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PurposeThe aim of this study is to determine the preferences to participate in diabetes screening program of women with gestational diabetes mellitus (GDM) in postpartum period.Design/methodology/approachThe data of retrospective and descriptive study were collected using “Individual Identification Form” and “Information Form for the Screening of Diabetes in the Postpartum Period” from 151 women in referred to obstetrics and gynecology clinic of a university hospital in Turkey.FindingsOnly 21.9% of women had diabetes screening in postpartum period and 21.2% of the participants were diagnosed with type 2 diabetes. It was determined that the participants mostly participated in screening because of the diabetes history in their family (30.3%). Women who had diabetes screening in postpartum period had lower level of education than those who did not and their level of knowledge about the screening in postpartum and the history of abortion were higher (p Originality/valueThe rate of participation in the screening for diabetes in the postpartum period is very low in pregnant women diagnosed with GDM. It was determined that the educational status, history of previous abortion and knowledge level of the women were factors that prevented participation in diabetes screening. This research is original because there are inadequacy of studies examining determining the participation status of pregnant women with GDM to diabetes screening in the literature. This study will contribute to health professionals in order to improve preventive factors and increase the participation of pregnant women with GDM in diabetes screening in the postpartum period.

Data of alumni from 2012 to 2015 found that the average percentage of students graduating on time was 22%. The comparison between the number of students who graduate on time and new students who enter each year is not comparable, therefore a study is needed to find out the factors that affect student graduation and to prediction of the graduation period of the student through data mining research using the C4.5 algorithm. The data tested was student alumni data from 2012 to 2015. The instruments studied include study period, academic year, GPA, corner focus, gender, intensity of work during college, type of thesis, intensity of campus internal organization, intensity of external organization of campus, UKT group, scholarship status, pre-college education, hobby intensity, intensity of game play, academic competition participation status, non-academic competition participation status, and availability of facilities and infrastructure. The best test results using percentage-split 75% obtained 83.33% accuracy as well as the rules contained in the decision tree.

PurposeFarmer organizations (FOs) can elevate many of the production- and marketing-related challenges by ensuring access to technology, farming information and loan for inputs and mechanization. This study assesses the major factors that affect the participation in FOs by the smallholder rice farmers in Bangladesh and evaluates the impacts of the participation on rice yield and production efficiency.Design/methodology/approachThe present study used primary data collected from 1,000 smallholder rice farmers in northwest Bangladesh, consisting of 250 farmers those participated in an organization. This study utilized a sample selection stochastic production frontier (SPF) method, a combination of the conventional SPF and the Heckman's sample selection model, to control for biases stemming from observed and unobserved attributes.FindingsThis study demonstrates that participation in an organization is significantly affected by smallholder rice farmers' education, occupation, family size, household income, land ownership and the location where they reside. At the same time, the participation status affects the productivity of smallholder farmers. Findings indicate that farmers who participated in an organization had higher rice yield (11% more) and were technically more efficient (1.4 percentage points higher) compared to farmers who did not participate.Research limitations/implicationsSince this study was carried out with representative sampled farmers from northwest Bangladesh, the findings may not represent all farmers' perceptions of FOs in the country.Originality/valueEven though more than 200,000 FOs are currently in operation, knowledge regarding the effectiveness of Bangladesh's FOs is limited. Notably, this study used a relatively new method, sample selection SPF model, to investigate the impact of FOs on the production efficiency of smallholder rice farmers in northwest Bangladesh. Therefore, this study contributes to the literature in elucidating the factors affecting participation in FOs and its impact on rice yield and efficiency. Since FOs have been somewhat ineffective in their role as service providers in Bangladesh, this study’s results will guide policymakers to intervene more successfully regarding the changes needed.

School meals provide nourishment to a large portion of US schoolchildren. Research has examined the relationship between the consumption of school meals and the quality of schoolchildren's diets, with little emphasis on studying spillovers at the household level. Using National Food Acquisition and Purchase Survey data and unconditional quantile regression, we study the relationship between a household's quality of food‐at‐home acquisitions and the number of school meals acquired, subsampling households by their Supplemental Nutrition Assistance Program participation status. We do not find strong evidence supporting beneficial spillovers of school meals on a household's quality of food‐at‐home acquisitions. JEL CLASSIFICATION C31; D12; I14; Q18

Objective: Physical activity and work ability are increasingly important topics due to aging of the modern workforce. Workplace physical activity programs can help attenuate the decline in physical resources that typically transpires with age yet, older employees are less likely to participate. The study’s primary aim was to understand how perceived benefits and barriers and physical activity climate are related to older employees’ participation in workplace physical activity programs. Methods: The inquiry design was a needs assessment utilizing an 18-item survey. Respondents consisted of 862 older employees (>55 years) of a public university in the southeastern United States. Differences in total subscale scores between sexes, program participation status, occupational category and physical activity were compared and contrasted. Results: Differences in perceived benefit and barrier scores between workplace physical activity program participants (N = 474) and non-participants (N = 388) were significant with a p-value 0.001. Physical activity climate scores were significantly different as well with a p-value of 0.003. All three subscale scores (benefits, barriers, climate) were also significantly different between physically active and inactive employees with a p value 0.001. Conclusions: The findings from this investigation suggest that employees’ participation in workplace physical activity programs is influenced by their individual beliefs and perceptions of social and organizational norms. Physical activity climate should be a primary consideration to promote workplace physical activity program participation among older employees. Additional recommendations to improve participation among older employees are discussed.

The purpose of this research is to determine the participation status of the school counselors working in official institutions to school management. In the research, phenomenology design was used within the scope of qualitative research method. The study group of the research consists of 31 school counselors working in Istanbul in the 2019-2020 academic year. The data of the research were collected by making individual face-to-face interviews with 6 open-ended questions and evaluated with content analysis. According to the results of the research, the participations of school counselors in school administration is not considered sufficient. School counselors usually participate in school management through formal meetings. According to the school counselors, participation in school management is necessary and important in terms of solving problems, cooperation and participation in decisions. However, for some reasons, school counselors cannot participate effectively in school management. In order to ensure effective participation of school counselors in school management, it may be beneficial to make legal arrangements, arrange of guidance services, improve of working conditions, training of managers and teachers.

Drawing on the positioning theory and the conditions for language use, this article examines Vietnamese ethnic minority students’ language choice in interactions with their same-ethnicity and majority peers, focusing particularly on their communication motives underlying this choice. Findings suggest that in regulating their language alternation practices across peer groups in different contexts, the students shifted their participation status – from aligning (being alike) to disaligning (being distinct) – to (re)position themselves in relation to their peers. As their desires for alignment or disalignment were either supported or disrupted by their peers, peer attitudes played a critical role in providing opportunities and encouraging minority students’ willingness to use their L1 in school and ethnic community spaces. Implications are suggested for engaging peer support as a resource for maintaining or widening L1 use among young minority people in both of the domains.

Despite efforts to increase the diversity of cancer clinical trial participants, African Americans are still underrepresented. While perceptions of participation have been studied, the objective of this study was to compare perceptions and decisional conflict towards clinical trials among African American cancer patients who have and have not participated in clinical trials to identify key areas for intervention. Post hoc analysis also looked at whether they had been asked to participate and how that group differed from those who did. Forty-one African American cancer patients were surveyed at two urban cancer centers and asked to agree/disagree to statements related to clinical trials perceptions (facilitators, barriers, beliefs, values, support, and helpfulness), and complete the O'Connor Decisional Conflict Scale. Independent-samples t tests compared participants by clinical trials participation status; 41% had participated in a clinical trial. Results revealed significant perceptual differences among the groups in three main areas: helpfulness of clinical trials, facilitators to participate in clinical trials, and barriers to participating in clinical trials. Post hoc analysis indicated that those who were not asked about clinical trials and had not participated differed significantly in all areas compared with participants. Additionally, clinical trial participants reported significantly lower decisional conflict in most items compared with both those who had and had not be asked to participate. These differences can give practitioners clues as to how to bridge the gap from non-participator to participator. Messages could then be infused in the clinician-patient dyad when introducing and discussing clinical trials, potentially providing a more effective strategy for communicating with African American patients.

Supplemental Digital Content is available in the text., Background: In the context of declining levels of participation, understanding differences between participants and non-participants in health surveys is increasingly important for reliable measurement of health-related behaviors and their social differentials. This study compared participants and non-participants of the Finnish Health 2000 survey, and participants and a representative sample of the target population, in terms of alcohol-related harms (hospitalizations and deaths) and all-cause mortality. Methods: We individually linked 6,127 survey participants and 1,040 non-participants, aged 30–79, and a register-based population sample (n = 496,079) to 12 years of subsequent administrative hospital discharge and mortality data. We estimated age-standardized rates and rate ratios for each outcome for non-participants and the population sample relative to participants with and without sampling weights by sex and educational attainment. Results: Harms and mortality were higher in non-participants, relative to participants for both men (rate ratios = 1.5 [95% confidence interval = 1.2, 1.9] for harms; 1.6 [1.3, 2.0] for mortality) and women (2.7 [1.6, 4.4] harms; 1.7 [1.4, 2.0] mortality). Non-participation bias in harms estimates in women increased with education and in all-cause mortality overall. Age-adjusted comparisons between the population sample and sampling weighted participants were inconclusive for differences by sex; however, there were some large differences by educational attainment level. Conclusions: Rates of harms and mortality in non-participants exceed those in participants. Weighted participants’ rates reflected those in the population well by age and sex, but insufficiently by educational attainment. Despite relatively high participation levels (85%), social differentiating factors and levels of harm and mortality were underestimated in the participants.

This cross-sectional study aimed to characterize the physical activity (PA) of older adults with pre-frail status by examining sedentary behavior (SB) and PA using triaxial accelerometer data, with non-frail older adults as the control group. In this study, we divided the study participants into older adults who regularly participated in self-initiated citizen group exercise activities and those who did not. Data were collected between September and December 2017. We analyzed data from 256 older adults (women: 86.3%) aged ≥65 years. The interaction effect of participation status (participation and non-participation group) and frailty status (pre-frail and non-frail group) for moderate-to-vigorous PA (F = 9.178, p = 0.003) and daily mean number of steps (F = 9.351, p = 0.002) was significant. For the participation group, there was no difference between pre-frail older adults and non-frail older adults regarding length of SB and PA time, indicating that PA level was maintained in the participating pre-frail older adults. In contrast, moderate-to-vigorous PA and daily mean number of steps were low in pre-frail older adults who did not participate in the activities. The opportunity to participate in self-initiated group exercise activities and other PAs in the community may help pre-frail older adults maintain their PA.

INTRODUCTION The Supplemental Nutrition Assistance Programme (SNAP) is a federal programme aimed to alleviate hunger and improve food insecurity. The impact of SNAP participation on overall health has been studied. However, little is known about the effects of SNAP participation on oral health. We aimed to investigate the association between participating in SNAP and dental caries and to explore the role of food insecurity as a moderator in this relationship. METHODS We obtained data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 and 2013-2014.The primary outcome was untreated dental caries (none vs. one or more). Self-reported SNAP participation status in the past 12 months was the predictor, and food security was the moderator. Food security was measured as overall food security status (full food secure/ food insecure) and household-level food security (full, marginal, low and very low). Bivariate and multiple logistic regression analyses were conducted to evaluate the relationship between SNAP and dental caries, and whether food insecurity moderates this relationship. Statistical analysis was carried out in September 2020. RESULTS Our results suggested that after adjusting for potential confounders, SNAP participants were more likely to have untreated dental caries than non-SNAP participants (odds ratio: 1.6; 95% CI: 1.2-2.0). Food security status did not alter the relationship between SNAP participation and untreated dental caries. CONCLUSIONS Food security status did not alter the relationship between SNAP participation and untreated dental caries. SNAP participation was associated with untreated dental caries among U.S. adults, and this was not affected by their food security status.

Effective teamwork is a critical feature of surgical practice and is based on shared expectations and understandings between team members. These shared understandings are intimately tied to a hierarchy of expertise pertaining to role, responsibility and participation status, and it has been suggested that this can sometimes negatively impact trainees’ experience of intraoperative surgical training. This paper examines this issue, exploring how surgeons and their trainees collaboratively manage decision making amidst the hierarchy of expertise. Our data set consists of audio and video recordings of surgical procedures, which are examined using conversation analysis. Our findings indicate that implicit in the interactions between consultant surgeons and trainees is the expectation that the lead surgeon is the authoritative expert and will therefore direct decision making. Trainees actively acquiesce to that order. Notwithstanding this, the analysis underscores some of the interactional practices used by surgeons and trainees which preserve, and on rare occasions, challenge that hierarchical relation. The paper concludes by considering the implications of the findings within the broader context of patient safety.

University environment offers numerous advantages and easy opportunities for improving students' participation in physical activity and sport. However, there are paucity of researches on the reasons for non-participation in the university physical activity and sport programs in Kenya. The purpose of this study was to establish the institutional based reasons for the students' non-participation in the universities' physical activity and sport programs. Cross-sectional survey design was used and data was collected through questionnaires from Sixty-three (33 males, and 30 females) students. Mean standard deviation and graphs respectively, were used to describe and present data. Findings showed that key reasons for non-participation in physical activity and sport programs in the university were inadequate sport facility 74.6%, overcrowded facility 73%, unorganized sport program 63.5%, lack of sport facility 58.7%, lack of sport variety 57.1%, inaccessible facility 49.2%, no coaches 47.6%, unfriendly time for sport 39.7%, unsafe sport equipment 38.1%, inappropriate behaviour of sport personnel 36.5% and 34.9% was due to unskilled sport personnel. Students' age, year and course of the study influenced non-participation of students in the universities' sport programs. Also, students' previous and current participation status confirmed students avoid universities' sport programs although they participate in the same elsewhere. Diversifying and professionalizing sport and aligning programs with academic schedules would attract students. TRA can be useful in sensitizing students on the benefits of sports. Similar studies with larger student population are necessary.

The aim of this study is to determine serious leisure perspectives of professional athletes. 689 athletes selected through random sampling participated in the study. The data were collected with the “Serious Leisure Inventory and Measure (Short Form) (SLIM)’’, developed by Gould et al. (2011) adapted to Turkish by Ozdemir, Ayyildiz Durhan, and Akgul (2020) which consisting of 12 items and 3 sub-dimensions. It was determined that the data were not distributed homogeneously and non parametric tests were applied. In the analysis of the data, descriptive statistics, Man Whitney U, Kruskall Wallis, Tukey (HSD-LSD) and Pearson Correlation test were used for within-group comparisons. In this study, total internal reliability coefficient of SLIM (short form) scale was determined as .93. Participants had higher SLIM scores (89,60 ± 15,76), the highest subscale score was ‘’identification with pursuit and social outcomes’’ sub-dimension (37,39 ± 7,35), and the lowest subscale score was ‘’individual outcomes’’ (22,30 ± 4,39). Significant relationships and differences were found among the variables of gender, sports, age of athletics, number of trainings per week, participation status of international competitions, perceived challenge of duties, perceived skill development and perceived total development. As a result of the research, it was determined that professional athletes had high serious leisure perspectives and this situation being in interaction with certain variables.

Parents are the bearers and investors of their children’s education expenditures. It is important to discuss the impact of mothers’ labor participation on the educational investment behavior of families. Actually. This paper uses the 2010 Chinese Family Panel Studies (CFPS) questionnaire data to conduct an empirical analysis of the impact of mother labor participation on family education investment behavior. The education level of parents is an important factor that affects children’s performance, but the labor participation status of mothers affects children’s academic performance by affecting family education expenditure.

Objective We evaluate differences in school‐safety‐related practices and problems between school sectors (private, public charter, and traditional public) in Indiana in 2018. Methods Using survey data collected from 618 school leaders in the state, we empirically examine the relationship between school sector and the reported presence of school‐safety‐related practices and problems occurring at school. Subgroup analyses based on voucher program participation status, school level, and location are also performed. Results After controlling for factors such as school type, enrollment, number of students eligible for the federal free and reduced‐price lunch, the number of minority students and teachers, and urbanicity, we find evidence to suggest that private and charter schools tend to report fewer discipline problems while employing fewer disciplinary practices than traditional public schools. Conclusion Our descriptive results suggest that school sector may play a role in producing positive school environments. Further research is needed to better understand short‐ and long‐run consequences of school safety problems and how school safety and school sector might affect students’ academic and life trajectories.

Findings indicate that sports have positive effects on young girls’ cognitive and social skills, as well as on their mental and physiological states (Beets P Blom, Bronk, Coakley, Lauer & Sawyer, 2013). However, the participation of young girls in sport, and especially in male-dominated sports, declines dramatically during adolescence. Male-dominated sports are sports which comprise face-to-face competition, physical contact and reward body-size, strength and toughness. Beginning at a very young age, society reinforces each individual's behavior and activities corresponding to his or her gender role. These gender-roles reflect beliefs about attributes of men and women. In this fashion, male-dominated sports include attributes that are socially associated with the masculine-role, leading to the perception that being female is incompatible with engaging in male-dominated sports (Desertain & Weiss, 1988; Miller & Levy, 1996; Green, 2010). As a result, females who engage in sport experience a female-athlete paradox: either to undermine her femininity and satisfy her own interests, or to repress her desires to play and live up to social norms (Ross & Shinew, 2008). This paradox is particularly noticeable during early-adolescence, a time when many girls decide to dropout of male-dominated sports. Socialization is a process in which an individual learns and internalizes cultural norms (Weiss & Glenn, 1992). One factor that influences both socialization into sport and socialization out of sport is the socializing agent. Socializing agents are people who have a significant influence on the practices and thoughts of other people, and they transmit social norms and values by their perceptions (validation support), their behavior (role modeling and companionship support) and interpretation of these experiences (emotional, esteem, informational, and instrumental support). Exposing boys and girls to separate, gendered experiences, because of gender-related social norms, prevents them from opportunities to discover their various interests and talents (Eccles & Harold, 1991). Because socialization processes occur in a cultural context and because gender-related norms vary among cultures, it is important to identify cultural influences on young girls’ and socializing agents’ expectancies and values about participation in male-dominated sports. An investigation of this process can help us establish an optimal environment for young girls to engage in male-dominated sports. Therefore, the purpose of the study was to investigate the role of socializing agents on dropout and continuing participation of young adolescent girls in male-dominated sports. To accomplish this, Israeli and US female young adults who played organized sports during their early-adolescence, were recruited. The participants completed a questionnaire about the social support experience as early-adolescent participants in sports, and their participation status (dropout or continuing participation) at late-adolescence. Results revealed that girls who engaged in male-dominated sports received greater social support than those who participated in neutral and feminine sports. In addition, girls who continued participation during late-adolescence were provided with more social support than girls who dropped out. Finally, American girls who engaged in male-dominated sports were provided with greater social support than Israeli girls.

Aim: It was aimed to investigate the differences in perceived health outcomes of recreation and life satisfaction levels of leisure participants with regard to some variables and to examine the relationship between these two independent variables. Methods: The sample group of this study is 229 male and 98 females, totally 327 individuals who are participating in different leisure activities. Participants were asked to fill "Perceived Health Outcomes of Recreation Scale (PHORS)" (Yerlisu Lapa et al., 2017) and "Life Satisfaction Scale (LSS)" (Yetim, 1993). Independent Samples t-test and MANOVA were used to analyze the data. Pearson correlation coefficient was also calculated to test the relationship between the sub-dimensions of “PHORS” and “LSS”. Results: The t-test analysis indicated that there was no significant difference between the mean scores of "PHORS"s sub-dimensions and "LSS" with regard to gender and marital status. There was no significant difference between the mean scores of "PHORS"s sub-dimensions and "LSS" according to leisure activity preference field variable (p>.05). MANOVA results indicated that the main effect was statistically significant. ANOVA was conducted to test which dependent variable contributed to the multivariable significance. In terms of the main effect of physical activity participation status, there were significant differences in "Realization of Psychological Experience" sub-dimension. Physical activity participants reported higher mean scores than non-participants in this sub-dimension. In addition, there was a statistically significant positive correlation between the "PHORS" sub-dimension and "LSS" mean scores. Conclusion: Perceived health outcomes of physical activity participants were higher than the others in “Realization of Psychological Experience”. As a result, it could be concluded that individuals’ perceived health outcomes of recreation increases with the life satisfaction scores of the participants.

In many medical research settings, such as the neonatal intensive care unit, the number of patients who are eligible for a randomised clinical trial is relatively small and recruiting a sufficient number of patients into trials is often difficult. Furthermore, some infants may have already been enrolled into a trial as a fetus. Sequential co-enrolment of patients into more than one trial may offer a solution, yet runs the risk of contaminated results. We consider the situation of two sequential trials and describe requirements for different possible treatments effects (‘estimands’) to be estimated in such situations. These estimands differ regarding the extent to which participation status and treatment status in the previous trial is accounted for. Because of differences in available information about previous trials, analyses may result in estimated effects which differ in terms of interpretation and generalisability, except when in the absence of an interaction between the studied treatments. If co-enrolment cannot be ruled out, researchers should collect information about co-enrolment and treatment status in a previous or concurrent trial and mitigate the trial analysis plan in order to estimate meaningful effects.

Background The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental foods to assist participants in meeting their dietary needs. Few studies have described the extent to which WIC-eligible foods contribute to the overall diet of children who were enrolled in WIC prenatally or in early infancy. Objective Our aims were to examine commonly consumed foods and estimate the proportion of dietary intake contributed by WIC-eligible foods among 13- and 24-month-old children, and to assess differences by WIC participation status at 24-months. Design This was a national observational study. Participants/setting Children participating in the WIC Infant and Toddler Feeding Practices Study-2 were included (13 months old [n=2,777] and 24 months old [n=2,450]) from 2013 to 2016. Main outcome measures Dietary intakes were assessed using 24-hour dietary recalls at 13 and 24 months. The 10 most commonly consumed foods were described using the What We Eat in America food category classification system. WIC-eligible foods were defined as meeting the WIC nutrient criteria set forth in the Federal regulation. Statistical analyses performed The estimated proportion (mean±standard error) of WIC-eligible foods to total daily intake was calculated for energy, macronutrients, and select micronutrients. Multiple linear regression, adjusted for confounders, was conducted to compare the estimated proportion of nutrient intake from WIC-eligible foods by WIC participation at 24 months. Results At 13 and 24 months, most (60% and 63%, respectively) of the commonly consumed foods were eligible for purchase as part of the child WIC food package. WIC-eligible foods provided >40% of calories and close to 50% or more of other nutrients, and the contribution of WIC-eligible foods to overall micronutrient intake increased between 13 and 24 months. Children still on WIC at 24 months obtained a larger proportion of calories and most other nutrients from WIC-eligible foods than children no longer on WIC. Conclusions WIC-eligible foods could contribute to the overall diet of toddlers who were enrolled in WIC prenatally or in early infancy. Further, there may be additional nutritional benefits of staying on the program through 24 months.

OBJECTIVE: To understand whether the Comprehensive Care for Joint Replacement (CJR) program induces participating hospitals to (1) preferentially select lower risk patients, (2) reduce 90‐day episode‐of‐care costs, (3) improve quality of care, and (4) achieve greater cost reduction during its second year, when downside financial risk was applied. DATA SOURCES: We identified beneficiaries of age 65 years or older undergoing hip or knee joint replacement in the 100% sample of Medicare fee‐for‐service inpatient (Part A) claims from January 1, 2013 to August 31, 2017. Cases were linked to subsequent outpatient, Part B, home health agency, and skilled nursing facility claims, as well as publicly available participation status for CJR. STUDY DESIGN: We estimated the effect of CJR for hospitals in the 67 metropolitan statistical areas (MSA) selected to participate in CJR (785 hospitals), compared to those in 104 non‐CJR MSAs (962 hospitals; maintaining fee‐for‐service). A difference‐in‐differences approach was used to detect patient selection, as well as to compare 90‐day episode‐of‐care costs and quality of care between CJR and non‐CJR hospitals over the first two performance years. DATA COLLECTION: We excluded 172 hospitals from our analysis due to their preexisting BPCI participation. We focused on elective admissions in the main analysis. PRINCIPAL FINDINGS: While reductions in 90‐day episode‐of‐care costs were greater among CJR hospitals (−$902, 95% CI: −$1305, −$499), largely driven by a 16.8% (p

Objective: This study aimed to reflect on the participation status of charities at different levels (i.e., prevention, treatment, and rehabilitation) of Iran’s health care system. Methods: This descriptive cross-sectional study was fulfilled in 2019 based on 40 charitable organizations involved in health care services delivery, which were randomly selected from the Iranian Charities Portal (ICP). Data were collected via a valid and reliable researcher-made questionnaire. SPSS software version 16.0 was used to analyze data. Results: Direct and indirect methods of service delivery were used in 63% of organizations. The most important sources of funding were associated with public donations. Furthermore, 94% of charities were evaluating the health care services with internal and external evaluation and customer satisfaction surveys. Conclusions: The charities could be a precious contribution to the health care system. To use this potential as a synergistic factor of the health system, adopting such strategies as creating sustainable funding sources and establishing more coordination between organizations are essential.

The sport team social environment plays an important role in athletes’ experiences, including their enjoyment of sport, and these experiences may influence athletes’ decision to continue or dropout of sport. In the current study, enjoyment was examined as a mediator of the relationship between social identity and sport dropout. Adolescent girls (N = 150) who participated on a community sports team completed a questionnaire assessing social identity with their team and enjoyment of sport, and their sport participation status was measured 1 year later. Controlling for age and socioeconomic position, a path model showed that enjoyment mediated the relationship between social identity and sport dropout, bootstrapped unstandardized indirect effect = −0.04, 95% confidence interval [−0.08, −0.01]; p

BACKGROUND People with poor health or mental conditions are generally unwilling to participate in the health examinations, and no studies have directly examined the relationship of psychological distress among disaster survivors with participation status to date. The present study thus examined psychosocial differences according to the respondent status in a 5-year follow-up survey among participants in the prospective health surveys on survivors of the Great East Japan Earthquake and Tsunami Disaster study in Iwate prefecture, Japan. METHODS We analyzed data from 10203 Japanese survivors aged ≥18 years (mean age, 65.6 years; 38.0% men) and who underwent health examinations at baseline in 2011. Participants were classified into responders and nonresponders according to their 2015 health examination participation status. Psychological distress was evaluated using the Kessler 6 scale and categorized as none, mild, and severe. Multinominal logistic regression was used to examine the risk of psychological distress in relation to participation status. RESULTS In the 2015 survey, 6334 of 6492 responders and 1686 of 3356 nonresponders were analyzed. The most common reasons for nonparticipation in the survey were participated in other health examinations, examined at a hospital, and did not have time to participate. Nonresponse in males was associated only with mild psychological stress, whereas nonresponse in females was associated with mild and severe psychological distress. CONCLUSIONS Nonresponders in the follow-up survey had a higher risk of psychological distress than responders. Continuous monitoring of the health of nonresponders and responders may help to prevent future health deterioration.

The main objective of this paper is to assess the determinants and challenges of economic achievement for women entrepreneurs in Ethiopia. The study used 698 sample women entrepreneurs selected randomly from a total of 2450 respondents. The data were analyzed using descriptive statistics and multiple linear regression models. The results revealed that there is a high rate of challenges for divorced (30%) and widowed (41%) women entrepreneurs in the selected area. The results of multiple linear regression show that the educational level, family size, region (SNNP, Gambella, Harari, Dire Dawa, and Addis Ababa), parents’ educational level, number of financially dependent people, business experiences, and access to raw materials were positive predictors of the income of women entrepreneurs. It is also found that entrepreneurial area (Afar, Amhara, and Oromiya), marital status (divorced and widowed), entrepreneurship training, enterprise’s license, and lack of supporting institutions were negatively related with the income of women entrepreneurs. Therefore, improving entrepreneurs’ and parents’ education, providing entrepreneurship training, sharing business experiences, supporting entrepreneurs is the main instrumental in minimizing the factors affecting the income of women entrepreneurs. Moreover, it is advisable if the business participation status of women be assessed periodically to monitor the situation and to take appropriate measures for combating and preventing the challenges facing women entrepreneurs in economic growth.

Sahil Gupta,1 Scott Palmer,2 Guilherme Ferreira-Dos-Santos,3,4 Mark Friedrich Hurdle2 1Department of Pain Medicine, Southern Illinois Healthcare, Carbondale, IL, USA; 2Department of Pain Medicine, Mayo Clinic, Jacksonville, FL, USA; 3Department of Physical Medicine and Rehabilitation, Central Lisbon University Hospital Center, Lisbon, Portugal; 4NOVA Medical School, NOVA University of Lisbon, Lisbon, PortugalCorrespondence: Sahil GuptaDepartment of Pain Medicine, Southern Illinois Healthcare, 305 W Jackson St Suite 103, Carbondale, IL, 62901, USATel +1 618-351-4972Fax +1 618-457-3020Email sahil.mamc@gmail.comObjective: To evaluate the content of Pain Medicine Fellowship Program websites in the United States of America.Methods: We obtained a list of accredited 104 Pain Medicine Fellowship Program websites from the Accreditation Council for Graduate Medical Education and the Electronic Residency Application Service. Individual Pain Medicine Fellowship Program websites were then evaluated on 14 different criteria. We grouped fellowship programs based on census region and Electronic Residency Application Service participation status, and analyzed the differences using nonparametric statistics.Results: A total of 104 accredited Pain Medicine Fellowship Program websites were evaluated for a total of 14 different criteria. Of the 14 different criteria, an average of 3.94 were described in each website. Number of Fellowship positions per year (71.8%), clinical rotations during the program (65.1%), and faculty background (62.2%) were the most frequently described features on the websites. Night call responsibilities (3.9%), meal allowance (7.8%) and parking availability (10.7%) were the least described features in the websites. There were no significant differences between program websites when grouped by census regions or the participation status in the Electronic Residency Applications Service.Conclusion: The content of Pain Medicine Fellowship Program websites is extremely variable across the United States of America. This study indicates that there is room for improvement and enhancement of the comprehensiveness of website content for the majority of the programs analyzed. Additionally, this study also emphasizes the importance of having accurate and easily available online information in a post-pandemic era, when prospective fellows evaluate programs online through their websites.Keywords: ACGME, application, ERAS, fellowship program, pain medicine, website

This study was presented as oral presentation in 17th International Sport Sciences Congress, Antalya, Turkey, 2019 November and published in abstract book of the congress [Abstract] The aim of the present study is to examine the athletic identity, status transitions and health-related behavioral dynamics of student athletes. Descriptive survey model was used and 398 individuals participated in the present study. Data was collected by Athletic Identity Measurement Scale (AIMS), information form, ranking and closed-ended qualitative questions. According to findings, it was found that the students' downright transitions increased in processes. On the contrary, ANOVA analyses show no differences in athletic identity scores according to grade levels (p>.05). An increase was seen in maladaptive health behaviors (p .05). Se observó un aumento en los comportamientos de salud desadaptativos (p

study conducted on 900 farm families in six agro-climatic zones of the State which clearly indicate an active participation of both women and men in most of the selected activities in the area of post harvesting. Data were collected with the help of interview schedule by personal interview method. Participatory interviews with individual member of the households by using a combination of PRA techniques to quantify gender perspectives were used for data collection. The results indicated that majority of the rural women were working with male members almost in all the activities leaving aside marketing and management of produce at commercial level. . The role of rural women in post harvest operations especially in drying, storage and cleaning of grains was more prominent. It necessary to transfer of technical knowhow on these aspects to women, the technical guidance would help in enhancement of their efficiency and reduced the losses during storage. Such education would lead to increase their income and active role in post harvest activities An effort has The purpose of the study is to recognize the gender role in post harvest activities in rural areas of Assam.The been made in this study to understand the gender role in post harvest operation in Assam so as to know their present participation status. The data will enable for area based programmes to develop capacities of farm women.

Teacher competencies can be influenced by several factors, but not all factors that affect teacher competencies can be well described. This research attempts to answer some of the problems through differences analysis, which is the effect of participation in scientific research and conference on vocational teachers’ competencies. A total of 77 vocational school teachers in Indonesia’s East Java province were used as samples, and research data were obtained from participants of vocational teacher competency tests. This research uses a survey method through expose facto research with a quantitative approach. The data obtained are then analyzed by analysis of variance techniques. The results of the study conclude 1) teacher’s participation in scientific forums and participation status in scientific meetings have a nonsignificant effect on vocational teacher competency, 2) the frequency of writing articles has a non-significant impact on the competencies of vocational teachers, 3) vocational high school teachers’ research experience gives a non-significant effect on the competencies of vocational teachers. The results of this study are expected to be input for improving the competence of vocational teachers in Indonesia.

The federal Child and Adult Care Food Program (CACFP) provides reimbursable meals to 4.6 million children annually and sets nutrition standards for foods served. Licensing regulations in many states extend these rules to nonparticipating programs.To evaluate the quality of meals and snacks served in Connecticut licensed childcare centers in 2019 and assess implementation of a state licensing requirement to adhere to CACFP minimum nutrition standards in all centers.Cross-sectional survey.Two hundred licensed childcare centers in Connecticut in 2019.Meal/snack quality was assessed based on menus. Foods/beverages listed were compared to the minimum CACFP nutrition standards and optional best practices. Surveys completed by center directors measured center characteristics.Logistic and linear multivariable regression models tested differences in centers' adherence to nutrition standards and best practices by CACFP participation status.CACFP centers complied with more required nutrition standards than non-CACFP centers (an adjusted mean of 4.7 vs 3.4 standards among programs serving meals, P0.001), with particularly large mean differences for whole grains and low-fat milk. Implementation of optional best practices, except for beverages, was relatively low among all centers, especially for snacks. Compliance (adjusted mean number of minimum nutrition standards met) was greater among centers accredited by the National Association for the Education of Young Children and those using a registered dietitian or a sponsoring agency to prepare menus and receiving food from a vendor. Recent completion of nutrition training was associated with greater mean implementation of best practices.Better adherence to minimum nutrition standards and best practices among CACFP-participating childcare centers contributed to higher nutritional quality of meals and snacks offered. Snack quality would benefit most from greater compliance with nutrition standards. Providers outside of CACFP need additional supports in the implementation of licensing regulations to improve the food environment for young children.

Women constitute about 50% of the world population and contribute about 75% to subsistence production. On the other hand, they earn one tenth of the world’s income and they own one hundredth of the world’s property including land. In Ethiopia, as in most parts of the world, women’s role in the socio-economic activities is high, but they have less access basic resources than men do. Therefore, the enhancement of women’s participation in all spheres of life has become a key issue in development discourses, which ratifies socio-economic development, cannot be fully achieved without the active participation of women. The primary economic activity of Ethiopia is agriculture which greatly depends on family labor where women play crucial role. Majorities of the rural populations are engaged in agricultural cooperatives, which is the business owned and controlled by the people to meet peoples’ common requirements. Hence, this article explored women participation status and associated factors influencing their participation in agricultural cooperatives. Although the feminist theory proved that women and men have equal potential for individual development, the fruits that go to women are by far very low. The review identified that culture/customs, heavy work load and lack of time, lack of capital/credit, gender differentials, lack of education and training, lack of access to key economic resources, laws and rules, lack of access to property ownership, income generation and purchasing power as determinant factors influencing women participation in agricultural cooperatives. Therefore, to improve the situation, proposed interventions have to be made include: creating awareness through education and training to bring attitudinal change in the society, encouraging women participation, making different types of credit accessible, following the implementation of laws and rules as designed. For that matter, government organs at all levels and other stakeholders ought to work to attract more women to the cooperative members and also to bring them to the decision making positions. Keywords: Agriculture; Contribution; Cooperative; Determinants; Participation; Women DOI: 10.7176/JCSD/61-03 Publication date: September 30 th 2020

Background The Government of Vietnam has set the goal of achieving universal health coverage (UHC) by 2025. Health insurance (HI) is being considered a tool to achieve this goal. However, out-of-pocket spending and catastrophic health expenditure (CHE) remain high. Research evidence on how to reduce these expenditures to achieve UHC is essential. Therefore, this study examines the determinants of CHE, especially the HI factor. Method To identify HI participation status and other factors associated with CHE, we use logistic regression on a dataset from the 2016 Vietnam Household Living Standards Survey. Results The study finds that HI is a protective factor against CHE, although this result is not always statistically significant across different subsamples. Moreover, the household head's age and employment status, household size, share of the elderly above 60 years, income, illness status, healthcare utilisation, availability of hospitals, commune health stations with medical doctors and place of residence all correlate with household CHE. Conclusion Although there has been a rise in HI coverage, the financial protection capacity of HI schemes in Vietnam remains inadequate, particularly for households living in rural areas. Further investigations of the causal effect of HI, other health system factors and CHE in rural settings are necessary to reduce the incidence of CHE. Additionally, policies aimed at groups vulnerable to CHE, such as those with higher incidences of severe illness or inpatient admissions, low income, and higher age, should be considered.

Background Participation in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) among 0- to 5-year-old children is associated with healthier diets. Extension of dietary benefits to older, age-ineligible children (5-18 years old) residing in WIC households has not been fully investigated. Objective Examine the association between household WIC participation and dietary behaviors of age-ineligible children. Design Cross-sectional secondary analysis of data collected from 2 independent panels (2009-2010 and 2014) of the New Jersey Child Health Study, using household surveys. Questions derived from national surveys assessed consumption frequency of specific foods among 5- to 18-year-old children. Participants/setting The analytic sample included 616 age-ineligible children from households with incomes below 200% of the federal poverty level, 398 of whom were from WIC-participating households. Main outcome measures Eating behaviors were measured as frequency of daily consumption of fruit, vegetables, 100% juice, sugar-sweetened beverages, and sweet and salty snacks. Statistical analysis Multivariable negative binomial models examined the association between eating behaviors and household WIC participation status adjusting for child's age, sex, and race; mother's education; city of residence; household size; and panel. Results are expressed as incidence rate ratios (IRRs). Results Household WIC participation was not associated with dietary behaviors among age-ineligible children (5-18 years old) in the overall sample. However, healthier dietary patterns were observed for specific demographic groups. Compared with age-ineligible children in non-WIC households, age-ineligible children in WIC households had (1) a higher frequency of vegetable consumption among 12- to 18-year-old children (IRR = 1.29; 95% confidence interval [CI] 1.05-1.58; P = .015); (2) a marginally significant higher frequency of 100% juice consumption among females (IRR = 1.27; 95% CI 1.00-1.62; P = .053); and (3) a lower frequency of sugar-sweetened beverages consumption among Hispanic children (IRR = 0.61; 95% CI 0.43-0.86; P = .004). Conclusions Household WIC participation may positively influence dietary behaviors of age-ineligible children, suggesting a possible WIC spillover effect. Revisions to WIC package composition should consider the possible dietary implications for all children in the household.

Highlights • SNAP participants had poorer diet quality compared to non-participants. • The HEI-2015 disparity between SNAP participants and income-eligible non-participants was 3.24. • Demographics explained 36% of the disparity in diet quality between SNAP participants and income-eligible non-participants. • The HEI-2015 disparity between SNAP participants and income-ineligible non-participants was 6.30. • Demographics explained 72% of the disparity in diet quality between SNAP participants and income-ineligible non-participants., Recent studies have reported that SNAP participants have poorer diet quality than non-participants. This study aimed to examine how differences in socio-demographic, household, and health-related measures explain disparities in diet quality between SNAP participants and non-participants using Oaxaca-Blinder decomposition analysis. We analyzed cross-sectional data on 14,331 adult respondents of the National Health and Nutrition Examination Survey (NHANES) 2009 – 2014. To measure diet quality, we applied the Healthy Eating Index (HEI)-2015 to respondents’ 24-hour dietary recall data (scale: 0–100 points). We used Oaxaca-Blinder decomposition analysis to determine how much of the disparity in HEI-2015 total score between SNAP participants and non-participants was explained by socio-demographic (e.g., age, race/ethnicity, educational), household (e.g., household size, food security status), and health-related measures (e.g., BMI, smoking status). Analyses performed revealed significant differences in HEI-2015 total score by SNAP participation status (p

Background: The purpose of this study was to examine the independent and joint associations between physical activity (PA) and sports participation on academic performance variables within a representative sample of children and adolescents. Methods: Data were analyzed from the combined 2017–2018 National Survey of Children’s Health. Household addresses were randomly selected within each US state. One household parent answered health and wellness questions pertaining to one randomly selected household child (N = 37,392; 48.1% female; 6- to 17-y old). Weighted logistic regression models were employed to examine the independent and joint associations between child PA frequency and sports participation with academic performance variables, adjusting for child- and family-level covariates. Results: Child PA frequency independently associated with 37% to 46% lower odds and child sports participation independently associated with 53% lower odds of reported difficulty concentrating, remembering, or making decisions (P P = .01). Conclusions: Frequency of weekly PA and sports participation independently and negatively associated with difficulty concentrating, remembering, and making decisions, whereas the negative association between PA and ever repeating a grade level differed by child sports participation status.

Background: The paucity of population-based research indicates that the application of intensive chemotherapy (ICT) among elderly acute myeloid leukemia (AML) patients, as well as their accrual to randomized controlled trials (RCTs) remains low for several decades. Therefore, a contemporary, comprehensive apprehension on patient-, disease-, and treatment-specific characteristics of elderly AML patients at the population level can inform treatment choices and facilitate increased patient accrual in upcoming RCTs. Objectives: In this population-based study, we investigated patient- and disease-specific characteristics in elderly AML patients, and their association with treatment and survival. Methods: We retrospectively obtained data on all over 65-year-old AML patients diagnosed between 2010–2013 in the referral area of two university hospitals in the Netherlands. Multivariable analyses were performed to assess factors associated with treatment choice and overall survival. Results: Of all 356 patients, 77% received non-intensive therapy (NIT), and 15% and 8% received ICT within and outside a RCT, respectively. Cytogenetic (74%) and molecular (93%) analyses were not performed in most NIT recipients. Age and comorbidity were independently associated with NIT, whereas only comorbidity was associated with decreased trial participation. The adjusted risk of mortality among ICT recipients was not influenced by trial participation status. Conclusion: The application of ICT and accrual to RCTs remains staggeringly low in an elderly AML population. Since survival of ICT-treated patients was not affected by trial participation status, exclusion criteria might be relaxed in upcoming RCTs. Furthermore, appropriate management strategies can be accomplished by comprehensive comorbidity assessment and augmented genetic prognostication.