ResearchPad - housing https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Financial health as a measurable social determinant of health]]> https://www.researchpad.co/article/elastic_article_15758 Financial health, understood as one’s ability to manage expenses, prepare for and recover from financial shocks, have minimal debt, and ability to build wealth, underlies all facets of daily living such as securing food and paying for housing, yet there is inconsistency in measurement and definition of this critical concept. Most social determinants research and interventions focus on siloed solutions (housing, food, utilities) rather than on a root solution such as financial health. In light of the paucity of public health research on financial health, particularly among low-income populations, this study seeks to: 1) introduce the construct of financial health into the domain of public health as a useful root term that underlies other individual measures of economic hardship and 2) demonstrate through outcomes on financial, physical and mental health among low-income caregivers of young children that the construct of financial health belongs in the canon of social determinants of health.Materials and methodsIn order to extract features of financial health relevant to overall well-being, principal components analysis were used to assess survey data on banking and personal finances among caregivers of young children who participate in public assistance. Then, a series of logistic regressions were utilized to examine the relationship between components of financial health, depression and self-rated health.ResultsComponents aligned with other measures of financial health in the literature, and there were strong associations between financial health and health outcomes.Practice implicationsFinancial health can be conceived of and measured as a key social determinant of health. ]]> <![CDATA[Associations between socio-economic factors and alcohol consumption: A population survey of adults in England]]> https://www.researchpad.co/article/5c61e91ed5eed0c48496f828

Aim

To gain a better understanding of the complex relationships of different measures of social position, educational level and income with alcohol consumption in England.

Method

Between March 2014 and April 2018 data were collected on n = 57,807 alcohol drinkers in England taking part in the Alcohol Toolkit Study (ATS). Respondents completed the AUDIT-C measure of frequency of alcohol consumption, amount consumed on a typical day and binge drinking frequency. The first two questions were used to derive a secondary measure of quantity: average weekly unit consumption. Socio-economic factors measured were: social-grade (based on occupation), employment status, educational qualifications, home and car ownership and income. Models were constructed using ridge regression to assess the contribution of each predictor taking account of high collinearity. Models were adjusted for age, gender and ethnicity.

Results

The strongest predictor of frequency of alcohol consumption was social-grade. Those in the two lowest occupational categories of social grade (e.g. semi-skilled and unskilled manual workers, and unemployed, pensioners, casual workers) has fewer drinking occasions than those in professional-managerial occupations (β = -0.29, 95%CI -0.34 to -0.25; β = -0.31, 95%CI -0.33 to -0.29). The strongest predictor of consumed volume and binge drinking frequency was lower educational attainment: those whose highest qualification was an A-level (i.e. college/high school qualification) drank substantially more on a typical day (β = 0.28, 95%CI 0.25 to 0.31) and had a higher weekly unit intake (β = 3.55, 95%CI 3.04 to 4.05) than those with a university qualification. They also reported a higher frequency of binge drinking (β = 0.11, 95%CI 0.09 to 0.14). Housing tenure was a strong predictor of all drinking outcomes, while employment status and car ownership were the weakest predictors of most outcomes.

Conclusion

Social-grade and educational attainment appear to be the strongest socioeconomic predictors of alcohol consumption indices in England, followed closely by housing tenure. Employment status and car ownership have the lowest predictive power.

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<![CDATA[How happy are your neighbours? Variation in life satisfaction among 1200 Canadian neighbourhoods and communities]]> https://www.researchpad.co/article/5c5217fed5eed0c484795ed8

This paper presents a new public-use dataset for community-level life satisfaction in Canada, based on more than 500,000 observations from the Canadian Community Health Surveys and the General Social Surveys. The country is divided into 1216 similarly sampled geographic regions, using natural, built, and administrative boundaries. A cross-validation exercise suggests that our choice of minimum sampling thresholds approximately maximizes the predictive power of our estimates. The resulting dataset reveals robust differences in life satisfaction between and across urban and rural communities. We compare aggregated life satisfaction data with a range of key census variables to illustrate some of the ways in which lives differ in the most and least happy communities.

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<![CDATA[Knowledge, interest, and anticipated barriers of pre-exposure prophylaxis uptake and adherence among gay, bisexual, and men who have sex with men who are incarcerated]]> https://www.researchpad.co/article/5c141ed1d5eed0c484d28626

Criminal justice (CJ) settings disproportionately include populations at high risk for acquiring HIV, and CJ-involved individuals are often at the intersection of multiple overlapping risk factors. However, few studies have examined attitudes about pre-exposure prophylaxis (PrEP) among incarcerated men who have sex with men (MSM). This study explored interest in, knowledge of, and barriers to PrEP uptake among gay, bisexual, and other men who have sex with men at the Rhode Island Department of Corrections. Using semi-structured interviews, 26 MSM were interviewed about PrEP knowledge, interest, timing preferences for provision (e.g. before or after release), and barriers to uptake and adherence during community re-entry. Interviews were coded and analyzed using a general inductive approach. Participants demonstrated low initial knowledge of PrEP but high interest after being told more about it. Participants self-identified risk factors for HIV acquisition, including condomless sex and substance use. In addition, participants preferred provision of PrEP prior to release. Post-release barriers to PrEP uptake and adherence included 1) concerns about costs of PrEP medications; 2) anticipated partner or family disapproval; 3) lack of access to transportation; 4) unstable housing; 5) compounding impacts of multiple hardships leading to a de-prioritization of PrEP and 6) fears of future re-incarceration. These results point to the need for future PrEP interventions among incarcerated populations that address incarceration and PrEP related barriers during community re-entry via wraparound services that address PrEP and incarceration-related barriers.

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<![CDATA[Accounting for peoples’ preferences in establishing new cities: A spatial model of population migration in Kuwait]]> https://www.researchpad.co/article/5c1c0ac4d5eed0c484426a56

Modelling of internal migration to new cities is challenging, yet necessary to ensure that these newly established urban areas will be populated and function as intended. In the State of Kuwait, there is a unique set of push and pull factors: government subsidised housing for citizens, the existence of a single urban area, and the initiation of a new and ambitious master plan for the construction of 12 new cities, which are expected to attract not only locals, but also international residents and businesses. On top of these factors, there is an unusual demographic situation, as non-citizens outnumber Kuwaiti citizens by a factor of 2.3, with these groups having widely different preferences in terms of housing. Currently, there is no plan to take these resident groups’ opinions into consideration for the new cities project. Besides, the current study simulates the impacts of the involvement of residents in urban planning. Samples from resident groups (citizens and non-citizens) participated in targeted surveys and useful answers were extracted in relation to the migration likelihood, push and pull factors that may affect their decisions, spatial preferences for new cities and their opinions on segregation by nationality. Specifically, the survey results showed significant interest of residents in moving to the new cities. For citizens, the most important factors in deciding whether to move or not were proximity to their close family and housing availability, while for non-citizens the most important factor was the creation of new employment opportunities. Both survey groups agreed that existing city property prices are too high and make the prospect of moving to a new city more attractive. The responses were transferred in an Agent Based Model, and the simulations showed certain differences to the official projections for 2050 without the public responses, in regards to the geographical distribution of the most desirable suburbs. Furthermore, the simulations showed that in the new cities, nationality segregation levels are expected to drop by at least 15% compared to the 2015 levels. The findings may be utilised by the authorities to modify the master plan accordingly.

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<![CDATA[Commentary on “The number of undocumented immigrants in the United States: Estimates based on demographic modeling with data from 1990-2016”]]> https://www.researchpad.co/article/5bae98d740307c0c23a1c146

“The number of undocumented immigrants in the United States: Estimates based on demographic modeling with data from 1990–2016” by Fazel-Zarandi, Feinstein and Kaplan presents strikingly higher estimates of the unauthorized immigrant population than established estimates using the residual method. Fazel-Zarandi et. al.’s estimates range from a low or “conservative” number of 16.7 million unauthorized immigrants, to an “average” of 22.1 million, and to a high of 27.5 million. The Pew Hispanic Center estimated the population at 11.3 million in 2016, and the Department of Homeland Security (DHS) estimated it at 12.3 million. The new method shows much more rapid growth in unauthorized immigration during the 1990s and a substantially higher population in 2000 (13.3 million according to their “conservative” model) than Pew (8.6 million) and DHS (8.5 million). In this commentary, we explain that such an estimate for 2000 is implausible, as it suggests that the 2000 Census undercounted the unauthorized immigrant population by at least 42% in the 2000 Census, and it is misaligned with other demographic data. Fazel-Zarandi, Feinstein and Kaplan’s model produces estimates that have a 10 million-person range in 2016, far too wide to be useful for public policy purposes; their estimates are not benchmarked against any external data sources; and their model appears to be driven by assumptions about return migration of unauthorized immigrants during the 1990s. Using emigration rates from the binational Mexican Migration Project survey for the illegal border-crosser portion of the unauthorized population, we generate a 2000 unauthorized population estimate of 8.2 million—slightly below Pew and DHS’s estimates—without changing other assumptions in the model. We conclude that this new model’s estimates are highly sensitive to assumptions about emigration, and moreover, that the knowledge base about emigration in the unauthorized population during the 1990s is not well enough developed to support the model underlying their estimates.

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<![CDATA[From welcome culture to welcome limits? Uncovering preference changes over time for sheltering refugees in Germany]]> https://www.researchpad.co/article/5b6d94b5463d7e2f79286cbe

Europe recently experienced a large influx of refugees, spurring much public debate about the admission and integration of refugees and migrants into society. Previous research based on cross-sectional data found that European citizens generally favour asylum seekers with high employability, severe vulnerabilities, and Christians over Muslims. These preferences and attitudes were found to be homogeneous across countries and socio-demographic groups. Here, we do not study the general acceptance of asylum seekers, but the acceptance of refugee and migrant homes in citizens’ vicinity and how it changes over time. Based on a repeated stated choice experiment on preferences for refugee and migrant homes, we show that the initially promoted “welcome culture” towards refugees in Germany was not reflected in the views of a majority of a sample of German citizens who rather disapproved refugee homes in their vicinity. Their preferences have not changed between November 2015, the peak of “welcome culture,” and November 2016, after political debates, media reporting and public discourse had shifted towards limiting admission of immigrants. A minority of one fifth of the sample population, who were initially rather approving of refugee and migrant homes being established in their vicinity, were more likely to change their preferences towards a rather disapproving position in 2016. Experience of contact with refugees and migrants, higher education, and general pro-immigration attitudes explain acceptance of refugee and migrant homes as well as preference stability over time. Country of origin and religion of refugees and migrants are considered less important than decent housing conditions and whether refugee and migrants arrive as families or single persons. In this respect our results highlight the importance of humanitarian aspects of sheltering and integration of refugees and other migrants into society.

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<![CDATA[Measuring wealth in rural communities: Lessons from the Sanitation, Hygiene, Infant Nutrition Efficacy (SHINE) trial]]> https://www.researchpad.co/article/5b49f73a463d7e3c6cfa9216

Background

Poverty and human capital development are inextricably linked and therefore research on human capital typically incorporates measures of economic well-being. In the context of randomized trials of health interventions, for example, such measures are used to: 1) assess baseline balance; 2) estimate covariate-adjusted analyses; and 3) conduct subgroup analyses. Many factors characterize economic well-being, however, and analysts often generate summary measures such as indices of household socio-economic status or wealth. In this paper, a household wealth index is developed and tested for participants in the cluster-randomized Sanitation, Hygiene, Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe.

Methods

Building on the approach used in the Zimbabwe Demographic and Health Survey (ZDHS), we combined a set of housing characteristics, ownership of assets and agricultural resources into a wealth index using principal component analysis (PCA) on binary variables. The index was assessed for internal and external validity. Its sensitivity was examined considering an expanded set of variables and an alternative statistical approach of polychoric PCA. Correlation between indices was determined using the Spearman’s rank correlation coefficient and agreement between quintiles using a linear weighted Kappa statistic. Using the 2015 ZDHS data, we constructed a separate index and applied the loadings resulting from that analysis to the SHINE study population, to compare the wealth distribution in the SHINE study with rural Zimbabwe.

Results

The derived indices using the different methods were highly correlated (r>0.9), and the wealth quintiles derived from the different indices had substantial to near perfect agreement (linear weighted Kappa>0.7). The indices were strongly associated with a range of assets and other wealth measures, indicating both internal and external validity. Households in SHINE were modestly wealthier than the overall population of households in rural Zimbabwe.

Conclusion

The SHINE wealth index developed here is a valid and robust measure of wealth in the sample.

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<![CDATA[The Vaccination of 35,000 Dogs in 20 Working Days Using Combined Static Point and Door-to-Door Methods in Blantyre, Malawi]]> https://www.researchpad.co/article/5989d9fdab0ee8fa60b72dd9

An estimated 60,000 people die of rabies annually. The vast majority of cases of human rabies develop following a bite from an infected dog. Rabies can be controlled in both human and canine populations through widespread vaccination of dogs. Rabies is particularly problematic in Malawi, costing the country an estimated 13 million USD and 484 human deaths annually, with an increasing paediatric incidence in Blantyre City. Consequently, the aim of this study was to vaccinate a minimum of 75% of all the dogs within Blantyre city during a one month period. Blantyre’s 25 administrative wards were divided into 204 working zones. For initial planning, a mean human:dog ratio from the literature enabled estimation of dog population size and dog surveys were then performed in 29 working zones in order to assess dog distribution by land type. Vaccination was conducted at static point stations at weekends, at a total of 44 sites, with each operating for an average of 1.3 days. On Monday to Wednesday, door-to-door vaccination sessions were undertaken in the areas surrounding the preceding static point stations. 23,442 dogs were vaccinated at static point stations and 11,774 dogs were vaccinated during door-to-door vaccinations. At the end of the 20 day vaccination programme, an assessment of vaccination coverage through door-to-door surveys found that of 10,919 dogs observed, 8,661 were vaccinated resulting in a vaccination coverage of 79.3% (95%CI 78.6–80.1%). The estimated human:dog ratio for Blantyre city was 18.1:1. Mobile technology facilitated the collection of data as well as efficient direction and coordination of vaccination teams in near real time. This study demonstrates the feasibility of vaccinating large numbers of dogs at a high vaccination coverage, over a short time period in a large African city.

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<![CDATA[A Structural Equation Model of HIV-Related Stigma, Racial Discrimination, Housing Insecurity and Wellbeing among African and Caribbean Black Women Living with HIV in Ontario, Canada]]> https://www.researchpad.co/article/5989da9fab0ee8fa60ba50c8

African and Caribbean Black women in Canada have new HIV infection rates 7 times higher than their white counterparts. This overrepresentation is situated in structural contexts of inequities that result in social, economic and health disparities among African and Caribbean Black populations. Economic insecurity is a distal driver of HIV vulnerability, reducing access to HIV testing, prevention and care. Less is known about how economic insecurity indicators, such as housing security, continue to influence the lives of women living with HIV following HIV-positive diagnoses. The aim of this study was to test a conceptual model of the pathways linking HIV-related stigma, racial discrimination, housing insecurity, and wellbeing (depression, social support, self-rated health). We implemented a cross-sectional survey with African and Caribbean Black women living with HIV in 5 Ontario cities, and included 157 participants with complete data in the analyses. We conducted structural equation modeling using maximum likelihood estimation to evaluate the hypothesized conceptual model. One-fifth (22.5%; n = 39) of participants reported housing insecurity. As hypothesized, racial discrimination had significant direct effects on: HIV-related stigma, depression and social support, and an indirect effect on self-rated health via HIV-related stigma. HIV-related stigma and housing insecurity had direct effects on depression and social support, and HIV-related stigma had a direct effect on self-rated health. The model fit the data well: χ2 (45, n = 154) = 54.28, p = 0.387; CFI = 0.997; TLI = 0.996; RMSEA = 0.016. Findings highlight the need to address housing insecurity and intersecting forms of stigma and discrimination among African and Caribbean Black women living with HIV. Understanding the complex relationships between housing insecurity, HIV-related stigma, racial discrimination, and wellbeing can inform multi-level interventions to reduce stigma and enhance health.

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<![CDATA[High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV]]> https://www.researchpad.co/article/5989db59ab0ee8fa60bdf156

Context

French Guiana is a South American French territory, where HIV prevalence consistently exceeds 1% in the adult population. In the only correctional facility, HIV prevalence fluctuates at around 4%.

Aims

After describing the population of HIV-positive inmates, we aimed to evaluate mortality after release from the correctional facility, and to identify its predictive factors.

Rationale

Outside North American settings, data on treatment outcome and vital status of HIV-positive former inmates are scarce. There were no data in French Guiana. Filling this gap represents a basis for potential improvements.

Methods

All HIV-infected adults released from an incarceration of 30 days or more, between 2007 and 2013, were enrolled in a retrospective cohort study. Mortality was described over time, one to seven years following release, using Kaplan-Meier estimates. Factors associated with mortality were identified through a non-parametric survival regression model.

Results

147 former inmates were included. The male to female ratio was 4.4. The median age was 37.3 years. The majority were migrants, 25.8% were homeless, 70.1% suffered from substance abuse, with 34.0% of crack-cocaine users. On admission, 78.1% had an early HIV-stage infection (CDC-stage A), with a median CD4 count of 397.5/mm3, 34.0% had one comorbidity, mainly hypertension. Upon release, 50.3% were on ART. Reasons for not being treated were not fulfilling the criteria for 74.6%, and refusing for 15.1%. Before release, 84.5% of the patients on ART had a viral load≤200cp/ml. After release, 8.2% of the cohort had died, with a crude incidence of 33.8/1000 person-years. All recorded deaths were males, with an incidence of 42.2/1000 person-years. Comparing with the age-specific mortality rates for males in French Guiana, the standardized mortality ratio was 14.8. In multivariate analysis, factors associated with death were age and CD4 count before release.

Conclusion

Despite access to ART while incarcerated, with good virological outcome, the post-release mortality was very high for males, almost 15 times what is observed in the general male population living in French Guiana, after age standardization. Access to ART in correctional facilities may be a necessary, but not sufficient condition to protect male inmates from death after release.

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<![CDATA[A measurement model for real estate bubble size based on the panel data analysis: An empirical case study]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbe47

Employing the fundamental value of real estate determined by the economic fundamentals, a measurement model for real estate bubble size is established based on the panel data analysis. Using this model, real estate bubble sizes in various regions in Japan in the late 1980s and in recent China are examined. Two panel models for Japan provide results, which are consistent with the reality in the 1980s where a commercial land price bubble appeared in most area and was much larger than that of residential land. This provides evidence of the reliability of our model, overcoming the limit of existing literature with this method. The same models for housing prices in China at both the provincial and city levels show that contrary to the concern of serious housing price bubble in China, over-valuing in recent China is much smaller than that in 1980s Japan.

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<![CDATA[Malaria Incidence Rates from Time Series of 2-Wave Panel Surveys]]> https://www.researchpad.co/article/5989dab4ab0ee8fa60bac63f

Methodology to estimate malaria incidence rates from a commonly occurring form of interval-censored longitudinal parasitological data—specifically, 2-wave panel data—was first proposed 40 years ago based on the theory of continuous-time homogeneous Markov Chains. Assumptions of the methodology were suitable for settings with high malaria transmission in the absence of control measures, but are violated in areas experiencing fast decline or that have achieved very low transmission. No further developments that can accommodate such violations have been put forth since then. We extend previous work and propose a new methodology to estimate malaria incidence rates from 2-wave panel data, utilizing the class of 2-component mixtures of continuous-time Markov chains, representing two sub-populations with distinct behavior/attitude towards malaria prevention and treatment. Model identification, or even partial identification, requires context-specific a priori constraints on parameters. The method can be applied to scenarios of any transmission intensity. We provide an application utilizing data from Dar es Salaam, an area that experienced steady decline in malaria over almost five years after a larviciding intervention. We conducted sensitivity analysis to account for possible sampling variation in input data and model assumptions/parameters, and we considered differences in estimates due to submicroscopic infections. Results showed that, assuming defensible a priori constraints on model parameters, most of the uncertainty in the estimated incidence rates was due to sampling variation, not to partial identifiability of the mixture model for the case at hand. Differences between microscopy- and PCR-based rates depend on the transmission intensity. Leveraging on a method to estimate incidence rates from 2-wave panel data under any transmission intensity, and from the increasing availability of such data, there is an opportunity to foster further methodological developments, particularly focused on partial identifiability and the diversity of a priori parameter constraints associated with different human-ecosystem interfaces. As a consequence there can be more nuanced planning and evaluation of malaria control programs than heretofore.

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<![CDATA[Malaria Epidemiology in Kilifi, Kenya during the 21st Century: What Next?]]> https://www.researchpad.co/article/5989da10ab0ee8fa60b7955b

Lorenz von Seidlein and Jakob Knudsen discuss the changes in malaria incidence recorded at a single site in Africa over 25 years, along with future implications for disease prevention.

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<![CDATA[Rat tickling: A systematic review of applications, outcomes, and moderators]]> https://www.researchpad.co/article/5989db52ab0ee8fa60bdc5ec

Introduction

Rats initially fear humans which can increase stress and impact study results. Additionally, studying positive affective states in rats has proved challenging. Rat tickling is a promising habituation technique that can also be used to model and measure positive affect. However, current studies use a variety of methods to achieve differential results. Our objective was to systematically identify, summarize, and evaluate the research on tickling in rats to provide direction for future investigation. Our specific aims were to summarize current methods used in tickling experiments, outcomes from tickling, and moderating factors.

Methods

We systematically evaluated all articles about tickling identified from PubMed, Scopus, Web of Science, and PsychInfo. Our inclusion criteria were publication in a peer-reviewed journal and collection of original, empirical data on rats using the handling method of tickling. One researcher extracted information from each article. Bias was assessed by 2 investigators using the SYRCLE bias assessment tool.

Results

We identified 32 articles (56 experiments) published in peer-reviewed journals about rat tickling for inclusion. A wide variety of strains, sexes, and ages of rats were included. The most common method used for tickling was cycling through 15 seconds of tickling and 15 seconds of rest for 2 minutes for 3 to 5 days. Experiments with a control for tickling (N = 22) showed that tickling increases positive vocalization, approach behavior, decreases anxiety measures, improves handling, and in some cases decreases stress hormones. Tickling juvenile, individually housed rats with a trait predisposition to respond more positively to tickling, results in the most positive outcomes. Methods to reduce bias were insufficiently reported.

Conclusions

We conclude that tickling is a promising method for improving rat welfare and investigating positive affect. However, the establishment of tickling best practices is essential as the outcomes from tickling can be moderated by several factors.

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<![CDATA[A Systematic Review of Health Economic Analyses of Housing Improvement Interventions and Insecticide-Treated Bednets in the Home]]> https://www.researchpad.co/article/5989da40ab0ee8fa60b89d13

Background

Housing improvements have considerable potential for improving health. So does the provision of insecticide-treated bednets for malaria prevention. Therefore we aimed to conduct updated systematic reviews of health economic analyses in both these intervention domains.

Methods and findings

The search strategy included economic analyses of housing improvement interventions and use of insecticide-treated bednets for community-dwelling, healthy populations (published between 1 January 2000 and 15 April 2014). We searched the Cochrane Database of Systematic Reviews, MEDLINE, PubMed, EMBASE, and three health economics databases. Thirty-five economic analyses of seven types of intervention fulfilled the inclusion criteria. Most included studies adopted a health sector perspective and were cost-effectiveness analyses using decision analytic modeling or conducted alongside trials. The overall quality of the studies was generally likely to be adequate for informing policy-making (albeit with limitations in some areas). There was fairly consistent evidence for the cost-effectiveness/favorable cost-benefit of removing indoor lead to prevent lead poisoning and sequelae, and retrofitting insulation to prevent lung disease. But the value of assessing and improving home safety and providing smoke alarms to prevent injuries was more mixed and the economic evidence was inconclusive or insufficient for: home ventilation to prevent lung disease, installing heaters to prevent lung disease and regulating tap water temperatures to prevent scalding. Few studies (n = 4) considered health equity. The 12 studies of providing insecticide-treated bednets or hammocks to prevent malaria found these interventions to be moderately to highly cost-effective.

Conclusions

This systematic review provides updated evidence that several housing improvement interventions (such as removing indoor lead and retrofitting insulation) and also the provision of insecticide-treated bednets are cost-effective interventions. Nevertheless, for some interventions additional analyses are required to better clarify their health economic and health equity value.

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<![CDATA[The Effects of Community Attachment and Information Seeking on Displaced Disaster Victims’ Decision Making]]> https://www.researchpad.co/article/5989da9eab0ee8fa60ba4b95

This paper uses original survey data of the Great East Japan earthquake disaster victims to examine their decision to apply for the temporary housing as well as the timing of application. We assess the effects of victims’ attachment to their locality as well as variation in victims’ information seeking behavior. We additionally consider various factors such as income, age, employment and family structure that are generally considered to affect the decision to choose temporary housing as victims’ solution for their displacement. Empirical results indicate that, ceteris paribus, as the degree of attachment increases, victims are more likely to apply for the temporary housing but attachment does not affect the timing of application. On the other hand, the victims who actively seek information and are able to collect higher quality information are less likely to apply for the temporary housing and if they do apply then they apply relatively later.

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<![CDATA[Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study]]> https://www.researchpad.co/article/5989da76ab0ee8fa60b96a78

Introduction

Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals.

Methods

We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes.

Results

Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline) was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses.

Conclusions

Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario’s HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression) and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and demonstrate the need for long-term support and routine management of depression, particularly for individuals at high risk.

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<![CDATA[Temporal Dynamics and Spatial Patterns of Aedes aegypti Breeding Sites, in the Context of a Dengue Control Program in Tartagal (Salta Province, Argentina)]]> https://www.researchpad.co/article/5989dac4ab0ee8fa60bb1d0f

Background

Since 2009, Fundación Mundo Sano has implemented an Aedes aegypti Surveillance and Control Program in Tartagal city (Salta Province, Argentina). The purpose of this study was to analyze temporal dynamics of Ae. aegypti breeding sites spatial distribution, during five years of samplings, and the effect of control actions over vector population dynamics.

Methodology/Principal Findings

Seasonal entomological (larval) samplings were conducted in 17,815 fixed sites in Tartagal urban area between 2009 and 2014. Based on information of breeding sites abundance, from satellite remote sensing data (RS), and by the use of Geographic Information Systems (GIS), spatial analysis (hotspots and cluster analysis) and predictive model (MaxEnt) were performed. Spatial analysis showed a distribution pattern with the highest breeding densities registered in city outskirts. The model indicated that 75% of Ae. aegypti distribution is explained by 3 variables: bare soil coverage percentage (44.9%), urbanization coverage percentage(13.5%) and water distribution (11.6%).

Conclusions/Significance

This results have called attention to the way entomological field data and information from geospatial origin (RS/GIS) are used to infer scenarios which could then be applied in epidemiological surveillance programs and in the determination of dengue control strategies. Predictive maps development constructed with Ae. aegypti systematic spatiotemporal data, in Tartagal city, would allow public health workers to identify and target high-risk areas with appropriate and timely control measures. These tools could help decision-makers to improve health system responses and preventive measures related to vector control.

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<![CDATA[High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates]]> https://www.researchpad.co/article/5989db5cab0ee8fa60bdfde5

Lead in maternal blood can cross the placenta and result in elevated blood lead levels in newborns, potentially producing negative effects on neurocognitive function, particularly if combined with childhood lead exposure. Little research exists, however, into the burden of elevated blood lead levels in newborns, or the places and populations in which elevated lead levels are observed in newborns, particularly in rural settings. Using ~2300 dried bloods spots collected within 1–3 days of birth among Iowa newborns, linked with the area of mother’s residence at the time of birth, we examine the spatial patterns of elevated (>5 μg/dL) blood lead levels and the ecological-level predictors of elevated blood lead levels. We find that one in five newborns exceed the 5 μg/dL action level set by the US Centers for Disease Control & Prevention (CDC). Bayesian spatial zero inflated regression indicates that elevated blood lead in newborns is associated with areas of increased pre-1940s housing and childbearing-age women with low educational status in both rural and urban settings. No differences in blood lead levels or the proportion of children exceeding 5 μg/dL are observed between urban and rural maternal residence, though a spatial cluster of elevated blood lead is observed in rural counties. These characteristics can guide the recommendation for testing of infants at well-baby appointments in places where risk factors are present, potentially leading to earlier initiation of case management. The findings also suggest that rural populations are at as great of risk of elevated blood lead levels as are urban populations. Analysis of newborn dried blood spots is an important tool for lead poisoning surveillance in newborns and can direct public health efforts towards specific places and populations where lead testing and case management will have the greatest impact.

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