Showing papers in "International Journal of Public Health in 2015"

Quantifying the health impacts of ambient air pollutants: recommendations of a WHO/Europe project

Abstract: Quantitative estimates of air pollution health impacts have become an increasingly critical input to policy decisions. The WHO project “Health risks of air pollution in Europe—HRAPIE” was implemented to provide the evidence-based concentration–response functions for quantifying air pollution health impacts to support the 2013 revision of the air quality policy for the European Union (EU). A group of experts convened by WHO Regional Office for Europe reviewed the accumulated primary research evidence together with some commissioned reviews and recommended concentration–response functions for air pollutant–health outcome pairs for which there was sufficient evidence for a causal association. The concentration–response functions link several indicators of mortality and morbidity with short- and long-term exposure to particulate matter, ozone and nitrogen dioxide. The project also provides guidance on the use of these functions and associated baseline health information in the cost–benefit analysis. The project results provide the scientific basis for formulating policy actions to improve air quality and thereby reduce the burden of disease associated with air pollution in Europe.

Physical inactivity and associated factors among university students in 23 low-, middle- and high-income countries

Abstract: The aim of this study was to determine estimates of the prevalence and social correlates of physical inactivity among university students in 23 low-, middle- and high-income countries. The International Physical Activity Questionnaire was used to collect data from 17,928 undergraduate university students (mean age 20.8, SD = 2.8) from 24 universities in 23 countries. The prevalence of physical inactivity was 41.4 %, ranging from 21.9 % in Kyrgyzstan to 80.6 % in Pakistan. In multivariate logistic regression, older age (22–30 years), studying in a low- or lower middle-income country, skipping breakfast and lack of social support were associated with physical inactivity. In men, being underweight, being overweight or obese, not avoiding fat and cholesterol, not having severe depression symptoms, low beliefs in the health benefits of physical activity, low personal control and knowledge of exercise-heart link, and in women, not trying to eat fibre, low personal mastery and medium personal control were additionally associated with physical inactivity. Four in each ten students are physically inactive, calling for strategic interventions by relevant professionals in higher educational institutions.

A longitudinal study of the social and emotional predictors and consequences of cyber and traditional bullying victimisation.

Abstract: Few longitudinal studies have investigated how cyberbullying interacts with traditional bullying among young people, who are increasingly using online environments to seek information, entertainment and to socialise. This study aimed to identify the associations between the relative contribution of cyberbullying victimisation and traditional bullying victimisation on social and emotional antecedents and outcomes among adolescents. Participants were a cohort of 1,504 adolescents from 16 Australian schools followed from age 13 to 15 years. Adolescents experiencing social and emotional difficulties were more likely to be cyberbullied and traditionally bullied, than traditionally bullied only. Those targeted in both ways experienced more harm and stayed away from school more often than those traditionally bullied only. These findings suggest a high coexistence of cyber and traditional bullying behaviours and their antecedents, and higher levels of harm from a combination of these behaviours for adolescents over time. Future research should engage students as co-researchers to enhance school and parent strategies to support adolescents experiencing difficulties, and to reduce the likelihood of both cyber and traditional bullying.

Syria: health in a country undergoing tragic transition

Abstract: To document the ongoing destruction as a result of the tragic events in Syria, to understand the changing health care needs and priorities of Syrians. A directed examination of the scientific literature and reports about Syria before and during the Syrian conflict, in addition to analyzing literature devoted to the relief and rebuilding efforts in crisis situations. The ongoing war has had high direct war casualty, but even higher suffering due to the destruction of health system, displacement, and the breakdown of livelihood and social fabric. Millions of Syrians either became refugees or internally displaced, and about half of the population is in urgent need for help. Access to local and international aid organizations for war-affected populations is an urgent and top priority. Syrians continue to endure one of the biggest human tragedies in modern times. The extent of the crisis has affected all aspects of Syrians’ life. Understanding the multi-faceted transition of the Syrian population and how it reflects on their health profile can guide relief and rebuilding efforts’ scope and priorities.

Problematic mobile phone use in adolescents: derivation of a short scale MPPUS-10

Abstract: Objectives Our aim was to derive a short version of the Mobile Phone Problem Use Scale (MPPUS) using data from 412 adolescents of the Swiss HERMES (Health Effects Related to Mobile phonE use in adolescentS) cohort.

Media use and depression: exposure, household rules, and symptoms among young adolescents in the USA

Abstract: OBJECTIVES: To determine the longitudinal and cross-sectional associations between different types of electronic media use (mobile phones, TV, computers, video games, and music) and young adolescents' depressive symptoms, and to explore the potential for household media rules to reduce young people's depression. METHODS: 126 young adolescents were recruited from the Northeastern USA. Each type of media use was assessed using survey questions, time use diaries, and ecological momentary assessment. The Beck Depression Index for Primary Care was administered at baseline and 1 year later as part of a questionnaire that also included items assessing the presence of household rules about TV and video games. RESULTS: Baseline use of mobile phones and TV viewing were associated with higher levels of depression 1 year later controlling for demographic information and baseline depression score. Having household rules about TV at baseline predicted lower levels of depression at follow-up. CONCLUSIONS: Both TV viewing and mobile phone use may contribute to the development of depressive symptoms. Implementing household rules about the duration and content of TV could help reduce depression in young adolescents. Language: en

Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation

Abstract: Objective: The Mashhad stroke and heart atherosclerotic disorder (MASHAD) study is a 10-year cohort study that aims to evaluate the impact of various genetic, environmental, nutritional and psychosocial risk factors on the incidence of cardiovascular events among an urban population in eastern Iran. Methods: The MASHAD study comprises a cohort of 9704 individuals aged 35-65 years using a stratified cluster random sampling design. This cohort will be followed up until 2020, with follow-up examinations being undertaken every 3 years. Ten-year cardiovascular disease (CVD) risk estimation was determined using NCEP ATP III criteria. Results: Overall, 88.4 of women and 79.2 of men (P 20 were observed to be 86.6, 11 and 2.5 , respectively. Predicted risk of CVD > 10 using the Framingham algorithm was considerably higher in men compared to women. Overall, 9.5 95 % confidence interval (CI) 8.9�10.1 % of our subjects had prevalent CAD. Conclusion: The prevalence of CVD risk factors within our population is high compared to Western countries, indicating the necessity for interventional risk modifications. © 2015, Swiss School of Public Health.

Exposing concerns about vaccination in low- and middle-income countries: a systematic review.

Abstract: Concerns about vaccination lead to under- and no-vaccination. Our objective is to synthesise and expose evidence on individuals’ and communities’ concerns about vaccination to influence current debates on strategies to improve vaccination coverage in low- and middle-income countries. Systematic literature review till February 2014, following standard methods. Published and grey literature that focused on individuals and community concerns on childhood vaccinations were selected. 44 quantitative, qualitative and mixed-methods studies were included. Main reported concerns referred to perceptions of vaccine harms (e.g. attribution of fatal events). Other concerns included programme distrust (mainly due to rumours and conspiracies) and health system unfriendliness. Concerns about vaccination are widespread and further worsen the challenges related to programmatic and health system barriers to vaccination. There is a disconnection between qualitative and quantitative research which misses the opportunity to quantify what is reported in the former. Strikingly, there is a wealth of evidence on concerns but much lesser evidence on interventions to address them. We welcome World Health Organization initiative to tackle vaccine hesitancy and call for the synthesis of evidence and production of guidance on strategies to address concerns on vaccination.

Excessive internet use in European adolescents: What determines differences in severity?

Abstract: Objectives This study investigated the differences between non-excessive, moderately excessive, and highly excessive internet use among adolescents. These differences were explored in terms of personal characteristics, psychological difficulties, environmental factors, and manner of internet use.

Correlates of healthy fruit and vegetable diet in students in low, middle and high income countries

Abstract: The aim of this study was to assess the prevalence of fruits and vegetable consumption and associated factors among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected in a cross-sectional survey from 17,789 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Overall, 82.8 % of the university students consumed less than the recommended five servings of fruits and/or vegetables. The mean fruit and vegetable consumption varied by country, ranging from ≤2.5 mean daily servings in Jamaica, Philippines and Barbados to ≥3.9 mean daily servings in Mauritius, Tunisia and Ivory Coast. In multivariate logistic regression analysis, sociodemographic factors, psychosocial factors, and behavioural factors (inadequate dietary behaviours, binge drinking and physical inactivity) were associated with low prevalence of fruit and vegetable intake. Findings stress the need for intervention programmes aiming at increased consumption of fruit and vegetables considering the identified sociodemographic, psychosocial and behavioural risk factors.

Cyberbullying, help-seeking and mental health in young Australians: implications for public health

Abstract: To examine the relationship between young Australians’ cyberbullying experiences, their help-seeking practices and associated mental well-being and social connectedness, with a view to informing national health and well-being agendas. An online survey was administered to young people aged 12–18 years (n = 2,338), recruited across Australia in year 2 of a larger 4-year study. Youth with no experience of cyberbullying had better well-being profiles and mental health overall. Conversely, cyberbully victims, had poorer well-being and mental health and tended not to engage with online support services, in spite of being more likely to be online after 11 pm. Parents and peers were identified as key sources of help for most young people when dealing with problems. Cyberbullying is a public health issue particularly for vulnerable youth whose mental health and well-being is impacted more than those not involved. As youth are spending increasing time in the 24/7 online environment, there is a need to develop initiatives that engage young people and encourage help-seeking online, whilst concomitantly building capacity of parents and peers to support their well-being.

How well does Europe sleep? A cross-national study of sleep problems in European older adults.

Abstract: In this study, we aim to provide insight into the socio-demographic, family-related and socio-economic determinants of sleep problems in European older adults. Data from the Survey of Health Ageing and Retirement in Europe (2011/2012) were used to perform multilevel logistic regression analyses on whether one has been bothered by sleep problems for at least 6 months. The final sample consisted of 54,722 respondents aged 50 and older from 16 countries. Prevalence rates varied from 16.6 % in Denmark and Italy to 31.2 % in Poland. The odds ratio of 2.014 confirmed a higher likelihood of sleep problems in women. People aged 60–69 (OR 0.898) reported less sleep problems than people between 50 and 59 years old. Finally, marriage compared to divorce and widowhood and having a higher socio-economic status were associated with less sleep problems. This study confirms sleep problems to be quite prevalent in the European older population. Increased awareness of the importance of sleep for health is needed, as well as further cross-national comparative research to explain the existing cross-country variation in sleep problems.

Test–retest reliability of selected physical activity and sedentary behaviour HBSC items in the Czech Republic, Slovakia and Poland

Abstract: Better assessment of the reliability of the physical activity and sedentary behaviour items across countries in all WHO regions is highly needed. The aim of the study was to examine the test–retest reliability of selected physical activity and sedentary behaviour items of the HBSC questionnaire in Czech, Slovak and Polish adolescents. We obtained data from 693 Czech, Slovak and Polish (50.9 % boys) primary school pupils, grades five (mean age = 11.08; SD = 0.45) and nine (mean age = 15.12; SD = 0.45), who participated in a test–retest study in 2013. We used the single measures of Intraclass Correlation Coefficients (ICC) and Cohen’s Kappa statistic to estimate the test–retest reliability of all selected items within the sample and stratified by gender, age group and country. Both physical activity items (VPA and MVPA) and most of the sedentary behaviour items showed moderate agreement (ICC 0.41–0.60) and a similarly moderate correlation (Cohen’s Kappa 0.3–0.5) after dichotomization. The physical activity and sedentary behaviour items of the HBSC questionnaire seem to be at the borderline of reliability to be used in adolescents.

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda

Abstract: Objective Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda.

Longitudinal associations between cyber-bullying perpetration and victimization and problem behavior and mental health problems in young Australians

Abstract: Objectives To investigate associations between Grade 9 and 10 cyber-bullying perpetration and victimization and Grade 11 problem behavior and mental health problems after controlling for risk factors for these outcomes in the analyses.

Intimate partner violence: a study in men and women from six European countries.

Abstract: We aimed to assess intimate partner violence (IPV) among men and women from six cities in six European countries. Four IPV types were measured in a population-based multicentre study of adults (18–64 years; n = 3,496). Sex- and city-differences in past year prevalence were examined considering victims, perpetrators or both and considering violent acts’ severity and repetition. Male victimization of psychological aggression ranged from 48.8 % (Porto) to 71.8 % (Athens) and female victimization from 46.4 % (Budapest) to 70.5 % (Athens). Male and female victimization of sexual coercion ranged from 5.4 and 8.9 %, respectively, in Budapest to 27.1 and 25.3 % in Stuttgart. Male and female victims of physical assault ranged from 9.7 and 8.5 %, respectively, in Porto, to 31.2 and 23.1 % in Athens. Male victims of injury were 2.7 % in Ostersund and 6.3 % in London and female victims were 1.4 % in Ostersund and 8.5 % in Stuttgart. IPV differed significantly across cities (p < 0.05). Men and women predominantly experienced IPV as both victims and perpetrators with few significant sex-differences within cities. Results support the need to consider men and women as both potential victims and perpetrators when approaching IPV.

Is the association between screen-based behaviour and health complaints among adolescents moderated by physical activity?

Abstract: The aim of this study was to assess the association between screen-based (SB) behaviour and selected health complaints in adolescents and whether physical activity (PA) moderates this association. Data from the cross-sectional Health Behaviour of School-aged Children study collected in 2010 among Slovak adolescents (age 11–15 years, N = 8,042, 48.6 % boys) were used. Logistic regression models adjusted for age and gender were used to analyse the associations between watching TV, working with a computer or playing computer games and headache, backache, sleep difficulties, feeling low, irritability and feeling nervous. Next, we assessed the interactions of SB behaviours and PA regarding health complaints. Watching TV more than 3 h is associated with increased chance of reporting headache, feeling low, being irritable or feeling nervous, while working with computer or playing computer games for more than 3 h does so in all of the explored health complaints. Being physically active does not moderate the associations of SB activities with health complaints. SB behaviours are associated with health complaints among adolescents, and these associations are not moderated by PA.

Supportive communication with parents moderates the negative effects of electronic media use on life satisfaction during adolescence.

Abstract: Objectives To examine the impact of electronic media (EM) use on teenagers’ life satisfaction (LS) and to assess the potential moderating effect of supportive communication with parents (SCP). Methods Data were drawn from the cross-national Health Behaviour in School-aged Children (HBSC) study (2009/ 2010) in Canada, England, Germany, Hungary, Italy, Israel, The Netherlands, Poland and Scotland. Sample size: 53,973 students aged 11–15 years. Results More hours per day spent on the computer were associated with lower LS; more EM communication with friends with higher LS. This relationship became negative if EM use reached and exceeded a certain threshold. SCP moderated the effect of EM communication with friends, but not computer use for the total sample. SCP seems to be more important than computer use or EM communication with friends for LS and it seems to buffer negative effects of EM use. Conclusions Communication with parents seems to buffer the negative effects of EM use on LS during adolescence. Higher computer use was related to lower LS, but ‘‘optimal’’ frequency of EM communication with friends was country specific.

Corruption and population health outcomes: an analysis of data from 133 countries using structural equation modeling

Abstract: The current study aims to develop a theoretical framework for understanding the antecedents of corruption and the effects of corruption on various health indicators. Using structural equation models, we analyzed a multinational dataset of 133 countries that included three main groups of variables—antecedents of corruption, corruption measures, and health indicators. Controlling for various factors, our results suggest that corruption rises as GDP per capita falls and as the regime becomes more autocratic. Higher corruption is associated with lower levels of health expenditure as a percentage of GDP per capita, and with poorer health outcomes. Countries with higher GDP per capita and better education for women have better health outcomes regardless of health expenditures and regime type. Our results suggest that there is no direct relationship between health expenditures and health outcomes after controlling for the other factors in the model. Our study enhances our understanding of the conceptual and theoretical links between corruption and health outcomes in a population, including factors that may mediate how corruption can affect health outcomes.

Food access and children’s BMI in Toronto, Ontario: assessing how the food environment relates to overweight and obesity

Abstract: The objective was to examine how access to fast food restaurants, less healthy/healthier food outlets and supermarkets relate to measured levels of overweight and obesity among grade 5 and 6 students. Measured height and weight data were obtained to measure BMI. The location and type of food outlet were derived from Toronto Public Health. The density of fast food, less healthy/healthy food outlets and supermarkets within a 1-km walk of the child’s home was calculated along with the distance to the closest. Logistic regression models examined the relationship between food access and overweight/obesity. Lower income residents were more likely to be overweight or obese, as were boys. Living in an area with a higher density of healthy food outlets and in close proximity to a supermarket decreased the odds of being overweight or obese. Addressing several limitations in the literature, the findings confirm an association between the food retail environment and body weight. Density of healthy food outlets and distance to the nearest supermarket are important factors to be considered in addressing the childhood obesity pandemic.

Online gaming and risks predict cyberbullying perpetration and victimization in adolescents.

Abstract: The present study examined factors associated with the emergence and cessation of youth cyberbullying and victimization in Taiwan. A total of 2,315 students from 26 high schools were assessed in the 10th grade, with follow-up performed in the 11th grade. Self-administered questionnaires were collected in 2010 and 2011. Multiple logistic regression was conducted to examine the factors. Multivariate analysis results indicated that higher levels of risk factors (online game use, exposure to violence in media, internet risk behaviors, cyber/school bullying experiences) in the 10th grade coupled with an increase in risk factors from grades 10 to 11 could be used to predict the emergence of cyberbullying perpetration/victimization. In contrast, lower levels of risk factors in the 10th grade and higher levels of protective factors coupled with a decrease in risk factors predicted the cessation of cyberbullying perpetration/victimization. Online game use, exposure to violence in media, Internet risk behaviors, and cyber/school bullying experiences can be used to predict the emergence and cessation of youth cyberbullying perpetration and victimization.

Physical inactivity of adults and 1-year health care expenditures in Brazil.

Abstract: To analyze the association between physical inactivity in different domains and direct public healthcare expenditures in adults and to identify whether the clustering of physical inactivity in different domains would contribute to increased public healthcare. The sample composed of 963 adults randomly selected in a middle-size Brazilian city. Annual healthcare expenditure was estimated including all items registered in the medical records in the last 12 months prior to the interview. Habitual physical activity was estimated using Baecke questionnaire, which considers three components of physical activity (work, sports and leisure-time activities). Higher healthcare expenditures of medicines were associated with lower physical activity at work (OR 1.58 [1.06–2.35]), sport (OR 1.57 [1.12–2.18]) and physical inactivity in three domains (OR 2.12 [1.18–3.78]). Expenditures related to medicine (r = 0.109 [95 % CI 0.046–0.171]) and overall expenditures (r = 0.092 [95 % CI 0.029–0.155]) were related to physical inactivity, independently of age, sex, smoking, blood pressure and obesity. Physically inactive subjects in different domains of physical activity have increased likelihood to be inserted at groups of higher healthcare expenditure.

Global health and environmental pollution.

Abstract: Environmental pollution—contamination of air, water and soil by human activity—is the largest cause of disease and death in lowand middle-income countries (LMICs). The World Health Organization (WHO) estimates that 8.9 million persons die each year of diseases caused by pollution, 8.4 million (94 %) of them in poor countries (WHO 2014a, b). By comparison, HIV/AIDS causes 1.5 million deaths per year (WHO 2014c), and malaria and tuberculosis cause fewer than 1 million deaths each (WHO 2014d). In the world’s poorest countries, the predominant forms of pollution have been indoor air pollution and contaminated drinking water (PAHO 2012). Pneumonia and diarrhea are their principal consequences. By contrast, ambient air pollution, toxic chemicals, pesticides and hazardous wastes are the predominant environmental hazards in richer countries. They are linked to noncommunicable diseases—to asthma, neurodevelopmental disorders and birth defects in children, and to heart disease, stroke, and cancer among adults (PAHO (Pan American Health Organization) 2012). Toxic chemicals are increasingly important causes of pollution worldwide. Many thousands of new chemicals have been invented in the past 50 years. They are used in a vast array of products, are widely disseminated in the global environment and are detectable today in the bodies of most people. Many have never been adequately tested for safety (Landrigan and Goldman 2011). Toxic chemicals are linked to a wide range of diseases. Chemical contamination in LMICs is increasing rapidly (Laborde et al. 2015). Globalization of the chemical manufacturing industry, the recycling industry and other polluting industries is a powerful driver of this trend. These industries are relocating to poor countries where production costs are low and environmental regulations and public health infrastructure often absent. Workers and communities in LMICs are increasingly exposed to toxic chemicals, often under highly uncontrolled conditions. Examples include the Bhopal disaster in India (Mishra et al. 2009); the continuing global trade of 2 million tons per year of newly produced asbestos (Frank and Joshi 2014); the shipment into poor countries of 45 million tons per year of e-waste (Perkins et al. 2014); informal recycling of car batteries for lead scrap in third world mega-cities; and enormous releases of mercury to the environment from artisanal gold mining. The diseases caused by pollution impose great economic costs on countries around the world—direct medical costs, opportunity costs reflecting the diminished productivity of populations damaged by pollution, and costs to health care systems (Landrigan and Fuller 2015). In the United States, the annual cost of diseases in children caused by environmental pollution is estimated to be US$ 76.6 billion (Trasande and Liu 2011) and the cost of occupational diseases and injuries is US$ 250 billion (Leigh 2011). Pollution can be controlled. High-income countries have identified and controlled many of their worst problems of environmental pollution. They have developed feasible, cost-effective and replicable strategies that have reduced incidence and prevalence of the diseases caused by pollution. The most effective of these strategies, such as the This Editorial is part of the special issue ‘‘Driving the Best Science to Meet Global Health Challenges’’ edited on the occasion of the 9th European Congress on Tropical Medicine and International Health 2015.

What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review

Abstract: Objectives This study describes the current state of research on knowledge transfer strategies to improve public health in low-income countries, to identify the knowledge gaps on this topic.

Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis

Abstract: Diabetes appears to be a growing problem in the African region. This study aims to estimate the prevalence of diabetes in Zimbabwe by collating and analyzing previously published data. Systematic review and meta-analysis of data reporting prevalence of diabetes in Zimbabwe was conducted based on the random effects model. We searched for studies published between January 1960 and December 2013 using MEDLINE, EMBASE and Scopus and University of Zimbabwe electronic publication libraries. In the meta-analysis, sub-groups were created for studies conducted before 1980 and after 1980, to understand the potential effect of independence on prevalence. Seven studies were included in the meta-analysis with a total of 29,514 study participants. The overall pooled prevalence of diabetes before 1980 was 0.44 % (95 % CI 0.0–1.9 %), after 1980 the pooled prevalence was 5.7 % (95 % CI 3.3–8.6 %). This study showed that the prevalence of diabetes in Zimbabwe has increased significantly over the past three decades. This poses serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting.

Youth unemployment and economic recession in Spain: influence on health and lifestyles in young people (16–24 years old)

Abstract: Objectives To explore health status and lifestyles in young Spanish people in 2006 and 2012, the changes between these 2 years and the influence of employment status on health and lifestyles in this period.

The impact of digital media on health: children’s perspectives

Abstract: Previous research has mainly focused on the effects of excessive digital media use or overuse on the health of children, primarily utilizing quantitative designs. More research should be conducted on general populations of children, rather than focusing exclusively on excessive technology users. This qualitative study describes technology’s impact on physical and mental health from children’s perspectives. Focus groups and interviews were conducted with children between the ages of 9 and 16 in 9 European countries (N = 368). During focus groups and interviews, researchers asked what children perceive as being potentially negative or problematic while using the internet and technology. In this study, children reported several physical and mental health problems without indicating internet addiction or overuse. Physical health symptoms included eye problems, headaches, not eating, and tiredness. For mental health symptoms, children reported cognitive salience of online events, aggression, and sleeping problems. Sometimes they reported these problems within 30 min of technology usage. This suggests that even shorter time usage can cause self-reported health problems for some children. Qualitative methodology helps to understand what children’s perspectives are concerning the impact of digital media on health. We recommend future studies focused on average technology users and low technology users to determine whether average levels of technology usage relate to health problems of children. Parents and teachers should also be informed about the possible physical and mental health issues associated with children's average usage of technology.

Absolute or relative? A comparative analysis of the relationship between poverty and mortality

Abstract: We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cr ...

Exploring traditional and cyberbullying among Irish adolescents

Abstract: Objectives This study aimed to explore the associations of traditional and cyberbullying victimisation with self-reported health and life satisfaction, and to examine whether involvement in risk behaviours contributes to these health outcomes.

Governance and functionality of community water schemes in rural Ethiopia.

Abstract: A key challenge for achieving universal water access in Sub-Saharan Africa is poor sustainability of water schemes. Previous studies have posited factors that may lead to failed schemes; however, empirical data are lacking. We conducted direct observations of water sources and interviewed water committee members about governance in two regions of Ethiopia. Based on direct observation at each water point, and harmonizing previous research in the sector, we developed an ordinal measure of functionality. Among functional systems, linear regression models were used to assess changes in score or level of functionality against governance characteristics. Of 89 water schemes over 5 years old, 82 had sufficient data to receive a score. Higher functionality scores were associated with having good records, meeting regularly, financial audits, higher monthly fees, a paid caretaker and water committees with capacity to perform minor repairs. Our continuous measure of functionality was simple to derive, objective and may be widely applicable for further studies assessing key indicators of sustainability.