Search results for: elderly households
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1208

Search results for: elderly households

818 Influence of Engaging Female Caregivers in Households with Adolescent Girls on Adopting Equitable Family Eating Practices: A Quasi-Experimental Study

Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

Abstract:

Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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817 Music Therapy Intervention as a Means of Stimulating Communicative Abilities of Seniors with Neurocognitive Disorders – Theory versus Practice

Authors: Pavel Svoboda, Oldřich Müller

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The paper contains a screening of the opinions of helping professional workers working in a home for seniors with individuals with neurocognitive disorders and compares them with the opinions of a younger generation of students who are just preparing for this work. The authors carried out a comparative questionnaire survey with both target groups, focusing on the analysis and comparison of possible differences in their knowledge in the field of care for elderly people with neurocognitive disorders. Specifically, they focused on knowledge and experience with approaches, methods and tools applicable within the framework of music therapy interventions, as they are understood in practice in comparison with the theoretical knowledge of secondary school students focused on social work. The questionnaire was mainly aimed at assessing the knowledge of the possibilities of effective memory stimulation of the elderly and their communication skills using the means of music. The conducted investigation was based on the research of studies dealing with so-called non-pharmacological approaches to the given clientele; for professional caregivers, it followed music therapy lessons, which the authors regularly implemented from the beginning of 2022. Its results will, among other things, serve as the basis for an upcoming study with a scoping design review.

Keywords: neurocognitive disorders, seniors, music therapy intervention, melody, rhythm, text, memory stimulation, communication skills

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816 Characteristics of Acute Bacterial Prostatitis in Elderly Patients Attended in the Emergency Department

Authors: Carles Ferré, Ferran Llopis, Javier Jacob, Jordi Giol, Xavier Palom, Ignasi Bardés

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Objective: To analyze the characteristics of acute bacterial prostatitis (ABP) in elderly patients attended in the emergency department (ED). Methods: Observational and cohort study with prospective follow-up including patients with ABP presenting to the ED from January-December 2012. Data were collected for demographic variables, comorbidities, clinical and microbiological findings, treatment, outcome, and reconsultation at 30 days follow up. Findings were compared between patients ≥ 75 years (study group) and < 75 years (control group). Results: During the study period 241 episodes of ABP were included for analysis. Mean age was 62,9 ± 16 years, and 64 (26.5%) were ≥ 75 years old. A history of prostate adenoma was reported in 54 cases (22,4%), diabetes mellitus in 47 patients (19,5%) and prior manipulation of the lower urinary tract in 40 (17%). Mean symptoms duration was 3.38 ± 4.04 days, voiding symptoms were present in 176 cases (73%) and fever in 154 (64%). From 216 urine cultures, 128 were positive (59%) and 24 (17,6%) out of 136 blood cultures. Escherichia coli was the main pathogen in 58.6% of urine cultures and 64% of blood cultures (with resistant strains to fluoroquinolones in 27,7%, cotrimoxazole in 22,9% and amoxicillin/clavulanic in 27.7% of cases). Seventy patients (29%) were admitted to the hospital, and 3 died. At 30-day follow-up, 29 patients (12%) returned to the ED. In the bivariate analysis previous manipulation of the urinary tract, history of cancer, previous antibiotic treatment, resistant E. coli strains to amoxicillin-clavulanate and ciprofloxacin and extended spectrum beta-lactamase (ESBL) producers, renal impairment, and admission to the hospital were significantly more frequent (p < 0.05) among patients ≥ 75 years compared to those younger than 75 years. Conclusions: Ciprofloxacin and amoxicillin-clavulanate appear not to be good options for the empiric treatment of ABP for patients ≥ 75 years given the drug-resistance pattern in our series, and the proportion of ESBL-producing strains of E. coli should be taken into account. Awaiting bacteria identification and antibiogram from urine and/or blood cultures, treatment on an inpatient basis should be considered in older patients with ABP.

Keywords: acute bacterial prostatitits, antibiotic resistance, elderly patients, emergency

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815 Frailty and Quality of Life among Older Adults: A Study of Six LMICs Using SAGE Data

Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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814 Well-Being Inequality Using Superimposing Satisfaction Waves: Heisenberg Uncertainty in Behavioral Economics and Econometrics

Authors: Okay Gunes

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In this article, for the first time in the literature for this subject we propose a new method for the measuring of well-being inequality through a model composed of superimposing satisfaction waves. The displacement of households’ satisfactory state (i.e. satisfaction) is defined in a satisfaction string. The duration of the satisfactory state for a given period of time is measured in order to determine the relationship between utility and total satisfactory time, itself dependent on the density and tension of each satisfaction string. Thus, individual cardinal total satisfaction values are computed by way of a one-dimensional form for scalar sinusoidal (harmonic) moving wave function, using satisfaction waves with varying amplitudes and frequencies which allow us to measure well-being inequality. One advantage to using satisfaction waves is the ability to show that individual utility and consumption amounts would probably not commute; hence it is impossible to measure or to know simultaneously the values of these observables from the dataset. Thus, we crystallize the problem by using a Heisenberg-type uncertainty resolution for self-adjoint economic operators. We propose to eliminate any estimation bias by correlating the standard deviations of selected economic operators; this is achieved by replacing the aforementioned observed uncertainties with households’ perceived uncertainties (i.e. corrected standard deviations) obtained through the logarithmic psychophysical law proposed by Weber and Fechner.

Keywords: Heisenberg uncertainty principle, superimposing satisfaction waves, Weber–Fechner law, well-being inequality

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813 Estimating the Effect of a Newly Developed Portable Innovative Balance Room System with a Digital Game Program on Falls and Incontinence Symptoms in the Elderly

Authors: Özge Çeliker Tosun, Melda Başer Secer, İsmail Düşmez, Sedat Çapar, İlkay Kozak, Melahat Aktaş, Furkan Can Şimşek, Gökhan Tosun

Abstract:

Purpose: Portable innovative balance room system with digital game program; It was created to be able to be divided into small areas, such as inside the house, garden, balcony, to enable the person to enter and perform both evaluation and exercise safely, and to ensure that these results can be stored and sent to the therapist live or later when desired. The aim is to compare the effectiveness of the exercise program applied by the elderly within this system and the exercise program implemented under the supervision of a physiotherapist on balance and urinary incontinence symptoms. Materials and Methods: The study was conducted in a randomized controlled manner on 63 people with urinary incontinence (mean age: 75.5 years) at Narlıdere Nursing Home Elderly Care and Rehabilitation Center. Elderly people participating in the study were divided into 3 groups: 1. Group, an exercise program consisting of pelvic floor muscle training and OTOGA exercises, 2. Group, only pelvic floor muscle training, and 3. Group, pelvic floor muscle training and Otoga exercises in the form of a digital game program in a portable balance room system. (self-administered) for 12 weeks. Pelvic floor distress inventory (PTDE-20) and bladder diary were used to evaluate the incontinance symptoms of the cases. Pelvic floor muscle function was evaluated with superficial EMG. Berg, Fall Effectiveness Scale (FES) and Functional Status Evaluations (Chair Stand Test, Eight (8) Food Up and Go Test, Chair Sit and Reach Test, Two Minutes Step Test) were used to evaluate balance. The existence of differences between groups was analyzed using Krusskal Wallis analysis of variance, and the difference between before and after exercise was analyzed with Wilcoxon tests. Results: After treatment, PTDE-20, daily urinary incontinence and toilet visits values decreased significantly in all three groups (p < 0.001). While there was a statistically significant increase in pelvic floor muscle EMG values in the 2nd and third groups after treatment, there was no change in the other group (2nd Group PFM average EMG before-after: 5.5 (4.15-10.95) - 10.95 (8.68-13.68), P=0.05, 3 Group PFM average EMG before-after: 6.5 (4.28-11.55) - 11.75 (8.67-14.26), p=0.04). While BERG score, Chair Stand Test, Eight (8) Food Up and Go Test, and Two Minutes Step Test values increased in all groups (p<0.05), Fall Effectiveness Scale (FES) values did not change after treatment. Conclusion: Although pelvic floor muscle training combined with balance exercises reduces symptoms, it may not lead to a positive improvement in the functions of the pelvic floor muscles. For this reason, recovery lasts for a short time, and then symptoms may reoccur in the future. However, thanks to the new system, when balance exercises are combined with a game program for the pelvic floor muscles, a double effect can be achieved with a single application and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on this subject. However, thanks to the new system, a double effect can be achieved with a single application, and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on new system

Keywords: fall, urinary incontinance, balance, elderly

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812 Association Between Renewable Energy and Community Forest User Group of Siranchowk Rural Municipality, Nepal

Authors: Prem Bahadur Giri, Mathinee Yucharoen

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Community Forest User Groups (CFUGs) have been the core stone of forest management efforts in Nepal. Due to the lack of a smooth transition into the local governance structure in 2017, policy instruments have not been effectively cascaded to the local level, creating ambiguity and inconsistency in forest governance. Descriptive mixed-method research was performed with community users and stakeholders of Tarpakha community forest, Siranchowk Rural Municipality, to understand the role of the political economy in CFUG management. A household survey was conducted among 100 households (who also are existing members of the Tarpakha CFUG) to understand and document their energy consumption preferences and practices. Likewise, ten key informant interviews and five focus group discussions with the municipality and forest management officials were also conducted to have a wider overview of the factors and political, socio-economic, and religious contexts behind the utilization of renewable energy for sustainable development. Findings from our study suggest only 3% of households use biogas as the main source of energy. The rest of the households mention liquid petroleum gas (LPG), electricity and firewood as major sources of energy for domestic purposes. Community members highlighted the difficulty in accessing firewood due to strict regulations from the CFUG, lack of cattle and manpower to rear cattle to produce cow dung (for biogas), lack of technical expertise at the community level for the operation and maintenance of solar energy, among others as challenges of resource. Likewise, key informants have mentioned policy loopholes at both the federal and local levels, especially with regard to the promotion of alternative or renewable energy, as there are no clear mandates and provisions to regulate the renewable energy industry. The study recommends doing an in-depth study on the feasibility of renewable energy sources, especially in the context of CFUGs, where biodiversity conservation aspects need to be equally taken into consideration while thinking of the promotion and expansion of renewable energy sources.

Keywords: community forest, renewable energy, sustainable development, Nepal

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811 Household Size and Poverty Rate: Evidence from Nepal

Authors: Basan Shrestha

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The relationship between the household size and the poverty is not well understood. Malthus followers advocate that the increasing population add pressure to the dwindling resource base due to increasing demand that would lead to poverty. Others claim that bigger households are richer due to availability of household labour for income generation activities. Facts from Nepal were analyzed to examine the relationship between the household size and poverty rate. The analysis of data from 3,968 Village Development Committee (VDC)/ municipality (MP) located in 75 districts of all five development regions revealed that the average household size had moderate positive correlation with the poverty rate (Karl Pearson's correlation coefficient=0.44). In a regression analysis, the household size determined 20% of the variation in the poverty rate. Higher positive correlation was observed in eastern Nepal (Karl Pearson's correlation coefficient=0.66). The regression analysis showed that the household size determined 43% of the variation in the poverty rate in east. The relation was poor in far-west. It could be because higher incidence of poverty was there irrespective of household size. Overall, the facts revealed that the bigger households were relatively poorer. With the increasing level of awareness and interventions for family planning, it is anticipated that the household size will decrease leading to the decreased poverty rate. In addition, the government needs to devise a mechanism to create employment opportunities for the household labour force to reduce poverty.

Keywords: household size, poverty rate, nepal, regional development

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810 Readiness of Estonian Working and Non-working Older Adults to Benefit from eHealth

Authors: Marianne Paimre

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Estonia is heralded as the most successful digital country in the world with the highly acclaimed eHealth system. Yet 40% of the 65–74-year-olds do not use the Internet at all, and digital divide between young and elderly people's use of ICT is larger than in many advanced countries. Poor access to ICT resource and insufficient digital skills can lead to detachment from digital health resources, delayed diagnoses, and increased rates of hospitalization. To reveal digital divide within the elderly population itself, the presentation focuses on the health information behavior of Estonian seniors who either continue or have stopped working after retirement to use digital health applications. The author's main interest is on access, trust, and skills to use the Internet for medical purposes. Fifteen in-depth interviews with 65+ working persons, as well as 15 interviews with full-time retirees, were conducted. Also, six think-aloud protocols were conducted. The results indicate that older adults, who due to the nature of their work, have regular access to computers, often search for health-related information online. They exposed high source criticism and were successful in solving the given tasks. Conversely, most of the fully retired older adults claimed not using computers or other digital devices and cited lack of skills as the main reason for their inactivity. Thus, when developing health applications, it should be borne in mind that the ability and willingness of older adults to use e-solutions are very different.

Keywords: digital divide, digital healthcare, health information behavior, older adults

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809 Utilizing Experiential Teaching Strategies to Reduce the Incidence of Falls in Patients in Orthopedic Wards

Authors: Yu-Shi Ye, Jia-Min Wu, Jhih-Ci Li

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Background: Most orthopedic inpatients and primary caregivers are elderly, and patients are at high risk of falls. We set up a quality control team to analyze the root cause and found the following issues: 1. The nursing staff did not conduct cognitive assessments of patients and their primary caregivers to ensure that health education content was understood. 2. Nurses prefer to use spoken language in health education but lack the skills to use diverse teaching materials. 3. Newly recruited nurses have insufficient awareness of fall prevention. Methods: The study subjects were 16 nurses in the orthopedic ward of a teaching hospital in central Taiwan. We implemented the following strategies: 1. Developed a fall simulation teaching plan and conducted teaching courses and assessments in the morning meeting; 2. Designed and used a "fall prevention awareness card" to improve the prevention awareness of elderly patients; 3. All staff (including new staff) received experiential education training. Results: In 2021, 40% of patients in the orthopedic wards were aged 60-79 years (792/1979) with a high risk of falls. According to data collection, the incidence of falls in hospitalized patients was 0.04% (5/12651), which exceeded the threshold of 0.02% in our ward. After completing the on-the-job education training in October, the nursing staff expressed that they were more aware of the special situation of fall prevention. Through practical sharing and drills, combined with experiential teaching strategies, nurses can reconstruct the safety awareness of fall prevention and deepen their cognitive memory. Participants scored between 30 and 80 on the pretest (16 students, mean: 72.6) and between 90 and 100 on the post-test (16 students, mean: 92.6), resulting in a 73.8% improvement in overall scores. We have a total of 4 new employees who have all completed the first 3 months of compulsory PGY courses. From January to April 2022, the incidence of falls in hospitalized patients was 0.025% (1/3969). We have made good improvements and will continue to track the outcome. Discussion: In addition to enhancing the awareness of falls among nursing staff, how-to guide patients and primary caregivers to prevent falls is also the focus of improvement. The proper way of health education can be better understood through practical exercises and case sharing.

Keywords: experiential teaching strategies, fall prevention, cognitive card, elderly patients, orthopedic wards

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808 Effect of Cap and Trade Policies for Carbon Emission Reduction on Delhi Households

Authors: Vikram Singh

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This paper aims to take into account carbon tax or cap-and-trade legislation to manage Delhi carbon emissions after a post-Kyoto treaty. This report estimated the influence of the carbon taxes or rebate/compensation cost at the household level. Here, the three possible scenarios will help to comprehend the difference between a straightforward compensation/rebate, and two clearly denoting progressive formula. The straightforward compensation is basically minimizing the regressive applications that will bears on cost. On the other hand, both the progressive formula will generate extra revenue, which will help for feasibility of more efficient, vehicles, appliances and buildings in the low-income household. For the hypothetical case of carbon price $40/tonne, low-income household for both urban and rural region could experience price burden up to 5% and 9% on their income as compared to 3% and 7% for high-income household respectively. The survey report also shown that carbon emission due low-income household are primarily by the substantive requirement like housing and transportation whereas almost 40% emission due to high-income household are by luxurious and non-essential items. The equal distribution of revenue cum incentives will not completely overcome high-income household’s investment in inessential items. However, it will merely help in investing their income in energy efficient and less carbon intensive items. Therefore, the rebate distribution on per capita basis instead on per households will benefit more especially large families at low-income group.

Keywords: household emission, carbon credit, carbon intensity, green house gas emission, carbon generation based insentives

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807 Retrospective Study for Elective Medical Patients Evacuation of Different Diagnoses Requiring Different Approach in Oxygen Usage

Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

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806 Describing Cognitive Decline in Alzheimer's Disease via a Picture Description Writing Task

Authors: Marielle Leijten, Catherine Meulemans, Sven De Maeyer, Luuk Van Waes

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For the diagnosis of Alzheimer's disease (AD), a large variety of neuropsychological tests are available. In some of these tests, linguistic processing - both oral and written - is an important factor. Language disturbances might serve as a strong indicator for an underlying neurodegenerative disorder like AD. However, the current diagnostic instruments for language assessment mainly focus on product measures, such as text length or number of errors, ignoring the importance of the process that leads to written or spoken language production. In this study, it is our aim to describe and test differences between cognitive and impaired elderly on the basis of a selection of writing process variables (inter- and intrapersonal characteristics). These process variables are mainly related to pause times, because the number, length, and location of pauses have proven to be an important indicator of the cognitive complexity of a process. Method: Participants that were enrolled in our research were chosen on the basis of a number of basic criteria necessary to collect reliable writing process data. Furthermore, we opted to match the thirteen cognitively impaired patients (8 MCI and 5 AD) with thirteen cognitively healthy elderly. At the start of the experiment, participants were each given a number of tests, such as the Mini-Mental State Examination test (MMSE), the Geriatric Depression Scale (GDS), the forward and backward digit span and the Edinburgh Handedness Inventory (EHI). Also, a questionnaire was used to collect socio-demographic information (age, gender, eduction) of the subjects as well as more details on their level of computer literacy. The tests and questionnaire were followed by two typing tasks and two picture description tasks. For the typing tasks participants had to copy (type) characters, words and sentences from a screen, whereas the picture description tasks each consisted of an image they had to describe in a few sentences. Both the typing and the picture description tasks were logged with Inputlog, a keystroke logging tool that allows us to log and time stamp keystroke activity to reconstruct and describe text production processes. The main rationale behind keystroke logging is that writing fluency and flow reveal traces of the underlying cognitive processes. This explains the analytical focus on pause (length, number, distribution, location, etc.) and revision (number, type, operation, embeddedness, location, etc.) characteristics. As in speech, pause times are seen as indexical of cognitive effort. Results. Preliminary analysis already showed some promising results concerning pause times before, within and after words. For all variables, mixed effects models were used that included participants as a random effect and MMSE scores, GDS scores and word categories (such as determiners and nouns) as a fixed effect. For pause times before and after words cognitively impaired patients paused longer than healthy elderly. These variables did not show an interaction effect between the group participants (cognitively impaired or healthy elderly) belonged to and word categories. However, pause times within words did show an interaction effect, which indicates pause times within certain word categories differ significantly between patients and healthy elderly.

Keywords: Alzheimer's disease, keystroke logging, matching, writing process

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805 The Indebtedness of Men and Women: A Study of Personal Bankruptcies in the Czech Republic

Authors: Zuzana Fišerová, Marie Paseková

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Debt relief (also labelled personal bankruptcy) is a bankruptcy settlement method which was implemented into Czech legislation by the Insolvency Act (Act No. 182/2006 Coll. on Insolvency and its Resolution) on 1 January 2008. The need to implement the institute of personal bankruptcy arose from the excessive over-indebtedness of many inhabitants of the Czech Republic after the crisis that arose around 2008 and 2009. The contribution analyses the development in the manner in which households approach personal bankruptcy and assesses and surveys the differences between indebtedness among men and women. The first section analyses the development in numbers of filed personal bankruptcy petitions and the successfulness thereof; it likewise analyses the impact of other economic influences (regional differences, unemployment etc.). The differences between debtors in dependency to gender are also surveyed. A survey of insolvency proceedings for 664 persons whose insolvency proceedings were commenced in 2008 was conducted, whilst the data were acquired from the publicly accessible insolvency register. The hypothesis on the equality of the average debt level of men and women was tested when comparing indebtedness in dependency to debtor gender. At a significance level of 0.05, the test confirmed that the mean value of debt level for women is lower than the mean value of debt level for men. Through analysis of further results, it was found that the average level of debt among women was CZK 537 thousand, while the average level of creditor satisfaction reached 46.2%. Men in the monitored sample had an average level of reported receivables of CZK 652 thousand, satisfaction of their creditors reached 58.8%. The main changes in the institute of personal bankruptcy are then evaluated in the closing discussion, and the impacts of these changes for households are assessed. The development of legislation in the Czech Republic and practice are shifting towards broader usage of personal bankruptcy, especially insofar as it can now also be used by entrepreneurs. Furthermore, the amendment of the Insolvency Act has enabled married couples to apply for joint debt relief, which has improved the position of the marriage partner with lower income and who would not get permission for debt relief on his/her own (mostly women are at issue). In current practice, the condition of adequate income is also solved by the fact that another person (usually a family member) undertakes to donate a certain monthly sum throughout the duration of the debt relief. Personal bankruptcy can thus be completed also by individuals to whom it would previously have been denied by the court.

Keywords: debtor, households, insolvency act, over-indebtedness, personal bankruptcy

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804 Household Food Insecurity, Maternal Mental Health and Self-Efficacy

Authors: Nahid Salarkia, Nasrin Omidvar, Erfan Ghassemi, Vahideh Arab-Salari, Tirang Reza Neyestani

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Background: Household food insecurity has an adverse impact on the maternal mental health. This study was carried out to assess the relationship between household food insecurity, maternal depression and mother’s self-efficacy in Varamin, Iran, in 2014. Methods: In this cross-sectional study 423 mothers with children under 2 years old, with mean age 28.1±5.2 year; weight 66.3±13.4 kg; height 160.3± 5.7 cm and BMI 25.7±4.8 kg/m2 were selected by a multistage random sampling scheme. The instruments were: Beck Depression Inventory (BDI-III) and mother’s self-efficacy questionnaire. Data was analyzed using χ2 test, ANOVA and Pearson correlation. Results: Mildly, moderately and severely food insecure households were 39.5, 9.7 and 3.1%, respectively. Mild, moderate and sever depression was: 18.7, 13.9 and 5.7%. Mean score of depression in moderate and severe food insecure (8.6±5.3) was more than mild food insecure (4.8±4.7) and food secure (3.1±3.6) mothers. Frequency of very good, good and low mother’s self-efficacy were 62.8, 36.5, and 0.7%, respectively. Very good mother’s self-efficacy in food secure mothers (33.4%) was more than mild (25.4%) and moderate-sever food insecure groups (4%). There was a negative significant association between household food insecurity and mother’s self-efficacy (r= -0.297, p<0.01), and between mother’s depression and self-efficacy (r= -0.309, p=0.001). Conclusion: Empowerment of mothers with educational programs and social support can decrease mothers’ depression and increase self-efficacy that lead to improve maternal practices in food insecure households.

Keywords: Household food insecurity, Iran, mothers, physiological characteristics, self-efficacy

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803 Impact of the 2015 Drought on Rural Livelihood – a Case Study of Masurdi Village in Latur District of Maharashtra, India

Authors: Nitin Bhagat

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Drought is a global phenomenon. It has a huge impact on agriculture and allied sector activities. Agriculture plays a substantial role in the economy of developing countries, which mainly depends on rainfall. The present study illustrates the drought conditions in Masurdi village of Latur district in the Marathwada region, Maharashtra. This paper is based on both primary as well as secondary data sources. The multistage sample method was used for primary data collection. The 100 households sample survey data has been collected from the village through a semi-structured questionnaire. The crop production data is collected from the Department of Agriculture, Government of Maharashtra. The rainfall data is obtained from the Department of Revenue, Office of Divisional Commissioner, Aurangabad for the period from 1988 to 2018. This paper examines the severity of drought consequences of the 2015 drought on domestic water supply, crop production, and the effect on children's schooling, livestock assets, bank credit, and migration. The study also analyzed climate variables' impact on the Latur district's total food grain production for 19 years from 2000 to 2018. This study applied multiple regression analysis to check the relationship between climatic variables and the Latur district's total food grain production. The climate variables are annual rainfall, maximum temperature and minimum temperature. The study considered that climatic variables are independent variables and total food grain as the dependent variable. It shows there is a significant relationship between rainfall and maximum temperature. The study also calculated rainfall deviations to find out the drought and normal years. According to drought manual 2016, the rainfall deviation calculated using the following formula. RF dev = {(RFi – RFn) / RFn}*100.Approximately 27.43 % of the workforce migrated from rural to urban areas for searching jobs, and crop production decreased tremendously due to inadequate rainfall in the drought year 2015. Many farm and non-farm labor, some marginal and small cultivators, migrated from rural to urban areas (like Pune, Mumbai, and Western Maharashtra).About 48 % of the households' children faced education difficulties; in the drought period, children were not going to school. They left their school and joined to bring water with their mother and fathers, sometimes they fetched water on their head or using a bicycle, near about 2 km from the village. In their school-going days, drinking water was not available in their schools, so the government declared holidays early in the academic education year 2015-16 compared to another academic year. Some college and 10th class students left their education due to financial problems. Many households benefited from state government schemes, like drought subsidies, crop insurance, and bank loans. Out of 100 households, about 50 (50 %) have obtained financial support from the state government’s subsidy scheme, 58 ( 58 %) have got crop insurance, and 41(41 %) irrigated households have got bank loans from national banks; besides that, only two families have obtained loans from their relatives and moneylenders.

Keywords: agriculture, drought, household, rainfall

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802 Glycemic Control in Rice Consumption among Households with Diabetes Patients: The Role of Food Security

Authors: Chandanee Wasana Kalansooriya

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Dietary behaviour is a crucial factor affecting diabetes control. With increasing rates of diabetes prevalence in Asian countries, examining their dietary patterns, which are largely based on rice, is timely required. It has been identified that higher consumption of some rice varieties is associated with increased risk of type 2 diabetes. Although diabetes patients are advised to consume healthier rice varieties, which contains low glycemic, several conditions, one of which food insecurity, make them difficult to preserve those healthy dietary guidelines. Hence this study tries to investigate how food security affects on making right decisions of rice consumption within diabetes affected households using a sample from Sri Lanka, a country which rice considered as the staple food and records the highest diabetes prevalence rate in South Asia. The study uses data from the Household Income and Expenditure Survey 2016, a nationally representative sample conducted by the Department of Census and Statistics, Sri Lanka. The survey used a two-stage stratified sampling method to cover different sectors and districts of the country and collected micro-data on demographics, health, income and expenditures of different categories. The study uses data from 2547 households which consist of one or more diabetes patients, based on the self-recorded health status. The Household Dietary Diversity Score (HDDS), which constructed based on twelve food groups, is used to measure the level of food security. Rice is categorized into three groups according to their Glycemic Index (GI), high GI, medium GI and low GI, and the likelihood and impact made by food security on each rice consumption categories are estimated using a Two-part Model. The shares of each rice categories out of total rice consumption is considered as the dependent variable to exclude the endogeneity issue between rice consumption and the HDDS. The results indicate that the consumption of medium GI rice is likely to increase with the increasing household food security, but low GI varieties are not. Households in rural and estate sectors are less likely and Tamil ethnic group is more likely to consume low GI rice varieties. Further, an increase in food security significantly decreases the consumption share of low GI rice, while it increases the share of medium GI varieties. The consumption share of low GI rice is largely affected by the ethnic variability. The effects of food security on the likelihood of consuming high GI rice varieties and changing its shares are statistically insignificant. Accordingly, the study concludes that a higher level of food security does not ensure diabetes patients are consuming healthy rice varieties or reducing consumption of unhealthy varieties. Hence policy attention must be directed towards educating people for making healthy dietary choices. Further, the study provides a room for further studies as it reveals considerable ethnic and sectorial differences in making healthy dietary decisions.

Keywords: diabetes, food security, glycemic index, rice consumption

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801 Factors Affecting Households' Decision to Allocate Credit for Livestock Production: Evidence from Ethiopia

Authors: Kaleb Shiferaw, Berhanu Geberemedhin, Dereje Legesse

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Access to credit is often viewed as a key to transform semi-subsistence smallholders into market oriented producers. However, only a few studies have examined factors that affect farmers’ decision to allocate credit on farm activities in general and livestock production in particular. A trivariate probit model with double selection is employed to identify factors that affect farmers’ decision to allocate credit on livestock production using data collected from smallholder farmers in Ethiopia. After controlling for two sample selection bias – taking credit for the production season and decision to allocate credit on farm activities – land ownership and access to a livestock centered extension service are found to have a significant (p<0.001) effect on farmers decision to use credit for livestock production. The result showed farmers with large land holding, and access to a livestock centered extension services are more likely to utilize credit for livestock production. However since the effect of land ownership squared is negative the effect of land ownership for those who own a large plot of land lessens. The study highlights the fact that improving access to credit does not automatically translate into more productive households. Improving farmers’ access to credit should be followed by a focused extension services.

Keywords: livestock production, credit access, credit allocation, household decision, double sample selection

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800 A Qualitative Meta-Synthesis of the Caregiving Experiences of Family Caregivers for Elderly Cancer Patients in China: Implications for Health Social Work

Authors: Longtao He, Han Wu

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Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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799 The Association of Empirical Dietary Inflammatory Index with Musculoskeletal Pains in Elderlies

Authors: Mahshid Rezaei, Zahra Tajari, Zahra Esmaeily, Atefeh Eyvazkhani, Shahrzad Daei, Marjan Mansouri Dara, Mohaddesh Rezaei, Abolghassem Djazayeri, Ahmadreza Dorosti Motlagh

Abstract:

Background: Musculoskeletal pain is one of the most prevalent symptoms in elderly age. Nutrition and diet are considered important underlying factors that could affect chronic musculoskeletal pain. The purpose of this study was to identify the relationship between empirical dietary inflammatory patterns (EDII) and musculoskeletal pain. Method: In this cross-sectional study, 213 elderly individuals were selected from several health centers. The usual dietary intake was evaluated by a valid and reliable 147-items food frequency questionnaire (FFQ). To measure the intensity of pain, Visual Analogue Scale (VAS) was used. Multiple Linear Regression was applied to assess the association between EDII and musculoskeletal pain. Results: The results of multiple linear regression analysis indicate that a higher EDII score was associated with higher musculoskeletal pain (β= 0.21: 95% CI: 0.24-1.87: P= 0.003). These results stayed significant even after adjusting for covariates such as sex, marital status, height, family number, sleep, BMI, physical activity duration, waist circumference, protector, and medication use (β= 0.16: 95% CI: 0.11-1.04: P= 0.02). Conclusion: Study findings indicated that higher inflammation of diet might have a direct association with musculoskeletal pains in elderlies. However, further investigations are required to confirm these findings.

Keywords: musculoskeletal pain, empirical dietary inflammatory pattern, elderlies, dietary pattern

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798 Attitudinal Change: A Major Therapy for Non–Technical Losses in the Nigerian Power Sector

Authors: Fina O. Faithpraise, Effiong O. Obisung, Azele E. Peter, Chris R. Chatwin

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This study investigates and identifies consumer attitude as a major influence that results in non-technical losses in the Nigerian electricity supply sector. This discovery is revealed by the combination of quantitative and qualitative research to complete a survey. The dataset employed is a simple random sampling of households using electricity (public power supply), and the number of units chosen is based on statistical power analysis. The units were subdivided into two categories (household with and without electrical meters). The hypothesis formulated was tested and analyzed using a chi-square statistical method. The results obtained shows that the critical value for the household with electrical prepared meter (EPM) was (9.488 < 427.4) and those without electrical prepared meter (EPMn) was (9.488 < 436.1) with a p-value of 0.01%. The analysis demonstrated so far established the real-time position, which shows that the wrong attitude towards handling the electricity supplied (not turning off light bulbs and electrical appliances when not in use within the rooms and outdoors within 12 hours of the day) characterized the non-technical losses in the power sector. Therefore the adoption of efficient lighting attitudes in individual households as recommended by the researcher is greatly encouraged. The results from this study should serve as a model for energy efficiency and use for the improvement of electricity consumption as well as a stable economy.

Keywords: attitudinal change, household, non-technical losses, prepared meter

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797 The Influence of Housing Choice Vouchers on the Private Rental Market

Authors: Randy D. Colon

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Through a freedom of information request, data pertaining to Housing Choice Voucher (HCV) households has been obtained from the Chicago Housing Authority, including rent price and number of bedrooms per HCV household, community area, and zip code from 2013 to the first quarter of 2018. Similar data pertaining to the private rental market will be obtained through public records found through the United States Department of Housing and Urban Development. The datasets will be analyzed through statistical and mapping software to investigate the potential link between HCV households and distorted rent prices. Quantitative data will be supplemented by qualitative data to investigate the lived experience of Chicago residents. Qualitative data will be collected at community meetings in the Chicago Englewood neighborhood through participation in neighborhood meetings and informal interviews with residents and community leaders. The qualitative data will be used to gain insight on the lived experience of community leaders and residents of the Englewood neighborhood in relation to housing, the rental market, and HCV. While there is an abundance of quantitative data on this subject, this qualitative data is necessary to capture the lived experience of local residents effected by a changing rental market. This topic reflects concerns voiced by members of the Englewood community, and this study aims to keep the community relevant in its findings.

Keywords: Chicago, housing, housing choice voucher program, housing subsidies, rental market

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796 Impact of Climate Variability on Household's Crop Income in Central Highlands and Arssi Grain Plough Areas of Ethiopia

Authors: Arega Shumetie Ademe, Belay Kassa, Degye Goshu, Majaliwa Mwanjalolo

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Currently the world economy is suffering from one critical problem, climate change. Some studies done before identified that impact of the problem is region specific means in some part of the world (temperate zone) there is improvement in agricultural performance but in some others like in the tropics there is drastic reduction in crop production and crop income. Climate variability is becoming dominant cause of short-term fluctuation in rain-fed agricultural production and income of developing countries. The purely rain-fed Ethiopian agriculture is the most vulnerable sector to the risks and impacts of climate variability. Thus, this study tried to identify impact of climate variability on crop income of smallholders in Ethiopia. The research used eight rounded unbalanced panel data from 1994- 2014 collected from six villages in the study area. After having all diagnostic tests the research used fixed effect method of regression. Based on the regression result rainfall and temperature deviation from their respective long term averages have negative and significant effect on crop income. Other extreme devastating shocks like flood, storm and frost, which are sourced from climate variability, have significant and negative effect on crop income of households’. Parameters that notify rainfall inconsistency like late start, variation in availability at growing season, and early cessation are critical problems for crop income of smallholder households as to the model result. Given this, impact of climate variability is not consistent in different agro-ecologies of the country. Rainfall variability has similar impact on crop income in different agro-ecology, but variation in temperature affects cold agro-ecology villages negatively and significantly, while it has positive effect in warm villages. Parameters that represent rainfall inconsistency have similar impact in both agro-ecologies and the aggregate model regression. This implies climate variability sourced from rainfall inconsistency is the main problem of Ethiopian agriculture especially the crop production sub-sector of smallholder households.

Keywords: climate variability, crop income, household, rainfall, temperature

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795 Full Mini Nutritional Assessment Questionnaire and the Risk of Malnutrition and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras

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Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.

Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality

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794 Health Trajectory Clustering Using Deep Belief Networks

Authors: Farshid Hajati, Federico Girosi, Shima Ghassempour

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We present a Deep Belief Network (DBN) method for clustering health trajectories. Deep Belief Network (DBN) is a deep architecture that consists of a stack of Restricted Boltzmann Machines (RBM). In a deep architecture, each layer learns more complex features than the past layers. The proposed method depends on DBN in clustering without using back propagation learning algorithm. The proposed DBN has a better a performance compared to the deep neural network due the initialization of the connecting weights. We use Contrastive Divergence (CD) method for training the RBMs which increases the performance of the network. The performance of the proposed method is evaluated extensively on the Health and Retirement Study (HRS) database. The University of Michigan Health and Retirement Study (HRS) is a nationally representative longitudinal study that has surveyed more than 27,000 elderly and near-elderly Americans since its inception in 1992. Participants are interviewed every two years and they collect data on physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning. The dataset is publicly available and we use the RAND HRS version L, which is easy to use and cleaned up version of the data. The size of sample data set is 268 and the length of the trajectories is equal to 10. The trajectories do not stop when the patient dies and represent 10 different interviews of live patients. Compared to the state-of-the-art benchmarks, the experimental results show the effectiveness and superiority of the proposed method in clustering health trajectories.

Keywords: health trajectory, clustering, deep learning, DBN

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793 Assessment of Intra-City Road Infrastructure in Ado-Ekiti, Ekiti State, Nigeria

Authors: Aruna Kemisola Kehinde, Oyinloye Michael Ajide, Aboluje Oluwafemi Bolarinwa

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The development of the nation's overall growth is directly impacted by the vital substructure of the transportation system. The majority of developing countries experience issues with road transportation, including limited and low-quality infrastructure. The study assessed intra-city road infrastructure in Ado-Ekiti with a view to identifying its adequacy and functionality for efficient transport in the town. To this end, the study examined the locations of the road infrastructure, characteristics of the road infrastructure, and condition of the road infrastructure. A systematic random sampling method was adopted to select respondents for the study. Data were sourced from both primary and secondary sources. A 2.5% of 20,160 households, amounting to 503 households, was used as the sample size. Data analysis was based on responses from 500 questionnaires retrieved, and the data were analyzed using descriptive statistics. The results of this study showed that based on the locations of road infrastructure, disparity exists in the distribution of infrastructure amongst the major roads. Inferences from the results gathered also demonstrated that the infrastructure that is available is very much less than the non-available infrastructure. About 50% of the respondents are satisfied that the condition of road infrastructure in Ado-Ekiti is fair. The study's recommendations for the Ekiti state government include quantifying the number of existing road infrastructure, establishing a state maintenance board to expedite their renovation, and diversifying its goals for providing road infrastructure through public-private partnership (PPP) agreements with the private sector.

Keywords: road transportation, infrastructure, availability, intra-city

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792 The Occurrence of Sporeformers in Processed Milk from Household Refrigerators and The Effect of Heat Treatment on Bacillus Spores Activation

Authors: Sarisha Devnath, Oluwatosin A. Ijabadeniyi

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In recent years milk contamination has become a major problem in households; due to the likely occurrence of bacteria, even after the milk has been processed. One such genus of bacteria causing unwanted growth is Bacillus. This research project looks at the presence of spore formers in processed milk from household refrigerators and the effect of pasteurization and high temperature on Bacillus spores activation. 24 samples each of UHT milk and pasteurised milk from 24 households were sampled for the presence of spore formers. While anaerobic spore formers were not found in any of the samples, the average aerobic spore formers in UHT milk and pasteurized milk however were 5.77 cfu/ml and 5.88 cfu/ml respectively. After sequencing, it was detected that the mixed culture contained Bacillus cereus, for both pasteurised and UHT milk samples. For the activation study, raw milk samples were collected and subjected to four different temperatures; 65˚C, 72˚C, 80˚C, 100˚C respectively. Samples were stored for 7 days at 5˚C and 10˚C and analysed daily. The average aerobic spore formers in raw milk for samples stored at 5˚C range between 4.67-6.00 cfu/ml while it ranges between 4.84-6.00 cfu/ml at 10˚C, signifying that the high temperatures could have resulted in germination of dominant spores. Statistical analysis conducted on these results indicated a significant difference between the numbers of colonies present at the different treatment temperatures the bacterium was exposed to. This work showed that household milk may constitute public health risk furthermore; pasteurization and higher temperatures may not be effective to remove aerobic spore formers because of Bacillus spores activation.

Keywords: sporeformers, bacillus, spores, activation, milk

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791 The Good, the Bad and the Unknown: Exploring the Knowledge, Attitude and Behaviour towards the Use of Insecticide Treated Mosquito Nets among Pregnant Women and Children in Rural South-Western Uganda

Authors: Ivan M. Taremwa, Scholastic Ashaba, Harriet O. Adrama, Carlrona Ayebazibwe, Daniel Omoding, Imelda Kemeza, Jane Yatuha, Thadeus Turuho, Noni E. MacDonald, Robert Hilliard

Abstract:

Background: The burden of malaria in Uganda remains unacceptably high, especially among children and pregnant women. To prevent malaria related complications, household possession and use of Insecticide Treated mosquito Nets (ITNs) has become a common practice in the country. Despite the availability of ITNs, the number of malaria cases has not gone down. We sought to explore knowledge, attitude, and behaviour towards the use of ITNs as a nightly malaria prevention strategy among pregnant women and children under five years of age in rural southwest Uganda. Materials and Methods: This was a community based, descriptive cross-sectional study, in which households with children under 5 years, and/or pregnant women were enrolled. We used a structured questionnaire to collect data on participants’ understanding of the causes, signs and symptoms of malaria; use of ITNs to prevent malaria; attitudes and behaviours towards the use of ITNs. We also conducted key informant interviews (KIIs) to get in-depth understanding of responses from the participants. We analysed quantitative data using STATA version 12. Qualitative findings from the KIIs were transcribed and translated, and manually analysed using thematic content analysis. Results: Of the 369 households enrolled, 98.6% (N=363) households had children under five. Most participants (41.2%, N=152) were in the 21-30 years of age category (mean age; 32.2). 98.6% (N=362) of the respondents considered ITNs a key malaria prevention strategy. The ITN possession rate was 84.0% (N=310), of these, 67.0% (N=205) consistently used them. 39% of the respondents did not have a positive attitude towards ITNs, as they considered more the perceived effects of ITNs. Conclusions: Although 84.0% of the respondents possessed ITNs, many were not consistently using them. There is need to engage all stakeholders (including cultural leaders, community health workers, religious leaders and the government) in the malaria prevention campaigns using ITNs through: a) government’s concerted effort to ensure universal access of good quality ITNs, b) end-user directed education to correct false beliefs and misinformation, c) telling the ITN success stories to improve on the usage.

Keywords: ITNs use, malaria, pregnant women, rural Uganda

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790 Accessible Facilities in Home Environment for Elderly Family Members in Sri Lanka

Authors: M. A. N. Rasanjalee Perera

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The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: aging population, elderly care, home environment, housing facilities

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789 Determinants of Household Food Security in Addis Ababa City Administration

Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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