The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health.

Use of Homeostatic Model Assessment Indexes for the Identification of Metabolic Syndrome and Insulin Resistance among Cuban-Americans: A Cross Sectional Study

Aim: to determine cut off points for The Homeostatic Model Assessment Index 1 and 2 (HOMA-1 and HOMA-2) for identifying insulin resistance and metabolic syndrome among a Cuban-American population. Study Design: Cross sectional. Place and Duration of Study: Florida International University, Robert Stempel School of Public Health and Social Work, Department of Dietetics and Nutrition, Miami, FL from July 2010 to December 2011. Methodology: Subjects without diabetes residing in South Florida were enrolled (N=146, aged 37 to 83 years). The HOMA1-IR and HOMA2-IR 90th percentile in the healthy group (n=75) was used as the cut-off point for insulin resistance. A ROC curve was constructed to determine the cut-off point for metabolic syndrome. Results: HOMA1-IR was associated with BMI, central obesity, and triglycerides (P3.95 and >2.20 and for metabolic syndrome were >2.98 (63.4% sensitivity and 73.3% specificity) and >1.55 (60.6% sensitivity and 66.7% specificity), respectively. Conclusion: HOMA cut-off points may be used as a screening tool to identify insulin resistance and metabolic syndrome among Cuban-Americans living in South Florida.

Dioon Lindl. (Zamiaceae): Perspectives from phylogeny and a population genetic study of Dioon edule

Dioon Lindl. (Zamiaceae) is a small genus restricted to Mexico (12 species) and Honduras (one species). Previous systematic studies have been unable to fully resolve species relationships within the genus. Phylogenetic analyses were conducted with data from several sources, including Restriction Fragment Length Polymorphisms from the chloroplast genome, morphology, two introns of the low copy nuclear gene S-adenosyl-L-homocysteine hydrolase (SAHH) and the 5.8S/ITS2 regions of the nuclear ribosomal DNA. The goals of the study were to construct a total evidence species level phylogeny and to explore current biogeographical hypotheses. None of the analyses performed produced a fully resolved topology. Dioon is comprised of two main lineages (the Edule and Spinulosum Clades), which represents an ancient divergence within the genus. The two introns of the nuclear gene SAHH offer additional evidence for the split into two lineages. Intron 2 contains a 18 bp deletion in the Spinulosum Clade, providing a synapomorphy for that group. The 5.8S/ITS2 regions were highly polymorphic and subsequently omitted from the combined analyses. In order to visualize congruence between morphology and molecular data, morphological characters were mapped onto the combined molecular tree. Current biogeographical hypotheses of a general northward pattern of migration and speciation are supported here. However, sister relationships within the Edule Clade are not fully resolved. Seven DNA microsatellite markers were developed to investigate patterns of genetic variation of seven populations of D. edule, a species restricted to Eastern Mexico. We found that most of the genetic variation lies within populations (Ho = 0.2166–0.3657) and that levels of population differentiation are low (Fst = 0.088); this finding is congruent with the breeding system of this species, dioicy. Four of the populations deviate from Hardy Weinberg Equilibrium and have a high number of identical genotypes, we suggest that this unexpected pattern is due to the life-history strategy of the species coupled with the few number of polymorphic loci detected in these populations. Our results are not congruent with earlier evidence from morphology and allozyme markers that suggest that the two northernmost populations represent a distinct entity that is recognized by some taxonomists as D. angustifolium.

Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India

Background While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.

The response to an ESL population boom in the Beaufort County, South Carolina school system: A case study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers.^ Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers' recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. ^ The findings from the teachers' interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes.^ Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County's ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County's schools. Finally, recommendations for further research are provided.^

A study to identify the nutritional problems in the elementary school population in the Republic of Venezuela

The purpose of this research is to identify and evaluate the nutritional problems that exist in the student population at the elementary school level in the Republic of Venezuela and to develop a system that will make it possible to deliver a more adequate diet to this population, with a greater fulfillment of their nutritional needs.

The Response to an ESL Population Boom in the Beaufort County, South Carolina School System: A Case Study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers. Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers’ recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. The findings from the teachers’ interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes. Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County’s ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County’s schools. Finally, recommendations for further research are provided.