Neighborhood Factors Associated with Mental Disorder among Children in the USA: Evidence from National Survey of Children\u27s Health 2011/12

INTRODUCTION: Neighborhood factors affect mental health of children. There are not many studies done on neighborhood conditions and common childhood mental disorders using national level data in the US. This study aims to study the association between neighborhood characteristics and mental disorder among children in the US by analyzing nationally representative data. METHODS: Data on children aged 6-17 years from 2011/12 national survey of children’s health was analyzed. Primary dependent variable was current diagnosed mental disorder that was based on the diagnosis of at least one of the attention deficit hyperactivity disorder (ADHD), behavioral or conduct problem, depression and anxiety problem among children. Five neighborhood conditions (neighborhood amenities, neighborhood distracting element, supportive neighborhood, neighborhood safety, and school safety) were the independent variables. Analysis was conducted using bivariate and multivariable logistic regression at 95% CI. RESULTS: All the neighborhood conditions were significantly associated with current diagnosed mental disorder among children. In the multivariable model, children living in neighborhood perceived to be not supportive by parents/guardians had greater odds of mental disorder (OR 1.37, 95% CI:1.10-1.71) compared to children living in supportive neighborhood. Other noticeable factors associated with mental disorder among children were father’s and mother’s mental health, and number of adverse childhood experiences (ACEs). CONCLUSION: Neighborhood level interventions should be a part of broad interventions designed to improve mental health of children. Besides, assessment of conditions of a child’s neighborhood, parents’ perception of neighborhood social support, father’s and mother’s mental health, and adverse childhood experiences can be helpful in evaluating childhood mental disorders as well as in planning neighborhood level interventions

Structural identifiability analysis of epidemic models based on differential equations: A Primer

The successful application of epidemic models hinges on our ability to estimate model parameters from limited observations reliably. An often-overlooked step before estimating model parameters consists of ensuring that the model parameters are structurally identifiable from a given dataset. Structural identifiability analysis uncovers any existing parameter correlations that preclude their estimation from the observed variables. Here we review and illustrate methods for structural identifiability analysis based on a differential algebra approach using DAISY and Mathematica (Wolfram Research). We demonstrate this approach through examples of compartmental epidemic models previously employed to study transmission dynamics and control. We show that lack of structural identifiability may be remedied by incorporating additional observations from different model states or fixing some parameters based on existing parameter correlations, or by reducing the number of parameters or state variables involved in the system dynamics. We also underscore how structural identifiability analysis can help improve compartmental diagrams of differential-equation models by indicating the observed variables and the results of the structural identifiability analysis

Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal:perspectives of stakeholders

BACKGROUND: Nepal adopted the Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (MSAP) in 2014. Implementation of the plan has been challenging, with limited participation from non-health sectors. OBJECTIVES: The overall aim of the study was to gain the perspectives of key stakeholders involved in the Nepal MSAP on the barriers and facilitators to its implementation, through the participation of relevant sectors in the plan. METHODS: We held face-to-face semi-structured interviews with 12 stakeholders working in sectors involved in the MSAP. These sectors included the Office of the Prime Minister and Council of Ministries; Ministry of Health and Population (MOHP); Ministry of Education, Science and Technology; Ministry of Forest and Environment; academia; and professional organizations. Thematic analysis of transcripts was used to identify themes on awareness of NCDs, awareness of the MSAP, and barriers and facilitators to participation in the MSAP. RESULTS: Participants recognised NCDs as a growing and major burden in Nepal. However, a number of participants were not familiar with the MSAP, identifying a lack of leadership and poor dissemination. Political and systemic transformation, since the adoption of the MSAP, was seen as a key barrier to implementation. International commitments to develop multisectoral action made by the Government of Nepal were identified as drivers. The recent establishment of a separate section for NCDs and Mental Health within the Department of Health Services of MOHP and the promotion of a Health in All Policies (HiAP) approach in recent national documents, were both considered to support implementation. CONCLUSIONS: The establishment of permanent multisectoral or multistakeholder mechanisms has been challenging despite strong political calls for their development. Moving beyond 2020, multisectoral action plans should engage with stakeholders from federal, provincial and local governments in order to develop costed action plans with specific roles and responsibilities for each sector

Application of epidemiologic methods to investigate the heterogenous impact of COVID-19

Epidemiologic methods have been critical in shedding light on the dynamics and impact of the COVID-19 pandemic, including monitoring and quantifying morbidity and mortality over time to guide prevention and mitigation strategies. Here we apply different epidemiologic methods across different geospatial levels, population groups, and time scales to investigate the impact of COVID-19 using epidemiological data from Mexico. In the first study, we assess the mortality impact of the COVID-19 pandemic by estimating absolute and relative excess mortality above an expected level of deaths and employ a generalized logistic growth model to generate short-term forecasts of excess mortality. We also evaluate the association between the excess mortality rate and the use of hashtag terms indicating death in tweets from Mexico. In the second study, we expand the estimation of the excess mortality rate per 10,000 population from the national level to the ‘federal entity’ level in Mexico and use multiple linear regression analysis and spatial lag models to assess the factors associated with excess mortality rate. In addition, we use functional data analysis to compare, cluster, and summarize the excess mortality growth rate curves. In the third study, we compare the COVID-19 mortality rates and investigate the transmission dynamics among indigenous and non-indigenous populations in Mexico by using different methods such as estimation of person-time mortality rates, Cox Proportional Hazards regression, and instantaneous reproduction number (Rt) over a weekly sliding window as well as for the early ascending phase of four different waves of COVID-19 among the two subpopulations. The results from these studies indicate that Mexico was heavily affected by the COVID-19 pandemic, with central states exhibiting the highest excess mortality rates. The aging index, marginalization index, and average household size explained the variability in excess mortality rates across federal entities. The indigenous status was found to be a significant risk factor for COVID-19 mortality, with a 68% higher mortality among indigenous groups compared to non-indigenous. Overall, the three studies presented here demonstrate the power of different epidemiologic methods to gain insights on the heterogenous impact of the COVID-19 pandemic

Characteristics of Consumers of Family Planning Services in Eastern Nepal

Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO) Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of female users of permanent method were in age group 20-29 years and 25-29 years respectively. The major reasons for removal of IUCD were husband&rsquo;s migration and experienced physical problems. Most of the females doing sterilization were from Disadvantaged Janajati group whereas most of the males doing sterilization were from Upper caste ethnic group. Among females doing sterilization, 70% already had their second live birth baby. Out of the total sterilization performed in 8 months, only 15.15% was done among males. So, there is need of increasing male involvement in Family planning. There is also need of programs to encourage spacing methods among the target population. DOI: http://dx.doi.org/10.3126/dsaj.v6i0.8482 Dhaulagiri Journal of Sociology and Anthropology Vol. 6, 2012 125-138</p

Patients’ and Caretakers’ Satisfaction at Western Regional Hospital, Pokhara, Nepal

Curative services are highly demanded component of health service. Besides competence in technical aspects; behavior of health care providers, availability of consumer friendly environment and the trusting relationship with the physician along with open two way communication between health care provider and consumer determines the consumers’ perception about the quality of service that further determines whether they seek and continue to use services. This study was conducted with the objective of finding out consumers’ satisfaction with the services of Western Regional Hospital, Pokhara and the findings can be helpful in designing interventions accordingly. A client-exit interview was conducted which included 146 respondents representing both old and new OPD cases of the hospital. Two Focus Group Discussions were also conducted. Results obtained showed that service of hospital were of good satisfaction to more than half of the respondents. Drug availability and cheap cost of service were strong aspects of hospital. More than half of the respondents had visited private medicals before coming to hospital. Poor place of examination, poor hospital sanitation, long waiting time for doctor and service of staffs other than doctor were some of the aspects that consumers were poorly satisfied with. Fifty four out of 115 (47%) who had spent less than 5 minutes with the doctor, had good satisfaction with doctors’ service. Hence, consumers’ satisfaction is influenced by the factors like behavior of attending physician and other hospital staffs, place of examination, waiting time for doctor, hospital sanitation etc.DOI: http://dx.doi.org/10.3126/dsaj.v5i0.6364 Dhaulagiri Journal of Sociology and Anthropology Vol. 5, 2011: 205-16</p

Association between Neighborhood Conditions and Mental Disorders among Children in the US: Evidence from the National Survey of Children’s Health 2011/12

Background. This study examines the association between mental disorders and neighborhood conditions in a nationally representative sample of US children. Methods. Data from US children aged 6–17 years (N=95,677) were obtained from the 2011/12 National Survey of Children’s Health. Analysis examined neighborhood conditions and demographic and psychosocial characteristics including adverse childhood experiences (ACEs), parental mental health status, and the associations with any current diagnosed mental disorders (ACDMD). ACDMD was a composite variable derived from four childhood mental disorders examined. We computed descriptive statistics and logistic regression analyses. Results. Approximately 14% children had ACDMD. Of the neighborhood factors examined, nonsupportive neighborhood (AOR 1.37, 95% CI: 1.10, 1.71) was significantly associated with ACDMD in the multivariable models. Similarly, mother’s mental health (AOR 1.84, 95% CI: 1.39, 2.43) and ACEs (e.g., AOR for 5–9 ACEs 6.36, 95% CI: 4.67, 8.65) were also found to be strongly associated with mental disorders. Conclusion. Our findings show that parental poor mental health, living in a nonsupportive neighborhood, and ACEs were important risk factors for child mental disorders. While more research is needed, children who have had early trauma and who reside with parents and caretakers with poor mental health are in need of additional services and treatment