SOCIOECONOMIC FACTORS AND THE 2014-16 EBOLA VIRUS DISEASE OUTBREAK IN GUINEA, LIBERIA, AND SIERRA LEONE INTRODUCTION: Ebola virus disease (EVD) is an infectious disease transmitted by close contact with an estimated case fatality rate fluctuating around 50%. The most affected countries by the 2013-16 West African Ebola outbreak were Guinea, Liberia, and Sierra Leone. These countries reported a total of 28616 probable, suspected and confirmed cases. However, we are still learning about the sociodemographic factors that contributed to the outbreak characteristics at the subnational level. METHODS: Data were collected from the World Health Organization, Demographic Health Surveys, and Global Data Lab for 37 districts (8 for Guinea, 15 for Liberia, and 14 for Sierra Leone). The outcome of interest was epidemic size at the district level for Guinea, Liberia, and Sierra Leone (cumulative number of EVD patient confirmed and probable cases). Socio-demographic predictors included household density, sanitation level, mobility, and wealth status. We also controlled for the timing of the start of the outbreak across districts. Pearson’s correlation and multiple linear regression were employed in our analyses. Model building was informed by a review of the relevant literature. Sensitivity analyses were conducted to assess the impact of potential outliers. RESULTS: In the final multivariable regression model, wealth status and household density were positively associated with the epidemic size while sanitation level and the difference in the outbreak start dates were negatively associated with the outcome. These results did not change in the sensitivity analyses. The regression model explained 57% of the variance in epidemic size (Adj R-Sq=0.57), with the largest contribution from the international wealth index (semi-partial R-square=0.22). CONCLUSION: District sociodemographic characteristics such as household density, wealth and sanitation levels contributed to the EVD outbreak in Guinea, Liberia, and Sierra Leone, which is in agreement with recent studies. However, further research should consider other sociodemographic indicators as well as the role of migration and connectivity among regions.

The U.S. healthcare system is a complex segment of our society that is constantly evolving with changes to various areas such as education, financing, safety, and health. There continues to be a critical examination of how healthcare professionals are trained and utilized as healthcare demands increase. One category of healthcare professionals that has evolved over time to address societal needs is pharmacists. Pharmacists have kept their traditional function of dispensing medications while expanding into multiple areas of expertise and training from patient counseling and drug therapy, to being part of multidisciplinary teams treating acute care patients. According to the National Association of Boards of Pharmacy (NABP) in 2009 there were approximately 265,000 licensed pharmacists in the U.S. (NABP, 2010). The Health Resources and Services Administration (HRSA) reported the settings with the largest number of positions are chain pharmacies (77,300), hospitals (49,200), and independent pharmacies (36,200) (DHHS, 2008). The ratio of pharmacists per 100,000 population is expected to increase from 68.9 pharmacists per 100,000 population to 76.7 per 100,000 between 1995 and 2020 (Gershon, Cultice, & Knapp, 2000). This increase in the pharmacist to population ratio is consistent with a growth rate of 13% during this time period of time. Until 1998, the supply of pharmacists in the U.S. appeared to be in reasonable balance with demand. Market forces gradually upset the delicate balance between the supply of pharmacists and the demand for their services between 1998 and 2009. In particular, a precipitous increase in the volume of prescription written and filled during this time period contributed to upsetting this delicate balance between the supply of pharmacists and demand (Cooksey, Walton, Stankewicz, & Knapp, 2003). Researchers have noted a number of environmental factors affecting the pharmacist supply in the U. S. This inquiry explores these factors within the context of the population ecology theoretical framework. In addition to the volume of prescriptions, additional environmental factors believed to have a discernible impact on the pharmacist supply include, the number of physicians, size of the business industry and insurance coverage. Previous studies on pharmacists supply have pointed to income, physician population, and population among other variables that predict the demand for pharmacists (Walton, Cooksey, Knapp, Quist, & Miller, 2004; Cherry, D.K., Woodwell, D.A., & Rechtsteiner 2007; Walton, Knapp, Miller, & Schumock 2007). U. S. physicians wrote over 4 billion prescriptions in 2007 (Medical Expenditure Panel Survey, 2008). Physicians are the primary healthcare providers that generate prescriptions to be filled. Consequently, the number of physicians is believed to be a significant environmental factor affecting the supply of pharmacists. There were approximately 940,000 physicians in the U. S. in 2008. Projections call for continuous growth of the number of physicians well into the future (Smart, 2010). Another important environmental factor potentially impacting the demand for pharmacists is the size of the business industry. In 2006, the health plan offer rate for large or medium organizations (50 or more employees) was 96.7% compared to 61.2% for small organizations (50 or less employees) (Sommers & Crimmel, 2008; Crimmel & Sommers, 2008). Insurance cov¬erage has the potential to have a positive impact on the demand for pharmacists because it provides the opportunity to obtain required prescriptions (Ranji, Wyn, Salganicoff, & Yu, 2007; Weinick, Byron, & Bierman, 2005). The population ecology theoretical framework has been used in the study of restaurants, newspapers, and physicians and their interactions with their surrounding environments. The theoretical framework proved to be beneficial in the exploration of the pharmacist supply vis-á-vis the environment. The primary constructs in the population ecology theory are carrying capacity and density. Carrying capacity consists of two sub-constructs: munificence and concentration. Density points to the current pharmacists supply and its impact on the future pharmacist supply. Numerous variables have been used in previous empirical studies of the pharmacist supply. Among the indicators of munificence in previous studies in the extant literature on pharmacist supply are total population, elderly population, hospitals, and median household income. In the present inquiry, total population was found to be a statistically significant environmental factor affecting the pharmacist supply. This was hypothesized that there is a positive linear relationship between total population and the pharmacist supply. The number of hospitals with pharmacies was also found to be a statistically significant environmental factor affecting the pharmacist supply. Hospital pharmacies are important venues wherein pharmacists can demonstrate their unique expertise and make discernible contributions to desirable health care outcomes when pharmaceutical interventions are required. In light of this empirical finding, it seems reasonable that a growth in hospital pharmacies corresponds with an increased demand for pharmacists (Kaboli, Hoth, McClimon, & Schnipper, 2006). Measures of the concentration dimension included the number of hospital beds per 100,000 population, employer volume and size and the number of insured. The only putative indicator of concentration that was found to be statistically significant in this inquiry was the number of employers with 20 or more employees. Previous pharmacist supply was found to be a significant environmental factor affecting the pharmacist supply in the future. Thus, density is a significant environmental factor affecting the pharmacist supply. Five of the 13 hypotheses tested in this inquiry were accepted. These findings are consistent with related findings in the extant literature on the pharmacist supply. Empirical findings from this inquiry are believed to make significant contributions to the literature on the pharmacist supply. The population ecology theoretical framework appears to be a suitable tool for exploring environmental factors affecting the pharmacist supply. Recommendations for future research are presented in the final chapter.

Background: Chronic pain is prevalent worldwide and is estimated to range from 2% to 55% in the general population. There is a limited understanding of the prevalence and incidence of chronic pain in Canada. Furthermore, our understanding of the sociodemographic predictors of chronic pain is limited; thus we are poorly positioned to identify potential populations at risk. Objectives: The primary objectives for this study included: 1) to determine the prevalence and incidence of chronic pain and pain-related interference in Canada over time and, 2) to determine the influence of sociodemographic predictors on the development of chronic pain by sex in the Canadian adult population over 12 years. Methods: Using data from the cross-sectional components of the National Population Health Survey (NPHS) (1994/95, 1996/97, 1998/99) and the Canadian Community Health Survey (2000/01, 2003, 2005, 2007/08), we examined the prevalence and interference of chronic pain. The longitudinal component of the NPHS was used to determine the incidence and sociodemographic predictors of chronic pain. Chronic pain was defined as the presence of “usual pain”. Results: The prevalence in the cross-sectional samples ranged from 15.1% to 18.9%. In the longitudinal sample, the incidence ranged from 5.4% to 7.8% and the prevalence ranged from 15.3% to 19.5%. Women, compared to men, had a higher prevalence, but not incidence of chronic pain each year. Of those individuals reporting chronic pain, the majority reported at least a few activities prevented. Women who were older, with lower education, and widowed, separated, or divorced were more likely to develop chronic pain. There were no sociodemographic risk factors for chronic pain in men. Conclusion/Implications: This population-based study supports previous research findings indicating that chronic pain affects daily activities of many Canadians. Furthermore, this is the first population-based prospective study examining the incidence and sociodemographic predictors of chronic pain in Canadians. Further study with more detailed definitions of pain and pain-related interference is warranted. Moreover, our findings suggest that older women are more likely to develop chronic pain and that men and women may have different risk factors for chronic pain, suggesting the need for gender-based preventative interventions. / Thesis (Master, Nursing) -- Queen's University, 2010-07-20 13:38:13.996

No description available.

Individual growth curve (IGC) modeling evaluated longitudinal trajectories of glycemic control and diabetes care of youth with Type 1 Diabetes (T1D) over three years. IGC modeling allowed comparison of confounded sociodemographic predictors of disease outcomes that included ethnicity, SES, parent marital status, family structure, as well as disease duration, to determine the relative impact of these factors in the evolution of HbA1c and diabetes care throughout adolescence. At baseline, participants recruited from two pediatric endocrinology clinics included 198 youth, ages 9-15 (M age = 12.65, 77% Caucasian, 74% lived with married biological parents, M SES = 45.70) with average HbA1c of 8.43% and reported diabetes care behaviors consistent with ADA recommendations. Glycemic control did not deteriorate significantly, but IGC modeling detected a trend of a steady decline in HbA1c of .01% each year. Youth with married biological parents had HbA1c levels approximately 1.23% lower than youth with alternative parent marital status throughout adolescence, t = 4.03, p < .001, although an age by marital status interaction, t = -2.34, p < .05, indicated the impact of parent marital status on HbA1c decreased at age 17. Analyses revealed significant annual declines in blood glucose monitoring frequency, t = -7.61, p < .001, eating frequency, t = -9.04, p < .001, and exercise frequency, t = -7.87, p < .001. Alternatively, the consumption of carbohydrates and fats remained relatively stable throughout adolescence. Consideration of sociodemographic predictors and disease duration further clarified trajectories of disease care behaviors. Throughout adolescence, African American youth reported lower blood glucose monitoring frequency than Caucasian youth. Youth with lower SES exercised less frequently and demonstrated poorer dietary consumption than youth with higher SES. Youth from families with alternative parent marital status ate and exercised less frequently compared to youth from married biological families. However, youth from single-parent homes exercised more frequently than those from two-parent homes. Longer disease duration related to declines in blood glucose monitoring frequency, yet better dietary consumption. Results may inform development of interventions for youth at risk of poor glycemic control and diabetes management across ethnicity, SES, and parent marital status groups.

Adult physical activity is important for prevention of chronic diseases and to minimize health issues; therefore, the motivational influences of sociodemographic variables on participation in organized physical activity events warrant an investigation. The purpose of this quantitative study was to investigate differences in motivational influences between various sociodemographic variables as related to physical activity events in organized settings. The theoretical framework that guided this research study consisted of the theory of reasoned action (TRA), and the health belief model (HBM). The TRA was applied to study the intention of health behavior, while the HBM was used to investigate individuals' motivation to engage in organized physical activity events. A cross-sectional study design in which an online survey consisting of the 40 item Physical Activity and Leisure Motivation Scale was used to collect data from adults who participated in an organized 5K or 10K running or walking event. The inferential statistical tests of the independent t test, one-way ANOVA, and ordinal logistic regression were used to determine the statistical relationships. The main research finding suggested that 6 motivational influences showed statistically significant relationship with organized physical activity events, which consisted of others' expectations (p = .025), competition/ego (p = .001), appearance (p = .001), affiliation (p = .034), mastery (p = .001), and psychological condition (p = .002) as it relates to their age group and gender. The research findings may be used to influence engagement in future organized physical activity events by understanding the sociodemographic variables relating to participation rates that may result in increased physical activity behavior within the community.

Kūdikio maitinimas krūtimi yra natūralus fiziologinis procesas, bet turintis svarbų biologinį bei emocinį poveikį motinos ir vaiko sveikatai, tačiau daugelis besilaukiančių moterų renkasi kūdikių maitinimą pieno pakaitalais. Maitinimas krūtimi - sąmoningas procesas, kuriam būtinas motinos apsisprendimas. Šį pasirinkimą daugiausia lemia būsimosios mamos požiūris į kūdikio maitinimo būdus. Remiantis nėščiųjų asmeninio požiūrio modeliu, analizuojamas maitinimo krūtimi ar buteliuku privalumų ir trūkumų suvokimas bei socialinis palaikymas, kuris galimai įtakoja moters asmeninį požiūrį. Tikslas - nustatyti nėščių moterų požiūrio į maitinimo krūtimi sąsajas su sociodemografiniais rodikliais ir socialiniu palaikymu. Tiriamieji – 103 nėščiosios, besilankančios Mažeikių pirminės sveikatos priežiūros centre „Sveikata šeimai“. Tiriamųjų amžiaus vidurkis – 24 metai, vidutinė nėštumo trukmė – 20 savaičių. Matavimo priemonės – naudota penkių klausimynų anketa. Pirmoji sudaryta iš klausimų apie moters sociodemografinius rodiklius. Požiūrio įvertinimui skirtas Dungry požiūrio į kūdikio maitinimą krūtimi klausimynas (Dungry, 1994, pagal Shaker ir kiti, 2004), o įvairiems požiūrio aspektams nustatyti naudotas Chabrol (Chabrol ir kiti, 2004) požiūrio į maitinimo būdus klausimynas. Ketvirtas – Glazier (2002) sukonstruotas suvokiamo galimo socialinio palaikymo klausimynas, kuris kaip ir McLeod (2006) sukurtas medicinos specialistų suvokiamo palaikymo klausimynas yra pritaikyti specialiai... [toliau žr. visą tekstą] / Breastfeeding is natural physiological process, which have significant biological and emotional impact on mother’s and infant’s health but a lot of pregnant women choose to bottle-feed. Breastfeeding -conscious process, requireing mothers’s decision. This decision is influenced most by expectant woman’s attitude. According to pregnant women’s personal attitudes model was analized perception of breastfeeding or bottlefeeding advantages and disadvantaged and social support as it may possibly influence mother’s personal attitude. Purpose – to identify interface of pregnant women attitudes toward breastfeeding with sociodemographic factors and social support. Contingent – 103 pregnant women, attending prime health care center “Sveikata šeimai“ in Mažeikiai. Respondent’s mean age – 24 years, mean pregnancy term – 20 weeks. Measures – Used five questionnaire form. First – questions about women’s sociodemographic indexes. Dungry’s infant feeding attitude scale was used to assess women’s attitude toward breastfeeding, Chabrol infant feeding quoestionary helped to identify various attitude aspects. Forth – questionary of perceived social support, made-up by Glazier (2002), adapted specialy for pregnant women as questionary of perceived social support of health care providers (McLeod, 2006). Results – it was observed that 30% respondents sure or surely will bottlefeed their infant. After analysis, results showed that decision to breastfeed is linked with more positive attitude... [to full text]

Submitted by Oliveira Santos Dilzaná (dilznana@yahoo.com.br) on 2016-05-06T12:41:53Z No. of bitstreams: 1 Dissertação Quele de Souza Gomes Santos.pdf: 996061 bytes, checksum: fe62269601dbabb818880759138ef74d (MD5) / Approved for entry into archive by Oliveira Santos Dilzaná (dilznana@yahoo.com.br) on 2016-05-11T13:38:24Z (GMT) No. of bitstreams: 1 Dissertação Quele de Souza Gomes Santos.pdf: 996061 bytes, checksum: fe62269601dbabb818880759138ef74d (MD5) / Made available in DSpace on 2016-05-11T13:38:25Z (GMT). No. of bitstreams: 1 Dissertação Quele de Souza Gomes Santos.pdf: 996061 bytes, checksum: fe62269601dbabb818880759138ef74d (MD5) / O envolvimento paterno é um fenômeno complexo, influenciado por fatores individuais, contextuais e culturais, porém, existem controvérsias acerca do impacto desses fatores sobre a forma como o pai participará das atividades e cuidados que envolvem a criança. Nesse sentido, o objetivo deste estudo foi caracterizar o envolvimento paterno em pais de diferentes níveis socioeconômicos: nível socioeconômico alto, médio e baixo. Esperava-se que os pais de nível socioeconômico alto apresentassem maiores níveis de envolvimento paterno do que os pais de nível socioeconômico médio que, por sua vez, apresentariam maior níveis de envolvimento paterno do que os pais de nível socioeconômico baixo. Participaram do estudo 81 pais de crianças entre 4 e 6 anos de idade, de ambos os sexos, recrutados em escolas, organizações públicas e privadas da cidade do Salvador. Os pais foram divididos em três grupos de níveis socioeconômicos (NSE): NSE baixo (n= 31), NSE médio (n= 21) e NSE alto (n= 29). Para mensurar o envolvimento paterno foi utilizado o Questionário de Engajamento Paterno (QEP) e para avaliar o status socioeconômico da família foi utilizada a Escala Hollingshead (1975). A análise dos dados foi realizada através de procedimentos estatísticos descritivos e dos testes correlação de Pearson, ANOVA, ANCOVA e Kruskal-Wallis. Os resultados não indicaram diferenças entre os três grupos de NSE, exceto na dimensão cuidados básicos. Contudo, foram identificadas correlações positivas entre a escolaridade materna e paterna, a renda familiar, a idade paterna e materna e a dimensão cuidados básicos, bem como entre a escolaridade paterna e materna e escore total do QEP. Adicionalmente, foi encontrada uma correlação positiva entre a carga horária de trabalho semanal materna e a dimensão disciplina, assim como correlações negativas entre a quantidade de pessoas que moravam na casa e o envolvimento do pai em atividades de suporte emocional e jogos físico. Apesar de o nível socioeconômico enquanto variável composta por diferentes indicadores combinados, não impactar diretamente na maior parte das dimensões do envolvimento paterno, os componentes específicos do NSE como escolaridade, renda e carga horária de trabalho semanal materna, foram variáveis relevantes para a compreensão do envolvimento paterno. Ressalta-se a importância de se continuar investigando o papel do pai, bem como as crenças e mecanismos culturais que podem mediar as diferentes formas com que os homens têm vivenciado novas atribuições no contexto familiar. Paternal involvement is a complex phenomenon, influenced by personal, contextual and cultural factors; however, there are controversies about the impact of these factors on how fathers participate in activities and care involving the child. In this way, the goal of this study was to characterize the involvement of fathers in families with different socioeconomic status: low, middle and high. It was expected that high socioeconomic fathers related to higher levels of parental involvement than middle socioeconomic fathers, who, in turn, related to higher levels of parental involvement than low socioeconomic fathers. In this study, participated 81 fathers of children from four to six years old, from both sexes, recruited in public and private schools in the city of Salvador, Bahia. The fathers were divided into three groups of socioeconomic status (SES): low SES (n= 31), middle SES (n= 21) and high SES (n= 29). The Paternal Engagement Questionnaire (PEQ) was used to measure the father’s involvement, and the Hollingdshead Scale (1975) was used to measure the socioeconomic status of the family. Data analysis was conducted through descriptive statistics procedures and the Pearson correlation tests, ANOVA, ANCOVA and Kruskal-Wallis. Results show no differences in the groups, with the exception of the dimension basic care. Nevertheless, it was identified positive correlations between the age and education of the mother and the father, the income and the dimension basic care, as well as mother’s and father’s education and the total score on PEQ. Additionally, it was found a positive correlation between the mother’s weekly workload and the dimension discipline, as well as negative correlations between the number of individuals living in the house and the father’s involvement in emotional support activities and physical games. Although the socioeconomic status, as a variable composed by different factors combined, constituted as a factor with no influence in the majority of the father’s involvement dimensions, specific components from the SES, such as education, income and mother’s weekly workload, contributed as important variables for understanding the father’s involvement. The importance to continue investigating the role of the father is emphasized, as well as the beliefs and cultural influences that may play a mediator role on the different ways men have experienced new attributions in the family context. Key-words:

This thesis deals with the subject of life goals. It presents selected life goal theories and possible life goal classifications. Attention is also paid to developmental characteristics of life goals in the context of Theories of life-span development. Another related subject is meaningfulness of life - which is closely related to life goals. It outlines philosophical roots of this concept and some psychological theories. The last subject of the theoretical part is psychological construct of well-being, which is presented by selected theories. Empirical part of this thesis is trying to verify the hypothesis that there is a significant difference between the content of important goals of younger and older adults. It also examines the connexion between intrinsic and extrinsic aspirations and Life satisfaction. In order to attain this aim, we used two methods trough two different questionnaires - Satisfaction with Life Scale and Aspiration Index (AI). Samples were made by assessing answers of 962 Czech adult respondents, and the survey packet was distributed to participants online. We found significant differences between younger and older adults in the importance attributed to different goals which concerned: Affiliation, Sense of community, Physical health, Financial Success, Image, Popularity,...

The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship.Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants.There is an association between the female gender and the intention to choose Obstetrics/ Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.