Usual Residence Research Articles

Structural intervention at one bridge decreases the overall jumping suicide rate in Victoria, Australia.

There is clear evidence that installing safety barriers is effective in preventing jumping suicides from high-risk bridges with only moderate displacement to other nearby bridges. However, the impact of barriers on jumping suicides across broader geographical areas is not well understood. We examined patterns in jumping suicides across the state of Victoria, Australia, after a safety barrier was installed at the West Gate Bridge which, before the installation of the barrier, was the site of approximately 40% of Victoria's jumping suicides. We used negative binomial regression analyses on Victorian data from 2000 to 2019 to compare rates of jumping suicides at the West Gate Bridge, other bridges and non-bridge jumping locations before, during and after the West Gate Bridge barrier installation. We conducted linear regression analyses to examine whether the distance travelled from the deceased's usual residence to the location of their jumping suicide changed between the before, during and after barrier installation periods. After installation of the barrier, there were no jumping suicides at the West Gate Bridge (rate ratio [RR]=0.00, 95% credible intervals [95% Cr]=0.00-0.0001) and there was strong evidence that the rate of jumping suicides at all locations declined by 65% (RR=0.35, 95% Cr=0.22-0.54). At other bridges, there was also evidence of a reduction (RR=0.31, 95% Cr=0.11-0.70), but there was no evidence of a change at non-bridge locations (RR=0.74, 95% Cr=0.39-1.30). After installation of the safety barrier at the West Gate Bridge, jumping suicide in Victoria decreased overall and at other bridges, and did not appear to change at non-bridge locations. Our findings show that when barriers are installed at a site responsible for a disproportionately high number of jumping suicides, they are not only highly effective at the site where the barriers are installed but can also have a prevention impact beyond the immediate locale at similar sites.

Were there really 1 million unoccupied dwellings in Australia on census night 2021?

Background
 The 2021 Census in Australia revealed that just over 1 million dwellings were ‘unoccupied’ on census night. This finding was widely reported and may have given the impression of a large number of vacant dwellings ready for households to move into, potentially offering a solution to homelessness and those struggling to find suitable or affordable accommodation.
 Aims
 The aim of the paper is to investigate whether there really were 1 million unoccupied dwellings in Australia in 2021, to shed some conceptual and empirical light on exactly what is meant by an ‘occupied’ and an ‘unoccupied’ dwelling, and also try to understand why dwellings were unoccupied.
 Data and methods
 We used a variety of census, population, and dwelling data to estimate the number of private dwellings disaggregated by occupancy on both a de facto basis (whether people were present in dwelling on census night or not) and on a usual residence basis (whether people are usually resident in a dwelling or not). A comparison with the situation at the time of the 2016 Census is made.
 Results
 The results show that there were indeed about 1 million dwellings unoccupied on a usual residence basis in Australia in 2021. But they were not the exact same 1 million unoccupied on census night, and not all of these dwellings were available to households to live in. There was a substantial increase in the number of dwellings unoccupied by usual residents between 2016 and 2021; we suggest some possible reasons for this, including Covid-related effects.
 Conclusions
 Greater clarity and more detail are needed in census dwelling data. In addition, it would be useful if there were detailed annual official statistics on dwellings and households to better inform housing policy and research.

Understanding the context of hospital transfers and away-from-home hospitalisations for Māori.

In Aotearoa New Zealand, people regularly travel away from their home to receive hospital care. While the role of whānau support for patients in hospital is critical for Māori, there is little information about away-from-home hospitalisations. This paper describes the frequency and patterning of away-from-home hospitalisations and inter-hospital transfers for Māori. Data from the National Minimum Dataset (NMDS), for the 6-year period of 1 January 2009-31 December 2014, were analysed. Basic frequencies, means and descriptive statistics were produced using SAS software. We found that more than 10% of all routine hospitalisations constituted an away-from-home hospitalisation for Māori; that is, a hospitalisation that was in a district health board (DHB) other than the DHB of usual residence for the patient. One quarter (25.19%) of transfer hospitalisations were to a DHB other than the patient's DHB of domicile. Away-from-home hospital admissions increase for Māori as deprivation increases for both routine and transfer admissions, with over half of Māori hospital admissions among people who live in areas of high deprivation. This analysis aids in understanding away-from-home hospitalisations for Māori whānau, the characteristics associated with these types of hospitalisations and supports the development and implementation of policies which better meet whānau Māori needs. The cumulative impact of the need to travel to hospital for care, levels of poverty and a primarily reimbursement-based travel assistance system all perpetuate an unequal cost burden placed upon Māori whānau.

Multimorbidity and dementia risk in hospitalised patients: an administrative data linkage study of hospital patients in Northern Ireland.

IntroductionWhile chronic disease is a risk factor for dementia (Shang et al., 2020) studies addressing multimorbidity and dementia risk are limited. Multimorbidity leads to steeper dementia progression (Bauer, 2014; Haaksma, 2019) impacting cognitive dysfunction, cognitive decline and impairment (Wei, 2020; Vassilaki, 2015). Multimorbidity has generally been examined using a dose- response disease count, something cited as impractical for clinicians due to information deficits on identifying disease specific pathways (Whitty, 2020). Thus, differentiating disease clusters and dementia risk will provide insight into the pathophysiology of dementia, while informing priority targets for early intervention, potentially reducing burden and secondary care costs. AimTo investigate dementia risk and mortality in older adults with different disease patterns, characteristics of hospital admissions, medication use and the role of locale of residence. Data linkage and analysisWe used national data defined by the NHAIS, including basic demographics for all patients aged fifty-five plus and registered with a GP in Northern Ireland. The linked data comprised: Patient Admissions and Discharges (from 2013-2021); Electronically captured prescribing data, area-type of usual residence; Multiple Deprivation Indicators; and GRO mortality data (including cause of death). We identified multimorbidity through validated algorithms for ICD-10 coding of thirty morbidities in administrative hospital diagnostics data (Tonelli et al., 2019). The same data identified dementia-free patients at baseline. Latent Class Analysis assigned patient groups by the patterning of multimorbidity states, following them through the study period, with analysis in relation to subsequent diagnoses of both clinical dementia and mortality. As age has a potential modifier effect we tested through age group stratified analyses. A series of multinomial logistic regression models further examine (for the multimorbidity sub-groups of interest) risks associated socio-demographic, socio-economic, medication use and household indicators at the individual, family and area level. ResultsMultimorbidity occurs in two thirds, approximately, of this hospital population of older adults. By age sixty-five years, most people are multimorbid. We identify subgroups of multimorbidity associated with dementia onset and mortality, combinations of diabetes, hypertension, chronic kidney disease and cancer multimorbidity are highlighted as higher-risk conditions for increased dementia incidence and mortality. Greater disease burden is associated with frequent healthcare service use, medication use and is more common in the most socioeconomically deprived, compared with the least deprived. DiscussionEvidence on multimorbidity patterns and dementia is limited (Grande, 2021). Our study suggests that people with combinations of diabetes, hypertension, chronic kidney disease and cancer multimorbidity are associated with increased risks for dementia and socio demographic and economic circumstances further increase this risk. Overlapping combinations comprising chronic kidney disease + hypertension, or diabetes + hypertension, were a significant proportion of total secondary care costs for patients with multimorbidity; combinations comprising chronic heart failure + chronic kidney disease + hypertension had the highest proportion of total cost from potentially preventable emergency admissions (Stokes et al., 2021). Our finding support the body and mind connection in dementia development. Thus, we note that cardiovascular health is associated with dementia (Grande, 2021). Often described as a heart-brain connection, cardiovascular disease leads to higher dementia risk due to a number of mechanisms including but not limited to chronic inflammation (Grande, 2021). Identifying such high-risk groups will facilitate tailored interventions for dementia prevention and the reduction of healthcare use and costs.

Preserving familiarity: the care needs of people with intellectual disabilities at the end of life

Background There has been a significant increase in the life expectancy of people with intellectual disabilities. As a result, they experience life-limiting chronic conditions that require end of life care. Understanding their needs is paramount to providing exemplary end of life care.Aim To explore the importance of maintaining familiarity for people with intellectual disabilities at the end of life.Method A constructivist version of the grounded theory approach was adopted. Individual face-to-face, semi-structured interviews were conducted with 11 adults with intellectual disabilities. The data were analysed using the constant comparative method.Findings Maintaining familiarity at the end of life was essential to provide safety and comfort for people with intellectual disabilities. They wished to preserve their everyday routines and be cared for at their usual residence by familiar carers.Conclusion People with intellectual disabilities wish to receive end of life care at their usual residence from people they know. Therefore, service providers must consider appropriate strategies to accommodate their needs and wishes.

Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19 : A Randomized Controlled Trial.

Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection. To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone. Double-blind, randomized, placebo-controlled, clinical trial. (ClinicalTrials.gov: NCT04501978). Multinational, multicenter trial. Adults hospitalized with COVID-19. Intravenous ensovibep, 600 mg, or placebo. Ensovibep was assessed for early futility on the basis of pulmonary ordinal scores at day 5. The primary outcome was time to sustained recovery through day 90, defined as 14 consecutive days at home or place of usual residence after hospital discharge. A composite safety outcome that included death, serious adverse events, end-organ disease, and serious infections was assessed through day 90. An independent data and safety monitoring board recommended that enrollment be halted for early futility after 485 patients were randomly assigned and received an infusion of ensovibep (n=247) or placebo (n=238). The odds ratio (OR) for a more favorable pulmonary outcome in the ensovibep (vs. placebo) group at day 5 was 0.93 (95% CI, 0.67 to 1.30; P=0.68; OR>1 would favor ensovibep). The 90-day cumulative incidence of sustained recovery was 82% for ensovibep and 80% for placebo (subhazard ratio [sHR], 1.06 [CI, 0.88 to 1.28]; sHR>1 would favor ensovibep). The primary composite safety outcome at day 90 occurred in 78 ensovibep participants (32%) and 70 placebo participants (29%) (HR, 1.07 [CI, 0.77 to 1.47]; HR<1 would favor ensovibep). The trial was prematurely stopped because of futility, limiting power for the primary outcome. Compared with placebo, ensovibep did not improve clinical outcomes for hospitalized participants with COVID-19 receiving standard care, including remdesivir; no safety concerns were identified. National Institutes of Health.

Estimating international migration flows for the Asia-Pacific region: Application of a generation–distribution model

AbstractFlows of international migration are needed in the Asia-Pacific region to understand the patterns and corresponding effects on demographic, social, and economic change across sending and receiving countries. A major challenge to this understanding is that nearly all of the countries in this region do not gather or produce statistics on flows of international migration. The only information that are widely available represent immigrant population stocks measured at specific points in time—but these represent poor proxies for annual movements. In this paper, we present a methodology for indirectly estimating annual flows of international migration amongst 53 populations in the Asia-Pacific region and four macro world regions from 2000 to 2019 using a generation–distribution framework. The estimates suggest that 27–31 million persons from the Asia-Pacific region have changed their countries of usual residence during each year in the study. Southern Asia is estimated to have had the largest inflows and outflows, whilst intra-regional migration and return migration were highest in Eastern, Southern, and South-Eastern Asia. India, China, and Indonesia were estimated to have had the largest emigration flows and net migration losses. As a first attempt to estimate international migration flows in the Asia-Pacific region, this paper provides a basis for understanding the dynamics and complexity of the large-scale migration occurring in the region.

Prevalence and factors associated with self-reported injuries in Nepal: a secondary analysis of the nationally representative cross-sectional STEPS Survey, 2019

ObjectiveThis study aims to determine the prevalence and factors associated with injuries in the adult population of Nepal.Design and participantsSecondary analysis of the data from the cross-sectional WHO STEPwise Approach...

Community structure and timing of sexual activity among adolescent girls in Nigeria.

Studies have linked the timing of sexual debut to unplanned pregnancies and sexually transmissible infections, including HIV. Current understandings of sexual debut among Nigerian adolescents focused on the roles of individual and familial characteristics. We leveraged the 2018 Nigeria Demographic and Health Survey data to examine how community features like affluence, ethnic diversity, and women empowerment may be associated with the timing of sexual debut among adolescent girls. The sample comprised 7449 adolescent girls who were usual residents in 6,505 households and 1,352 clusters or communities. Statistical associations between community characteristics and the onset of sexual debut were assessed using a two-level mixed-effects parametric survival model with Weibull distribution. We found that community affluence [aHR:0.43, 95%CI: 0.30–0.62] and community ethnic diversity [aHR: 0.63, 95%CI: 0.42–0.94] are associated with a lower hazard of sexual debut among adolescent girls. We also observed that women that married within the observation period had an earlier sexual initiation than those who were unmarried. The results disaggregated by marital status further shows that higher community level of women’s employment [aHR: 2.45, 95%CI: 1.38–4.38] and women’s education [aHR:1.85, 95%CI: 1.03–3.33] were associated with a higher hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Higher community affluence [aHR:0.40, 95%CI: 0.27–0.60] was also associated with a lower hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Our results illuminate the associated factors of the timing of sexual debut among adolescent girls that moves beyond individual characteristics to community characteristics.

Safety profile and outcome after ultrasound-guided suprainguinal fascia iliaca catheters for hip fracture: a single-centre propensity-matched historical cohort study.

Peripheral nerve blocks improve analgesia following hip fracture; however, there are little published data on safety and outcomes of continuous regional anesthetic techniques. Our institution offers pre- and perioperative, anesthesiologist-delivered ultrasound-guided suprainguinal fascia iliaca catheters (FICs) to patients with hip fracture. We aimed to document the safety profile of this technique and establish whether there are any significant clinical benefits in outcomes measured by the UK National Hip Fracture Database. We performed a single-centre historical cohort study of 2,187 patients admitted to our institution with hip fracture over a 5.75-year period. Of these, 915 were treated with FIC and 1,272 received standard care (single-shot block). To control for baseline differences between these two cohorts, we used propensity score matching and exact matching, resulting in two well-matched groups of 728 patients treated with an FIC and standard care. No serious complications were observed as a result of an FIC. Unplanned removal occurred in 146/852 (17.1%) patients with documented data. No differences in 30-day mortality, pressure ulcer rates, or hospital length of stay were observed between the matched groups. The percentage of patients who were discharged to their usual residence was 79.3% in the FIC cohort vs 75.1% in the standard care cohort (difference, 4.2%; 95% confidence interval, -0.1 to 8.4; P = 0.06). Our single-centre propensity-matched historical cohort study suggests that ultrasound-guided suprainguinal fascia iliaca catheterization is a safe technique for patients with hip fracture and that our service is deliverable and sustainable within the UK's National Health Service. This study did not show statistically significant differences in outcomes between patients treated with FIC and standard care. An adequately powered multicentre randomized controlled trial comparing these approaches is warranted.

977 IMPLEMENTATION OF THE FIRST FRAILTY UNIT IN WESTERN AUSTRALIA

Abstract Background Implementation of the first Frailty Unit in Western Australia within the tertiary Hospital—Fiona Stanley. The Frailty Unit was based within the Acute Medical Unit and included a Geriatrician, Medical team, Multidisciplinary Allied Health (AH) Team and Acute Medical Nursing Staff to manage a 12 bed Frailty Unit. Introduction Evidence shows that a prolonged hospital stay can be a risk factor for hospital acquired complications, deconditioning, loss of independence and early entry into residential care. This is especially evident amongst the frail population. This leads to poor outcomes of patients, high costs from complications and prolonged hospital admissions. The primary goal of this unit was to provide comprehensive Geriatric assessment from a multidisciplinary team at the front door of the hospital which will improve patient centered care and allow earlier discharges with a multitude of issues being addressed on day 1. Method included the allocation of staffing as documented above which provided earlier Geriatric assessment as well as comprehensive AH input. The intent was to redirect patients out of the hospital and back into the community to utilise nursing, medical and AH staff who can further assess and support patients in their own home environment and out of the busy hospital system. Results The impact of this change comparing 2018 (calendar year) with 2020/21 (financial year) has included: Readmission rates (0–7 day readmission) reduced from 8.5% to 6% Increase of 7% (182 patients) returning to their usual residence For those returning home, significant reduction in length of stay on this ward by 30%. Conclusion The effect on length of stay and higher quality assessments of elderly patients on day 1 has been clear not only from the data but also from staff experience who have seen a difference in the impact of this model.

A gender-specific assessment of tobacco use risk factors: evidence from the latest Pakistan demographic and health survey

BackgroundThe high prevalence of tobacco use in Pakistan poses a substantial health and economic burden to Pakistani individuals, families, and society. However, a comprehensive assessment of the key risk factors of tobacco use in Pakistan is very limited in the literature. A better understanding of the key risk factors of tobacco use is needed to identify and implement effective tobacco control measures.ObjectivesTo investigate the key socioeconomic, demographic, and psychosocial determinants of tobacco smoking in a recent large nationally representative sample of Pakistani adults.MethodsN = 18,737 participants (15,057 females and 3680 males) from the 2017–18 Pakistan Demographic Health Survey, aged 15–49 years, with data on smoking use and related factors were included. Characteristics of male and female participants were compared using T-tests (for continuous variables) and χ2-tests (for categorical variables). Multivariable logistic regression models were used to identify gender-specific risk factors of tobacco use. The Receiver Operating Characteristic Curve test was used to evaluate the predictive power of models.ResultsWe found that the probability of smoking for both males and females is significantly associated with factors such as their age, province/region of usual residence, education level, wealth, and marital status. For instance, the odds of smoking increased with age (from 1.00 [for ages 15–19 years] to 3.01 and 5.78 respectively for females and males aged 45–49 years) and decreased with increasing education (from 1.00 [for no education] to 0.47 and 0.50 for females and males with higher education) and wealth (from 1.00 [poorest] to 0.43 and 0.47 for richest females and males). Whilst the odd ratio of smoking for rural males (0.67) was significantly lower than that of urban males (1.00), the odds did not differ significantly between rural and urban females. Finally, factors such as occupation type, media influence, and domestic violence were associated with the probability of smoking for Pakistani females only.ConclusionsThis study identified gender-specific factors contributing to the risk of tobacco usage in Pakistani adults, suggesting that policy interventions to curb tobacco consumption in Pakistan should be tailored to specific population sub-groups based on their sociodemographic and psychosocial features.

Participation in domestic energy retrofit programmes: key spatio-temporal drivers

The Canadian government created the EcoENEGY Retrofit for Homes programme (2007–12) to improve residential energy efficiency and reduce emissions produced through energy use. The uptake of retrofits varied both spatially and temporally. This research examines spatio-temporal patterns of retrofit adoption to understand the drivers behind participation in the grant programme and assess how future grant-based programmes might improve the uptake of efficiency measures. Temporal analysis demonstrated continued growth of programme participation over its original period of availability, and this accelerated once the programme was extended for an additional year after its original closure date. However, some spatial correlations weakened, which may be attributable to changes in programme design during the extension period. Seasonal variation was also observed, with spikes in retrofit activity occurring in winter. A regression analysis for conversion rates in Ontario and British Columbia displayed significant positive correlations for high shelter costs (&gt;30% of household income) and households occupied by usual residents (regular occupants). Population density, median property value (only in Ontario) and units that were recently occupied demonstrated negative correlations. Spatial variation at both the city and neighbourhood levels suggests a greater degree of programme customisation is required to ensure uniform building stock improvement. <em><strong>Policy relevance</strong></em> Domestic retrofit will be a crucial component of every developed nation’s net zero strategy. For example, in Canada and the UK, houses account for 13% and 20% of energy-related greenhouse gas emissions, respectively. This paper explores trends in the most recently completed national retrofit programme in Canada, demonstrating rates of adoption across the programme, the effects of programme design modification, and the value of an understood programme brand and format for uptake. Further, when faced with tighter deadlines, there is a weakening of the relationship between adoption and spatially linked attributes such as population density, and duration of occupancy. Conversely, a strengthening of the relationship with levels of education and household costs was observed in some jurisdictions. The evidence in this paper strengthens the case for long-term, actively managed retrofit programmes to enable the skills base and consumer interest towards market transformation.

An antiscalant with chelating residues of amino acid glycine

Cyclopolymerization of diallylammonioethanoate [(H2CCHCH2)2NH+CH2CO2−] afforded polyzwitterion (PZ) PZ-3800, PZ-4600 and PZ-6150 having respective M¯n of 3800, 4600, and 6150 g mol−1 in excellent yields. The PZs having residues of amino acid glycine were examined as antiscalant. PZ-4600 in the respective concentration and temperature ranges 1–20 ppm and 40–80 °C, effectively mitigated the scale formation from a supersaturated CaSO4 solution. Antiscalant efficacies were found to increase in the order: PZ-6150 < PZ-4600 < PZ-3800. At a 2.5 ppm concentration, PZ-3800, −4600, and −6150 were shown to impart percent scale inhibition (PSI) of ≈ 100% up to 180, 60, and 30 min, respectively. At 1 ppm concentration, PZ-3800 and -4600 demonstrated respective induction times (after which the scale formation starts to occur) of 80 and 60 min with a PSI value of 99% up to 60 and 30 min, respectively. The inexpensive antiscalant has the potential in mitigating scale formation during the usual residence time (15 min) of the reject brine in an osmosis chamber. The smaller size PZ-3-3800 is found to be the most efficient in disrupting the crystal growth of CaSO4.

745 PROACTIVE INPUT FROM GERIATRICIAN LED SURGICAL LIAISON SERVICE FOR OLDER SURGICAL PATIENTS AT ROYAL BERKSHIRE HOSPITAL, READING

Abstract Introduction Need for a geriatrician in the peri operative care of older surgical patients is evident by the NCEPOD reports in 2010 and 2011. Funding for Consultant Geriatrician led surgical liaison service for RBH was approved in 2014.We present a comparative review of the service during 2019/2020. Methods A retrospective audit of elective and emergency surgical patients over 65 years of age from January to March 2019 and June to September 2020 was done. Geriatrician input was provided on weekdays by Less than full time (80%) equivalent Consultant, 1 full time equivalent physician associate and a Gerontology Registrar on pro rota basis. Results We reviewed 76 patients in 2019 (Emergency 74/76 = 95% Vs Elective 2/76 = 3%) and 161patients in 2020 (Emergency134/161 = 83% Vs Elecetive27/161 = 17%). Majority of emergency presentations were small bowel obstruction, acute cholecystitis, and pancreatitis while laparoscopic right hemi colectomy was the commonest elective surgical admission. The average age of patients was 72 years (2019) and 79 years (2020). Length of stay up to 5 days reduced from 75% (51/76) in 2019 to 43% (70/161) in 2020. The overall length of stay reduced from 12 days to 8.5 days in 2019 and 2020, respectively 30 days readmission rate increased from 21% (16/76) in 2019 to 25.5% (41/161) in 2020. 75% (2019) and 96% (2020) of patients were discharged back to their usual residence and death rates reduced from 14% to 1% between the 2 audits. Conclusion There is an increase in patient number, age, and complexity. Number of elective surgical admissions after the 1st Covid wave has risen. Even with less than full time Consultant Geriatrician cover the service has helped to reduce the overall length of hospital, mortality rate and added to cost saving. There is need for senior cover for service to work efficiently and to meet its ever-increasing demand.

Factors Preventing IDPs from Returning to their Usual Residence in Maiduguri, Borno State

The study looked at what is preventing IDPs from returning to their normal house in Maiduguri, Borno State. The study's specific objectives were to assess IDPs' rights regarding relocation to their usual home of residence, examine the implications of insufficient funds for rebuilding IDPs' usual home of residence, examine the implications of insecurity on IDPs' relocation to their usual home of residence, and finally assess the effect of insecurity on IDPs' relocation to their usual home of residence. Primary and secondary sources were used to compile the data. The respondents were given a questionnaire to fill out as part of the primary data collection. A total of 400 people from Maiduguri were surveyed. The study looked at a variety of ideas, with human needs theory serving as the study's theoretical framework. The idea covers the essential cause for IDPs returning to their customary place of residence in order to alleviate the difficult circumstances faced by IDPs who have lost their homes, jobs, and families, among other things. Food, shelter, healthcare, education, and clothing are among the basic needs of IDPs. The findings revealed that Internally Displaced Persons have the right to relocate to their usual home of residence and the right to request and receive protection. The study further revealed that Internally Displaced Persons have the right to humanitarian assistance from national authorities without discrimination and the right for assistance in restoring family link, Health care, education, and economic and social rehabilitation are all things that need to be addressed. The findings also stated that due to a lack of funds, the funding for restoring IDPs' customary place of living is insufficient. It was discovered that returning IDPs are frequently attacked by militants in their homes and are frequently kidnapped by the group. It recommends that the Borno State governments should enact a local law in the State to compel IDP’s management agencies at all levels to stringently observe the U.N. Guiding Principles on the protection of the right of Internal Displacement on relocation to their settlement. The Nigerian Government should fight corruption and ensure a direct link between the management agencies and the IDP's. Contingency plans should be made financially and bureaucratically in anticipation of displaced events to accommodate the rapid nature of displacement, the bureaucratic process involved in the release of finances and other resources for the administration of IDPs should be simplified.

Impact of Alcoholism and Other Factors on Violence against Women in the State of Bihar, India - Data from NFHS (National Family Health Survey -5-2019-21)

National Family Health Survey-5 data which was conducted at household level in all 38 districts of the state of Bihar from 9 July, 2019 to 2 February, 2020 revealed that there is failure of complete alcohol ban in Bihar. Violence against women under the influence of alcoholism is still going on under influence of liquor consumption. Alcohol is a risk factor for partner violence across a range of settings for all types of violence where alcohol plays as a key situational factor, escalating the probability of violence by plummeting inhibitions, clouding judgment and deteriorating ability to interpret cues. Psychiatric morbidities such as paranoid schizophrenia, bipolar disorder, delusional and antisocial personality disorder formulate the man more likely to commit sexual crimes. In the light of the above mentioned background this study based on data of NFHS-5 is aimed to analyses the status of liquor consumption relation with violence against women in the state of Bihar and Gender role attitudes, experience of physical and sexual violence, experience of violence during pregnancy, forms of spousal violence, injuries to women due to spousal violence and help seeking against violence by the women of the state of Bihar in India. The total sample size of NFHS-5 was 35,834 households, 42,483 women of age group 15-49 (including 6,350 women interviewed in PSUs in the state module), and 4,897 men of age group 15-54 for the state of Bihar. Household questionnaire regarding Gender role attitudes, Experience of physical and sexual violence, Experience of violence during pregnancy, Forms of spousal violence, Injuries to women due to spousal violence, Help seeking against violence in the household three years preceding the survey were asked from respondents and the information was gathered and utilized to construct information in 19 languages using CAPI (Computer Assisted Personal Interviewing). In residents of Bihar eligible women and men were women ages 15-49 and men ages 15-54 who lived in the household the night before the household interview (including both usual residents and visitors). See table-1- This table is based on the unweight sample. 84.4% of women whose husbands often get drunk have experienced emotional, physical, or sexual violence, compared to those who gets drunk sometimes (61.4%), drinks/never gets drunk (45.4%) and minimum 36.4% of those whose husbands do not drink -see table-8 and figure-4. The survey data analysis revealed that the drinking pattern plays a crucial role in the extent of violence against women in the state. The more the men consume liquor, the more is the domestic abuse. Nearly, 56.6% of women are afraid of their husband most of the time that have experienced spousal violence.

Evaluation of access to electricity and the socioeconomic effects in rural and urban expanses of Nigeria

PurposeRecently, multidimensional aspects of poverty has been increasingly focused on which includes education, economy and health, while access to modern energy such as stable electricity is also one of the possible solution; thus, this article aims to divulge the relation between access to electricity and progression in socioeconomic status in urban and rural areas of Nigeria in an attempt to propose a sustainable framework for access to electricity.Design/methodology/approachDemographic and health survey data are collected using four categories of model of questionnaires. A standard questionnaire was designed to gather information on features of the household's dwelling element and attributes of visitors and usual residents between the 2018 period. Biomarker questionnaire was used to gather biomarker data on men, women and children. Logistic model estimation technique was employed to estimate the socioeconomic factors affecting access to electricity in Nigeria.FindingsThese studies discovered that there are diverse set of factors affecting access to electricity in Nigeria especially in the rural areas. However, respondent residing in rural areas are still largely deprived access to electricity; most importantly, households with no access to electricity are more likely to use self-generating sets as revealed. Additionally, empirical findings indicated that the higher the level of your education and wealth, the higher the likelihood of having access to electricity in Nigeria. These factors included political will to connect the rural areas to the national grid, development of other infrastructures in those deprived areas and others.Practical implicationsThe problem confronting access to electricity in Nigeria has three components. The first is the significance of those deprived access to electricity in the rural areas and the physical resources needed to connect them to the national grid. The second is the political willingness of the government to have equitable distribution of public goods evenly between rural and urban areas especially on electricity access which will go a long way in reducing poverty in Nigeria. The third is lack of robust national development plans and strategy to tackle the problems facing electricity access in Nigeria.Social implicationsAs the rate of socioeconomic status/development increases, access to electricity is anticipated to rise up in Nigeria.Originality/valueThe findings can be used by the policy makers to address problems facing access to electricity in Nigeria.

Disparities in emergency department access, resource allocation, and outcomes between migrants and the local population.

To characterize a group of migrant emergency department (ED) patients regarding demographics, access to the ED, mode of referral, use of resources, and short-term outcomes, and to compare them to a group of local ED patients. Prospective cohort study with consecutive enrollment of adult patients presenting to the ED of a Swiss tertiary care hospital from October 21st to November 11th, 2013 and February 1st to February 23rd, 2015. In accordance with the International Organization for Migration, we defined migrants as persons who have changed their country of usual residence, irrespective of their legal status. The primary outcome was defined as the number of resources allocated to migrants, as compared to local patients, using uni- and multivariable quasi-Poisson regressions. Acute morbidity, hospitalization, intensive care unit (ICU) admission, and 30-day mortality were assessed as secondary outcomes. Migrant patients were younger, more often male and self-presenters, and of lower acuity. After adjustment for age, gender and acuity, we observed a non-significant difference of 3.6% in the mean number of resources allocated to migrant patients as compared to local patients (adjusted RR 0.964, CI 0.923-1.006). No difference in 30-day mortality (adjusted OR 0.777, CI 0.346-1.559) was observed between the two patient groups, but migrant patients had lower odds of acute morbidity (adjusted OR 0.652, CI 0.560-0.759), hospitalization (adjusted OR 0.666, CI 0.555-0.799), and ICU admission (adjusted OR 0.649, CI 0.456-0.910). ED access approximation, resource allocation, and mortality were comparable between migrant patients and local patients. Lower admission rates to wards and the ICU may raise concerns but can be explained by lower acute morbidity in migrant patients.

Prevalence and factors associated with joint pain in Nepal: findings from a countrywide cross-sectional STEPS survey

ObjectiveThis study aims to determine the prevalence of joint pain and its association with demographic, socioeconomic and behavioural factors in Nepal.DesignThe study was a national cross-sectional population-based study.SettingWe used the...