Determinants of Access to Landholding in Female-Headed Cassava Farming Households in Abia State, Southeast Nigeria.

This study on determinants of access to landholding by female-headed households involved in Individual tenure system in Abia State, Southeast Nigeria was carried out to ascertain the access to farmland by gender in individual tenure systems in the area as well as identifying the factors affecting access to landholding of female-headed cassava-based farming households under individual tenure system. A multi-stage random sampling technique was adopted for this study while data were collected through primary sources. The sample size consists of male and female headed households involved in individual tenure system respectively making a total of 234 cassava farming household respondents. Descriptive statistics as well as multiple regression technique were employed in analyzing the field data. Male headed households had more access to farmland than female headed households. Results show that age, income, asset size, farming experience, level of education, access to credit, land prices and location of farmland were factors affecting access to landholding by female headed households under individual tenure system in the study area

Year in review in Intensive Care Medicine 2010: III. ARDS and ALI, mechanical ventilation, noninvasive ventilation, weaning, endotracheal intubation, lung ultrasound and paediatrics

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations.

Rationale: African American individuals have worse outcomes in chronic obstructive pulmonary disease (COPD). Objectives: To assess whether race-specific approaches for estimating lung function contribute to racial inequities by failing to recognize pathological decrements and considering them normal. Methods: In a cohort with and at risk for COPD, we assessed whether lung function prediction equations applied in a race-specific versus universal manner better modeled the relationship between FEV1, FVC, and other COPD outcomes, including the COPD Assessment Test, St. George's Respiratory Questionnaire, computed tomography percent emphysema, airway wall thickness, and 6-minute-walk test. We related these outcomes to differences in FEV1 using multiple linear regression and compared predictive performance between fitted models using root mean squared error and Alpaydin's paired F test. Measurements and Main Results: Using race-specific equations, African American individuals were calculated to have better lung function than non-Hispanic White individuals (FEV1, 76.8% vs. 71.8% predicted; P = 0.02). Using universally applied equations, African American individuals were calculated to have worse lung function. Using Hankinson's Non-Hispanic White equation, FEV1 was 64.7% versus 71.8% (P < 0.001). Using the Global Lung Initiative's Other race equation, FEV1 was 70.0% versus 77.9% (P < 0.001). Prediction errors from linear regression were less for universally applied equations compared with race-specific equations when examining FEV1% predicted with the COPD Assessment Test (P < 0.01), St. George's Respiratory Questionnaire (P < 0.01), and airway wall thickness (P < 0.01). Although African American participants had greater adversity (P < 0.001), less adversity was only associated with better FEV1 in non-Hispanic White participants (P for interaction = 0.041). Conclusions: Race-specific equations may underestimate COPD severity in African American individuals.Clinical trial registered with www.clinicaltrials.gov (NCT01969344)

Contribution of Individual and Neighborhood Factors to Racial Disparities in Respiratory Outcomes.

Rationale: Black adults have worse health outcomes compared with white adults in certain chronic diseases, including chronic obstructive pulmonary disease (COPD).Objectives: To determine to what degree disadvantage by individual and neighborhood socioeconomic status (SES) may contribute to racial disparities in COPD outcomes.Methods: Individual and neighborhood-scale sociodemographic characteristics were determined in 2,649 current or former adult smokers with and without COPD at recruitment into SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study). We assessed whether racial differences in symptom, functional, and imaging outcomes (St. George's Respiratory Questionnaire, COPD Assessment Test score, modified Medical Research Council dyspnea scale, 6-minute-walk test distance, and computed tomography [CT] scan metrics) and severe exacerbation risk were explained by individual or neighborhood SES. Using generalized linear mixed model regression, we compared respiratory outcomes by race, adjusting for confounders and individual-level and neighborhood-level descriptors of SES both separately and sequentially.Measurements and Main Results: After adjusting for COPD risk factors, Black participants had significantly worse respiratory symptoms and quality of life (modified Medical Research Council scale, COPD Assessment Test, and St. George's Respiratory Questionnaire), higher risk of severe exacerbations and higher percentage of emphysema, thicker airways (internal perimeter of 10 mm), and more air trapping on CT metrics compared with white participants. In addition, the association between Black race and respiratory outcomes was attenuated but remained statistically significant after adjusting for individual-level SES, which explained up to 12-35% of racial disparities. Further adjustment showed that neighborhood-level SES explained another 26-54% of the racial disparities in respiratory outcomes. Even after accounting for both individual and neighborhood SES factors, Black individuals continued to have increased severe exacerbation risk and persistently worse CT outcomes (emphysema, air trapping, and airway wall thickness).Conclusions: Disadvantages by individual- and neighborhood-level SES each partly explain disparities in respiratory outcomes between Black individuals and white individuals. Strategies to narrow the gap in SES disadvantages may help to reduce race-related health disparities in COPD; however, further work is needed to identify additional risk factors contributing to persistent disparities

Eating disorders, body image and media exposure among adolescent girls in rural Burkina Faso

OBJECTIVE: Body dissatisfaction and eating disorders (ED) among young females may increase in limited-resource settings as exposure to media and higher-resource cultures increases. We examined ED prevalence and its predictors among adolescent females in rural north-western Burkina Faso. METHODS: Fieldworkers interviewed 696 female adolescents aged 12-20 in the Nouna Health and Demographic Surveillance System (HDSS). ED were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5), self-perceived appearance and body ideal were measured using the Thompson and Gray's Contour Drawing Rating Scale (CDRS) and eating disorder predictors by the Eating Disorder Examination Questionnaire (EDE-Q). We assessed media exposure to magazines, radio, television and the internet. RESULTS: 16% of respondents had a BMI below WHO age-standardized 5th percentile while 4% were above the 85th percentile; most respondents wanted to be larger. DSM-5 criteria for anorexia nervosa (AN) were fulfilled by four of 696 respondents (0.6%), those for bulimia nervosa by none, and those for binge eating disorder by two (0.3%). In multivariable regression, more AN symptoms were associated with greater EDE-Q body dissatisfaction, desiring a thinner body and a history of sexual harassment or assault, but not with media exposure. Conversely, a thinner desired body was associated with greater media exposure, higher BMI z-score and greater EDE-Q disordered eating. CONCLUSION: ED was very rare in rural Burkinabé female adolescents, but factors predictive of ED in higher-resource settings were also predictive here. Our findings suggest that increasing media exposure in resource-limited settings may lead to increased body dissatisfaction, and potentially to increased future ED prevalence