Understanding multidimensional poverty in pakistan: implications for regional and demographic-specific policies.

This study enriches the limited literature on multidimensional poverty by focusing on household demographic characteristics as determinants of household-specific living arrangements in Pakistan. The study employs the Alkire and Foster methodology to measure the multidimensional poverty index (MPI) using data drawn from the latest available nationally representative Household Integrated Economic Survey (HIES 2018-19). The analysis investigates multidimensional poverty levels among households in Pakistan according to various criteria (such as access to education and healthcare, basic living standards, and monetary status) and how they differ across Pakistan's regions and provinces. The results indicate that 22% of Pakistanis are multidimensionally poor in terms of health, education, basic living standards, and monetary status; and that multidimensional poverty is more common in rural areas and Balochistan. Furthermore, the logistic regression results show that households with more working-age people, employed women, and employed young people are less likely to be poor, whereas households with more dependents and children are more likely to be poor. This study recommends policies for addressing poverty that consider the needs of multidimensionally poor Pakistani households in various regions and with various demographic characteristics.

Developing and Evaluating a Measure of the Willingness to Use Pandemic-Related mHealth Tools Using National Probability Samples in the United States: Quantitative Psychometric Analyses and Tests of Sociodemographic Group Differences.

BACKGROUND: There are no psychometrically validated measures of the willingness to engage in public health screening and prevention efforts, particularly mobile health (mHealth)-based tracking, that can be adapted to future crises post-COVID-19. OBJECTIVE: The psychometric properties of a novel measure of the willingness to participate in pandemic-related screening and tracking, including the willingness to use pandemic-related mHealth tools, were tested. METHODS: Data were from a cross-sectional, national probability survey deployed in 3 cross-sectional stages several weeks apart to adult residents of the United States (N=6475; stage 1 n=2190, 33.82%; stage 2 n=2238, 34.56%; and stage 3 n=2047, 31.62%) from the AmeriSpeak probability-based research panel covering approximately 97% of the US household population. Five items asked about the willingness to use mHealth tools for COVID-19-related screening and tracking and provide biological specimens for COVID-19 testing. RESULTS: In the first, exploratory sample, 3 of 5 items loaded onto 1 underlying factor, the willingness to use pandemic-related mHealth tools, based on exploratory factor analysis (EFA). A 2-factor solution, including the 3-item factor, fit the data (root mean square error of approximation [RMSEA]=0.038, comparative fit index [CFI]=1.000, standardized root mean square residual [SRMR]=0.005), and the factor loadings for the 3 items ranged from 0.849 to 0.893. In the second, validation sample, the reliability of the 3-item measure was high (Cronbach α=.90), and 1 underlying factor for the 3 items was confirmed using confirmatory factor analysis (CFA): RMSEA=0, CFI=1.000, SRMR=0 (a saturated model); factor loadings ranged from 1.000 to 0.962. The factor was independently associated with COVID-19-preventive behaviors (eg, "worn a face mask": r=0.313, SE=0.041, P<.001; "kept a 6-foot distance from those outside my household": r=0.282, SE=0.050, P<.001) and the willingness to provide biological specimens for COVID-19 testing (ie, swab to cheek or nose: r=0.709, SE=0.017, P<.001; small blood draw: r=0.684, SE=0.019, P<.001). In the third, multiple-group sample, the measure was invariant, or measured the same thing in the same way (ie, difference in CFI [ΔCFI]<0.010 across all grouping categories), across age groups, gender, racial/ethnic groups, education levels, US geographic region, and population density (ie, rural, suburban, urban). When repeated across different samples, factor-analytic findings were essentially the same. Additionally, there were mean differences (ΔM) in the willingness to use mHealth tools across samples, mainly based on race or ethnicity and population density. For example, in SD units, suburban (ΔM=-0.30, SE=0.13, P=.001) and urban (ΔM=-0.42, SE=0.12, P<.001) adults showed less willingness to use mHealth tools than rural adults in the third sample collected on May 30-June 8, 2020, but no differences were detected in the first sample collected on April 20-26, 2020. CONCLUSIONS: Findings showed that the screener is psychometrically valid. It can also be adapted to future public health crises. Racial and ethnic minority adults showed a greater willingness to use mHealth tools than White adults. Rural adults showed more mHealth willingness than suburban and urban adults. Findings have implications for public health screening and tracking and understanding digital health inequities, including lack of uptake.

Demographic differences in public acceptance of waste-to-energy incinerators in China: High perceived stress group vs. low perceived stress group.

Demographic characteristics have been recognized as an important factor affecting public acceptance of waste-to-energy (WTE) incineration facilities. The present study explores whether the differences in public acceptance of WTE incineration facilities caused by demographic characteristics are consistent in residential groups under different perceived stress using data collected by a large-scale questionnaire survey (1,066 samples) conducted in three second-tier cities in China. The result of data analysis using a T-test (one-way ANOVA) shows firstly that people with low perceived stress have higher public acceptance of WTE incineration facilities. Second, the differences in public acceptance of WTE incineration facilities caused by demographic characteristics (gender, educational attainment, and age) vary in residential groups with different perceived stress levels. The findings enrich the knowledge system related to demographic characteristics research on NIMBY infrastructure projects and provide the theoretical basis for the government to formulate more targeted policies about NIMBY infrastructure sitting.

Not One Pandemic: A Multilevel Mixture Model Investigation of the Relationship Between Poverty and the Course of the COVID-19 Pandemic Death Rate in the United States.

The COVID-19 pandemic, which began in China in late 2019, and subsequently spread across the world during the first several months of 2020, has had a dramatic impact on all facets of life. At the same time, it has not manifested in the same way in every nation. Some countries experienced a large initial spike in cases and deaths, followed by a rapid decline, whereas others had relatively low rates of both outcomes throughout the first half of 2020. The United States experienced a unique pattern of the virus, with a large initial spike, followed by a moderate decline in cases, followed by second and then third spikes. In addition, research has shown that in the United States the severity of the pandemic has been associated with poverty and access to health care services. This study was designed to examine whether the course of the pandemic has been uniform across America, and if not how it differed, particularly with respect to poverty. Results of a random intercept multilevel mixture model revealed that the pandemic followed four distinct paths in the country. The least ethnically diverse (85.1% white population) and most rural (82.8% rural residents) counties had the lowest death rates (0.06/1000) and the weakest link between deaths due to COVID-19 and poverty (b = 0.03). In contrast, counties with the highest proportion of urban residents (100%), greatest ethnic diversity (48.2% nonwhite), and highest population density (751.4 people per square mile) had the highest COVID-19 death rates (0.33/1000), and strongest relationship between the COVID-19 death rate and poverty (b = 46.21). Given these findings, American policy makers need to consider developing responses to future pandemics that account for local characteristics. These responses must take special account of pandemic responses among people of color, who suffered the highest death rates in the nation.

Changing trend in demographic characteristics of voluntary blood donors in Shandong, China / 中国输血杂志

【Objective】 To analyze the changes in demographic profile of voluntary blood donors from 2012 to 2019 in Shandong, so as to provide scientific basis for establishing effective recruitment strategy and promoting sustainable development of voluntary blood donation. 【Methods】 The demographic information of voluntary blood donors was obtained via the Shandong Blood Management Information System. The gender, age, occupation and education level of blood donors were descriptively analyzed. High socioeconomic status (SES) and low SES districts were defined according to GDP per capita, and the demographic characteristics of blood donors in the two districts were compared. 【Results】 The proportion of blood donors with a bachelor degree or above increased from 14.28% in 2012 to 20.81% in 2019, showing a significant increase in education level (P<0.01). The proportion of college students and medical staff increased from 14.82% and 2.36% in 2012 to 19.19% and 3.73% in 2019, respectively (P<0.01); the proportion of blood donors aged 26~35 years decreased by 8.82%, and those aged 46~60 years increased by 10.86% (P<0.01). The proportion of blood donors aged 18~25 years increased from 30.72% to 38.12% in high SES district, and decreased from 22.77% to 13.04% in low SES district. 【Conclusion】 The demographic profile of voluntary blood donors in Shandong showed significant changes during the past 8 years ( from 2012 to 2019), which may also exist in other areas in China. It is necessary to improve the recruitment strategies according to those changes, thus promot the sustainable and healthy development of voluntary blood donation.

IMPACT OF COMORBIDITIES IN MEXICAN SARS-COV-2-POSITIVE PATIENTS: A RETROSPECTIVE ANALYSIS IN A NATIONAL COHORT.

BACKGROUND: The coronavirus disease 2019 outbreak is a significant challenge for health-care systems around the world. OBJECTIVE: The objective of the study was to assess the impact of comorbidities on the case fatality rate (CFR) and the development of adverse events in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Mexican population. MATERIALS AND METHODS: We analyzed the data from 13,842 laboratory-confirmed SARS-CoV-2 patients in Mexico between January 1, 2020, and April 25, 2020. We investigated the risk of death and the development of adverse events (hospitalization, pneumonia, orotracheal intubation, and intensive care unit [ICU] admission), comparing the number of comorbidities of each patient. RESULTS: The patient mean age was 46.6 ± 15.6 years, 42.3% (n = 5853) of the cases were women, 38.8% of patients were hospitalized, 4.4% were intubated, 29.6% developed pneumonia, and 4.4% had critical illness. The CFR was 9.4%. The risk of hospitalization (odds ratio [OR] = 3.1, 95% confidence interval [CI]: 2.7-3.7), pneumonia (OR = 3.02, 95% CI: 2.6-3.5), ICU admission (OR = 2, 95% CI: 1.5-2.7), and CFR (hazard ratio = 3.5, 95% CI: 2.9-4.2) was higher in patients with three or more comorbidities than in patients with 1, 2, or with no comorbidities. CONCLUSIONS: The number of comorbidities may be a determining factor in the clinical course and its outcomes in SARS-CoV-2-positive patients.

Impact of comorbidities in mexican SARS-COV-2-positive patients: a retrospective analysis in a national cohort

ABSTRACT Background: The coronavirus disease 2019 outbreak is a significant challenge for health-care systems around the world. Objective: The objective of the study was to assess the impact of comorbidities on the case fatality rate (CFR) and the development of adverse events in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Mexican population. Materials and methods: We analyzed the data from 13,842 laboratory-confirmed SARS-CoV-2 patients in Mexico between January 1, 2020, and April 25, 2020. We investigated the risk of death and the development of adverse events (hospitalization, pneumonia, orotracheal intubation, and intensive care unit [ICU] admission), comparing the number of comorbidities of each patient. Results: The patient mean age was 46.6 ± 15.6 years, 42.3% (n = 5853) of the cases were women, 38.8% of patients were hospitalized, 4.4% were intubated, 29.6% developed pneumonia, and 4.4% had critical illness. The CFR was 9.4%. The risk of hospitalization (odds ratio [OR] = 3.1, 95% confidence interval [CI]: 2.7-3.7), pneumonia (OR = 3.02, 95% CI: 2.6-3.5), ICU admission (OR = 2, 95% CI: 1.5-2.7), and CFR (hazard ratio = 3.5, 95% CI: 2.9-4.2) was higher in patients with three or more comorbidities than in patients with 1, 2, or with no comorbidities. Conclusions: The number of comorbidities may be a determining factor in the clinical course and its outcomes in SARS-CoV-2-positive patients.

An analysis of depressive symptoms in stroke survivors: verification of a moderating effect of demographic characteristics.

BACKGROUND: The rehabilitation of depressed stroke patients is more difficult because poststroke depression is associated with disruption of daily activities, functioning, and quality of life. However, research on depression in stroke patients is limited. The aim of our study was to evaluate the interaction of demographic characteristics including gender, age, education level, the presence of a spouse, and income status on depressive symptoms in stroke patients and to identify groups that may need more attention with respect to depressive symptoms. METHODS: We completed a secondary data analysis using data from a completed cross-sectional study of people with stroke. Depression was measured using the Center for Epidemiologic Studies Depression Scale. RESULTS: In this study, depressive symptoms in women living with a spouse were less severe than among those without a spouse. For those with insufficient income, depressive symptom scores were higher in the above high school group than in the below high school group, but were lower in patients who were living with a spouse than in those living without a spouse. CONCLUSION: Assessing depressive symptoms after stroke should consider the interaction of gender, economic status, education level, and the presence/absence of a spouse. These results would help in comprehensive understanding of the importance of screening for and treating depressive symptoms during rehabilitation after stroke.

Factors related to the decision-making for moving the older adults into long-term care facilities in Taiwan.

AIM: To investigate the relationships between demographic characteristics of the elderly, type of long-term care (LTC) facilities, and the reasons for moving into LTC facilities. METHODS: Research participants included people aged over 65 years, living in LTC facilities. A total of 1280 questionnaires were distributed to 111 LTC facilities in Taiwan; 480 questionnaires were retrieved, and 232 were included in the valid sample. The study used a non-linear canonical correlation analysis, which assesses the relationships among similar sets of categorical variables. RESULTS: The results showed that the older adults in quadrant I were characterized by being involved in the decision-making regarding the choice of LTC facilities and received economic support from their children. The older adults in quadrant II mainly lived in LTC facilities to receive medical care, whereas those in quadrant III typically included individuals with low income, who did not choose to live in LTC facilities. Furthermore, those in quadrant IV had positive cognitions associated with LTC facilities. CONCLUSIONS: We believe that the results of the present study will facilitate policy-making in the field of LTC, provide reference to the practitioners and the older adults, and identify the types of decisions older adults make when moving into LTC facilities, thus assisting older adults to improve their strategies regarding staying in LTC facilities. Geriatr Gerontol Int 2017; 17: 1319-1327.

Spatially Analyzing the Inequity of the Hong Kong Urban Heat Island by Socio-Demographic Characteristics.

Recent studies have suggested that some disadvantaged socio-demographic groups face serious environmental-related inequities in Hong Kong due to the rising ambient urban temperatures. Identifying heat-vulnerable groups and locating areas of Surface Urban Heat Island (SUHI) inequities is thus important for prioritizing interventions to mitigate death/illness rates from heat. This study addresses this problem by integrating methods of remote sensing retrieval, logistic regression modelling, and spatial autocorrelation. In this process, the SUHI effect was first estimated from the Land Surface Temperature (LST) derived from a Landsat image. With the scale assimilated to the SUHI and socio-demographic data, a logistic regression model was consequently adopted to ascertain their relationships based on Hong Kong Tertiary Planning Units (TPUs). Lastly, inequity "hotspots" were derived using spatial autocorrelation methods. Results show that disadvantaged socio-demographic groups were significantly more prone to be exposed to an intense SUHI effect: over half of 287 TPUs characterized by age groups of 60+ years, secondary and matriculation education attainment, widowed, divorced and separated, low and middle incomes, and certain occupation groups of workers, have significant Odds Ratios (ORs) larger than 1.2. It can be concluded that a clustering analysis stratified by age, income, educational attainment, marital status, and occupation is an effective way to detect the inequity hotspots of SUHI exposure. Additionally, inequities explored using income, marital status and occupation factors were more significant than the age and educational attainment in these areas. The derived maps and model can be further analyzed in urban/city planning, in order to mitigate the physical and social causes of the SUHI effect.

Urinary concentrations of parabens and their association with demographic factors: A population-based cross-sectional study.

Parabens are broad-spectrum antimicrobial agents used in a range of consumer products, including personal care products, cosmetics, and food. Recently, the widespread use of parabens has raised concerns about the potential health risks associated with their endocrine-disrupting effect. In the present study, 2541 urine samples were collected and analyzed by liquid chromatography-mass spectrometry for the determination of the concentrations of methyl paraben (MeP), ethyl paraben (EtP), propyl paraben (PrP) and butyl paraben (BuP). The detection rate and geometric mean concentrations of parabens in the general population followed the order MeP (97.7%; 116ng/mL)>EtP (97.2%; 24.7ng/mL)>PrP (96.7%; 11.0ng/mL)>BuP (83.5%; 1.13ng/mL). The composition profiles showed that MeP and EtP accounted for >90% of the urinary paraben concentration. We performed statistical analysis in order to evaluate differences between demographic variables and urinary concentrations. Our results showed that adjusted proportional change of MeP, PrP, and BuP in adults were 2.67-6.13 times higher in females than in males. The urinary concentrations of PrP in adults increased significantly with age. The adjusted proportional changes of MeP and PrP in adults were associated with increased body mass index (BMI). The adjusted proportional changes of BuP and PrP in children and adolescents were 1.44 and 1.69 times higher in females than in males. However, there was no clear association between paraben concentrations and demographic variables in the children and adolescents groups. The estimated daily intake (EDIurine) of MeP and EtP in adults were 301µg/kg bw/day, which is lower than the acceptable daily intake (ADI; 10mg/kg bw/day). In summary, our results revealed that the general population in Korea was exposed to parabens during 2009-2010, and most Koreans are exposed to parabens. The urinary levels of parabens varied by age group with demographic factors in the Korean population. The results of study may be used to establish a nationally representative baseline of exposure to parabens in risk assessment.

Hospitalized pain patients have recently doubled: a retrospective case series study in Shenzhen Nanshan People's Hospital of China.

AIM: To study the characteristics of hospitalized pain patients in Shenzhen with the aim of identifying some of the social, economic and therapeutic aspects of pain management in China. METHODS: A retrospective study was designed to collect the information of 3061 hospitalized pain patients in 2003, 2007 and 2011. Their demographic characteristics, diagnoses of pain types, hospitalization, therapeutic effect, economic cost and payment types were analyzed. RESULTS: The number of female patients significantly increased with time. The patient's average age increased from 41.3 in 2003 to 49.7 years old in 2011. The most common diagnosis of pain was lumbar intervertebral disc herniation. The total hospitalization days of each patient per year significantly decreased from 15.7 days in 2003 to 10.4 days in 2011. However, the hospitalization cost for each patient was almost doubled. CONCLUSION: The hospitalized pain patients and their economic burdens have almost been doubled in the recent four years.

Relationship between Patient Demographic Characteristics, Valproic Acid Dosage and Clearance in Adult Iranian Patients.

OBJECTIVES: As there are conflicting findings regarding the clearance-dose and patient characteristics relationships for valproic acid (VPA), this study was conducted to investigate the relationship between patient demographic characteristics, VPA dosage and the drug clearance in adult Iranian patients. MATERIALS AND METHODS: Patients (N= 47) were either on monotherapy with VPA or were under co-treatment with drugs that have no effect on VPA pharmacokinetic (PK) profile. All of the patients received VPA at therapeutic dose. Steady state trough plasma concentrations of VPA were determined by Fluorescence Polarization Immunoassay (FPIA) and VPA apparent clearance (CL/F) were calculated in each patient. RESULTS: Mean VPA dose and VPA CL/F were 8.93±2.2 mg/kg/day and 0.65±0.55 l/hr respectively. No significant correlations were found between VPA CL/F and patients' age, TBW and VPA dose. VPA CL/F values of male and female patients were compared and no significant difference between these two groups was noted (P> 0.05). Significant correlation between VPA dose and total trough plasma concentration was found (P= 0.001). Mean total VPA plasma concentration was 54.51±23.74 mg/l. CONCLUSION: Our study showed PK of VPA was not affected by age, sex, TBW and VPA dose. However, for detailed results and construction of VPA PK model in Iranian patients, it is necessary to evaluate VPA PK in a larger sample size with different VPA doses, age and TBW ranges.

The Prevalence and Demographic Characteristics of Anterior Polar Cataract in a Hospital-Based Study in Korea

PURPOSE: Anterior Polar Cataract (APC) develops by a mechanism different from that of other age-related cataracts, and outside of Korea, it is an extremely rare condition. We investigated the prevalence and epidemiological characteristics of APC in Koreans. METHODS: The evaluation on the prevalence of APC in comparison to the other age-related cataracts was performed on the 2,108 cataract patients who were treated at 5 different areas in Korea from August 2003 to December 2003. The demographic characteristics of APC were studied on the, 656 cataract patients who were treated from January 2004 to January 2005 at one hospital. These patients were classified according to the type of lens opacity (nuclear, cortical, posterior subcapsular, mixed and APC). RESULTS: The prevalence of patients with APC among all the cataract patients was 6.02% during the 5 months in this hospital-based study. Eighty-seven per cent of patients with APC were male. In contrast, the proportion of female was greater than 50% in the other cataracts. The mean age of APC patients was 52.7 years. Among the APC patients, 38.9% were under 50 years of age, 42.6% in their 50s, 14.8% in their 60s, and 3.7% were in their 70s. However, 80% of patients were over the age of 60 years in nuclear, cortical, and mixed-type cataracts. CONCLUSIONS: The prevalence of APC among all cataracts was high in comparision with another country. The proportion of APC was high in individuals younger than 60 years of age, and in males.

Demographic characteristics of standardized patients (SPs) and their satisfaction and burdensome in Japan: The first report of a nationwide survey / 医学教育

SPs have made a dramatic development in medical education over 10 years, due to the influence of medical education curriculum reform and the introduction of the Objective Structured Clinical Examination. However the quality of SPs' activities varies. In order to increase the quality it is necessary to analyze the psychological needs of SPs. The purpose of this survey is to explore SPs' personal characteristics and how they feel during their activities.<BR>1) In a nationwide survey of Japanese SPs, 332 SPs (62%) out of 532 responded.<BR>2) Sixty percent of SPs were between the ages of 50 and 69 years and the ratio of male to female SPs was 1: 4. The ratio of workers and non-workers was 1: 2.<BR>3) A qualitative analysis found that SP motivations were derived mainly from making a contribution to society and self-improvement. Ninety six percent of SPs were satisfied with being an SP, especially when they saw improvements in the students.<BR>4) However, 67% of SPs expressed difficulty with the three core skills of feedback, evaluation and performance.