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PubMed1982

Prevalence and treatment of learning problems in upper and lower income areas.

In a telephone survey, a lower incidence of learning problems, help received, and perceived effectiveness was reported in lower income areas. More upper income respondents reported receiving formal diagnoses and treatment. Possible discrepancies between official and resident reports of learning problems, the apparent need for additional services by both income groups, and the likelihood that residents are overestimating effectiveness and prognosis are discussed.

California↗
PubMed1997

Nuclear targeting of incoming human foamy virus Gag proteins involves a centriolar step.

The pathways used in the transport of retroviral genomes to the nucleus are poorly identified. Analyzing the intracellular localization of incoming foamy viruses, we have found that the Gag antigens and the viral genome accumulate in a distinct perinuclear domain identified as the centrosome. Colchicine treatment completely abolished pericentriolar targeting of human foamy virus (HFV) proteins, suggesting a role for microtubules in the transport of the incoming viral proteins to the centrioles. Finally, we demonstrate that, similarly to human immunodeficiency virus DNA, HFV DNA can enter the nucleus of G1/S-phase-arrested cells, although no viral gene expression can be observed. Recent observations have demonstrated that foamy viruses have several features not shared by other retroviruses. The intracellular route of the incoming Gag antigens may constitute a new specificity of this class of viruses.

Cell Line↗
PubMed1998

Antiviral activity of the proteasome on incoming human immunodeficiency virus type 1.

Following cell surface receptor binding and membrane fusion, human immunodeficiency virus (HIV) virion cores are released in the cytoplasm. Incoming viral proteins represent potential targets for cytosolic proteases. We show that treatment of target cells with the proteasome inhibitors MG132 and lactacystin increased the efficiency of HIV infection. Proteasome inhibitors were active at the early steps of the viral cycle. Incoming p24Gag proteins accumulated in the cytosol, and larger amounts of proviral DNA were synthesized. In vitro, purified 20S proteasome degraded HIV virion components. Thus, degradation of incoming viral proteins by the proteasome represents an early intracellular defense against infection.

Acetylcysteine↗
PubMed2000

Pica during pregnancy in low-income women born in Mexico.

OBJECTIVE: To describe pica behavior (ingestion of nonfood items) in pregnant low-income Mexican-born women in Mexico and the United States. DESIGN: A convenience sample of informants was interviewed with a questionnaire containing open-ended and closed-ended questions. SETTING: A low-income community on the outskirts of Ensenada, Mexico, and clinics serving low-income people in southern California (Santa Ana, Bakersfield, and Los Angeles). PARTICIPANTS: Of a total of 225 Mexican-born women, 75 (33%) were interviewed in Ensenada, and 150 (67%) were interviewed in southern California. RESULTS: The prevalence of pica during pregnancy was 44% (n = 33) in the Ensenada group and 31% (n = 46) in the southern California group. Those who reported pica behavior more commonly had a relative who also practiced pica. CONCLUSION: The high reported rate of pica in this sample indicates that pregnant Mexican-born women should be screened for pica and educated about the potentially serious effects on the fetus and mother.

Adolescent↗
PubMed1998

Effect of a transient, geographically localised economic recovery on community health and income studied with longitudinal household cohort interview method.

STUDY OBJECTIVE: The main purpose of the study was to determine whether the health or economic status of a cohort of residents in an economically troubled geographical area changed between 1990 and 1993. DESIGN: Longitudinal, single cohort, interview survey method with the key variables of health status and economic status. Quasi-experimental pre-post design with economic rebound as the intervention. SETTING: A relatively low income geographical area in a rural, mountainous region before and after an economic rebound. In 1990, the local economy and health care system collapsed because of the closure of a series of manufacturing plants; outward migration from the area peaked. Between 1990 and 1993, new industries opened, and state and private community assistance programmes intervened, resulting in an economic rebound, migration into the area, and marked growth of the health service sector. PARTICIPANTS: A 2% sample of residents of households, using a combination of random, stratified, and clustered sampling. Residents included in the study had lived within the area throughout the 1990-1993 period of the study. MAIN RESULTS: Stable, non-migrating residents had a statistically significant 7% reduction in health status between 1990 and 1993, as measured by a composite of subjective and objective measures. The non-migrating residents also had a significant decrease in average household income ($14,700 in 1990 and $12,400 in 1993 in constant 1990 dollars) during the strong economic expansion, and therefore did not participate in or receive direct economic benefit from the expansion. There was a rapid population increase during the expansion, attributable to inward migrants who were younger and healthier than existing residents. The decline in health for the non-migrating residents was tentatively attributed to either direct or indirect effects of the decline in family income. CONCLUSIONS: Local economic development accompanied by expanded health care services availability can leave existing area residents poorer and less healthy, and this problem may be masked by an abundance of healthier, wealthier inward migrants.

Adolescent↗
PubMed2005

Effect of direct mail as a population-based strategy to increase mammography use among low-income underinsured women ages 40 to 64 years.

Women with inadequate health insurance have lower mammography rates than the general population. Finding successful strategies to enroll eligible women is an ongoing challenge for the National Breast and Cervical Cancer Early Detection Program. To test the effectiveness of a population-based strategy to increase mammography utilization among low-income underinsured women ages 40 to 64 years, a randomized trial was conducted to assess the effect of two mailed interventions on mammography utilization through Sage, the National Breast and Cervical Cancer Early Detection Program in Minnesota. Women (N = 145,467) ages 40 to 63 years [mean (SD), 49.7 (6.8)] with estimated household incomes below 50,000 US dollars (47.9% were < 35,000 US dollars) from a commercial database were randomized to three groups: Mail, Mail Plus Incentive, or Control. Both the Mail and the Mail Plus Incentive groups received two simple mailings prompting them to call a toll-free number to access free mammography services. The Mail Plus Incentive intervention offered a small monetary incentive for a completed mammogram. After 1 year, both intervention groups had significantly higher Sage mammography rates than the Controls, and the Mail Plus Incentive group had a significantly higher rate than the Mail group. The Mail and Mail Plus Incentive interventions were estimated to produce increases in Sage screening rates of 0.23% and 0.75%, respectively, beyond the composite Control rate of 0.83%. Direct mail is an effective strategy for increasing mammography use through Sage. Coupling direct mail with an incentive significantly enhances the intervention's effectiveness. Direct mail should be considered as a strategy to increase mammography use among low-income, medically underserved women.

Adult↗
PubMed2005

Connecting the past with the present: how do humans match an incoming visual display with visual memory?

Extensive cognitive research has been devoted to the sensitivity of the visual system to invariant statistical information. For example, many studies have shown that performance improves when a visual display is presented repeatedly. But what allows humans to connect the current visual input to previous memory? Is the connection made only when the entire incoming display matches with a previous memory, or can retrieval rely on an incomplete match between the input and a learned display? Using a visual search task, we show that (1) once a repeated display is learned, subjects can retrieve it even when an incoming display only matches it in 3-4 locations; (2) however, early during learning, repetition of a small proportion of a display is not enough to establish a strong memory trace for the repeated locations. We suggest that the retrieval of a well-established visual memory can proceed even if an incoming display partly matches the previous memory.

Adolescent↗
PubMed1990

The infant feeding decision in low and upper income women.

Few studies have described the woman who chooses breast-feeding by more than simple demographics. The purpose of our study was to characterize new mothers by their infant feeding decisions, by demographic and obstetrical data, and by sources of personal support they received during their pregnancies and in making their infant feeding decisions. To this end, 220 were interviewed, including 116 who chose to breastfeed. Breast-feeding women were more likely to be older, more educated, married, more affluent, experienced with breast-feeding, to have demonstrated good prenatal habits, and to have received support from other sources than those who chose bottle feeding. Participation in Lamaze classes, previous successful breast-feeding, and maternal education were significant predictors of feeding choice, and mode of delivery predicted duration of breastfeeding. Low income women who chose breastfeeding resembled low income bottle feeders in certain medical/social factors, but they showed support patterns similar to middle to upper income women.

Adolescent↗
PubMedDate not supplied

Strengthening social support for the low-income mother: five critical questions and a guide for intervention.

The visit to the nurse can become a vehicle for low-income mothers to develop one of the most critical health resources available to them: social support. Economic limitations require low-income mothers to create social support structures that are functional but may not match notions of ideal social support. Extensive experience of two advanced practice psychiatric mental health nurse-clinicians revealed that low-income mothers' social support was characterized by concern for basic necessities, precarious situations, self-replicating patterns, entrepreneurial requirements, and demonstrations of strengths. Five key questions during the encounter between nurse and mother can assist the nurse in planning interventions that fit these mothers' needs and benefit their health and that of their children.

Adolescent↗
PubMed2003

Policy implications of an annuity approach to integrating long-term care financing and retirement income.

The authors consider an integrated income and disability annuity as an alternative framework for long-term care financing, show that pooling disability and mortality risks can reduce the need for medical underwriting, and discuss private and public implications. Data from the National Mortality Followback Survey of 1986 were used to simulate current underwriting and minimal underwriting, excluding only those already eligible for benefits. Remaining disability, life expectancy, and premiums are compared under both underwriting assumptions. Under minimal underwriting, 98% of persons age 65 would be eligible to purchase disability protection through an integrated annuity, versus 77% under current underwriting. Premiums for both the income and disability components were lower with minimal underwriting. Combining income and disability protection may be able to expand private markets for long-term care financing beyond what appears possible in the long-term care insurance market. Public policy should avoid the distortion of choices created by focusing exclusively on an insurance model.

Aged↗
PubMed2006

Childhood nutrition: perceptions of caretakers in a low-income urban setting.

The incidence of overweight and obese children, especially those from low-income and minority backgrounds, continues to rise. Multiple factors contribute to the rising rates. In order to gain an understanding of factors contributing to obesity in low-income families, a qualitative study was conducted with the purpose of gaining knowledge of low-income urban caretakers' understanding and attitudes regarding children's nutrition. A focused ethnography was used as a means of understanding behavior within the context of a person's cultural environment. The sample was 17 caretakers of children in the 1st-3rd grades. Four focus groups were conducted. Two themes emerged from caretakers' perceptions: knowing the right things children should eat and balancing healthy nutrition with unhealthy choices. Four categories emerged regarding influences on food choices: tradition, finances, time constraints, and role models. Lastly, five barriers and three facilitating factors emerged. Implications of the study findings for school nurses include the need, when implementing healthy eating programs for school children, to gain information from caretakers about their perceptions of childhood nutrition.

Adult↗
PubMed2005

A culturally targeted intervention to promote breast cancer screening among low-income women in East Baltimore, Maryland.

In Maryland, outreach initiatives have been unsuccessful in engaging low-income African American women in mammography screening. This study aimed to identify factors influencing screening rates for low-income African American women. Based on the Health Belief Model, a modified time series design was used to implement a culturally targeted intervention to promote a no-cost mammography-screening program. Data were collected from women 40 years of age and older on their history of mammography use and their knowledge and beliefs about breast cancer. A 50% screening rate was achieved among 119 eligible participants. Significant predictors of screening behaviors were perceived barriers, lack of insurance, and limited knowledge. This culturally targeted intervention resulted in an unprecedented screening rate among low-income African American women in Baltimore, Maryland.

Adult↗
PubMed2002

Access to medical care for low-income persons: how do communities make a difference?

This paper considers the impact of community-level variables over and above the effects of individual characteristics on healthcare access of low-income children and adults residing in large metropolitan statistical areas (MSAs). Further, we rank MSAs' performance in promoting healthcare access for their low-income populations. The individual-level data come from the 1995 and 1996 National Health Interview Survey (NHIS). The community-level variables are derived from multiple public-use data sources. The outcome variable is whether low-income individuals received a physician visit in the past twelve months. The proportion receiving a visit by MSA varied from 63% to 99% for children and from 62% to 83% for adults. Access was better for individuals with health insurance and a regular source of care and for those living in communities with more federally-funded health centers. Children residing in MSA.

Adolescent↗
PubMed2003

The use of focus groups to plan poison prevention education programs for low-income populations.

Children younger than 5 are at greatest risk for unintentional poisonings. Children in low-income situations are particularly vulnerable for exposures to potential poisons. Focus groups were conducted at a Women, Infants, and Children (WIC) program located in a large urban public hospital in New York City to gain information from low-income parents of young children about real and perceived barriers to calling the local poison control center, resources for poison prevention messages, and ideas about public awareness campaigns. All focus group members were low-income parents of young children. Most participants reported that they would call 911 in the event of a poisoning due to child welfare and self-efficacy issues. Health education theory using the social-cognitive theory provides a framework for developing future poison prevention programs to address identified issues with parents of young children.

Adolescent↗
PubMed2006

The novella approach to inform women living on low income about early breast cancer detection.

Economically disadvantaged women have a greater likelihood of later-stage breast cancer diagnosis when compared to women with higher levels of income. Later-stage diagnosis decreases the chances of survival. The purpose of this article is to describe a project whereby breast cancer survivors, living on lower incomes, created novellas (stories) using artistic media to reach their peers with a message about the importance of early breast cancer detection. The recruitment and engagement of breast cancer survivors in a 2-year community development project that used participatory, women-driven approaches are discussed, and the reciprocal learning between health care providers, community partners, and women living on low income is shared. Recommendations for health promotion practice are presented.

Adult↗
PubMed2006

Weaning foods and their impact on child-feeding practices among low-income Nigerian mothers.

BACKGROUND: Many children in rural communities of developing countries die of nutrition-related causes due to lack of nutrition education and low purchasing power of the families, which result in low-quality weaning foods and poor feeding practices. OBJECTIVE: To evaluate the nutritional composition of local weaning foods and their impact on child feeding practices among low-income Nigerian mothers. METHODS: A cross-sectional survey was conducted between March and June 2005 among 294 randomly selected pairs of nursing mothers and their children who attended the postnatal clinic of State Specialist Hospital and Comprehensive Health Centers in Akure community, Ondo State, Nigeria. A structured, self-or interviewer-administered questionnaire was used to collect information on infant demographic characteristics, feeding, and socioeconomic characteristics of the parents. The children's weights were recorded, and samples of the weaning foods were analyzed. RESULTS: The mothers' ages ranged from 22 to 37 years, and the children's from one to 12 months. Among the parents, two-fifths of the respondents worked as drivers, mechanics, carpenters, and the like, while the remaining respondents were civil servants, health professionals, teachers, merchants, and housewives. The educational attainment of the parents ranged from no formal education (1.4%) to higher education (46%); 13% had completed primary school, and 39.6% had completed secondary school. The average monthly family income was between 3,500 and 30,000 naira (US dollar 23.3-dollar 200). Among the children, 58.3% were of normal weight, 41.1% were mildly underweight, 0.3% moderately underweight, and 0.3% severely underweight; 23.1% were exclusively breastfed, 9.5% received breastmilk and traditional medicinal herbs, 15.6% received breastmilk and commercial weaning food, 7.4% received commercial weaning food only, 14.8% received local weaning foods only, 24.1% received local weaning foods plus breastmilk, and 5.8% received the family diet. CONCLUSIONS: We found that a high proportion of the nursing mothers used local ingredients to formulate weaning foods for their babies. The nutritional compositions of these foods is of high quality and are suitable as weaning foods, particularly for infants of low-income parents who do not have access to commercial weaning foods.

Adult↗
PubMed2005

From wealth to health: modelling the distribution of income per capita at the sub-national level using night-time light imagery.

BACKGROUND: Sub-national figures providing information about the wealth of the population are useful in defining the spatial distribution of both economic activity and poverty within any given country. Furthermore, since several health indicators such as life expectancy are highly correlated with household welfare, sub-national figures allow for the estimation of the distribution of these health indicators within countries when direct measurement is difficult.We have developed methods that utilize spatially distributed information, including night-time light imagery and population to model the distribution of income per capita, as a proxy for wealth, at the country and sub-national level to support the estimation of the distribution of correlated health indicators. RESULTS: A first set of analysis are performed in order to propose a new global model for the prediction of income per capita at the country level. A second set of analysis is then confirming the possibility to transfer the country level approach to the sub-national level on a country by country basis before underlining the difficulties to create a global or regional models for the extrapolation of sub-national figures when no country data set exists. CONCLUSIONS: The methods described provide promising results for the extrapolation of national and sub-national income per capita figures. These results are then discussed in order to evaluate if the proposed methods could not represent an alternative approach for the generation of consistent country specific and/or global poverty maps disaggregated to some sub-national level.

Journal Article↗
PubMed2005

Multiple sclerosis management for low-income minorities.

Low-income minorities with complex chronic diseases and physical disabilities have difficulty accessing appropriate healthcare often resulting in suboptimal care. A survey was performed to determine the impact of cultural and socioeconomic factors on the quality of care for low-income minorities with multiple sclerosis (MS) enrolled in Independence Care System (ICS), a Medicaid long-term managed care plan. All 92 ICS members with a diagnosis of MS were surveyed on three aspects of their care: specialty contact, immunomodulating drug therapy and osteoporosis prevention. Of those surveyed, 32% were never seen by an MS specialist. One third were not taking immunomodulatory medications, primarily due to noncompliance caused by a lack of understanding about these drugs. The prevention of osteoporosis and potential fracture in this high-risk population was largely neglected by providers despite the fact that the majority of those surveyed also reported balance difficulties and a history of falling. The survey revealed several deficiencies in the care of low-income minorities with MS. A major issue was the lack of adequate education, particularly about the immunomodulating drugs. Education about the importance of osteoporosis prevention, falls mitigation programmes and rehabilitation evaluations are critical interventions to decrease the risk of fracture.

Adult↗