ABSTRACT
BACKGROUND: Research is sparse on the community-level impacts of home visiting programs on child maltreatment. OBJECTIVE: To examine community-level associations between state-funded home visiting programs (i.e., IDHS-HV), federal-funded home visiting programs (i.e., MIECHV), and child maltreatment report (CMR) rates, overall and within subgroups of age, sex, and maltreatment type. PARTICIPANTS AND SETTING: 3824 zip code-years during 2011-2018 in Illinois for IDHS-HV/CMR associations and 1896 zip code-years during 2015-2018 for MIECHV/CMR associations. METHODS: We measured county-level IDHS-HV rates (per 1000 children aged 0-5) since data were only available at that level. MIECHV rates (per 1000 children aged 0-5), CMR rates (per 1000 children), and all controls were measured at the zip code level. We used spatial linear models to handle spatial autocorrelation. RESULTS: Adjusted for controls, longitudinal increases of IDHS-HV rates were significantly associated with decreased overall CMR rates (coefficient: -0.28; 95 % CI: -0.45, -0.11), age 0-5 CMR rates (-0.52; -0.82, -0.22), age 6-11 CMR rates (-0.31; -0.55, -0.06), male CMR rates (-0.25; -0.45, -0.05), female CMR rates (-0.29; -0.49, -0.08), and neglect report rates (-0.13; -0.24, -0.02). In contrast, longitudinal increases of MIECHV rates were significantly associated with increased CMR rates within several subgroups. CONCLUSIONS: Our findings suggest that increasing state-funded home visiting services in communities may have benefits in lowering their CMR rates. Given the very low MIECHV service rates and the federal policy that requires MIECHV to target at-risk communities, the significant positive MIECHV/CMR associations we found might indicate MIECHV programs are typically in higher risk communities.
Subject(s)
Child Abuse , House Calls , Child , Male , Female , Humans , Infant , Mandatory Reporting , Illinois/epidemiology , PolicyABSTRACT
This study aimed to examine whether bullying reporting concerns mediate the relationship between school climate and student bullying victimization as well as aggressive behavior. Data were from a sample of 301 students in Grades 6 to 8 in two minority-predominant schools in a large U.S. metropolitan area. Findings from bootstrapped structural equation modeling (SEM) analyses indicated that for male students, a higher level of perceived anti-bullying school climate was negatively associated with bullying reporting concerns, while the reporting concerns subsequently were positively associated with bullying victimization and aggressive behavior. For female students, perceived school climate was not associated with bullying reporting concerns, but the latter were also positively associated with bullying victimization and aggressive behavior. Therefore, bullying reporting concerns mediated the association between perceived school climate and bullying victimization as well as aggressive behavior for male but not female students. The findings suggest the importance of strengthening anti-bullying school climate to help students overcome bullying reporting concerns to achieve effective outcomes. The gender difference of associations between school climate and bullying reporting concerns may reflect the variation of bullying types experienced by male and female students, which calls for attention to the development of anti-bullying strategies that take into account gender differences and address various types of bullying.
Subject(s)
Bullying , Crime Victims , Aggression , Female , Humans , Male , Schools , StudentsABSTRACT
Taking parity as the main analytic variable, the objective of this study is to investigate whether the patterns of response to national census questions in Brazil differ when Indigenous and non-Indigenous women are compared, taking into consideration whether the information was provided by the women directly or by a proxy respondent (another household member or a non-resident). We use data on children ever born to Indigenous and non-Indigenous women from two Brazilian regions, the Northeast and the North. Data on the number of household members, total household rooms, interviewee's color/race, educational attainment, age, parity, and type of respondent were obtained from the 2010 Brazilian census. The relation between color/race and reported parity, as well as the impact of the type of respondent on this association were assessed with the Zero-inflated Negative Binomial regression, stratified by region (North and Northeast) and urban/rural status. Just over half of census interviewees answered directly the census questions (51.2% in the North and 54.4% in the Northeast). Indigenous women in the North region had the highest percentage of interviews carried out with a non-resident (12.7% total; 15.0% and 3.0% in rural and urban areas, respectively). Regardless of color/race, parity means were considerably higher when the question was answered by the woman directly (93.5%-101.4% and 15.6%-21.7% higher, compared co-resident and non-resident based answers, respectively). Parity underreporting was particularly strong in Indigenous women living in the rural North (16.0% less in comparison to White women). Proxy respondents tend to underestimate the count of children, particularly among Indigenous women from the North. The implementation of certain methodological alternatives in the Brazilian national censuses, such as the selection and training of census takers to work specifically in Indigenous territories, might be a productive means to improve data collection.
Subject(s)
Data Collection/methods , Indians, South American , Parity , Population Dynamics/statistics & numerical data , White People , Adolescent , Adult , Brazil , Censuses , Child , Developing Countries , Female , Humans , Middle Aged , Pregnancy , Rural Population , Surveys and Questionnaires , Urban PopulationSubject(s)
Humans , Anthropology, Cultural , Culture , Demography , Human Ecology , Indians, South American , Language , Indigenous PeoplesABSTRACT
This study investigates the demographic and health behavior of the Xavante Indians of Mato Grosso State, Central Brazil. Data covering the period 1999 to 2004 was collected using information from household censuses and vital statistics. In addition to standard demographic analyses, survival analysis was carried out. Results show a young age structure, derived from a combination of high fertility rates (7.7 live births per woman) and declining mortality. Mortality rates, especially infant mortality (97 per thousand), remain very high, surpassing regional and national rates. Natural increase is the main contributing factor to population growth. The annual population growth rate is 4.4%. Results suggest that recent declines in mortality and fertility may be related to transformations in the implementation of basic health care services and internal diversity, the latter of which seems to be associated with local history and sociocultural determinants.
Subject(s)
Demography , Indians, South American/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Birth Rate/ethnology , Brazil/epidemiology , Child , Child, Preschool , Female , Health Services , Humans , Infant , Infant, Newborn , Male , Mortality/ethnology , Survival AnalysisABSTRACT
This study investigates the demographic and health behavior of the Xavante Indians of Mato Grosso State, Central Brazil. Data covering the period 1999 to 2004 was collected using information from household censuses and vital statistics. In addition to standard demographic analyses, survival analysis was carried out. Results show a young age structure, derived from a combination of high fertility rates (7.7 live births per woman) and declining mortality. Mortality rates, especially infant mortality (97 per thousand), remain very high, surpassing regional and national rates. Natural increase is the main contributing factor to population growth. The annual population growth rate is 4.4 percent. Results suggest that recent declines in mortality and fertility may be related to transformations in the implementation of basic health care services and internal diversity, the latter of which seems to be associated with local history and sociocultural determinants.
Este estudo investiga o comportamento demográfico dos índios Xavante de Mato Grosso, Brasil Central. Os dados foram coletados entre 1999 e 2004, a partir de censos domiciliares e da coleta de estatísticas vitais. Além das análises demográficas, realizou-se análise de sobrevida. Os Xavante apresentam uma estrutura etária jovem, típica de população em fase de recuperação populacional, com alta fecundidade (média de 7,7 nascidos vivos por mulher) e mortalidade em declínio. As taxas de mortalidade, especialmente a infantil (97 por mil), continuam a ser muito elevadas, ultrapassando as taxas regionais e nacionais. O crescimento natural é o principal fator no aumento populacional. A população cresce a uma taxa média de 4,4 por cento ao ano. Argumenta-se que não somente a recente queda da mortalidade, assim como da fecundidade, podem estar relacionadas à implementação do novo sistema de saúde voltado para os povos indígenas no Brasil a partir de 1999. Os Xavante apresentam significativa diversidade demográfica interna, que parece estar associada a histórias de contato e a determinantes socioculturais.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Demography , Indians, South American/statistics & numerical data , Age Factors , Birth Rate/ethnology , Brazil , Health Services , Mortality/ethnology , Survival AnalysisSubject(s)
Humans , Culture , Indians, South American , Indigenous Peoples , Photography , Health of Indigenous PeoplesSubject(s)
Humans , Male , Female , Indians, South American , Ethnic Distribution , Social Organization , Infant Mortality/ethnology , Disease OutbreaksABSTRACT
OBJECTIVE: Nonrandom assignment of therapy in observational studies and clinical practice can be accompanied by channeling bias and confounding by indication. This in turn can lead to unreliable conclusions about treatment effectiveness. Although widely acknowledged as important, no studies in rheumatology have measured the extent of these biases. We identified variables contributing to confounding and investigated the strength of the confounding effect. Analytical methods (propensity scores) are available to mitigate the effect of nonrandom assignment if the full extent of confounding can be understood. METHODS: A population of 6637 patients with rheumatoid arthritis (RA) and osteoarthritis (OA) from the practices of 433 US rheumatologists completed 2 sets of detailed questionnaires concerning (1) the last 6 months in 1998 and (2) the first 6 months of 1999, generally prior to and after the release of celecoxib and rofecoxib. Patients who received the COX-2 specific inhibitors in period 2 were identified (n = 1517), and their characteristics were compared to the 5120 who did not start a new COX-2 specific inhibitor during Period 1. RESULTS: Patients starting a new COX-2 specific inhibitor had a greater lifetime history of adverse reactions of all kinds, but particularly gastrointestinal adverse drug reactions. They also had more severe scores for pain, functional disability, fatigue, helplessness, and global severity, and they used more inpatient and outpatients services than patients who would not switch to COX-2 specific inhibitors. CONCLUSION: Confounding by indication and channeling bias result in an overall increase in severity of about 25% for the above measures. Observational studies should account for these biases by a broadly defined propensity score that includes the variables identified in this report. These observations are germane to observational studies of disease modifying antirheumatic drugs and biologics, as well, and suggest the need for careful control of confounders when assessing treatment effects in rheumatic disease observational studies.
Subject(s)
Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , Cyclooxygenase Inhibitors/adverse effects , Osteoarthritis/drug therapy , Osteoarthritis/epidemiology , Sulfonamides/adverse effects , Aged , Arthritis, Rheumatoid/physiopathology , Bias , Celecoxib , Confounding Factors, Epidemiologic , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Female , Gastrointestinal Diseases/chemically induced , Health Services/statistics & numerical data , Humans , Isoenzymes/antagonists & inhibitors , Lactones/adverse effects , Male , Membrane Proteins , Middle Aged , Osteoarthritis/physiopathology , Prostaglandin-Endoperoxide Synthases , Pyrazoles , Severity of Illness Index , SulfonesABSTRACT
Este trabalho reporta os resultados de um inquerito transversal qualitativo e quantitativo sobre parasitas intestinais entre os Xavantes do Brasil Central. A. lumbricoides (25 por cento) e ancilostomideos (33,6 por cento) foram os helmintos mais frequentes; complexo E.histolytica (7,8 por cento) e G. lamblia (8,6 por cento) os protozoarios mais comuns. A maioria dos individuos positivos albergava somente uma especie de helminto (58,5 por cento)...
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Helminthiasis/diagnosis , Intestines/parasitology , Indians, South American/classificationABSTRACT
Foi realizado inquérito soro-epidemiológico através de testes de imunofluorescência indireta e imunoprecipitaçao visando determinar a prevalência do pênfigo foliáceo endêmico (PFE) na populaçao indígena Xavánte do Brasil Central. Do total de 163 amostras de soros testadas, 5 (3,1%) foram positivas à imunofluorescência. Todos os soros positivos procediam de indivíduos com sintomas clínicos da doença. Nao foram observadas diferenças do PFE entre os Xavánte e a populaçao em geral sob o ponto de vista imunológico, já que se verificou uma predominância de IgG4 entre os anticorpos nos pacientes indígenas
