Socioeconomic Factors

For researchers interested in understanding men's health, there are two main literatures to harvest. The first is research on men's health arising from the study of men and masculinities. The second is the broader study of inequalities in health, including gender inequalities in health. However, these literatures have remained distinct. This paper seeks to develop a model of understanding men's health from both of these literatures. In order to achieve this integration, this paper argues that studies of men's health should be based on 'critical studies on men' which emerges from feminist theory. Critical studies on men's health is then integrated into the broader explanatory options identified in the health inequality literature in order to provide a more fulsome account of variance within men's health and between the health status of men and women. Given the amenability of men's health issues to interrogation within this resulting framework, it is argued that the inequalities literature should start to include men's health issues in its work. r

OBJECTIVES: To examine the effectiveness of a transitional care intervention delivered by advanced practice nurses (APNs) to elders hospitalized with heart failure. DESIGN: Randomized, controlled trial with follow-up through 52 weeks postindex hospital discharge. SETTING: Six Philadelphia academic and community hospitals. PARTICIPANTS: Two hundred thirty-nine eligible patients were aged 65 and older and hospitalized with heart failure. INTERVENTION: A 3-month APN-directed discharge planning and home follow-up protocol. MEASUREMENTS: Time to first rehospitalization or death, number of rehospitalizations, quality of life, functional status, costs, and satisfaction with care. RESULTS: Mean age of patients (control n 5 121; intervention n 5 118) enrolled was 76; 43% were male, and 36% were African American. Time to first readmission or death was longer in intervention patients (log rank w 2 5 5.0, P 5.026; Cox regression incidence density ratio 5 1.65, 95% confidence interval 5 1.13-2.40). At 52 weeks, intervention group patients had fewer readmissions (104 vs 162, P 5.047) and lower mean total costs ($7,636 vs $12,481, P 5.002). For intervention patients, only short-term improvements were demonstrated in overall quality of life (12 weeks, Po.05), physical dimension of quality of life (2 weeks, Po.01; 12 weeks, Po.05) and patient satisfaction (assessed at 2 and 6 weeks, Po.001).

The material and the symbolic in theorizing social strati cation: issues of gender, ethnicity and class ABSTRACT Within most approaches to strati cation gender and ethnicity are seen to pertain primarily to the symbolic or cultural realms, whilst class is regarded as pertaining to material inequality. This constructs gender and ethnic positioning as entailing honour, deference, worth, value and differential treatment (sometimes expressed through the notion of 'status'), but the social relations around these are themselves not seen as constitutive of social strati cation. In this paper I will rethink social strati cation away from the polarity between the material and the symbolic, and argue that material inequality, as a set of outcomes relating to life conditions, life chances and solidar y processes, is informed by claims and struggles over resources of different types, undertaken in terms of gender, ethnicity/race and class. This formulation allows us to include these categorial formations, alongside class, as important elements of social strati cation i.e. as determining the allocation of socially valued resources and social places/ locations.

Family environmental factors and parenting styles can be major determinants of obesity risk in children. 1-4 According to the Centers for Disease Control and Prevention, in 2012, 18% of children (aged 6-11 years) were obese, and 21% of adolescents (aged 12-19 years) were obese in the United States. 5 In Arabic-speaking countries, the prevalence of obesity in children and adolescents ranges from 5% to 14% in males and from 3% to 18% in females. 6 However, there is a lack of accurate and comprehensive data on the extent of the problem of obesity among Arab children. 7 To prevent obesity in Arab children, there is a need for research on parenting styles and family factors contributing to obesity so that nutrition education programs can be developed to address these factors. The validat

US Latino adults are disproportionately affected by the HIV epidemic and experience disparities in access to HIV care. However, relatively little is known about how acculturation affects perceived barriers to engagement in care among Latinos. This article examines factors that may be associated with engaging HIV-infected persons in primary care by using interview data from 651 Latino and non-Latino adults presenting for services at five agencies that participated in a multisite demonstration project Latinos (n=219) were more likely than non-Latino Whites (n=117) to be male, recently diagnosed with HIV, less educated, without health insurance, not on Medicaid, taking HIV medications, and in better physical health. In addition, Latinos were more likely to report facing numerous structural barriers, stigma-related worries/concerns, and belief barriers than were non-Latino Whites. Upon closer examination of the Latino subsample, acculturation (based on language) was associated with repo...

US Latino adults are disproportionately affected by the HIV epidemic and experience disparities in access to HIV care. However, relatively little is known about how acculturation affects perceived barriers to engagement in care among Latinos. This article examines factors that may be associated with engaging HIV-infected persons in primary care by using interview data from 651 Latino and non-Latino adults presenting for services at five agencies that participated in a multisite demonstration project. Latinos (n5219) were more likely than non-Latino Whites (n5117) to be male, recently diagnosed with HIV, less educated, without health insurance, not on Medicaid, taking HIV medications, and in better physical health. In addition, Latinos were more likely to report facing numerous structural barriers, stigma-related worries/concerns, and belief barriers than were non-Latino Whites. Upon closer examination of the Latino subsample, acculturation (based on language) was associated with reported structural barriers, worry/ concern barriers, and belief barriers. In the final multivariate model that controlled for site, Spanish language was significantly associated with experiencing stigma-related worries/concerns that impact HIV status.

The current study, utilizing data from the National Early Head Start Research and Evaluation Project explored the relationship between biological father presence and emotion regulation over toddlerhood among children from low-income families. Conceptualizing biological father presence as a proxy for family role development, results are interpreted from a role development theoretical perspective. The latent growth curve model was compared based on child ethnoracial status (African American, Caucasian, Hispanic) and child gender. Consistent biological father presence was associated with toddlers' regulatory development across toddlerhood, and this relationship was most robust among Caucasian toddlers as compared to African American toddlers. Findings for Hispanic toddlers were not significantly different from those of Caucasian or African American families. Results bolster the literature on father presence and child outcomes. Analyses address consistency in father presence as a proxy for coherent role development and define a link between consistent father presence and children's regulatory development, demonstrating ethnoracial differences which are likely attributed to the social construction of family roles.

Empirical research on the effects of school sport policies on children's physical activity is limited. This study examined sport policies (intramural vs. varsity), physical settings within schools, and supervision in relation to physical activity using the System for Observing Play and Leisure in Youth (SOPLAY). Data were collected on physical activity levels of children in four middle schools. Regression analyses assessed the main effects of sport policy, type of physical activity setting, and supervision as well as interactions. Regression models were stratified by gender. Children in intramural schools were more likely to use indoor spaces and be boys. Regression models indicated that varsity sport programs were associated with lower physical activity levels among boys but not girls. Significant associations between type of physical activity settings and physical activity levels were observed only for boys. Adult supervision was not associated with children's physical activity levels. Finally, descriptive results showed athletic facilities were under-utilized in all schools.

Background: Violence against women has long been considered a hidden health burden. Questions about violence have not been included in health surveys; hence, little is known about prevalence and the consequences for health in the general population. No national study has been conducted in Norway. Aims: To estimate the prevalence of partner violence in Norway and the relationship between victimization and somatic health and depression and anxiety and post-traumatic stress symptoms. Methods: Data collection was performed by Statistics Norway. Among a random sample of women aged 20—55 years, 2,407 women returned the questionnaire (63.3%), of whom 2,143 were ever-partnered. Selected demographic characteristics were obtained from registers. Results: In total, 26.8% of 2,143 ever-partnered women had experienced any violence by their partner during their lifetime, and 5.5% in the year before the study. Low educational level, being unmarried, separated or divorced, currently being unemploye...

Mothers who are involved with mental health services (for themselves or their children) rarely receive adequate support for their role as parents. Mental illness in a parent or child often exacerbates the challenges of managing psychological distress that is germane to the parenting roll. Mentalization-based approaches to psychotherapy for parents have the potential to address challenges of emotional regulation in parents by supporting their capacity to recognize and modulate negative affect during stressful parenting situations. In this study, we piloted Mothering from the Inside Out (MIO) with 17 mothers receiving services at a community-based mental health clinic. MIO is a 12-week, mentalization-based parenting intervention that demonstrated efficacy in two previous randomized controlled trials with substance using mothers. In this study, we were interested in determining whether community-based clinicians could deliver MIO with sustained fidelity. We were also interested in exam...

Many OECD countries have replied to economic recessions with an adaption in public spending on social benefits for families and young people in need. So far, no study has examined the impact of public social spending during the recent economic recession on health, and social inequalities in health among young people. This study investigates whether an increase in public spending relates to a lower prevalence in health complaints and buffers health inequalities among adolescents. Data were obtained from the 2009/2010 "Health Behaviour in School-aged Children (HBSC)" study comprising 11 - 15-year-old adolescents from 27 European countries (N = 144,754). Socioeconomic position was measured by the Family Affluence Scale (FAS). Logistic multilevel models were conducted for the association between the absolute rate of public spending on family benefits per capita in 2010 and the relative change rate in family benefits (2006-2010) in relation to adolescent psychological health co...

This study examined risk and determinants of rehospitalization of children and adolescents (n = 186) following a first psychiatric hospitalization. It specifically examined the role of postdischarge services. Data were collected for a 30-month follow-up period through structured telephone interviews with caregivers and case record abstractions. 43% of youth experienced readmissions during the follow-up period. Risk of rehospitalization was highest during the first 30 days following discharge and remained elevated for 3 months. 72% of youth received 284 postdischarge services during the follow-up period, which significantly reduced the risk of rehospitalization. Longer first hospitalizations and a higher risk score at admission increased risk.

Objective. To develop a generic French self-administered instrument for measuring hospitalized patients' satisfaction based on the patient's point of view: the questionnaire for satisfaction of hospitalized (QSH) patients. Design. The development was supervised by a steering committee and undertaken through three standard steps. Item generation was derived from 95 face-to-face interviews, performed in hospitalized patients and in patients scheduled to be admitted. The item reduction led to a 69-item questionnaire. The validation process was based on validity, reliability and some aspects of external validity. Setting. Medical, surgical and obstetrical departments (n ¼ 187) of public hospitals (n ¼ 11) from different French regions (n ¼ 3). Participants. Eligible patients were adult subjects hospitalized for at least 24 h. Main outcome measures. QSH, sociodemographic data, hospitalization department, visual analogue scales of satisfaction. Results. The final version of QSH contained 45 items describing 9 dimensions, leading to 2 composite scores (staff and structure index). The factor structure accounted for 71% of the total variance. Internal consistency was satisfactory (iteminternal consistency over 0.40; Cronbach's alpha coefficients ranged from 0.76 to 0.96). The scalability was satisfactory with inlier-sensitive fit (INFIT) statistics inside an acceptable range. Scores of dimensions were strongly positively correlated with visual analogue scale scores (all P , 0.001). External validity showed statistical associations between QSH scores and age or department. Participation rate was 91%. Conclusions. The availability of a reliable and valid French questionnaire concerning hospitalized patients' satisfaction, exclusively generated from patients' interviews, enables patient feedback to be incorporated in a continuous quality health-care improvement strategy.

Research indicates that exercise is an efficacious intervention for depression among adults; however, little is known regarding its efficacy for preventing postpartum depression. The Healthy Mom study was a randomized controlled trial examining the efficacy of an exercise intervention for the prevention of postpartum depression. Specifically, postpartum women with a history of depression or a maternal family history of depression (n=130) were randomly assigned to a telephone-based exercise intervention or a wellness/support contact control condition each lasting six months. The exercise intervention was designed to motivate postpartum women to exercise based on Social Cognitive Theory and the Transtheoretical Model. The primary dependent variable was depression based on the Structured Clinical Diagnostic Interview (SCID). Secondary dependent variables included scores on the Edinburgh Postnatal Depression Scale, the PHQ-9, and the Perceived Stress Scale. The purpose of this paper is to describe the study design, methodology, and baseline data for this trial. Upon completion of the trial, the results will yield important information about the efficacy of exercise in preventing postpartum depression.

Objectives: Diarrhoeal diseases (DDs) constitute public health problem. Reduction in related mortality and morbidity hinges on active participation of home caregivers. It is pertinent to determine the degree of their empowerment. Design: Cross-sectional study. Setting: Randomly selected community primary health centres in northwestern Nigerian. Subjects: Home caregivers presenting with children aged 1-59 months having DD. Outcome measures: Knowledge, attitude and practice regards home management of DD. Results: Less than 1% of caregivers was knowledgeable about home management of DD. Antibiotics and anti-diarrhoeal agents use was common at 36%. ORS use was abysmally low at 8.6%. Only 32% of caregivers were aware of the use of zinc in the management of DD. Adherence to 10-day zinc supplementation was encouraging at 75.5%. Conclusion: There is an urgent need to scale up educational and promotional activities with regards to the home management of DD if the millennium development goals are to be met.

One goal of this paper is to present an integrated tripartite model of violence, with a focus on structural violence within an oppression paradigm. Using qualitative and quantitative data from 27 women (70% African American and 30% European American) who participated in a national substance abuse treatment demonstration program, we describe a model of violence in which structural violence is presented within a transactional relationship with interpersonal, and intrapersonal violence. We suggest that the effects of structural, interpersonal, and intrapersonal violence are magnified when race and poverty are considered. The second goal of the paper is to present a preliminary test of the new model of violence. Results indicated that different levels and types of violence are interrelated. Implications of these findings for empowering solutions are suggested.

Background: A multi pronged community based strategy, known as National Rural Health Mission (NRHM), was implemented from 2005-06 to 2012-13 in India to curtail maternal and child health (MCH) disparities between poor and rich, rural and urban areas, and boys and girls,. This study aimed to determine the degree to which MCH plans of NRHM implemented, and resulted in improving the MCH outcomes and reducing the inequalities. Methods: An explanatory sequential mixed methods study was conducted, first to assess the degree of implementation of MCH plans by estimating the budget utilization rates of each MCH plan, and the effectiveness of these plans by comparing demographic health surveys data conducted post (2012-13), during (2007-08) and pre-(2002-04) NRHM implementation period, in the quantitative study. Then, perceptions and beliefs of stakeholders regarding extent and effectiveness of NRHM in Haryana were explored in the qualitative study during 2013. A logistic regression analysis was done for quantitative data, and inductive applied thematic analysis for qualitative data. The findings of the quantitative and qualitative parts of study were mixed at the interpretation level. Results: The MCH plans, like free ambulance service, availability of free drugs and logistics, accredited social health activists were fully implemented according to the budget spent on implementing these activities in Haryana. This was also validated by qualitative study. Availability of free medicines and treatment in the public health facilities had benefitted the poor patients the most. Accredited Social Health Activists scheme was also the most appreciated scheme that had increased the institutional delivery rates. There was acute shortage of human resources in-spite of full utilization of funds allocated for this plan. The results of the qualitative study validated the findings of quantitative study of significant (p < 0.05) improvement in MCH indicators and reduction in MCH disparities between higher and lower socioeconomic groups, and rural and urban areas. Conclusions: MCH plans of NRHM might have succeeded in improving the MCH outcomes and reducing the geographical and socioeconomic MCH inequalities by successfully implementing the schemes like accredited social health activists, free ambulance services, free treatment and medicines in hospitals for the poor and in rural areas.

Context and Purpose: This study investigates associations between the proportion of farm families in rural counties and the health of rural individuals, independent of county poverty rate and individual and family socioeconomic factors. This study also examines relationships of these socioeconomic factors and prevalence of specific diseases. Methods: Multilevel analysis of 10,485 responses to a mailed health survey in 27 nonmetropolitan Minnesota counties. Findings: Individual-and family-level variables such as age, gender, lower income, and unemployment were significantly associated with adverse physical health. The percentage of farm families in counties was significantly associated with adverse physical health of adults, independent of individual and family characteristics, county poverty rate, ethnic composition, and population density.

The purpose of the study was to investigate the psycho-social factors such as self-esteem, stress, and family support that affect the depression in pregnant women. Methods: The participants were 149 pregnant women who were seen at the urban G and M woman hospital. Data were collected using structured questionnaires from January 10 to May 20, 2011, and were analyzed using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficients, and Stepwise Multiple Regression with SPSS/WIN 17.0 program. Results: Mean age was 31 years, and 28.9% of the participants reported depression. Depression in the pregnant women showed a negative correlation with self-esteem (r=-.47, p<.001) and family support (r=-.38, p<.001), but a positive correlation with stress (r=.42, p<.001). In addition, variables that predicted depression in pregnant women were general health condition, stress, self-esteem, communication with husband, and planned pregnancy (39.0%). Conclusion: The findings from this study indicate the need to screen pregnant women for depression. There is also a need for programs to prevent depression in pregnant women and assess risk considering psycho-social factors.

This prospective cohort study examined the association between educational level and major causes of death in Japan.A baseline survey was conducted between 1988 and 1990 among 110,792 inhabitants of 45 areas aged 40–79 years. Follow-up surveys were conducted annually and causes of death were identified from death certificates. The analysis was restricted to 16,715 men and 23,284 women.During the follow-up period (377,139 person-years), 6628 deaths were recorded. Individuals with low levels of education had an increased overall risk of death [relative risk (RR) = 1.16, 95% confidence interval (CI): 1.08, 1.25, in men; RR = 1.26, 95% CI: 1.14, 1.39, in women], cancers (RR = 1.17, 95% CI: 1.04, 1.32, in men; RR = 1.10, 95% CI: 0.93, 1.30, in women), and death from external causes (RR = 1.81, 95% CI: 1.29. 2.54, in men; RR = 1.78, 95% CI: 1.18, 2.70, in women). Ischemic heart disease risk was marginally reduced in men with low levels of education (RR = 0.77, 95% CI: 0.58, 1.01).These results show that health inequalities exist in Japan, even though wealth inequalities are relatively low. Social and political initiatives will be needed to correct these inequities between different socioeconomic statuses.

This study examined agreement on aggressive and nonaggressive conduct disorder in a general population sample of 14to 17-year-old adolescents (n=1165) and their mothers. We collected diagnostic interview data and applied latent class analyses to estimate inter-informant agreement. The preferred model for aggressive conduct disorder for both males and females was a one-latent-variable/two-class model specifying no inter-informant disagreement beyond chance expectations. This model estimated the prevalence of aggressive conduct disorder to be 13% for males and 0.4% for females. For nonaggressive conduct disorder, a one-latent-variable/three-class model specifying asymmetric agreement was preferred for both males and females. This model estimated the prevalence of nonaggressive conduct disorder in adolescents to be 18% according to males and 13% according to mothers. Prevalence estimates were 12% according to females and 7% according to mothers. Symptom sensitivity estimates for all models were poor whereas specificity estimates were near perfect to perfect. Males had higher rates of aggressive and nonaggressive conduct disorder across informants. There was a high level of adolescent-mother agreement on both types of conduct disorder. However, there were some differences, suggesting that aggressive and nonaggressive are two valid subtypes of conduct disorder with different prevalence estimates and agreement levels.

This open-label randomized trial compared isoniazid (9 months) to rifampin (4 months) on toxicity and completion in a jailed population with latent tuberculosis infection. Rifampin resulted in fewer elevated liver function tests (risk ratio [RR] 0.39, 95% confidence interval [CI] [0.18, 0.86]) and less toxicity requiring medication withdrawal (RR 0.51, 95% CI [0.13, 2.01]), although one participant receiving rifampin experienced an allergic reaction. Completion was achieved for 33% receiving rifampin compared to 26% receiving isoniazid (p = .10). With careful monitoring rifampin is a safe and less toxic regimen and appears to be a reasonable alternative because of its shorter duration, allowing more people to complete treatment behind bars. Therapy completion in released inmates is unacceptably low and ensuring follow-up after discharge must be part of a decision to treat.

Of 613 children evaluated in a village in Haryana 94 (15.3%) were observed to have chronic suppurative otitis media (CSOM). Fifty eight (61.7%) children had hearing impairment. CSOM contributed to 71.6% of the hearing impaired (58/81). On analysis of association of CSOM with literacy and socio-economic status of mothers, and age, sex, and upper respiratory tract infections (URI) in children positive correlation was observed only with URIs (P Literacy and socio-economic status of the mothers did not correlate significantly with knowledge about treatment seeking, and ear cleaning practices, probably due to the narrow range of incomes and literacy levels. An intervention program consisting of play, demonstrations, health charts and slogans, and aural cleaning and antibiotic drops was introduced.

B ECAUSE of a large number of dialysis patients in Iran who needed renal transplantation (Tx) who had no living related donors (LRD) and the absence of cadaveric organ donation program, a controlled living unrelated donor (LUD) renal Tx program was adopted in Iran in 1988. As a result, in last 12 years more than 7,000 renal Tx from LUD and more than 2500 from LRD have been performed. The waiting list for renal Tx in this country has been eliminated. The characteristics, advantages, and disadvantages of this Tx program have previously been published and will briefly be discussed below. 1,2 This study compares the socioeconomic characteristics of LUD and their recipients in this program to see which socioeconomic group of the country are being transplanted more from LUD.

Background: In maintenance hemodialysis (MHD) outpatients, a reverse epidemiology is described, ie, baseline obesity appears paradoxically associated with improved survival. However, the association between changes in weight over time and prospective mortality is not known. Methods: Using time-dependent Cox models and adjusting for changes in laboratory values over time, the relation of quarterly-varying 3-month averaged body mass index (BMI) to all-cause and cardiovascular mortality was examined in a 2-year cohort of 54,535 MHD patients from virtually all DaVita dialysis clinics in the United States. Results: Patients, aged 61.7 ؎ 15.5 (SD) years, included 54% men and 45% with diabetes. Time-dependent unadjusted and multivariate-adjusted models, based on quarterlyaveraged BMI controlled for case-mix and available time-varying laboratory surrogates of nutritional status, were calculated in 11 categories of BMI. Obesity, including morbid obesity, was associated with better survival and reduced cardiovascular death, even after accounting for changes in BMI and laboratory values over time. Survival advantages of obesity were maintained for dichotomized BMI cutoff values of 25, 30, and 35 kg/m 2 across almost all strata of age, race, sex, dialysis dose, protein intake, and serum albumin level. Examining the regression slope of change in weight over time, progressively worsening weight loss was associated with poor survival, whereas weight gain showed a tendency toward decreased cardiovascular death. Conclusion: Weight gain and both baseline and time-varying obesity may be associated with reduced cardiovascular mortality in MHD patients independent of laboratory surrogates of nutritional status and their changes over time. Morbidly obese patients have the lowest mortality. Clinical trials need to verify these observational findings. Am J Kidney Dis 46:489-500.

Hepatitis B virus infection (HBV) is one of the most widespread, chronic viral infections in sub-Saharan Africa, and parts of South America. Therefore, efforts are being made to implement strategies aimed at reducing the incidence of hepatitis B viral infections. One route of HBV transmission is through unsafe blood transfusion, which could occur from the use of less sensitive laboratory diagnostic kits. Information on the sensitivity and specificity of these kits is however limited in many developing countries. This study was therefore performed to describe the prevalence of HBV infections and also to evaluate the performance of five rapid immunochromatographic kits commonly used in Ghana. A cross-sectional study was designed to describe the prevalence of HBsAg infection and also evaluate the performance of rapid kits used for screening hepatitis B in the northern part of Ghana. A total of 164 prospective blood donors were enrolled in this study from January 2012 to December 2013. ...

Anecdotal evidence on hidden inequity in health care in North African countries abounds. Yet firm empirical evidence has been harder to come by. This article fills the gap. It presents the first analysis of equity in the healthcare system using the particular case of Tunisia. Analyses are based on an unusually rich source of data taken from the Tunisian HealthCare Utilization and Morbidity Survey. Payments for health care are derived from the total amount of healthcare spending which was incurred by households over the last year. Utilization of health care is measured by the number of physical units of two types of services: outpatient and inpatient. The measurement of need for health care is apprehended through a rich set of ill-health indicators and demographics. Findings are presented and compared at both the aggregate level, using the general summary index approach, and the disaggregate level, using the distribution-free stochastic dominance approach. The overall picture is that direct out-of-pocket payments, which constitute a sizeable share in the current financing mix, emerge to be a progressive means of financing health care overall. Interestingly, however, when statistical testing is applied at the disaggregate level progressivity is retained over the top half of the distribution. Further analyses of the distributions of need for-and utilization of-two types of health care-outpatient and inpatient-reveal that the observed progressivity is rather an outcome of the heavy use, but not need, for health care at the higher income levels. Several policy relevant factors are discussed, and some recommendations are advanced for future reforms of the health care in Tunisia.

We conducted a systematic review to examine first generation immigrant adolescents' likelihood of experiencing bullying, violence, and suicidal behaviours compared to their later-generation and native born counterparts, and to identify factors that may underlie these risks. Eighteen studies met full inclusion criteria. First generation immigrant adolescents experience higher rate of bullying and peer aggression compared to third generation and native counterparts. Refugee status and advanced parental age were associated with increased parent to child aggression among South East Asians. Family cohesion was associated with lower rates of violence. Suicidal ideation was lower across most immigrant adolescents' ethnicities, with the exception of Turkish and South Asian Surinamese female adolescents in the Netherlands. Bullying and peer aggression of immigrant children and adolescents and potential mitigating factors such as family cohesion warrant research and program attention by policymakers, teachers and parents.

disease or aged ,18 yrs or other reasons. The 311 study patients were interviewed 3.7¡1.88 yrs (maximum range 1.1-6.3 yrs) after the diagnosis. In total, 190 (61%, 95% confidence interval (CI) 55-67) patients confirmed a smoking history (active or former) at the time of pulmonary embolism, of whom 94 (30%, 95% CI 25-36) patients were actively smoking. Out of these 94 patients, 32 (35%, 95% CI 25-45) had successfully quit smoking in the first year following the diagnosis. Overall, only two (0.64%, 95% CI 0.08-2.3) patients started smoking after the diagnosis of pulmonary embolism. The percentage of quitters was not associated with age in the pulmonary embolism cohort.

There is widespread recognition of the importance of family stability for child development. South Africa presents an interesting context in which to study the consequences of family instability because of the traditionally fluid nature of household composition due to labor migration, child fostering, and non-marital fertility. More recently, the HIV pandemic has added another source of instability. Within South Africa, however, patterns of instability differ markedly across racial groups. We use the Cape Area Panel Study (CAPS) data to examine the implications of changes in parent-child coresidence for educational and sexual development of young South Africans. We show that changes in maternal and paternal coresidence have implications for the timing of sexual initiation for both black and coloured adolescents. Maternal and paternal transitions also lead to poorer educational outcomes for coloured adolescents, but parental disruptions are not significantly related to educational outcomes for blacks. These findings suggest that the implications of coresidential instability vary by race, reflecting racial differences with respect to cultural, social, and economic conditions. (Studies in Family Planning 2016; 47[1]: 19-38) T he living arrangements of children in sub-Saharan Africa are remarkably heterogeneous. This diversity is particularly apparent in South Africa, where many children spend parts of their childhood without one or both of their biological parents (Madhavan et al. 2012; Sibanda 2011). High levels of male and female labor migration (Lu and Treiman 2011), coupled with high rates of non-marital childbearing and low rates of marriage (Hosegood, McGrath, and Moultrie 2009), result in many children not living with their fathers and, to a lesser extent, their mothers (Marteleto, Lam, and Ranchhod 2008).

Psychological well-being has been generally associated with vigorous aerobic activity and structured aerobic activity in adolescents and children. Low-income children are at greater risk than the general population for experiencing high environmental stress and increased mental health problems. This study investigated the effects of a structured physical fitness program on psychological well-being in low-income Hispanic children. A total of 66, 33 girls, 33 boys, in Grade 4 were randomly assigned to either an Aerobic intensity ( n = 34) or a Control intensity physical activity program ( n = 32) for 6 wk. Psychological well-being was defined as scores on trait anxiety, depression, and self-esteem, measured, respectively, by the Trait Anxiety Inventory, Beck Depression Inventory, and Rosenberg Self-esteem scale. Analysis showed the children in the Aerobic intensity program significantly ( p&lt; .05) improved their cardiovascular fitness as measured by the PWC170 test. After the progra...

Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic underlying these components is essential for the development of interventions tailored to the palliative context. The aims were to explore (i) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients, and (ii) the extent to which these non-physical determinants influence QOL. A cross-sectional study involving face-to-face interviews with Swiss palliative patients was performed, including the Schedule for Meaning in Life Evaluation (SMILE), the Spiritual Subscale of the Functional Assessment of Chronic Illness Therapy (FACIT-Sp), the Idler Index of Religiosity (IIR), the Hospital Anxiety and Depression Scale (HADS) and the Schedule of Attitudes toward Hastened Death (SAHD). QOL was measured with a single item visual analogue scale (0-10). 206 patients ...

Many unintentional injuries to young children occur in the home. The current study examines the relation between family socioeconomic and sociodemographic factors and risk factors for home injury. Presence of household hazards was examined in 80 families with toddler-aged children. Parental ability to identify household hazards in pictures was also assessed. ANOVAs and Pearson product-moment correlations examined the relationship between presence of household hazards, knowledge to identify hazards, and factors of yearly family income, parental age, parental education, parental marital status, child ethnicity, and the number of children living in the home. A greater number of hazards were found in the homes of both the lowest and highest income families, but poorer knowledge to identify household hazards was found only among parents of the lowest income families and younger parents. Across family socioeconomic status, parent knowledge of hazards was related to observed household haza...

Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India and France. The objectives of this study included the following: obtain qualitative information on representations of tobacco use and cessation within two vulnerable populations; identify cultural factors that influence tobacco use and cessation; and acquire information for the development of effective tobacco cessation strategies. A total of 21 focus groups were conducted in India and France. All study participants were disadvantaged adults 18 years old or older. Sixty women resided in South Delhi in India and 163 adults with disabilities resided in the south of France. They were all current tobacco users. Data were collected by focus group and analysed with thematic coding. In both samples, the most relevant reasons of tobacco use were daily life circumstances, which were also a major barrier to quitting. None of the participants reported that quitting difficulties could be due to depend...

Objective. Ten to 30% of students engage in bullying behavior. Bullies stand out on account of increased anger, poor interpersonal relationships, and poor quality of life. Our aim was to determine the effectiveness of outpatient family psychotherapy as a monotherapy for anger reduction and improvement of behavior and interpersonal relationships and of health-related quality of life in male youths with bullying behavior. Methods. Twenty-two boys with bullying behavior took part in a family therapy program for 6 months. The control group was also composed of 22 youths and took part in a placebo intervention program. Every 2 weeks, results were checked with the Adolescents Risky-Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Follow-up testing took place 12 months after treatment. Results. In comparison with the control group (according to the intention-to-treat principle), ...

The behaviour adopted by individuals is moulded by their perception of various issues. In spite of well established benefits of exclusive breastfeeding (EBF) to babies, mothers and society, the EBF practice rate (EBFPr) in our environment has remained low. To evaluate mother&#39;s perception of exclusive breastfeeding and determine the relationship between such view and their practices. Two hundred mothers were interviewed to elicit their perception of the merit and demerits of exclusive breastfeeding. The pattern of perception was related to actual practice in order to seek for possible associations. Of the 184 respondents, 39 (21.2%) practiced EBF for all their babies, while 95 (51.6%) never did so for any of their babies. Knowledge of EBF was excellent (94.0% and 90.8%) of the study group gave accurate definition and duration respectively. Most mothers felt that EBF babies look healthier (85.1%), have less disease (84.5%), are more intelligent (59.1%) but their mothers eat a lot ...

This study was aimed to estimate the prevalence of intimate partner violence (IPV) in a sample of 226 women with disabilities living in four different districts of Bangladesh. It also explored the physical and psychological suffering of women experiencing violence and their various coping strategies. A cross-sectional survey was carried out with 226 women with disabilities to measure the prevalence of IPV, and 16 in-depth interviews were conducted to document in detail the experiences of violence encountered by the abused women. Among the 226 women interviewed in the survey, about 84% reported ever having experienced at least one act of emotional abuse, physical, or sexual violence from their partner during their lifetime. Women who were older (aged above 32 years), separated, and members of economic/savings group were more likely to report ever having experienced any IPV than women with disabilities who were younger (aged 32 years and less), married, and not members of economic/sav...

Purpose There is growing interest in the assessment of positive mental health as a global indicator of societal wealth. We aimed to adapt the Warwick-Edinburgh Mental Well-being scale (WEMWBS) into Spanish and to perform a preliminary evaluation of its metric properties. Methods Forward and back-translations and cognitive debriefing were carried out. University students (n = 148) were recruited to evaluate the final Spanish version, following the UK original study. Distribution of WEMWBS responses, internal consistency, test-retest reliability, construct validity, and factor structure were assessed. Results Only 4 (out of 14) items of the initial Spanish version were not rated as conceptually and linguistically equivalent to the original and were modified. The final version was clear and comprehensible. Global score's Cronbach's alpha (0.90), item-total score correlations (0.44-0.76), and test-retest ICC (0.84) were all satisfactory. Moderate to high correlations (r = 0.45-0.70) were observed between the WEMWBS and validity scales. Preliminary confirmatory factor analyses did not support the hypothesis of a single factor. Conclusions A conceptually equivalent Spanish version of the WEMWBS was obtained with high internal consistency, good test-retest reliability, and similar construct validity as the original instrument. Further validity and factorial studies are necessary in larger and more heterogeneous samples.

The latest socio-economical changes have had a great impact on the perception of health issues. The definition of health according to the WHO is often citied here as a kind of postulate of psychical, psychological and sociological well being. Health education takes an important part in propagating ideas of promoting and protecting health and also shaping life skills. Health education especially affects schools but it also has an impact on family and local community. Contemporary definitions of health education underline that it is also a process of learning how to take care of one&#39;s own health and that of others&#39;. This attitude to health corresponds with the changing health problems affecting society. Despite implementing many programs and actions promoting health and preventing diseases on a world and European scale, there still exist many problems in this area. They are particularly due to disproportionate access to medical help and technological development resulting from...

Since 1994, higher education policy has been committed to equity of access for all, irrespective of race and gender. We investigated progress towards these goals in the education of medical doctors, with an emphasis on gender. Databases from the Department of Education (DoE), Health Professions Council of South Africa (HPCSA) and University of Cape Town (UCT) Faculty of Health Sciences were used to explore undergraduate (MB ChB) trends at all eight medical schools and postgraduate (MMed) trends at UTC. Nationally women have outnumbered men in MBChB enrollments since 2000, figures ranging between 52% and 63% at seven of the eight medical schools in 2005. However, the rate of change in the medical profession lags behind and it will take more than two decades for female doctors to outnumber male doctors. A study of UCT postgraduate enrollments shows that females had increased to 42% of MMed enrollments in 2005. However, female postgraduate students were concentrated in disciplines such...