In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on t...In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on the proposed model,the complex system of network connections and formal and informal financial transactions,which households use in their daily lives to cover their expenses,becomes graspable.The proposed theoretical model is analyzed through simulations based on agent-based modelling(ABM)centred on empirical network data.Through the simulations,the author explores the mechanisms of the market and asks what formal and informal credit transactions determine its operation,how these factors shape the local social structure and how resilient the market is to crises.The results show that this dynamic,complex risk-sharing system has an inherent logic and it can mitigate the small liquidity shocks but it is not resistant to bigger financial shocks or overconsumptions.展开更多
This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descr...This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.展开更多
Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors inclu...Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.展开更多
Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages a...Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.展开更多
Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disp...Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.展开更多
Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. ...Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.展开更多
In the context of China’s ongoing efforts to promote countryside revitalization and facilitate domestic economic circulation,it is of great significance to reduce the consumption disparity among rural households and ...In the context of China’s ongoing efforts to promote countryside revitalization and facilitate domestic economic circulation,it is of great significance to reduce the consumption disparity among rural households and unleash the consumption potential in the countryside.Based on data from China Family Panel Studies,this paper adopts a staggered difference-in-differences method to assess the impact of the e-commerce to enter rural areas on the consumption disparity among rural households.Findings:the comprehensive demonstration work of promoting e-commerce to enter rural areas has reduced the consumption disparity among rural households through the following mechanisms.Firstly,this policy initiative has mitigated the consumption-inhibiting effect on rural household consumption due to the local market size and external market accessibility by promoting the distribution of consumer goods to villages.Secondly,this policy initiative has also increased the agricultural income of rural households and reduced their consumption disparity by distributing farm produce to cities and enhancing the agricultural income of rural households.Moreover,the work is characterized by inclusive growth and is not susceptible to the“elite capture”phenomenon.展开更多
Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centr...Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.展开更多
Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing ...Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.展开更多
This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into t...This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into the economic benefits experienced by low-income households in the context of rural tourism development.Based on field research conducted from April 8,2023,to May 17,2023,including interviews and site visits,the study constructs an evaluation index system to assess the influencing factors.Through expert scoring and the application of a weighted set-valued mathematical statistical model,the importance and quantification of each factor are determined.The results indicate that the current stage of promoting shared prosperity through rural tourism in Yinan County is primarily influenced by the scale of tourist consumption of external visitors.This factor outweighs others such as the participation capacity and willingness of low-income households,the capacity of investment enterprises,and the policies and financial allocation of the local government.The findings emphasize the significance of external visitor spending and highlight the need to address the obstacles faced by low-income households in accessing economic benefits.The evaluation index system and measurement model presented in this study offer a scientific basis for assessing and improving the income situation of low-income households in rural tourism development initiatives.However,it is crucial to note that the importance of these influencing factors may evolve with the lifecycle of the tourism destination.Future research should include long-term tracking and consider a broader range of indicators to deepen our understanding of their mechanisms and significance.Furthermore,alternative approaches and theories may provide valuable perspectives for further exploration in this field.展开更多
Agriculture is one of the priority sectors in Timor-Leste. Introducing new agriculture technology is crucial to enhance agricultural production. Practicing cattle fattening can increase beef cattle body weight and gen...Agriculture is one of the priority sectors in Timor-Leste. Introducing new agriculture technology is crucial to enhance agricultural production. Practicing cattle fattening can increase beef cattle body weight and generate income to the beef cattle farmers. As farmers face problems including agricultural production decline, lack of forages and information and weather unfavourable. The study’s purpose was to examine the impact of adoption of cattle fattening technology on farmer households in Atabae administrative post, Bobonaro municipality in Timor-Leste. There were 200 beef cattle farmers households where randomly selected in four villages in Atabae. It consisted of 65 farmers practicing cattle fattening and 135 farmers non-practicing cattle fattening. Face to face interviews used structured questionnaire. Statistical analysis such as t-test and descriptive analysis were used to examine impact adoption of cattle fattening technology by farmers and factor constraints of cattle production and the solutions of it. The results indicated the average value of cattle and profit were significant different from zero and it is associated with practicing of cattle fattening. The average of labour used on cattle activities, the average of cattle sold, and total cost spent on cattle were not significant different from zero. The percentage of farmers said that factors constraints cattle production were shortage of water and forage (53%) and spend time on culture ceremony and lack of capital (33%). The number of farmers said that they collected water from river, feed cattle with sago and forage (55.3%) and cultivated forage (23.4%). This finding contributes information to the farmers, traders, and Timorese government to continue implementing cattle fattening activities as it enhances farmers’ income and developing cattle production.展开更多
As urbanization and population growth continue to increase in Freetown, due to changes in economic, social, environmental, political, and demographic factors, the municipal solid waste (MSW) generation also continues ...As urbanization and population growth continue to increase in Freetown, due to changes in economic, social, environmental, political, and demographic factors, the municipal solid waste (MSW) generation also continues to increase, making its management difficult for the municipal authority. Efficient separation and storage of solid waste at the source of generation can boost resource and energy recovery from MSW. This study examines the municipal solid waste management (MSWM) process, focusing on generation, storage and separation practices among households and their impact on the environment in Freetown. It emphasizes the inclusion of MSWM programs in primary schools to raise public awareness, the implementation of effective waste management practices, and the enforcement of related policies to enhance the MSWM sector, contributing to sustainable MSWM in Freetown. By utilizing both qualitative and quantitative methods, 393 structured questionnaires were administered across three selected sections to collect data on household solid waste storage and separation practices. The analysis employed descriptive statistics, using Origin-Pro9 and MS Excel. The findings show that with a population of 1.53 million people in Freetown, the per capita solid waste generation is 0.58 kg per day. The findings also show that 97% of the households have storage facilities as a result of the increase in awareness and education about the proper storage of solid waste. However, 96% of respondents do not practice separation of solid waste at the source of generation, which has become a concern among researchers in Sierra Leone. Additionally, 88% of respondents are unaware of ISWM principles, with only 12% aware, most of whom have received some education on proper solid waste management. The study recommends improving MSWM in Freetown to protect public health and the environment.展开更多
Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic disea...Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.展开更多
With the rapid development of rural tourism in China, more and more rural households operate a rural tourism business. The purpose of this study is to understand the energy consumption characteristic of ordinary rural...With the rapid development of rural tourism in China, more and more rural households operate a rural tourism business. The purpose of this study is to understand the energy consumption characteristic of ordinary rural households (ORHs) and rural tourism households (RTHs) in the mountainous area and islands area in Zhejiang province. 225 households were surveyed, including 185 ORHs and 40 RTHs, based on a field survey in Quzhou (mountainous area) and Zhoushan (islands area). Results reveal that energy consumption of ORHs is low, but energy comsumption of RTHs is high, about 3 to 5 times higher than that of ORHs. Given the results, the government and RTHs should pay more attention to take measures to reduce energy comsumption. Meanwhile, the factors affecting households’ energy consumption are also analyzed. Energy consumption of ORHs is affected by frequently used area, family income level and permanent population. Then energy consumption of RTHs is mainly related to the total building area, number of air conditioner (AC), number of guestrooms and family income level.展开更多
In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing p...In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.展开更多
This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cas...This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cash crops,an endogenous treatment regression model that accounts for potential selection bias issue is used to analyze the data.The empirical results show that cash crop cultivation exerts a positive and statistically significant impact on household income,but it does not affect household migration decisions significantly.The disaggregated analyses reveal that cash crop cultivation significantly increases farm income but decreases off-farm income.展开更多
BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key ...BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income individuals.This study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income participants.Our working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income participants.AIM To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United States.METHODS This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United States and with over 2.8 million responses.The period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent variables.Secondary analyses included stratification of the access by ethnicity/race,income,and education status.RESULTS A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blacks,or Multiracial.There was an increase in utilization across all educational levels.This was significant among those who reported having a high school graduate degree or more+4.26%(95%CI:3.16,5.35)compared to some high school or less+1.59%(95%CI:-1.37,4.55).CONCLUSION Medicaid expansion under the Affordable Care Act led to an overall increase in self-reported use of CRC screening tests by adults aged 50-64 years in the United States.This finding was consistent across all low-income populations,but not all races or levels of education.展开更多
Climate change impact and risks on agricultural livelihood affect women and men disproportionately and often to the disadvantage of women and girls. Consequently, this study assessed gender perspectives of vulnerabili...Climate change impact and risks on agricultural livelihood affect women and men disproportionately and often to the disadvantage of women and girls. Consequently, this study assessed gender perspectives of vulnerability to climate change of farming households at Ikpayongo community in Gwer local government area, Benue State, Nigeria using descriptive approach. The study identified a total of 120 male-headed and female-headed farming households across four neighbourhoods and administered structured questionnaire on them using simple random sampling method, while data analysis was done using descriptive statistics. The results indicate lower education and income status among female-headed households, though male-headed households have high household size. Both sexes have relatively equal access to land for farming, however men have large farm size compared to women. The major crops cultivated by men were rice and yam, while women cultivated largely groundnut and cassava. Women are more exposed and sensitive to climate-related hazards such as floods and heat stress due to the location of their farms. The result further shows that males possess better adaptive capacity given their higher incomes, social networks and more access to training/capacity building programmes and credit facilities. The study concludes that female-headed farming households are more vulnerable to climate change and variability than male-headed farming households due to higher exposure and a lower adaptive capacity. Programme and policies to improve women access to credit facilities and relevant training to boost their adaptive capacity and build resilience are highly recommended. This would also limit exposure with attendant reduction in vulnerability.展开更多
Ethnic Tibetans(ETs)typically reside in the remote plateaus of China and possess strong cultural and spiritual values.Their financial decision-making is influenced by economic and physical factors,unique culture,socia...Ethnic Tibetans(ETs)typically reside in the remote plateaus of China and possess strong cultural and spiritual values.Their financial decision-making is influenced by economic and physical factors,unique culture,social norms,and psychological motivators.We conducted an in-person survey of 480 randomly selected ET households across four provinces in rural China.The survey data was analyzed using three different econometric models—probit,ordered probit,and ranked ordered logit—to examine the choice of borrowing from formal or informal credit sources,the number of sources borrowed from,and repayment priority.Our findings indicate that mental accounting plays a significant role in the financial decision-making process of ET households.Additionally,we find that the informal credit source is strongly associated with the financial decisions of ET households.The majority of loans from formal financial institutions are used to meet daily needs,as opposed to purchasing productive inputs.Our results also suggest that strong social relationships and religious beliefs prevent households from defaulting,and that loans from formal financial sources receive repayment priority.China would benefit from promoting inclusive finance and encouraging the adoption of improved agricultural practices to support the prosperity of ET and other minority communities.展开更多
基金supported by the Hungarian National Research Fund,in the framework of the research project“Moralities of dependent relations in the era of financialisation”under Grant No.K-143543。
文摘In this paper,a theoretical model is developed on the basis of systems theory,which structures the livelihood system of low-income households in a European country characterized by a semi-peripheral economy.Based on the proposed model,the complex system of network connections and formal and informal financial transactions,which households use in their daily lives to cover their expenses,becomes graspable.The proposed theoretical model is analyzed through simulations based on agent-based modelling(ABM)centred on empirical network data.Through the simulations,the author explores the mechanisms of the market and asks what formal and informal credit transactions determine its operation,how these factors shape the local social structure and how resilient the market is to crises.The results show that this dynamic,complex risk-sharing system has an inherent logic and it can mitigate the small liquidity shocks but it is not resistant to bigger financial shocks or overconsumptions.
文摘This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.
文摘Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.
基金Under the auspices of the China Social Science(No.21BJY218)National Natural Science Foundation of China(No.41801113)Newcomer funding from Institute of Geographic Sciences and Natural Resources Research,Chinese Academy of Sciences(No.E0V00100)。
文摘Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.
文摘Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.
文摘Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.
基金National Natural Science Foundation of China(NSFC)Youth Project“Research on Household Debt Behavior and Its Impact on Economic Inequality in the Context of Common Prosperity”(Grant No.72203136),the Youth Project of the Guangdong Planning Office of Philosophy and Social Science(GDPOPSS)“E-commerce Development and Consumption Disparity of Rural Households:Theoretical Mechanism,Empirical Test and Policy Optimization”(Grant No.GD24YYJ27).
文摘In the context of China’s ongoing efforts to promote countryside revitalization and facilitate domestic economic circulation,it is of great significance to reduce the consumption disparity among rural households and unleash the consumption potential in the countryside.Based on data from China Family Panel Studies,this paper adopts a staggered difference-in-differences method to assess the impact of the e-commerce to enter rural areas on the consumption disparity among rural households.Findings:the comprehensive demonstration work of promoting e-commerce to enter rural areas has reduced the consumption disparity among rural households through the following mechanisms.Firstly,this policy initiative has mitigated the consumption-inhibiting effect on rural household consumption due to the local market size and external market accessibility by promoting the distribution of consumer goods to villages.Secondly,this policy initiative has also increased the agricultural income of rural households and reduced their consumption disparity by distributing farm produce to cities and enhancing the agricultural income of rural households.Moreover,the work is characterized by inclusive growth and is not susceptible to the“elite capture”phenomenon.
文摘Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.
文摘Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.
基金This research is supported by the National Social Science Fund of China(Grant No.21BGL150).
文摘This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into the economic benefits experienced by low-income households in the context of rural tourism development.Based on field research conducted from April 8,2023,to May 17,2023,including interviews and site visits,the study constructs an evaluation index system to assess the influencing factors.Through expert scoring and the application of a weighted set-valued mathematical statistical model,the importance and quantification of each factor are determined.The results indicate that the current stage of promoting shared prosperity through rural tourism in Yinan County is primarily influenced by the scale of tourist consumption of external visitors.This factor outweighs others such as the participation capacity and willingness of low-income households,the capacity of investment enterprises,and the policies and financial allocation of the local government.The findings emphasize the significance of external visitor spending and highlight the need to address the obstacles faced by low-income households in accessing economic benefits.The evaluation index system and measurement model presented in this study offer a scientific basis for assessing and improving the income situation of low-income households in rural tourism development initiatives.However,it is crucial to note that the importance of these influencing factors may evolve with the lifecycle of the tourism destination.Future research should include long-term tracking and consider a broader range of indicators to deepen our understanding of their mechanisms and significance.Furthermore,alternative approaches and theories may provide valuable perspectives for further exploration in this field.
文摘Agriculture is one of the priority sectors in Timor-Leste. Introducing new agriculture technology is crucial to enhance agricultural production. Practicing cattle fattening can increase beef cattle body weight and generate income to the beef cattle farmers. As farmers face problems including agricultural production decline, lack of forages and information and weather unfavourable. The study’s purpose was to examine the impact of adoption of cattle fattening technology on farmer households in Atabae administrative post, Bobonaro municipality in Timor-Leste. There were 200 beef cattle farmers households where randomly selected in four villages in Atabae. It consisted of 65 farmers practicing cattle fattening and 135 farmers non-practicing cattle fattening. Face to face interviews used structured questionnaire. Statistical analysis such as t-test and descriptive analysis were used to examine impact adoption of cattle fattening technology by farmers and factor constraints of cattle production and the solutions of it. The results indicated the average value of cattle and profit were significant different from zero and it is associated with practicing of cattle fattening. The average of labour used on cattle activities, the average of cattle sold, and total cost spent on cattle were not significant different from zero. The percentage of farmers said that factors constraints cattle production were shortage of water and forage (53%) and spend time on culture ceremony and lack of capital (33%). The number of farmers said that they collected water from river, feed cattle with sago and forage (55.3%) and cultivated forage (23.4%). This finding contributes information to the farmers, traders, and Timorese government to continue implementing cattle fattening activities as it enhances farmers’ income and developing cattle production.
文摘As urbanization and population growth continue to increase in Freetown, due to changes in economic, social, environmental, political, and demographic factors, the municipal solid waste (MSW) generation also continues to increase, making its management difficult for the municipal authority. Efficient separation and storage of solid waste at the source of generation can boost resource and energy recovery from MSW. This study examines the municipal solid waste management (MSWM) process, focusing on generation, storage and separation practices among households and their impact on the environment in Freetown. It emphasizes the inclusion of MSWM programs in primary schools to raise public awareness, the implementation of effective waste management practices, and the enforcement of related policies to enhance the MSWM sector, contributing to sustainable MSWM in Freetown. By utilizing both qualitative and quantitative methods, 393 structured questionnaires were administered across three selected sections to collect data on household solid waste storage and separation practices. The analysis employed descriptive statistics, using Origin-Pro9 and MS Excel. The findings show that with a population of 1.53 million people in Freetown, the per capita solid waste generation is 0.58 kg per day. The findings also show that 97% of the households have storage facilities as a result of the increase in awareness and education about the proper storage of solid waste. However, 96% of respondents do not practice separation of solid waste at the source of generation, which has become a concern among researchers in Sierra Leone. Additionally, 88% of respondents are unaware of ISWM principles, with only 12% aware, most of whom have received some education on proper solid waste management. The study recommends improving MSWM in Freetown to protect public health and the environment.
文摘Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.
文摘With the rapid development of rural tourism in China, more and more rural households operate a rural tourism business. The purpose of this study is to understand the energy consumption characteristic of ordinary rural households (ORHs) and rural tourism households (RTHs) in the mountainous area and islands area in Zhejiang province. 225 households were surveyed, including 185 ORHs and 40 RTHs, based on a field survey in Quzhou (mountainous area) and Zhoushan (islands area). Results reveal that energy consumption of ORHs is low, but energy comsumption of RTHs is high, about 3 to 5 times higher than that of ORHs. Given the results, the government and RTHs should pay more attention to take measures to reduce energy comsumption. Meanwhile, the factors affecting households’ energy consumption are also analyzed. Energy consumption of ORHs is affected by frequently used area, family income level and permanent population. Then energy consumption of RTHs is mainly related to the total building area, number of air conditioner (AC), number of guestrooms and family income level.
文摘In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.
基金Supported by the Humanities and Social Science Research Fund of the Ministry of Education of China(19YJC790063)the Natural Science Foundation of Fujian,China(2017J05112)the Social Science Foundation of Fujian,China(FJ2017C076).
文摘This study examines the impact of cash crop cultivation on household income and migration decisions,using survey data collected from low-income regions in China.Given farmers decide themselves whether to cultivate cash crops,an endogenous treatment regression model that accounts for potential selection bias issue is used to analyze the data.The empirical results show that cash crop cultivation exerts a positive and statistically significant impact on household income,but it does not affect household migration decisions significantly.The disaggregated analyses reveal that cash crop cultivation significantly increases farm income but decreases off-farm income.
文摘BACKGROUND Colorectal cancer(CRC)remains a relevant public health problem.Current research suggests that racial,economic and geographic disparities impact access.Despite the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income individuals.This study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income participants.Our working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income participants.AIM To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United States.METHODS This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United States and with over 2.8 million responses.The period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent variables.Secondary analyses included stratification of the access by ethnicity/race,income,and education status.RESULTS A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blacks,or Multiracial.There was an increase in utilization across all educational levels.This was significant among those who reported having a high school graduate degree or more+4.26%(95%CI:3.16,5.35)compared to some high school or less+1.59%(95%CI:-1.37,4.55).CONCLUSION Medicaid expansion under the Affordable Care Act led to an overall increase in self-reported use of CRC screening tests by adults aged 50-64 years in the United States.This finding was consistent across all low-income populations,but not all races or levels of education.
文摘Climate change impact and risks on agricultural livelihood affect women and men disproportionately and often to the disadvantage of women and girls. Consequently, this study assessed gender perspectives of vulnerability to climate change of farming households at Ikpayongo community in Gwer local government area, Benue State, Nigeria using descriptive approach. The study identified a total of 120 male-headed and female-headed farming households across four neighbourhoods and administered structured questionnaire on them using simple random sampling method, while data analysis was done using descriptive statistics. The results indicate lower education and income status among female-headed households, though male-headed households have high household size. Both sexes have relatively equal access to land for farming, however men have large farm size compared to women. The major crops cultivated by men were rice and yam, while women cultivated largely groundnut and cassava. Women are more exposed and sensitive to climate-related hazards such as floods and heat stress due to the location of their farms. The result further shows that males possess better adaptive capacity given their higher incomes, social networks and more access to training/capacity building programmes and credit facilities. The study concludes that female-headed farming households are more vulnerable to climate change and variability than male-headed farming households due to higher exposure and a lower adaptive capacity. Programme and policies to improve women access to credit facilities and relevant training to boost their adaptive capacity and build resilience are highly recommended. This would also limit exposure with attendant reduction in vulnerability.
基金financially supported by the Major Program of the National Social Science Foundation of China(No.18BMZ126)。
文摘Ethnic Tibetans(ETs)typically reside in the remote plateaus of China and possess strong cultural and spiritual values.Their financial decision-making is influenced by economic and physical factors,unique culture,social norms,and psychological motivators.We conducted an in-person survey of 480 randomly selected ET households across four provinces in rural China.The survey data was analyzed using three different econometric models—probit,ordered probit,and ranked ordered logit—to examine the choice of borrowing from formal or informal credit sources,the number of sources borrowed from,and repayment priority.Our findings indicate that mental accounting plays a significant role in the financial decision-making process of ET households.Additionally,we find that the informal credit source is strongly associated with the financial decisions of ET households.The majority of loans from formal financial institutions are used to meet daily needs,as opposed to purchasing productive inputs.Our results also suggest that strong social relationships and religious beliefs prevent households from defaulting,and that loans from formal financial sources receive repayment priority.China would benefit from promoting inclusive finance and encouraging the adoption of improved agricultural practices to support the prosperity of ET and other minority communities.