Comparative Assessment of Methods for Measuring Consensual Poverty: Sort Card Versus CAPI

Poverty means more than having a low income and includes exclusion from a minimally accepted way of life. It is now common practice in Europe to measure progress against poverty in terms of low income, material deprivation rates and some combination of both. This makes material deprivation indicators, and their selection, highly significant in its own right. The ‘consensual poverty’ approach is to identify deprivation items which a majority of the population agree constitute life’s basic necessities, accepting that these items will need revised over time to reflect social change. Traditionally, this has been carried out in the UK through specialised poverty surveys using a Sort Card (SC) technique.

Based on analysis of a 2012 omnibus survey, and discussions with three interviewers, this article examines how perception of necessities is affected by mode of administration – SC and Computer Assisted Personal Interviewing (CAPI). More CAPI respondents scored deprivation items necessary. Greatest disparities are in material items where 25 out of 32 items were significantly higher via CAPI. Closer agreement is found in social participation with 3 out of 14 activities significantly different. Consensus is higher on children’s material deprivation.
We consider influencing variables which could account for the disparities and believe that the SC method produces a more considered response. However, in light of technological advances, we question how long the SC method will remain socially acceptable. This paper concludes that the CAPI method can be easily modified without compromising the benefits of the SC method in capturing thoughtful responses.

The worldwide epidemic of diabetic retinopathy

Diabetic retinopathy (DR), a major microvascular complication of diabetes, has a significant impact on the world′s health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and we estimate that the number with vision-threatening diabetic retinopathy (VTDR) will increase from 37.3 million to 56.3 million, if prompt action is not taken. Despite growing evidence documenting the effectiveness of routine DR screening and early treatment, DR frequently leads to poor visual functioning and represents the leading cause of blindness in working-age populations. DR has been neglected in health-care research and planning in many low-income countries, where access to trained eye-care professionals and tertiary eye-care services may be inadequate. Demand for, as well as, supply of services may be a problem. Rates of compliance with diabetes medications and annual eye examinations may be low, the reasons for which are multifactorial. Innovative and comprehensive approaches are needed to reduce the risk of vision loss by prompt diagnosis and early treatment of VTDR.

Social Ecological Constraints to Park Use in Communities with Quality Access

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, with access to underutilized parks. We used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and access to parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed at increasing park use must specifically address barriers across social ecological levels to be successful.

Fear of oxygen therapy for children in Malawi

BACKGROUND: Although pneumonia is a common cause of death in children in Malawi, healthcare staff frequently encounter patients or carers who refuse oxygen therapy. This qualitative study documents factors that influence acceptance or refusal of oxygen therapy for children in Malawi.

METHODS: Nine group interviews involving 86 participants were held in community and hospital settings in rural and urban Malawi. Eleven in-depth interviews of healthcare staff providing oxygen were held in a central hospital. Thematic analysis of transcripts of the audio recordings was carried out to identify recurring themes.

RESULTS: Similar ideas were identified in the group interviews and in-depth staff interviews. Past experiences of oxygen use (direct and indirect, positive and negative) had a strong influence on views of oxygen. A recurrent theme was fear of oxygen, often due to a perceived association between death and recent oxygen use. Fears were intensified by a lack of familiarity with equipment used to deliver oxygen, distrust of medical staff and concerns about cost of oxygen.

CONCLUSIONS: This study identifies reasons for refusal of oxygen therapy for children in a low-income country. Findings from the study suggest that training of healthcare staff to address fears of parents, and information, education and communication (IEC) approaches that improve public understanding of oxygen and provide positive examples of its use are likely to be helpful in improving uptake of oxygen therapy in Malawi.

Brain responses and looking behavior during audiovisual speech integration in infants predict auditory speech comprehension in the second year of life

The use of visual cues during the processing of audiovisual (AV) speech is known to be less efficient in children and adults with language difficulties and difficulties are known to be more prevalent in children from low-income populations. In the present study, we followed an economically diverse group of thirty-seven infants longitudinally from 6–9 months to 14–16 months of age. We used eye-tracking to examine whether individual differences in visual attention during AV processing of speech in 6–9 month old infants, particularly when processing congruent and incongruent auditory and visual speech cues, might be indicative of their later language development. Twenty-two of these 6–9 month old infants also participated in an event-related potential (ERP) AV task within the same experimental session. Language development was then followed-up at the age of 14–16 months, using two measures of language development, the Preschool Language Scale and the Oxford Communicative Development Inventory. The results show that those infants who were less efficient in auditory speech processing at the age of 6–9 months had lower receptive language scores at 14–16 months. A correlational analysis revealed that the pattern of face scanning and ERP responses to audiovisually incongruent stimuli at 6–9 months were both significantly associated with language development at 14–16 months. These findings add to the understanding of individual differences in neural signatures of AV processing and associated looking behavior in infants.

Social tourism: a potential policy to reduce social exclusion?

Social tourism is often presented by charities and governmental organisations as a potential means to counter social exclusion. It has more specifically been linked to potential benefits such as improvements in family relations, a more pro-active attitude to life, an improvement in the academic performance of children etc. Even though this argument is often used when promoting social tourism, there is very little research evidence that supports these claims. This research concentrates on visitor-related social tourism for low-income groups, and the effects a social holiday can have on the daily lives of the families who are offered these holidays. The paper reports on qualitative two-stage research that has been conducted with participants of social holidays in the UK and their welfare agents. It will present findings as to how far holidays can assist with the integration of socially excluded, and this on different levels: family relations, parenting, pro-social attitudes, mental and physical health and community involvement are examples of categories used to measure change. Different types of holidays will also be compared to analyse the merits and limitations of each type (individual family holidays versus group holidays).

Literacia familiar: contributos para a promoção e desenvolvimento de boas práticas literácitas em contexto socio económico desfavorecido

Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção de grau de Mestre em Didática da Língua Portuguesa no 1.º e 2.º Ciclos do Ensino Básico

Logoplaste: Internationalization to South Africa through flexible packaging

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Logoplaste: Implementation of flexible packaging technology and internationalization to Nigeria

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Strategy of Logoplaste in Mozambique's flexible plastic packaging industry

Logoplaste is a specialist in operating in-house industrial sites for manufacturing rigid plastic packaging containers. In developing countries, especially in Africa, the low income of consumers does not allow a widespread adoption of products typically sold in rigid plastic containers. In these countries the flexible packages are usually adopted as they allow for better ratios of cost/litter of product, particularly in smaller packages. Should Logoplaste offer this type of technology in order to expand into developing countries?

Desigualdades na diabetes mellitus e hipertensão arterial: um estudo ao nível de freguesia

RESUMO - Introdução: A diabetes mellitus e a hipertensão arterial são problemas de saúde de elevada prevalência em Portugal. A sua distribuição geográfica e social é pouco conhecida, comprometendo o desenho e implementação de políticas de saúde. Assim, este estudo teve como objetivo avaliar a existência das desigualdades socioeconómicas na prevalência de diabetes mellitus tipo 2 e de hipertensão arterial, na população residente na região Norte de Portugal, no ano de 2013. Métodos: Foi realizado um estudo ecológico que analisou as 2028 freguesias da região Norte. Os dados foram obtidos através do Sistema de Informação das Administrações Regionais de Saúde e do Censos 2011. A associação entre os indicadores socioeconómicos e a prevalência destas doenças foi medida através da diferença de prevalências, do risco atribuível populacional, do índice relativo de desigualdades e pelo coeficiente de regressão. Resultados: A prevalência de diabetes mellitus tipo 2 e hipertensão arterial foi de 6,16% e 19,35%, respetivamente, e apresentou uma distribuição heterogénea entre freguesias (variando entre 0%-23,7% para a diabetes e 2,8%-66,7% para a hipertensão). A prevalência de ambas as doenças estava significativamente associada com o baixo nível educacional, baixa atividade em sector terciário, desemprego e baixo rendimento (com diferença de prevalências entre decis opostos de até 1,3% na diabetes e até 5,3% na hipertensão). Os determinantes socioeconómicos foram responsáveis até 20% da prevalência destas doenças na população. Conclusão: Estes resultados demonstram a existência de uma distribuição socioeconómica e geográfica heterogéneas e a necessidade de criação de políticas de saúde que atuem nas freguesias menos favorecidas.

National suicide prevention strategy for Afghanistan (NSPS)

RESUMO: Do suicídio no Afeganistão é uma prioridade de saúde pública. O Afeganistão é um país de baixo rendimento, emergindo de três décadas de conflitos. Há uma alta prevalência de sofrimento psicológico, perturbações mentais e abuso de substâncias. Existem várias questões sociais, tais como, desequilíbrio/violência de género, pobreza, atitudes e costumes obsoletos, rápidas mudanças sócio-culturais, violação dos direitos humanos e especialmente dos direitos das mulheres e das crianças. Estes fatores de risco contribuem para o aumento da vulnerabilidade da população em relação ao suicídio. A relativa alta taxa de suicídio no Afeganistão é especialmente significativa comparada com as taxas baixas em todos os países islâmicos. Os estudos mostraram predominância de suicídio nas mulheres (95%) e em pessoas jovens. Existe, por isso, uma necessidade urgente do país ter uma estratégia de prevenção do suicídio. A estratégia foi desenvolvida pela criação de um grupo técnico/ de assessoria multi-sectorial de diferentes intervenientes tais como governo, ONGs, agências doadoras, as famílias das vítimas e outraas partes interessadas. A estratégia baseia-se os seguintes valores chave:, respeito pelas diversidades; sensibilidade para as questões sócio-cultura-religiosa e de género; promoção da dignidade da sociedade; respeito pelos direitos humanoss.. Os 'seis pontos estratégicos' são: envolvimento das principais partes interessadas e criação de colaboração intersectorial coordenada; fornecimento de cuidados às pessoas que fazem tentativas de suicídio e às suas famílias; melhoria dos serviços para pessoas com doença mental e problemas psicossociais; promover uma comunicação e imagem adequada dos comportamentos suicidas, pelos meios de comunicação; reduzir o acesso aos meios de suicídio e coligir informação sobre as taxas de suicídio, os fatores de risco, os fatores protetores e as intervenções eficazes. A estratégia nacional de prevenção do suicídio será inicialmente implementada por 5 anos, com uma avaliação anual do plano de acção para entender os seus pontos fortes e limitações. Recomendações e sugestões serão incorporadas nos próxima planos anuais para uma intervenção eficaz. Um sistema de monitorização irá medir o progresso na implementação da estratégia.-----------------------------ABSTRACT: Suicide in Afghanistan is a public health priority. Afghanistan is a low-income country, emerging from three decades of conflicts. There is high prevalence of mental distress, mental disorders and substance abuse. There are multiple social issues, such as gender imbalance/violence, poverty, obsolete attitudes and customs, rapid social-cultural changes, human right violations, and especially women and children rights. These risk factors contribute to increase the vulnerability of the population for suicide. The relative high rate of suicide in Afghanistan is especially significant as the rates are low in all Islamic countries. Research studies have shown predominance of suicide in women (95%) and in young age people. There is an urgent need for the country to have a suicide prevention strategy. The strategy has been developed by establishing a multi-sectoral technical/advisory group of different stakeholders from government, NGOs, donor agencies, victim’s families, and interested parties. The strategy is based on the following key values, namely, respect for diversities; sensitiveness to socio-culture-religious and gender issues; promotion of the society dignity and respect for the human rights of people. The six ‘Strategic directions’ are: involving key stakeholders and creating coordinated inter-sectoral collaboration; providing after care for people making a suicide attempt and their families; improving services for people with mental disorders and psycho-social problems; promoting the safe reporting and image of suicidal behaviour by media; reducing access to the means of suicide and gathering information about suicide rates, risk factor, protective factors and effective interventions. The National Suicide Prevention Strategy will be initially implemented for 5 years, with an annual evaluation of the action plan to understand the strengths and limitations. Recommendations and suggestions will be incorporated into the next annual plans for effective intervention. A monitoring framework will measure progress in implementing the strategy.

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.

The role of molecular, clinical and socioeconomic factors in the long-term survival of axillary node negative breast cancer patients

The overall objective of this study was to investigate factors associated with long-term survival in axillary node negative (ANN) breast cancer patients. Clinical and biological factors included stage, histopathologic grade, p53 mutation, Her-2/neu amplification, estrogen receptor status (ER), progesterone receptor status (PR) and vascular invasion. Census derived socioeconomic (SES) indicators included median individual and household income, proportions of university educated individuals, housing type, "incidence" of low income and an indicator of living in an affluent neighbourhood. The effects of these measures on breast cancer-specific survival and competing cause survival were investigated. A cohort study examining survival among axillary node negative (ANN) breast cancer patients in the greater Toronto area commenced in 1 989. Patients were followed up until death, lost-to-follow up or study termination in 2004. Data were collected from several sources measuring patient demographics, clinical factors, treatment, recurrence of disease and survival. Census level SES data were collected using census geo-coding of patient addresses' at the time of diagnosis. Additional survival data were acquired from the Ontario Cancer Registry to enhance and extend the observation period of the study. Survival patterns were examined using KaplanMeier and life table procedures. Associations were examined using log-rank and Wilcoxon tests of univariate significance. Multivariate survival analyses were perfonned using Cox proportional hazards models. Analyses were stratified into less than and greater than 5 year survival periods to observe whether known markers of short-tenn survival were also associated with reductions in long-tenn survival among breast cancer patients. The 15 year survival probabilities in this cohort were: for breast cancerspecific survival 0.88, competing causes survival 0.89 and for overall survival 0.78. Estrogen receptor (ER) and progesterone receptor (PR) status (Hazard Ratio (HR) ERIPR- versus ER+/PR+, 8.15,95% CI, 4.74, 14.00), p53 mutation (HR, 3.88, 95% CI, 2.00, 7.53) and Her-2 amplification (HR, 2.66, 95% CI, 1.36, 5.19) were associated with significant reductions in short-tenn breast cancer-specific survival «5 years following diagnosis), however, not with long-term survival in univariate analyses. Stage, histopathologic grade and ERiPR status were the clinicallbiologieal factors that were associated with short-term breast cancer specific survival in multivariate results. Living in an affluent neighbourhood (top quintile of median household income compared to the rest of the population) was associated with the largest significant increase in long-tenn breast cancer-specific survival after adjustment for stage, histopathologic grade and treatment (HR, 0.36, 95% CI, 0.12, 0.89).

"Welcome to my life" : the experiences of single mothers who are the recipients of multiple state provided benefits

Abstract This research takes the lens of social reproduction as a starting point for an examination of the effects of recent social welfare reforms on the lives o.fsingle mothers. As the cumulative effects o.f diminishing state provided benefits take hold, tensions are heightened as single mothers internalize the insecurity of earning an income in 11 capitalist labour market, while trying to carry out all that is involved in social reproduction with inadequate means of survival. Through interviewing single mothers who are the recipients of mUltiple state provided benefits (social assistance, student loans, subsidized housing and subsidized childcare), this thesis illuminates the cOl1linued regulation of women in an effort to assure that social reproduction is occurring at the lowest cost possible. State provided benefits are set lip in such a way that it is near impossible for single mothers to make ends meet without entering the labour force or entering into co-residential relationships. This push towards the labour force and/or marriage via punitive welfare policies illuminates the devaluation of the labour that is done at home. Through interviewing 5 single mothers, I will demonstrate the extensive labour that goes into maintaining their households. In addition .J case managers are interviewed. The employees of social assistance, subsidized hOllsing, subsidized childcare and student loans, have much agency in deeming who is worthy of receiving benefits. The employees of these agencies have the ability to make these women's lives easier or more complicated by how the workers interpret the policy regulations. Social policies are of paramount importance in the quest for women's equality and thus have consequences for how women's daily lives are organized. The rules and regulations that govern the individual policies are complex and bureaucratic and have implications for the ways in which women must organize their lives in order to survive. The shifts in social policy have been guided by neo-liberal assumptions with a focus on individual responsibility and a market-modeled welfare state. The caring work that is involved in raising children to be productive in a capitalist society is ignored or devalued in current policies. The emphasis in each polic.:v is on getting women who receive benefits into the paid work force, with little facilitation or investment into the caring work these women do on a daily basis that in turn supports capitalism. Policies, such as social assistance, subsidized housing, subsidized childcare and student loans, are set up in such a way that ignores the reality of women's day-to-day lives and devalues the necessary work done at home. It takes an abundance of labour and strategizing for women to seek out necessary means of survival, labour that is amplified when a woman is dealing with mUltiple slate provided benefits.