Body Mass Index: Accounting for Full Time Sedentary Occupation and 24-Hr Self-Reported Time Use

Objectives

We used linked existing data from the 2006–2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities?

Methods

We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20–29, 30–39, 40–49, and 50–64 years. BMI groups were defined by 18.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, and ≥35.0 kg/m². Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income.

Results

The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20–64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income.

Conclusions

We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships.     

Distribution of Illness and Medical Expenditure: A Survey in Two Villages in Rural Beijing

Background

The main goal of this study is to examine the distributions of illness conditions and resulting medical expenditures and their associated factors. To achieve this goal, an in-house survey was conducted in August of 2012 in rural Beijing, the capital city of China.

Results

The survey was conducted in Nanjianchang and Beijianchang, which are two villages 20 KM away from Miyun, a satellite city of Beijing. Data was collected on 346 households, which included 834 members. Variables measured included household characteristics, household head characteristics, illness conditions, and medical expenditures. Illness conditions and corresponding expenditure were measured for inpatient treatment, outpatient treatment, and self-treatment separately. Multivariate analysis suggested that the presence of inpatient treatment was associated with household head characteristics including age, gender, and education. The presence of a high level of outpatient treatment was associated with household head characteristics including gender and education. The presence of a high level of self-treatment was significantly associated with household size. In the analysis of overall out-of-pocket (OOP) medical expenditure, only age of household head was borderline significant. In the analysis of OOP inpatient expenditure, age and gender of household head were borderline significant. The OOP outpatient expenditure was associated with household size, presence of members older than 60, household head''s gender, marital status, and occupation. The OOP self-treatment expenditure was not associated with any household characteristic.

Conclusions

For the surveyed households, medical expenditure made up a considerable proportion of the total consumption. This study suggested that the presence of illness conditions and resulting OOP medical expenditure were associated with certain household and household head characteristics. Such results may help identify the subgroup that is the most affected by illness conditions. As this study collected recent data on inpatient, outpatient, and self-treatment separately, it may provide a useful complement to the existing studies.     

A case-control study of maternal knowledge of malnutrition and health-care-seeking attitudes in rural South India.

INTRODUCTION: In India, approximately 20 percent of children under the age of four suffer from severe malnutrition, while half of all the children suffer from undernutrition. The contributions of knowledge and attitudes of nutrition-conscious behaviors of the mothers to childhood malnutrition has been unclear. The purpose of this study was to explore maternal knowledge of the causes of malnutrition, health-care-seeking attitudes and socioeconomic risk factors in relation to children''s nutritional status in rural south India. METHODS: A case-controlled study was conducted in a rural area in Tamil Nadu, India. Thirty-four cases and 34 controls were selected from the population of approximately 97,000 by using the local hospital''s list of young children. A case was defined as a mother of a severely malnourished child under four years of age. Severe malnutrition was defined as having less than 60 percent of expected median weight-for-age. A control had a well-nourished child and was matched by the location and the age of the child. Interviews obtained: (1) socioeconomic information on the family, (2) knowledge of the cause of malnutrition and (3) health-care-seeking attitudes for common childhood illnesses, including malnutrition. RESULTS: Poor nutritional status was associated with socioeconomic variables such as sex of the child and father''s occupation. Female gender (OR = 3.44, p = .02) and father''s occupation as a laborer (OR = 2.98, p = .05) were significant risk factors for severe malnutrition. The two groups showed a significant difference in nutrition-related knowledge of mild mixed malnutrition (OR = 2.62, p = .05). No significant difference was apparent in health-care-seeking attitudes. Based on their traditional beliefs, the mothers did not believe that medical care was an appropriate intervention for childhood illnesses such as malnutrition or measles. DISCUSSION: The results suggested that the gender of the child and socioeconomic factors were stronger risk factors for malnutrition than health-care availability and health-care-seeking attitudes. The father''s occupation was a more accurate indicator for malnutrition than household income. These results suggest a need for intensive nutritional programs targeted toward poor female children and their mothers.     

Household factors influencing participation in bird feeding activity: a national scale analysis

Ameliorating pressures on the ecological condition of the wider landscape outside of protected areas is a key focus of conservation initiatives in the developed world. In highly urbanized nations, domestic gardens can play a significant role in maintaining biodiversity and facilitating human-wildlife interactions, which benefit personal and societal health and well-being. The extent to which sociodemographic and socioeconomic factors are associated with engagement in wildlife gardening activities remain largely unresolved. Using two household-level survey datasets gathered from across Britain, we determine whether and how the socioeconomic background of a household influences participation in food provision for wild birds, the most popular and widespread form of human-wildlife interaction. A majority of households feed birds (64% across rural and urban areas in England, and 53% within five British study cities). House type, household size and the age of the head of the household were all important predictors of bird feeding, whereas gross annual household income, the occupation of the head of the household, and whether the house is owned or rented were not. In both surveys, the prevalence of bird feeding rose as house type became more detached and as the age of the head of the household increased. A clear, consistent pattern between households of varying size was less evident. When regularity of food provision was examined in the study cities, just 29% of households provided food at least once a week. The proportion of households regularly feeding birds was positively related to the age of the head of the household, but declined with gross annual income. As concerns grow about the lack of engagement between people and the natural environment, such findings are important if conservation organizations are successfully to promote public participation in wildlife gardening specifically and environmentally beneficial behaviour in society more generally.     

Public attitudes toward euthanasia and suicide for terminally ill persons: 1977 and 1996

This study replicates Singh's (1979) "classic" examination of correlates of euthanasia and suicide attitudes. The purposes of the current study were to assess (1) changes in public attitudes toward these voluntary termination of life practices, and (2) changes in the effects on attitudes of selected independent variables. I found Americans' approval of both euthanasia and suicide in 1996 to be higher than that in 1977. The increase in the approval of suicide, however, far outstripped that of euthanasia. Results of OLS regressions indicated that race, religious commitment, religious attendance, political identification, and suicide approval were statistically significant predictors of euthanasia approval. Only religious attendance and euthanasia approval were statistically significant predictors of suicide approval in both 1977 and 1996. The findings regarding euthanasia approval support those of Singh (1979); those regarding suicide approval do not. Triangulation of methods in future research is necessary to illuminate other aspects of these multifaceted issues.     

Impact of Illness and Medical Expenditure on Household Consumptions: A Survey in Western China

Background

The main goal of this study is to examine the associations between illness conditions and out-of-pocket medical expenditure with other types of household consumptions. In November and December of 2011, a survey was conducted in three cities in western China, namely Lan Zhou, Gui Lin and Xi An, and their surrounding rural areas.

Results

Information on demographics, income and consumption was collected on 2,899 households. Data analysis suggested that the presence of household members with chronic diseases was not associated with characteristics of households or household heads. The presence of inpatient treatments was significantly associated with the age of household head (p-value 0.03). The level of per capita medical expense was significantly associated with household size, presence of members younger than 18, older than 65, basic health insurance coverage, per capita income, and household head occupation. Adjusting for confounding effects, the presence of chronic diseases was negatively associated with the amount of basic consumption (p-value 0.02) and the percentage of basic consumption (p-value 0.01), but positively associated with the percentage of insurance expense (p-value 0.02). Medical expenditure was positively associated with all other types of consumptions, including basic, education, saving and investment, entertainment, insurance, durable goods, and alcohol/tobacco. It was negatively associated with the percentage of basic consumption, saving and investment, and insurance.

Conclusions

Early studies conducted in other Asian countries and rural China found negative associations between illness conditions and medical expenditure with other types of consumptions. This study was conducted in three major cities and surrounding areas in western China, which had not been well investigated in published literature. The observed consumption patterns were different from those in early studies, and the negative associations were not observed. This study may complement the existing rural studies and provide useful information on western Chinese cities.     

Factors associated with utilization of long term family planning methods among women of reproductive age attending Bahir Dar health facilities,Northwest Ethiopia

Objective

This health institution based cross section study was designed to determine factors associated with utilization of long term family planning methods among women reproductive age attending Bahir Dar health facilities.

Result

A total of 406 women were interviewed in this study. The mean age (standard deviation) of the study participants was 26.96?±?6.31. About 99% of the study participants were consisted from Amhara ethnic group and 60.6% of them urban dwellers. In this study about 90.9% of the study participants had information about LTFP methods and 26.4% of them utilizing the methods. Factors like; knowledge of the women towards LTFP, spousal discussion on FP and occupation of the women affects LTFP utilization (6 times, 3 times and 4 times, respectively) when compared with their counter parts. In addition monthly income of the household was also associated to LTFP methods. In this study less percentage (26.4%) of women’s utilizing LTFP methods that were significantly associated with the knowledge of women on LTFP, spousal discussion on FP, occupation of the women and monthly income of the household. As result continuous health education will be recommended.

     

Determinants of Sexual Activity and Pregnancy among Unmarried Young Women in Urban Kenya: A Cross-Sectional Study

Objectives

With age of marriage rising in Kenya, the period between onset of puberty and first marriage has increased, resulting in higher rates of premarital sexual activity and pregnancy. We assessed the determinants of sexual activity and pregnancy among young unmarried women in urban Kenya.

Methods

Baseline data from five urban areas in Kenya (Nairobi, Mombasa, Kisumu, Machakos, and Kakamega) collected in 2010 by the Measurement, Learning & Evaluation project were used. Women aged 15-24 years, who had never been married, and were not living with a male partner at the time of survey (weighted n=2020) were included. Using weighted, multivariate Cox proportional hazard regression and logistic regression analyses, we assessed factors associated with three outcome measures: time to first sex, time to first pregnancy, and teenage pregnancy.

Results

One-half of our sample had ever had sex; the mean age at first sex among the sexually-experienced was 17.7 (± 2.6) years. About 15% had ever been pregnant; mean age at first pregnancy was 18.3 (±2.2) years. Approximately 11% had a teenage pregnancy. Three-quarters (76%) of those who had ever been pregnant (weighted n=306) reported the pregnancy was unwanted at the time. Having secondary education was associated with a later time to first sex and first pregnancy. In addition, religion, religiosity, and employment status were associated with time to first sex while city of residence, household size, characteristics of household head, family planning knowledge and misconceptions, and early sexual debut were significantly associated with time to first pregnancy. Education, city of residence, household wealth, early sexual debut, and contraceptive use at sexual debut were associated with teenage pregnancy for those 20-24 years.

Conclusion

Understanding risk and protective factors of youth sexual and reproductive health can inform programs to improve young people’s long-term potential by avoiding early and unintended pregnancies.     

Abortion in Canada: religious and ideological dimension's of women's attitudes

This paper examines a number of demographic and sociocultural factors (e.g., age, marital status, family size, religion, religious assiduity, sex-role ideology) as predictors of women's attitudes toward abortion, using data from the Canadian Fertility Survey of 1984. The findings suggest that women's abortion attitudes are to a greater extent based on ideological positions. It appears that anti-abortion stance affects those women who are religious, presumably by increasing the relationship between their general sex-role ideological stances and abortion attitudes. Abortion attitudes also vary according to a woman's education, her size, and province/region of residence.     

Fears,attitudes and opinions of suburban residents with regards to their urban foxes

Throughout Central Europe, foxes have taken over urban areas as their habitat. In Southern Germany, these foxes are also carriers of the small fox tapeworm, which causes a serious zoonotic infection in humans. Therefore, a survey was carried out in a suburb of the city of Munich. A postal questionnaire was used to analyse the attitudes, opinions and fears of these participants towards their urban foxes and the background to these attitudes. Questionnaires were sent to all households with gardens and collected in again via the community council. Seven hundred and seventy-nine or 31% of questionnaires were returned. Only a few people are afraid of the fox itself; however, 55% are afraid of the fox tapeworm. Worming the animals is the preferred counter-measure, with 81% in favour. The majority of inhabitants are pleased to see a fox in the community and feel the animals have a right to live. People are afraid of the tapeworm either because they have children in the household or because of increased knowledge of the subject or because it has increasingly become an issue. On the basis of the results of this study, it is to be expected that radical solutions such as killing the foxes are unlikely to be accepted among the population. Worming of the foxes does, however, meet with general approval.     

Poverty or income inequality as predictor of mortality: longitudinal cohort study.

OBJECTIVE: To determine the effect of inequality in income between communities independent of household income on individual all cause mortality in the United States. DESIGN: Longitudinal cohort study. SUBJECTS: A nationally representative sample of 14,407 people aged 25-74 years in the United States from the first national health and nutrition examination survey. SETTING: Subjects were followed from initial interview in 1971-5 until 1987. Complete follow up information was available for 92.2% of the sample. MAIN OUTCOME MEASURES: Relation between both household income and income inequality in community of residence and individual all cause mortality at follow up was examined with Cox proportional hazards survival analysis. RESULTS: Community income inequality showed a significant association with subsequent community mortality, and with individual mortality after adjustment for age, sex, and mean income in the community of residence. After adjustment for individual household income, however, the association with mortality was lost. CONCLUSIONS: In this nationally representative American sample, family income, but not community income inequality, independently predicts mortality. Previously reported ecological associations between income inequality and mortality may reflect confounding between individual family income and mortality.     

Factors associated with contraceptive approval among religious leaders in Pakistan

Research is needed to understand the role of religion in family planning dynamics, particularly in societies where the views of religious leaders can be an important influence on the reproductive decisions of individuals. This paper attempts to describe the factors associated with approval of contraception among religious leaders in Pakistan. The data are taken from the 1999-2000 Survey of Perception of Religious Leaders about Population Welfare. Regression modelling shows that whether or not religious leaders approve of family planning is associated with their views on the ideal family size, their level of religious education, the specific religious sect to which they belong, their own knowledge and use of family planning, their exposure to television and the region of the country in which they live.     

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas.     

Seasonal relation of NTFPs and socio-economic indicators to the household income of the forest-fringe communities of Jaldapara National Park

For India's forest-dependent communities, Non-Timber Forest Products (NTFPs) are a major source of income and survival. NTFPs collection and their varieties differ season to season. However, little attention has been given on the income variation according to the seasons and various socio-economic factors influencing it. The present study examined the household income of the forest dwelling communities from NTFPs and their relation to the time spent for its collection in three different seasons i.e., summer, winter and rainy. We interviewed randomly selected families of the forest-dependent communities living in the forest fringe areas of Jaldapara National Park (JNP), West Bengal state of India located in the Eastern Himalayas using a semi-structured questionnaire. The average annual household income of the communities was greatly affected by NTFPs obtained during the rainy season. The majority of the households supplemented their total annual household income through NTFPs (1–20% of total family income annually). In the rainy season, the majority of the respondents (75%) spent 1–10 days for NTFPs collection, the time spent significantly influenced their household income. Furthermore, we found that socio-economic variables such as age, education, and family size have an effect on total annual household income from NTFPs. The other variable also influenced the family income is time spent, in terms of number of days expended in NTFP collection during summer and winter seasons. The study affirms the contribution of NTFPs in family income is strongly determined by the period spent in the collection, which also varies with season and socio-economic variables of the inhabitants.     

A comparison of female- and male-headed households in Tanzania and poverty implications

Female- and male-headed households were compared using data from a Demographic and Health Survey conducted in Tanzania in 1996. Chi-squared tests showed that sex of head of household was highly significantly associated with: residence, household size and composition, radio ownership, having enough food to eat, and age and marital status of head of household. An analysis by the logit regression model showed that female-headed households were more likely than male-headed households to be in rural areas, be small, have fewer men, not have radios and not have enough food to eat. The majority of female heads of households were unmarried and older than male heads of households. The implication is that female-headed households are poorer than male-headed households.     

Impact of the Economic Structure of Cities on Urban Scaling Factors: Implications for Urban Material and Energy Flows in China

We explore the population‐scaling and gross domestic product (GDP)‐scaling relationships of material and energy flow (MEF) parameters in different city types based on economic structure. Using migration‐corrected population data, we classify 233 Chinese city propers (Shiqu) as “highly industrial” (share of secondary GDP exceeds 63.9%), “highly commercial” (share of tertiary GDP exceeds 52.6%), and “mixed‐economy” (the remaining cities). We find that, first, the GDP population‐scaling factors differ in the different city types. Highly commercial and mixed‐economy cities exhibit superlinear GDP population‐scaling factors greater than 1, whereas highly industrial cities are sublinear. Second, GDP scaling better correlates with city‐wide MEF parameters in Chinese cities; these scaling relationships also show differences by city typology. Third, highly commercial cities are significantly different from others in demonstrating greater average per capita household income creation relative to per capita GDP. Further, highly industrial cities show an apparent cap in population. This also translates to lower densities in highly industrial cities compared to other types, showing a size effect on urban population density. Finally, a multiple variable regression of total household electricity showed significant and positive correlation with population, income effect, and urban form effect. With such multivariate modeling, the apparent superlinearity of household electricity use with respect to population is no longer observed. Our study enhances understanding of MEFs associated with Chinese cities and provides new insights into the patterns of scaling observed in different city types by economic structure. Results recommend dual scaling by GDP and by population for MEF parameters and suggest caution in applying universal scaling factors to all cities in a country.     

Knowledge,use and management of native wild edible plants from a seasonal dry forest (NE,Brazil)

Background

Despite being an ancient practice that satisfies basic human needs, the use of wild edible plants tends to be forgotten along with associated knowledge in rural communities. The objective of this work is to analyze existing relationships between knowledge, use, and management of native wild edible plants and socioeconomic factors such as age, gender, family income, individual income, past occupation and current occupation.

Methods

The field work took place between 2009 and 2010 in the community of Carão, Altinho municipality, in the state of Pernambuco in northeastern Brazil. We conducted semi-structured interviews with 39 members of the community regarding knowledge, use and management of 14 native wild edible plants from the Caatinga region, corresponding to 12 vegetable species. In parallel, we documented the socioeconomic aspects of the interviewed population (age, gender, family income, individual income, past occupation and current occupation).

Results

Knowledge about edible plants was related to age but not to current occupation or use. Current use was not associated with age, gender or occupation. The association between age and past use may indicate abandonment of these resources.

Conclusion

Because conservation of the species is not endangered by their use but by deforestation of the ecosystems in which these plants grow, we suggest that the promotion and consumption of the plants by community members is convenient and thereby stimulates the appropriation and consequent protection of the ecosystem. To promote consumption of these plants, it is important to begin by teaching people about plant species that can be used for their alimentation, disproving existing myths about plant use, and encouraging diversification of use by motivating the invention of new preparation methods. An example of how this can be achieved is through events like the “Preserves Festival”.

     

Birth Control,Sterilization and Abortion: Attitudes of Catholic and Protestant Clergymen in San Diego Toward Use in Families with Genetic Illness

A questionnaire comprising case histories was administered to 27 Protestant and 27 Catholic clergymen in the San Diego area to test their attitudes toward the use of birth control, sterilization and abortion in families with specific genetic problems. The responses indicated:• Catholic and Protestant clergymen do not always follow the official positions of their churches in these matters, although the majority of them do.• Protestant clergymen were more likely to approve of birth control, sterilization, and abortion than Catholic clergymen.• The approval responses of Protestant and Catholic clergymen were not greatly influenced by whether the illness variables involved high Mendelian risk, high psychological cost, high social cost, or poor prognosis.• The approval responses of Protestant and Catholic clergymen were not significantly influenced by the socio-ethnic background of the families.     

Medical Students’ Attitudes toward Abortion Education: Malaysian Perspective

Background

Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools.

Methods and Results

A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity.

Conclusions

Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights.     

Dental utilisation for older Americans aged 55–75

Objectives: The purpose of this study was to analyze a comprehensive nationally representative data set to determine the effect of economic and non economic determinants on the decision to seek care and the decision to select a specific number of dental visits. Design: The conduct of this study involved the examination and analyses of secondary data available from the National Health Interview Survey. A two-pan choice logistic regression model was utilized to first describe the decision to seek care and second to describe factors associated with the decision to select a specific number of dental visits as a function of income, education, family size, age, marital status, presence of teeth, employment status, health status, gender, race, insurance status, and reason for dental visit. Subjects: Data analysis focused on 5.327 non-institutional older adults between the ages of 55 and 75 who were not eligible for Medicaid. Results: Results provide supporting evidence that income, presence of dental insurance, presence of teeth, gender, family size, education race and age are associated with the decision to seek dental care and that income, presence of dental insurance, gender, family size, education, and race are associated with the number of dental visits among users even when the effects of other variables are controlled for. Discussion : Analyses suggest that employment may have a surprisingly limited effect on dental utilisation and that among explanatory variables there are differences in significance and magnitude between the decision to seek care and the decision to select a specific number of dental visits. In addition, in contrast with some prior studies, health status does not appear to be associated with the decision to seek care or associated with the number of dental visits among respondents.