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Persons PA, Williams L, Fields H, Mishra S, Mehta R. Weight gain during midlife: Does race/ethnicity influence risk? Maturitas 2024; 185:108013. [PMID: 38703595 DOI: 10.1016/j.maturitas.2024.108013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 05/06/2024]
Abstract
Fears regarding weight gain and body changes commonly plague midlife women. The aim of this paper is to discuss the impact of weight gain and body changes on midlife women across various cultural backgrounds. Midlife weight gain in women is associated with age as opposed to menopausal status. Weight gain during midlife occurs across all cultural/ethnic groups; however, African Americans and Hispanic women exhibit higher rates of weight gain than their Caucasian counterparts. Although use of menopause hormone replacement therapy does not produce a clinical difference in weight gain, exercise decreases the risk of obesity in midlife women. Cultural differences in perception of body image exist. Recognizing these differences may help clinicians better address the weight concerns of women from diverse backgrounds. A shift in focus from weight goals to cardiometabolic risk reduction may help patients feel more successful and improve health outcomes.
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Affiliation(s)
- Patress Ann Persons
- Mayo Clinic Arizona, Community Internal Medicine, 13400 E Shea Blvd, USA, Scottsdale, AZ 85259.
| | - Lesley Williams
- Mayo Clinic Arizona, Department of Family Medicine, 13737 N. 92nd St., USA, Scottsdale, AZ 85260.
| | - Heather Fields
- Mayo Clinic Arizona, Community Internal Medicine, 13400 E Shea Blvd, USA, Scottsdale, AZ 85259.
| | - Sneha Mishra
- Mayo Clinic Arizona, Community Internal Medicine, 13400 E Shea Blvd, USA, Scottsdale, AZ 85259.
| | - Rajal Mehta
- Mayo Clinic Arizona, Community Internal Medicine, 13400 E Shea Blvd, USA, Scottsdale, AZ 85259.
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Cockerham WC. Health Lifestyle Theory in a Changing Society: The Rise of Infectious Diseases and Digitalization. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:437-451. [PMID: 36912383 DOI: 10.1177/00221465231155609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Social change produces alterations in society that necessitate changes in sociological theories. Two significant changes affecting health lifestyle theory are the behaviors associated with the COVID-19 pandemic and the digitalization of society. The health-protective practices emerging from the ongoing pandemic and the recent parade of other newly emerging infectious diseases need to be included in the theory's framework. Moreover, the extensive digitalization of today's society leads to the addition of connectivities (electronic networks) as a structural variable. Connectivities serve as a computational authority influencing health lifestyle practices through health apps and other digital resources in contrast to collectivities (human social networks) as a normative authority. The recent literature supporting these features in an updated and expanded model of health lifestyle theory is discussed.
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Affiliation(s)
- William C Cockerham
- University of Alabama at Birmingham, Birmingham, AL, USA
- College of William & Mary, Williamsburg, VA, USA
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Leiter E, Greenberg KL, Donchin M, Keidar O, Siemiatycki S, Zwas DR. Cardiovascular disease risk factors and health behaviors of ultra-Orthodox Jewish women in Israel: a comparison study. ETHNICITY & HEALTH 2022; 27:1031-1046. [PMID: 33249884 DOI: 10.1080/13557858.2020.1849567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
Objectives: Women from low socio-economic, culturally insular populations are at increased risk for cardiovascular disease (CVD). The ultra-Orthodox Jewish (UOJ) community in Israel is a rapidly growing low socio-economic, insular, cultural-ethnic minority with numerous obstacles to health. The current cross-sectional study investigates CVD-related health behaviors and risk factors in a sample of UOJ females, comparing sample characteristics with the general population. Design: Self-administered questionnaires completed by a cluster randomized sample of 239 UOJ women included demographics, CVD-related health behaviors (consumption of fruit, vegetables, and sweetened beverages; hours of sleep; secondhand smoke exposure; and physical activity engagement) and risk factors (BMI, reported diagnoses of diabetes, high blood pressure, and heart disease). Results: Compared with the general population, UOJ women were less likely to consume 5 fruits and vegetables a day (12.7% vs. 24.3%, p < .001); more likely to consume ≥ 5 cups of sweetened beverages a week (18.6% vs. 12.6%, p = .019), and more likely to sleep <7 hours a night (62.0% vs. 50.6%, p = .002). UOJ women also reported less secondhand smoke exposure (7.2% vs. 51.4%, p < .001) and higher rates of physical activity recommendation adherence (60.1% vs. 25.6%, p < .0001) than the general population. Obesity was higher in UOJ women (24.3% vs. 16.1%, p < .0001). Increased parity and reduced moderate physical activity were associated with increased BMI. Increased parity was also associated with reduced sleep. Grand multiparous women (a 68% prevalence rate), in particular, were more likely to be overweight or obese than women with less than 5 children. Conclusions: This study suggests that health promotion interventions in this population target healthy weight maintenance, nutrition, and physical activity.
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Affiliation(s)
- Elisheva Leiter
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Cardiology Department, Hadassah University Medical Center, Jerusalem, Israel
| | - Keren L Greenberg
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Cardiology Department, Hadassah University Medical Center, Jerusalem, Israel
| | - Milka Donchin
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Cardiology Department, Hadassah University Medical Center, Jerusalem, Israel
- Braun School of Public Health and Community Medicine, Hebrew University, Hadassah, Jerusalem, Israel
| | - Osnat Keidar
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Cardiology Department, Hadassah University Medical Center, Jerusalem, Israel
- Braun School of Public Health and Community Medicine, Hebrew University, Hadassah, Jerusalem, Israel
| | - Sara Siemiatycki
- Bishvilaych, The Evelyne Barnett Women's Medical Center, Jerusalem, Israel
| | - Donna R Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Cardiology Department, Hadassah University Medical Center, Jerusalem, Israel
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Ferrer-Lues M, Anigstein MS, Bosnich-Mienert M, Robledo C, Watkins L. [From theory to practice: the discourse of healthy lifestyles and its application to the daily lives of low-income Chilean women]. CAD SAUDE PUBLICA 2021; 37:e00333720. [PMID: 34932687 DOI: 10.1590/0102-311x00333720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/25/2021] [Indexed: 11/22/2022] Open
Abstract
The discourse on healthy lifestyles (HLS) states that a population will remain healthy by adopting such lifestyles, modifying unhealthy and thus morally incorrect individual behaviors. The HLS discourse has been hegemonic in Public Health since the late 20th century. It assumes freedom of choice by individuals, who purportedly make rational decisions, seeking the lowest cost and maximum individual benefit, the neoliberal model's basic premise. It thus overlooks the relevance of living conditions for health and health inequality. The current study focused on the perception of the HLS discourse and its repercussions on the behavior of low-income Chilean women. Semi-structured interviews were held with beneficiaries of a government program (Healthy Life Program), based on the HLS discourse. The study explored the women's discourse on health and its correspondence with the HLS discourse. It also analyzed the possibilities of implementing the discourse in practice, from the women's own perspective. The results showed that the women view health as the result of lifestyle, which can be freely chosen. However, they identify various barriers to implementing healthy lifestyle in practice at the economic, family, and sociocultural levels. The conclusion is that individuals should be considered within the family, social, and structural contexts in which health and disease are produced, while abandoning the moralist perspective that legitimizes the neoliberal definition of health.
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Affiliation(s)
| | - Maria Sol Anigstein
- Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile.,Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | | | - Consuelo Robledo
- Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Loreto Watkins
- Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
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Zhang P, Gao J. Quality of public health insurance and individuals' consumption structure upgrades: evidence from China. HEALTH ECONOMICS REVIEW 2021; 11:45. [PMID: 34860293 PMCID: PMC8641222 DOI: 10.1186/s13561-021-00343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 11/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between the quality of public health insurance and individuals' consumption structure upgrades in China. METHODS This study was conducted using data from a population of 6430 Chinese individuals aged 18 to 70 y from the 2017 Chinese Social Survey. We used multiple linear regression models and the two-stage least-squares model to explore the impact and heterogeneity of the quality of public health insurance on individuals' consumption structure upgrades. Furthermore, we performed structural equation modelling to clarify the mediation effects of the impact. RESULTS The quality of public health insurance was significantly correlated with individuals' consumption structure upgrades (β = 0.368, SD = 0.084), and the impact of the quality of public health insurance on individuals' hedonic consumption in urban regions was significantly higher than that in rural regions (β = 0.499, SD = 0.218). Furthermore, the quality of public health insurance could promote upgrades to individuals' consumption structure by reducing the burden of medical expenses and stabilizing or increasing individuals' expectations regarding the future economic level. CONCLUSION The results indicated that developing countries should implement additional measures to enhance the quality of public health insurance, which would not only help protect the health of individuals but also stimulate individuals' consumption to achieve rapid economic growth.
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Affiliation(s)
- Pengfei Zhang
- School of Labor and Human Resources, Renmin University of China, No 59, Zhongguancun Street, Beijing, 100872 China
| | - Jinghua Gao
- Centre for Social Investment (CSI), Heidelberg University, Bergheimer Str. 58, 69115 Heidelberg, Germany
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Wang W, Luo X, Zhang C, Song J, Xu D. Can Land Transfer Alleviate the Poverty of the Elderly? Evidence from Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111288. [PMID: 34769804 PMCID: PMC8582979 DOI: 10.3390/ijerph182111288] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
This study explores the impact of farmland transfer on the multidimensional relative poverty of the elderly in rural areas to provide a reference for the study of rural land transfer in China and improve the welfare system for the elderly. Based on the China Family Panel Studies (CFPS) rural sample data in 2018, this paper uses the AF multidimensional index measurement method to assess multidimensional relative poverty in rural areas. Logit regression estimation examines the single index poverty of rural older adults transferred from rural land and the impact of multidimensional relative poverty, using the propensity score matching method (PSM) to analyze the results' robustness. The transfer of agricultural land has different impacts on the poverty of different rural elderly poverty indicators and negatively affects the comprehensive effect of rural elderly poverty. The transfer of agricultural land significantly alleviates rural elderly poverty. Reasonable and effective transfer of agricultural land, together with improved rural social security and a caring service system for the elderly, will promote the continuous operation of large-scale agricultural operations and alleviate rural elderly poverty.
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Affiliation(s)
- Wei Wang
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Xin Luo
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Chongmei Zhang
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Jiahao Song
- Department of Rural and Regional Development, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China
- Correspondence: (J.S.); (D.X.); Tel.: +86-189-7227-0055 (J.S.); +86-028-8629-0893 (D.X.)
| | - Dingde Xu
- Sichuan Center for Rural Development Research, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China
- Correspondence: (J.S.); (D.X.); Tel.: +86-189-7227-0055 (J.S.); +86-028-8629-0893 (D.X.)
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Yoeli H, Macnaughton J, McLusky S. Menopausal symptoms and work: a narrative review of women's experiences in casual, informal, or precarious jobs. Maturitas 2021; 150:14-21. [PMID: 34219903 PMCID: PMC7611109 DOI: 10.1016/j.maturitas.2021.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Governments, employers, and trade unions are increasingly developing "menopause at work" policies for female staff. Many of the world's most marginalised women work, however, in more informal or insecure jobs, beyond the scope of such employment protections. This narrative review focuses upon the health impact of such casual work upon menopausal women, and specifically upon the menopausal symptoms they experience. Casual work, even in less-then-ideal conditions, is not inherently detrimental to the wellbeing of menopausal women; for many, work helps manage the social and emotional challenges of the menopause transition. Whereas women in higher status work tend to regard vasomotor symptoms as their main physical symptom, women in casual work report musculoskeletal pain as more problematic. Menopausal women in casual work describe high levels of anxiety, though tend to attribute this not to their work as much as their broader life stresses of lifelong poverty and ill-health, increasing caring responsibilities, and the intersectionally gendered ageism of the social gaze. Health and wellbeing at menopause is determined less by current working conditions than by the early life experiences (adverse childhood experiences, poor educational opportunities) predisposing women to poverty and casual work in adulthood. Approaches to supporting menopausal women in casual work must therefore also address the lifelong structural and systemic inequalities such women will have faced. In the era of COVID-19, with its devastating economic, social and health effects upon women and vulnerable groups, menopausal women in casual work are likely to face increased marginalisation and stress. Further research is need.
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Affiliation(s)
- Heather Yoeli
- Institute for Medical Humanities & Department of Anthropology, Durham University, UK
| | - Jane Macnaughton
- Institute for Medical Humanities & Department of Anthropology, Durham University, UK
| | - Sarah McLusky
- Institute for Medical Humanities & Department of Anthropology, Durham University, UK
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Wei W, Sarker T, Roy R, Sarkar A, Ghulam Rabbany M. Women's empowerment and their experience to food security in rural Bangladesh. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:971-994. [PMID: 33780030 DOI: 10.1111/1467-9566.13273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/17/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Global discourses have advocated women's empowerment as a means to reduce their own's food insecurity, which is also key development challenges in Bangladesh. However, little empirical research has conducted on this issue, especially in the rural area of Bangladesh. Therefore, the present study was conducted to examine the relationship of six domains of women's empowerment with their food security in rural Bangladesh using a partial least square structural equation modelling approach. Our empirical analysis indicates that women's accesses to their legal and familial rights and decision-making roles in households increase their bargaining power over the utilization of resources and to choices of food which significantly and negatively decrease their food insecurity. Moreover, information and communication technologies and infrastructure facilities also negatively and significantly associated with women's food insecurity. However, women's leadership has a negative but not significant effect on their food insecurity, as low self-esteem rural women feel no ease in publicly addressing their inequalities. By understanding family composition from women's perceptions, the results from our research can assist policymakers to develop more suitable strategies to enhance the empowerment status of rural women and reduce their food insecurity.
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Affiliation(s)
- Wei Wei
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China
| | - Tanwne Sarker
- School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China
| | - Rana Roy
- College of Natural Resources and Environment, Northwest A&F University, Yangling, Shaanxi, China
- Department of Agroforestry and Environmental Science, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Apurbo Sarkar
- College of Economics and Management, Northwest A&F University, Yangling, Shaanxi, China
| | - Md Ghulam Rabbany
- College of Economics and Management, Northwest A&F University, Yangling, Shaanxi, China
- Department of agribusiness and marketing, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
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Deng JR, Tan WQ, Yang SY, Ao LP, Liang JP, Li LX, Gao YH, Yang Y, Liu L. High birth weight and its interaction with physical activity influence the risk of obesity in early school-aged children. World J Pediatr 2020; 16:385-392. [PMID: 32100262 DOI: 10.1007/s12519-020-00336-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 01/03/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND High birth weight (HBW) is associated with childhood obesity, but with inconsistent results. This study investigated the relationship between HBW and childhood obesity, and further explored the interaction of HBW with behavioral and socio-economic determinants of obesity. METHODS This cross-sectional study enrolled 1906 grade-two children of Guangzhou, China, from June to November, 2016. Overweight/obesity corresponded to a body mass index higher than the sex-age-specific criteria. Abdominal obesity was assessed using the sex-specific waist-height ratio cutoffs. The association of HBW with obesity was evaluated in multivariable logistic regression model. The relative excess risk due to interaction (RERI) and the attributable proportion of interaction (AP) indices were used to measure additive interaction, while applying the interaction of OR index for multiplicative interaction assessment. RESULTS Children with HBW had an increased risk of overweight/obesity [odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.56-3.76] compared with those without HBW. Significant additive interaction of HBW with physical activity was found for overweight/obesity [relative excess risk due to interaction (RERI) = 2.69, 95% CI = 0.62-4.75; attributable proportion of interaction (AP) = 0.72, 95% CI = 0.42-1.02]. The HBW children with insufficient activity had higher odds of overweight/obesity compared to the non-HBW children with sufficient activity (OR = 3.75, 95% CI = 2.06-6.83). In addition, we identified a significant interaction of HBW with household income for abdominal obesity (RERI = 1.20, 95% CI = 0.02-2.37; AP = 0.76, 95% CI = 0.16-1.36). CONCLUSIONS HBW confers an increased risk for childhood overweight/obesity. Physical activity attenuates the effect of HBW on overweight/obesity, and HBW possibly synergistically interacts with high household income to promote abdominal obesity in childhood.
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Affiliation(s)
- Jia-Ru Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China.,Futian Hospital for Prevention and Treatment of Chronic Disease, Shenzhen, 518048, China
| | - Wei-Qing Tan
- Guangzhou Health Care Promotion Center for Primary and Middle Schools, Guangzhou, 510180, China
| | - Shu-Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China
| | - Li-Ping Ao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China
| | - Jian-Ping Liang
- Guangzhou Health Care Promotion Center for Primary and Middle Schools, Guangzhou, 510180, China
| | - Li-Xia Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China
| | - Yan-Hui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China.
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Cruz R, Garcia-Rosa M, Faria C. Nocturia: Prevalence and associated factors in community-dwelling subjects - a population- based study. ACTA ACUST UNITED AC 2020; 66:830-837. [PMID: 32696869 DOI: 10.1590/1806-9282.66.6.830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/13/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess the prevalence of nocturia and identify factors associated with it in a community-dwelling population. METHODS A cross-sectional study was conducted in subjects aged 45 years or more and registered with a Family Doctor Program. Information was collected about nocturia, other urinary symptoms, physical examination, co-morbidities, demographics, socio-economic, and lifestyle factors. Multiple logistics regression models were developed to analyze associated factors for nocturia according to gender and the number of nocturnal micturitions(≥1 and ≥2). RESULTS Out of the 661 individuals included in the study, 62.3% were women. Among the women, the prevalence rates for nocturia ≥1 time and ≥2 times were, respectively, 68.4% and 49%, whereas, among the men, they were 64.3% and 43.8%. Among the women, nocturia ≥1 time was associated with brown skin, a higher BMI, lower schooling, and calcium channel blockers(CCB) use, while nocturia ≥2 times showed association with higher BMI, lower schooling, obstructive sleep apnea (OSA), and the use of CCB. Among the men, nocturia ≥1 time was associated positively with age, alcohol intake, and OSA, and negatively with angiotensin receptor blockers and beta-blockers use. Besides, nocturia ≥2 times was associated with age, not having health insurance, and OSA. CONCLUSIONS Nocturia is a condition highly prevalent in the studied population. For the female subjects, a higher BMI, lower schooling, and the use of CCB were associated with nocturia regardless of the definition used, whereas, among the men, that same association was found with age, not having health insurance, and OSA.
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Affiliation(s)
- Rodrigo Cruz
- Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Maria Garcia-Rosa
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Carlos Faria
- Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil
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Franklin M, Lewis S, Willis K, Rogers A, Venville A, Smith L. Goals for living with a chronic condition: The relevance of temporalities, dispositions, and resources. Soc Sci Med 2019; 233:13-20. [PMID: 31150928 DOI: 10.1016/j.socscimed.2019.05.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/18/2019] [Accepted: 05/19/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Premised on the idea that setting goals motivates action and allocation of resources toward a desired future state, goal-setting has become a key component of self-management support. The notions that underpin goal-setting situate self-management firmly within the control and responsibility of individuals. Yet, we argue that goals are not solely individual pursuits to be achieved if individuals have the right knowledge and enough motivation; rather, they are social products, influenced by individual and collective subjectivities, which are structured over time. OBJECTIVE Drawing primarily on Bourdieu's concept of habitus, along with capital and field, we examine how goals are constructed in self-management support encounters. METHOD Seventeen patient-professional dyads comprising 15 patients and 11 health professionals were interviewed on up to three occasions. In total 64 semi-structured interviews were conducted between 2015 and 2017 in Sydney, Australia. RESULTS Goals were manifested through patient participants' expressions of goal agency (as self-owned wants and opportunities; responsibilities to self and others; or necessities); goal-oriented dispositions (determined; responsible; or powerless); temporal orientations (past, present or future); and access to resources to support self-management. These characteristics were grouped into three typologies: 'Goals as opportunities'; 'From goals to responsibilities'; and 'Necessities when living precariously'. CONCLUSIONS The way goals were constructed was structured over time by present experiences superimposed on past experiences and access to resources. These findings help broaden understandings of the tensions between patient and professionals' goals for living well with chronic conditions and draw attention to the need for structural change to support people to live well with their chronic conditions.
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Affiliation(s)
- Marika Franklin
- College of Science, Health and Engineering, La Trobe University, Australia.
| | - Sophie Lewis
- Faculty of Arts and Social Sciences, University of New South Wales, Australia
| | - Karen Willis
- College of Science, Health and Engineering, La Trobe University, Australia; Allied Health Research, Royal Hospital of Melbourne, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, United Kingdom
| | - Annie Venville
- College of Health and Biomedicine, Victoria University, Australia
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Ramírez AS, Arellano Carmona K. Beyond fatalism: Information overload as a mechanism to understand health disparities. Soc Sci Med 2018; 219:11-18. [PMID: 30342382 PMCID: PMC6240483 DOI: 10.1016/j.socscimed.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. METHOD Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California. RESULTS Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. CONCLUSIONS We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.
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Affiliation(s)
- A Susana Ramírez
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| | - Kimberly Arellano Carmona
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
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Kandasamy S, Anand SS. Cardiovascular Disease Among Women From Vulnerable Populations: A Review. Can J Cardiol 2018; 34:450-457. [PMID: 29571426 DOI: 10.1016/j.cjca.2018.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 12/14/2022] Open
Abstract
On a global scale, cardiovascular disease (CVD) is the leading cause of mortality. It is also the number 1 cause of death among women, resulting in 8.6 million deaths annually and constituting one third of all deaths in women worldwide. The burden of CVD and related risk factors has taken priority in the policy development for noncommunicable diseases. However, vulnerable populations, defined here as women who are socially or economically disadvantaged (eg, low income), nonwhite (specifically South Asian and indigenous women), and those who are elderly have often been overlooked in these discussions. These additional vulnerabilities, which may exist independently or in combination, place such women at higher risk for CVD. Specifically, these vulnerabilities include low socioeconomic status, a low sense of control, high stress, South Asian or indigenous ancestry, and increased age. Thus it is vital that we initiate a multipronged approach to CVD prevention that includes rigorous monitoring of CVD risk factors in high-risk populations and the implementation of timely, accurate, and contextually tailored prevention programs, services, and treatments. Well-trained nonphysician health care workers can support the accurate monitoring and management of CVD and CVD risk factors so that groups of women who may otherwise be overlooked can receive adequate attention.
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Affiliation(s)
- Sujane Kandasamy
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
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