidity and complex multimorbidity in individuals with severe obesity was higher and the risk for multimorbidity and complex multimorbidity increased in individuals living in households of four or more residents, with fair or poor/very poor self-perceived health and with a higher BMI.

Gender disparity and risk of noncommunicable disease among adults in Islamic Republic of Iran.

The relationship between gender disparity and the risk of developing noncommunicable disease and other social health determinants has not been well researched in the Islamic Republic of Iran. To assess how gender disparity contributes to the overall risk of noncommunicable disease in the Islamic Republic of Iran. This was a secondary analysis of data on about 11 000 adults aged 15-69 years from the 2011 WHO STEPwise approach to NCD risk factor surveillance (STEPS) survey in the Islamic Republic of Iran. The outcome variable in our analysis was the noncommunicable disease risk factor index. We used an extension of the Blinder-Oaxaca decomposition model to decompose the predicted mean difference in this index. Sampling method, study design and sex were considered in the analysis. The predictor variables were age, household assets index, education, employment status, ethnicity, and residence. The overall mean (standard deviation) noncommunicable disease risk score was 39.26 (22.4). The risk score for women was significantly higher than for men (41.75 versus 36.84; P < 0.001). About 35% of gender disparity in risk score was due to the differences in distribution of the predictor variables (explained component); of these, age contributed the most (23.79%), followed by education (7.82%). The different gender effects on work status and age made the largest contributions to the unexplained component of the disparity, 36.40% and 14.82%, respectively. Policies to reduce the risk of noncommunicable diseases need to consider gender groups and how gender affects social determinants such as employment status to make some gender subgroups more vulnerable than others.

House modifications as a malaria control tool: how does local context shape participants’ experience and interpretation in Uganda?

BackgroundEvidence that house design can provide protection from malaria is growing. Housing modifications such as screening windows, doors, and ceilings, and attaching insecticide-impregnated materials to the eaves (the gap between the top of the wall and bottom of the roof), can protect against malaria. To be effective at scale, however, these modifications must be adopted by household residents. There is evidence that housing modifications can be acceptable, but in-depth knowledge on the experiences and interpretation of modifications is lacking. This qualitative study was carried out to provide a holistic account of the relationship between experiences and interpretations of four types of piloted housing modifications and the local context in Jinja, Uganda.MethodsQualitative research was conducted between January to June 2021, before and during the installation of four types of housing modifications. The methods included nine weeks of participant observations in two study villages, nine focus group discussions with primary caregivers and heads of households (11–12 participants each), and nine key informant interviews with stakeholders and study team members.ResultsMost residents supported the modifications. Experiences and interpretation of the housing modifications were shaped by the different types of housing in the area and the processes through which residents finished their houses, local forms of land and property ownership, and cultural and spiritual beliefs about houses.ConclusionsTo maximize the uptake and benefit of housing modifications against malaria, programme development needs to take local context into account. Forms of local land and house ownership, preferences, the social significance of housing types, and religious and spiritual ideas shape the responses to housing modifications in Jinja. These factors may be important in other setting.Trial registration Trial registration number is NCT04622241. The first draft was posted on November 9th 2020.

Intimate partner violence and its associated factors among reproductive-age women in East Africa:-A generalized mixed effect robust poisson regression model.

The World Health Organization (WHO) has published estimates revealing that around one out of every three women across the globe has been a victim of either physical and/or sexual violence from an intimate partner or non-partner throughout their lifetime. The available evidence on intimate partner violence in East Africa is limited Consequently, the objective of this study was to evaluate the occurrence and factors linked to intimate partner violence in East Africa. The study utilized the most recent data from the Demographic and Health Surveys (DHS) conducted between 2011 and 2018/19 in 11 countries in Eastern Africa. A total of 59,000 women were included in the study. Descriptive and inferential statistics were used to exmine factors associated with IPV. A mixed effect robust Poisson regression model was fitted to identify factors associated with intimate partner violence. The adjusted prevalence ratio (aPR) and its corresponding 95% confidence interval (CI) were employed to determine the presence of a significant association between intimate partner violence and the independent variables. In this study, the prevalence of intimate partner violence in East Africa was 43.72% with 95% CI 43.32% to 44.12%. In the mixed effect robust Poisson regression model:-Marital status, working status, parity, sex of household headed, wealth index, community poverty, and residence, were significantly associated with intimate partner violence. The prevalence of intimate partner violence in East Africa is high as compared to the global prevalence 30%, which hinders The Sustainable Development Goals (SDGs), specifically goal 5, aim to attain gender equality and empower women and girls worldwide by the year 2030 Women being previously married and cohabitated, working, having a high number of children, rural residents were positively associated with IPV and household and community wealth index and sex of household headed were negatively related with IPV in East Africa. Therefore, we recommend establishing effective health and legal response using an integrated policy approach and Special attention should be given to women who live rural and poorest to reduce IPV and to achieve Sustainable Development Goals (SDGs) goal 5.

A study on social contact rates relevant for the spread of infectious diseases in a Brazilian slum

Inspired by the POLYMOD study, an epidemiological survey was conducted in June 2021 in one of the most densely populated and socially vulnerable sectors of Belo Horizonte (Brazil). A sample of 1000 individuals allowed us to identify, within a 24-hour period, the rates of social contacts by age groups, the size and frequency of clique in which respondents participated, as well as other associated sociodemographic factors (number of household residents, location of contact, use of public transportation, among others). Data were analyzed in two phases. In the first one, results between two SIR models that simulated an eight-day pandemic process were compared. One included parameters adjusted from observed contact rates, the other operated with parameters adjusted from projected rates for Brazil. In the second phase, by means of a log-lin regression, we modeled the main social determinants of contact rates, using clique density as a proxy variable. The data analysis showed that family size, age, and social circles are the main covariates influencing the formation of cliques. It also demonstrated that compartmentalized epidemiological models, combined with social contact rates, have a better capacity to describe the epidemiological dynamics, providing a better basis for mitigation and control measures for diseases that cause acute respiratory syndromes.

Parenting stress and Chinese preschoolers' approaches to learning: a moderated mediation model of authoritative parenting and household residency.

According to the family stress model, this study examined the relationship between parenting stress and preschoolers' approaches to learning (ATL) in China, as well as the mediating effect of authoritative parenting and the moderating effect of household residency (migrant and native). A survey of 5,047 preschoolers' parents (2,186 natives and 2,861 migrants) supports the proposed moderated mediation model. The results showed that after controlling for gender and age, parenting stress affected preschoolers' development of ATL negatively. Authoritative parenting mediates the relationship between parenting stress and preschoolers' ATL. Further, household residency moderated the relationship between authoritative parenting and preschoolers' ATL. The findings of this study suggest that high levels of parenting stress are detrimental to the development of preschoolers' ATL. And parents with low parenting stress are more likely to adopt authoritative parenting, which in turn fosters preschoolers' ATL. In addition, native families' authoritative parenting style are more conducive to fostering preschoolers' ATL than migrant families. Finally, this study contributes to previous research by examining the mechanisms of parenting stress on preschoolers' ATL and provides support for the extension of the family stress model. Importantly, it also informs efforts to improve ATL among preschoolers in Chinese migrant and native families.