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Background: The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative.Objective: The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information.Methods: The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS).Results: Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications. [ABSTRACT FROM AUTHOR]

Aim: Documentation is a critical element in the function of the nursing team, and cannot be separated from high-quality, patient-centered care. The aim of this study was to compare the quality of nursing documentation in electronic and paper-based systems.Method: A retrospective descriptive study was designed to compare the quality of nursing documentation in electronic health records (EHR) versus paper-based documentation systems before and after the application of the electronic system.Results: Analysis of data found a significant difference in the quality of nursing documentation in the two hospitals both before and after the implementation of an EHR system (p < 0.001).Quality of nursing documentation in the electronic system was significantly better than that of paper-based documentation systems.Conclusion: Vocal-electronic systems help to improve quality of nursing documentation, suggesting this aspect may be essential to implementing a successful system in local settings. [ABSTRACT FROM AUTHOR]

The criminalization of Latinx immigration combined with anti-immigrant rhetoric from politicians and media outlets, have led to an array of poor psychosocial outcomes for those who arrive and remain within the United States. Using an Ecological Risk and Resilience Framework, this paper examines the relationship between perceived discrimination within the recent anti-immigration social context and the mental health of Latino immigrants in Arizona. In addition, this study examined whether hope and optimism serve as protective factors against the negative mental health impacts of discrimination among men and women. Data were drawn from a sample of adult Latinx immigrants (n = 421) living in Arizona. Results indicated that participants who reported a greater discrimination reported significantly higher symptoms of 1) depression, 2) anxiety, and 3) stress. In addition, a moderation analysis was conducted to examine whether hope and optimism serve as protective factors against the negative mental health impacts of discrimination. The results indicated hope and optimism moderated the effect of discrimination for males' reported symptoms of depression, anxiety, and stress. However, for females, hope and optimism moderated the effect of discrimination for depression, but not on anxiety and stress. Implications for practice and research are discussed. [ABSTRACT FROM AUTHOR]

Globally, women with disabilities experience heightened and unique forms of violence compared to men with disabilities and women without disabilities. Yet formalised guidelines for their inclusion in gender-based violence (GBV) research is lacking. This paper draws on ethical guidelines for researching violence against women, and studies on the ethicality of including people with disabilities in research, to advocate for women with disabilities' inclusion and safety in GBV research. Reflecting on lessons from a qualitative study on violence against women living with disabilities in South Africa, the paper considers what could be of value for GBV researchers and ethics review committees in low-middle income countries (LMICs). It aims to stimulate debate around the integration of reasonable accommodation, accessibility, and equal participation of women with disabilities in planning and conducting ethical GBV research. The paper recommends that considerations are practically applied and tested in other LMICs, and thereafter critiqued in consultation with a range of stakeholders and women with disabilities, to enhance best practice and form a basis for developing guidelines for undertaking ethical and inclusive GBV research in LMICs. [ABSTRACT FROM AUTHOR]

Background: While social determinants of health perspective might lead to the hypothesis that higher economic achievements should be associated with better mental health, the evidence for adults is mixed and inconclusive. Aim: We test the role of wealth as a predictor of depressive symptoms controlling for a number of socio-demographic covariates, with a specific interest in gender-specific patterns. Methods: Using a nationally representative survey from Mexico (N = 44,618), we carry out multivariate regression analysis where we jointly model linear and quadratic measures of wealth to detect non-linear relations between depression and wealth. Results: The paper reports clear evidence of an inverted-U relationship between depressive symptoms and wealth for females, whereas the relationship for males tends to be linear and decreasing with wealth as expected (though weak and significant only in the upper part of the wealth distribution). Our findings are robust to alternative empirical strategies and we discuss potential explanations for this novel finding. Conclusion: The paper confirms that the association between standards of living and depression is complex, due to the mediating role of socio-demographic characteristics and the existence of non-linearities not fully explored in the literature. [ABSTRACT FROM AUTHOR]

Aging in place has become a popular social policy worldwide. This paper argues that well-being is an important outcome of aging in place, upon which older people develop autonomy and environmental proactivity. The temporal dimension of aging in place highlights development of place attachment, which includes place identity and place dependence. The study explores how older people, who live inhigh-density urban environments, make sense of well-being and place attachment by articulating their daily lives. Community dwelling older people aged 65 and above, who came from neighborhoods with high aging population and residential density but high and low median household incomes, were invited for focus group discussions. Multifaceted meanings of well-being include various dimensions that cover individual-collective and material-spiritual (psychological) construct. Meanings of place attachment include values of, bonding ties to, and memories about places. Three pathways are identified linking place attachment and multifaceted well-being. The study finds that social welfare and material richness are not the only determinants of well-being. Fulfillment of higher psychological needs, such as positive evaluation of life and self-actualization, should be emphasized by which older people can make the most of their life in old age. [ABSTRACT FROM AUTHOR]

Mobility, access to transport and healthcare play a crucial part in healthy ageing. However, these often posechallenges for older adults in the global South. This study applies the three concepts of 'motility' (access, competence and appropriation), to explore transport inequalities and barriers to access healthcare services for older adults in Bengaluru, India. The paper draws on interviews with sixty adults, aged 50 years and over, residing in urban Bengaluru. A semi-structured in-depth interview guide was employed to explore the transport inequalities. Applying thematic analysis, we present the mobility and transport barriers to access healthcare. Restricted access to healthcare services due to unavailable and unaffordable transportation resulted in missed appointments, delayed care and deterioration of health conditions. To cope with the barriers, older adults often visited less specialised clinics for regular check-ups and those with financial constraints resorted to self-medication. These actions further deteriorated health and led to adverse health outcomes. Our findings suggest that integrated health and transport policies must be designed to ensure equitable access to transportation services. Enabling older adults to have more independent lives and improve access to preventive healthcare is essential for better health outcomes. [ABSTRACT FROM AUTHOR]

The history of physiotherapy in Latin America has received little attention thus far in the English-speaking literature. In this paper, we draw on narratives from activists, educators, and professional leaders who have been instrumental in shaping the development of physiotherapy in Argentina, Colombia, and Ecuador. Physiotherapists in the Latin American countries faced many similar challenges, including developing physiotherapy in the shadow of medicine, overcoming conservative attitudes toward women professionals, and frequent social upheaval. The paper explores the disputed story of physiotherapy's origins in the polio epidemics, the influence of Swedish remedial gymnastics, and the educational colonialism of North American and European educators. We examine some of the effects of social unrest and trauma, military rule, and economic instability on the professions attempts to establish itself in the face of competition from other professions allied to medicine. And we consider the efforts taken to establish the profession's autonomy and its shifting relationship with the state. We employed two different methods for data collection to explore aspects of physiotherapy's history in Latin America from a political and socio-cultural context: 1) A reconstruction of memories from activist physiotherapists in Colombia, Ecuador, and Argentina, who have seen, lived, and promoted the development of physiotherapy in their own countries, gleaned from in-depth interviews; and 2) Analysis of secondary sources. Data were analyzed following the method described by Maynes, Pierce, and Laslett (2008), exploring personal narratives. Textual data were analyzed using documentary research (Prior, 2003) using thematic analysis, to inductively discover, and describe relevant themes about the two main guiding study questions. A constant comparative method as outlined by Boeije (2002) was used to form categories, establish boundaries, and discerning conceptual similarities between participants' narrative. Five physiotherapists were interviewed. One from Colombia, two from Argentina and two from Ecuador. Three main themes were identified: 'A Female Profession?', 'training and education', and 'Present Day in Argentina, Ecuador, and Colombia'. Tensions between the interests of the State, professionals, patients, cultures, urban and rural services, and practices are prevalent throughout physiotherapy in Argentina, Colombia, and Ecuador. Operating within these tensions is very much the reality for physiotherapists in Latin America today. Multiple histories emerge from the research, opening up a space for a more nuanced, polyphonic reading of physiotherapy in Colombia, Ecuador, and Argentina than has been heard to date. [ABSTRACT FROM AUTHOR]

Based on the rich extant research in the field of mental health in acculturation, it is calling to identify religion as one of the meditative variables of the relationship between acculturation and mental health. In addition, little knowledge exists about the detailed religious experience of Chinese migrants in Ireland. This research adopted classic grounded theory to guide data collection and analysis. The findings show that Christian faith plays a significant role as a mediator in the cross-cultural adaptation of the participants with two aspects of the mental impacts: helping to cope with mental stress and providing spiritual satisfaction. The results in this paper are part of the findings from an investigation of the religious experience of the participants during their cross-cultural adaptation in Ireland. [ABSTRACT FROM AUTHOR]

The current discussion explores the myriad of challenges facing African American males across the social, political, and economic landscape. As such, this paper examines the impact of such challenges on the life course trajectories and outcomes for this population group. Also discussed is the extent to which the impact of gendered cultural demands and expectations, combined with the adverse effects of gendered racism, may create for many African American males, a byzantine conundrum from which there is no respite. This is thought to create a tremendous psychological burden with serious ramifications for mental health and well-being. Lastly, it is argued that a more holistic approach to examining the issues, challenges, and dilemmas facing African American males is potentially more informative, and can support efforts to disrupt racial bias, create opportunity, and improve life course trajectories for African American males. [ABSTRACT FROM AUTHOR]

This paper reports on significant gender differences in psychological distress and perceived social support (PSS) among a clinical sample of Hong Kong Chinese depressed parents (Nmen = 17, Nwomen = 94; 73.8% belonging to 30−50 age group). Men's mental health and PSS were found to relate to their employment status, while women's to family income and family origin. PSS had positive effects on psychological wellbeing of both genders, while gender-specific effects were found for some subtypes of PSS. The results of our study contributed a gendered perspective and validated the importance of PSS to understanding and helping depressed parents' recovery. [ABSTRACT FROM AUTHOR]

Recent declines in life expectancy in the US, especially for middle-aged White persons, have called attention to mortality from deaths of despair – deaths due to alcohol, drugs, and suicide. Using data from the Centers for Disease Control and the U.S. Census Bureau, this paper examined deaths of despair by race/ethnicity, age, cause of death, birth cohort, and sex in Missouri. We focused on Area Agencies on Aging as geographic units of interest to increase usefulness of our findings to public administrators. Deaths of despair began trending up for all age groups beginning in 2007–2009, with the sharpest increases occurring for Black or African American non-Hispanics beginning in 2013–2015. The most dramatic increases occurred for the population age 50–59 in St. Louis City and Area Agency on Aging regions in southern Missouri. For older adults, considerable variation in rates, trends, and cause of deaths of despair is evident across the state. [ABSTRACT FROM AUTHOR]

Objectives: This paper reviews research on the topic of cannabis use and mental health harms in older adults and illustrates potential contributing factors and special clinical considerations for working with this population. Known risk factors for cannabis-related mental disorders and mental health problems are outlined, first for the general population and then specifically for older adults. Methods: Studies were identified through online databases using a variety of search words. Articles were included in the review if they were peer-reviewed or published by a reputable national organization, published in English, and were pertinent to the topic of mental health harms of cannabis use. Results: Risk factors that emerged from the literature review aligned with the following categories: (1) patterns of use (i.e., potency of product, frequency of use), (2) personal characteristics (i.e., age, sex, social demographics), (3) psychosocial constructs (motivations, perceptions), and (4) morbidities (mental health, medication interactions). Conclusions: Frequent use was associated with increased risk for mental health consequences related to cannabis use. Certain motives for use (i.e., using to cope, using as a sleep aid) may increase susceptibility to cannabis-related harms, although more empirical work is required. Mental health conditions may predispose to cannabis-related harms through a variety of mechanisms, including increased vulnerability for cannabis-related psychiatric disorders, poorer prognosis for preexisting psychiatric disorders, and possibility of cannabis-medication interactions. Personal characteristics (younger age, being male, lower socioeconomic status) predict more frequent cannabis use, which may dispose to adverse outcomes. Clinical Implications: Predictors of cannabis-related harms hold relevance for public health messaging, as well as clinical interventions. Understanding how cannabis interacts with sociodemographic factors, mental health morbidities, and medications is crucial in providing accurate guidance to patients about their recreational cannabis use and in informing prescriber decisions about medicinal cannabis. [ABSTRACT FROM AUTHOR]

Objectives:This paper investigates risk profiles of frailty among older people, as these are essential for detecting those individuals at risk for adverse outcomes and to undertake specific preventive actions. Frailty is not only a physical problem, but also refers to emotional, social, and environmental hazards. Methods:Using data generated from the Belgian Ageing Studies, a cross-sectional study (n= 28,049), we tested a multivariate regression model that included sociodemographic and socioeconomic indicators as well as four dimensions of frailty, for men and women separately. Results:The findings indicated that for both men and women, increased age, having no partner, having moved house in the previous 10 years, having a lower educational level and having a lower household income are risk characteristics for frailty. Moreover, when looking at the different frailty domains, different risk profiles arose, and gender-specific risk characteristics were detected. Discussion:This paper elaborates on practical implications, and formulates a number of future research recommendations to tackle frailty in an aging society. The conclusion demonstrates the necessity for a thorough knowledge of risk profiles of frailty, as this will save both time and money and permit preventive actions to be more individually tailored. [ABSTRACT FROM AUTHOR]

We have only just begun to understand the long-term impact of living with chronic HIV on health and livelihood after a decade of widespread access to treatment in southern Africa. This paper explores health and well-being, disability, and livelihood dynamics among people living with HIV (PLHIV) in a public healthcare setting in South Africa. We undertook a cross-sectional survey among a cohort of 1042 people on ART and explored associations between socio-demographic characteristics, treatment adherence, measures of disability (functional and activity limitations), livelihood resources (capitals) and outcomes, including food security, and exposure to livelihood shocks. A range of dynamic relationships relevant for decision-makers is evident. Age, gender, and marital status all had significant associations with levels of livelihood capitals and outcomes. Those who had been on ART for longer periods of time also had significantly higher aggregate livelihood capital. This was particularly driven by social and financial capital. Livelihoods are built within specific social and health contexts. Of particular importance is that the resources drawn on to build a livelihood differ significantly between men and women, and that different forms of disability also have gender-specific pathways in influencing livelihood and livelihood outcomes. Our results support the need for a gender-sensitive approach to supporting the well-being and livelihoods of PLHIV. Of equal importance is an approach that considers more comprehensively the new experiences of comorbidities and disabilities that may occur with a long life on ART. [ABSTRACT FROM PUBLISHER]

This paper examines family planning in Brazil as biopolitics and explores how the democratization of the State and of reproductive health services after two decades of military dictatorship (1964–1984) has influenced health professionals’ and family planning users’ discourses and practices. Do health professionals envisage family planning as a ‘right’ or do they conceive it, following the old neo-Malthusian rationale, as a ‘moral duty’ of poor people, whose ‘irrational’ reproduction jeopardizes the family's and the nation's well being? And how do their patients conceptualize and embody family planning? To answer these questions, this paper draws on 13 months of multi-sited ethnographic research undertaken between 2003 and 2005 in two public family planning services in Salvador da Bahia, where participant observation was undertaken and unstructured interviews were conducted with 11 health professionals and 70 family planning users, mostly low income black women. The paper examines how different bio-political rationalities operate in these services and argues that the old neo-Malthusian rationale and the current, dominant discourse on reproductive rights, gender equality and citizenship coexist. The coalescence of different biopolitical rationalities leads to the double stigmatization of family planning users as ‘victims’ of social and gender inequalities and as ‘irrational’ patients, ‘irresponsible’ mothers and ‘bad’ citizens if they do not embody the neo-Malthusian and biomedical rationales shaping medical practice. However, these women do not behave as ‘docile bodies’: they tactically use medical and non-medical contraceptives not only to be good mothers and citizens, but also to enhance themselves and to attain their own goals. [ABSTRACT FROM PUBLISHER]

The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex. [ABSTRACT FROM AUTHOR]

Intersectionality is increasingly adopted in research to understand the complex ways that social inequalities shape health. Intersectional research thus explores how multiple forms of oppression intersect and shape how marginalised social groups experience health issues. Yet intersectionality research has often neglected to focus on the upstream structural factors that (re)produce social inequalities in health. In this paper, we argue that intersectionality can further advance social inequality in health research when it is used to understand more than just the multiplicity of socially marginalised groups' experiences and identities, but also how interlocking social structures and power relations perpetuate social inequalities in health. We suggest that analysing policy with an intersectional lens is a key entry point to empirically explicate the underlying mechanisms that permit social inequalities in health to persist. To illustrate our argument, we use the example of how an intersectional perspective can be adopted to better understand the role of tobacco control policies in contributing to social inequalities in smoking. [ABSTRACT FROM AUTHOR]

Objectives: Characterized by infrequent contact, low emotional intensity, and limited intimacy, weak ties are found to be associated with better subjective well-being and other health outcomes. Drawing on the theory of weak ties and the convoy model of social relations, this paper aims to examine the association between weak ties and cognitive function among older adults in China. Methods: We used multilevel growth modeling to analyze panel data for adults aged 60 years and over (N = 2,650) selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015). Weak ties were measured based on the frequency of social activity participation and the number of social activities. Results: Weekly or irregular social activity participation in at least one social activity was significantly associated with better mental status and memory. The number of participated social activities was also significantly and positively associated with mental status and memory. After controlling for age, gender, marital status, educational attainment, geographic residence, household expenditures, and health conditions (i.e., depressive symptoms and self-reported health), we found that participation in a greater number of social activities protected memory from declining by 4% for every 2 years (p < 0.001). Conclusion: These findings suggest that social interactions with peripheral members of a diverse social network may help prevent cognitive decline for older Chinese adults. Greater attention on weak ties might yield practical implications for non-pharmacological dementia prevention and health promotion for the general older population. [ABSTRACT FROM AUTHOR]

Physical Activity is an important contributor to health, both physical and cognitive. The relationship between physical activity and educational outcomes has been explored in a variety of venues. Little research, however, has recently interrogated this subject longitudinally, and especially for a national sample of Black students. To address that gap, this paper employs data from the High School Longitudinal Study (HSLS), hierarchical regression modeling, and intersectionality theory to evaluate the relative impact of extracurricular activities, school attitudes, and the impact of demographics on the Personal Health and Physical Education Grade Point Average of over 1,000 Black high school students. The High School Longitudinal Study is a nationally representative, longitudinal study of ninth graders followed through their secondary and postsecondary years. Further, we examined the results separately for male and female students, in order to achieve a better understanding of physical activity and academic achievement from the female perspective. Our findings reinforce the importance of participating in sports and extracurricular activities in fostering positive educational outcomes for Black students, male and female, nationally. Finally, recommendations are offered to parents, community leaders, teachers, school administrators, and policy makers regarding implementation strategies to optimize the benefits of Physical Activity to Black adolescents. [ABSTRACT FROM AUTHOR]

Objective: To understand health disparities, it is important to use an intersectional framework that examines unique experiences of oppression faced by particular groups due to their intersecting identities and social positions linked to societal structures. We focus on Black and Latina women and their experiences with 'gendered racism' – unique forms of oppression due to the intersection of race/ethnicity and gender – to foster understanding of disparities between Black and Latina versus White women in sexual and reproductive health outcomes in the U.S. Specifically, we focus on stereotype-related gendered racism (ongoing discrimination and stereotype threat based on historically-rooted stereotypes about Black and Latina women's sexuality and motherhood) and birth control-related mistrust (ongoing mistrust of the government and medical system related to birth control due to historical and current abuses). Design: We analyzed data from two survey studies with adult women in New York (Study 1: paper-and-pencil community data collection, N = 135, Mage = 43.35) and across the U.S. (Study 2: online data collection, N = 343, Mage = 29.49) who were currently pregnant or had at least one child and identified as Black, Latina, or White. Results: Black and Latina women reported greater frequency of and concern over stereotype-related gendered racism (F(3,131) = 17.90, p <.001 Study 1; F(3,339) = 22.23, p <.001 Study 2) and greater birth control-related mistrust (F(3,131) = 7.55, p <.001 Study 1; F(3,339) = 17.32, p <.001 Study 2) than White women did. In turn, stereotype-related gendered racism was positively associated with pregnancy-specific stress (ß =.40, p <.001 Study 1; ß =.33, p <.001 Study 2), and birth control-related mistrust was negatively associated with sexual relationship power (ß = −.19, p =.002 Study 2), which are factors known to contribute to birth outcomes and sexual risk, respectively. Conclusion: Findings suggest that gendered racism may play an important role in existing racial/ethnic disparities in women's sexual and reproductive health outcomes, and interventions addressing gendered racism at multiple levels are needed to promote health equity. [ABSTRACT FROM AUTHOR]

Prior studies on substance use in Brazil have not focused on opioid misuse, previously thought to be nearly non-existent. This paper presents new findings on heroin and non-medical use of opioid analgesics. Data come from the 2015 Brazilian Household Survey on Substance Use (BHSU-3), a nationally representative survey estimating epidemiological parameters related to substance use by residents across Brazil. BHSU-3 used stratified multi-stage probability sampling across multiple geographic domains of interest, resulting in 16,273 interviews with household residents. Lifetime heroin use among Brazilians was 0.3 (95% C.I:0.2–0.4). Lifetime, past-year, and past-month non-medical use of opioid analgesics were respectively 2.9 (95%C.I.:2.3–3.4), 1.4 (95%C.I.:1.1–1.7) and 0.6 (95%C.I.:0.4–0.8). Past-year prevalence of non-medical opioid analgesics use was lower among males [Prevalence Ratio (PR): 0.54 (95% C.I.:0.36–0.78)], those aged 12–24 [0.56 (95% C.I.:0.34–0.92)], persons with monthly family incomes between R$1,501–3,000 [0.59 (95% C.I.:0.38–0.92)] or greater than R$3,000 [0.64 (95% C.I.:0.42–0.98)], and persons who were unemployed [0.65 (95% C.I.:0.46–0.92)]. Non-medical use of opioids in Brazil may be more prevalent than previously recognised. Proper measurement and evaluation of opioid misuse across Brazil and other Latin American countries is critical to understand and prevent opioid-related harms. [ABSTRACT FROM AUTHOR]

Using a legal violence framework, this paper examines the relationship between current immigration policies and the mental health of Latino immigrants in Arizona. Data were drawn from a sample of adult Latino immigrants (n = 427) living in Arizona. Results indicated that participants who reported a greater personal suffering as a consequence of current immigration policies reported significantly higher symptoms of 1) depression, 2) anxiety, and 3) stress. In addition, participants who reported greater family suffering as a consequence of current immigration policies reported significantly higher symptoms of: 1) anxiety and 2) stress. [ABSTRACT FROM AUTHOR]

The demographic shift marks the beginning of a social transformation with far reaching implications, and differences in aging processes across individuals render one-size fits-all policies ineffective. An area of increasing importance is assistive technology, including physical and Social Assistance Robots (SARs) for elderly support. In order to increase the effectiveness of such technologies, their design, functionality, and acceptance by target users must be evaluated. This paper presents a study that examines SAR technology acceptance among the future elderly (aged 20–60) in a German-speaking population (N=188). In doing this, we investigated the relationships between personality, resilience, technology experience, expectations for technology, fulfilment of expectations for technology, and technology acceptance. The study found significant correlations between age, gender, education, personality, resilience, experience, expectations, and technology acceptance and its subdimensions. Of the personality dimensions, agreeableness and neuroticism were found most relevant. Small effects were found between resilience and acceptance, and highly significant ones between technology acceptance, technology experience, expectations for SARs, and fulfilment of expectations for SARs. In keeping with previous research, the findings suggest that personality plays a significant role in the acceptance of SAR technologies. This study may be one of the first that considers and evaluates resilience as a factor in technology acceptance. [ABSTRACT FROM AUTHOR]

Background: Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. Purpose: The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM. Methods: A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c. Results: The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale (P = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years (P = 0.05) and a higher number of diabetes complications (P < 0.001) were associated with higher HbA1c levels. However, advanced age (P = 0.055), female gender (P = 0.003), and diabetes education (P = 0.011) were significantly associated with lower HbA1c levels. Conclusion: This is the first study in the Arab region that identifies diabetes fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This paper examines factors associated with happiness and to estimate happy life expectancy for older people in South Africa. Methods: The study uses data from the first wave of the Study on Ageing and Adult Health (SAGE) survey, which is a nationally representative population-based survey with a sample of 3,840 individuals aged 50 years and above. The Sullivan method and multivariate linear regression analysis were used in the analysis. Results: The prevalence of happiness was the same for men (55.5%) and women (55.4%) at the youngest of the age groups (50–59). However, this prevalence was higher in men than women across older ages. Women demonstrated longer life expectancy and happy life expectancy, but also unhappy life expectancy, compared to men, across all the ages. However, men had greater proportions of happy life expectancies compared to women. In multivariate analysis, wealth status, health, activity limitation, race and age were significantly associated with happiness among men and women. Conclusions: Gender disparities in happiness are demonstrated in this study. It is important to understand the factors that promote happiness in older people as this may point to areas that need intervention for improving overall quality of life. [ABSTRACT FROM AUTHOR]

Nationally, juvenile justice reforms have largely rolled back the surge in youth incarceration that resulted from the "tough on crime" era of the late 1990s and early 2000s: the numbers of young people arrested, detained, and placed in the justice system has fallen by half to the lowest numbers the country has seen since the 1980s. This paper analyzes gender-specific trends in juvenile justice involvement to assess whether declines in juvenile justice-involved youth population have made it possible to eliminate the practice of detaining or placing girls in juvenile justice facilities in many jurisdictions around the country. Descriptive data from the Bureau of Justice Statistics "Arrest Data Analysis Tool" as well as the Office of Juvenile Justice and Delinquency Prevention's "Easy Access to Juvenile Court Statistics" and "Census of Juveniles in Residential Placement" are compiled to provide an overview of gender demographics and charge severity at arrest and placement over time. Findings indicate that in many states girls numbers are sufficiently small and the severity of their offenses sufficiently low-level that targeted policy changes, diversion efforts, and investment community-based prevention and intervention programing could eliminate confinement altogether. [ABSTRACT FROM AUTHOR]

A large body of evidence suggests that within the juvenile justice system, girls fare worse than boys on several measures, including number of arrests, length of stay, and mental health outcomes while in the system. Scholarship suggests a myriad of gendered social factors that precipitate girls' involvement in the juvenile justice system; however, less is known about how stakeholders within the juvenile justice system perceive the girls they work with or interpret their experiences. The current paper examines the attributions that juvenile justice system workers make about the reasons girls offend. In line with previous research, we identify both internal (personality, character traits) and external (situational) explanations for girls' involvement in the juvenile justice system that correspond to gender stereotypes and expectations of girls. Furthermore, we identify structural attributions as a special subset of external attributions that take into account how larger social, economic, and historical factors shape girls' situations and experiences and contribute to their criminal behavior. These structural attributions have implications for practitioners' views of justice and the role of the juvenile justice system in the lives of girls. We conclude with a set of implications for practice and policy. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. Objectives: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. Methods: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. Conclusion: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage. [ABSTRACT FROM AUTHOR]

AIDS permeates all aspects of the lives of individuals, families and the society at large. In addition, it is beset with dynamics, dilemmas and complexities that have a bearing on people's psychosocial health. However, AIDS presents a wealth of learning opportunities to affected people and to governments. Using Botswana as an exemplar, the author explores the way AIDS has transformed the way of life of a people through the challenges and the opportunities that it presents. The author reflects on the interface of AIDS and mental illness. The paper concludes with recommendations for the way forward. [ABSTRACT FROM AUTHOR]

Does more income mean more leisure? This paper investigates the impact of wages and income on leisure time using merged data from two nationally representative samples in Thailand: (1) the Time Use Survey, and (2) the Labor Force Survey. Results will depend on our definition of income or wages. The data indicate that Thai people tend to reduce their leisure time in response to monthly income changes. The reason for such a negative relationship is that monthly income is composed of extra income other than wages, for example, overtime and bonus pay, which are found to be inversely related to leisure time. However, when the relationship between leisure time and hourly wage is estimated, we find that an increase in hourly wage substantially and significantly induces people to engage in more leisure and that a percentage change in hourly wage also provides a positive percentage change in leisure time. [ABSTRACT FROM AUTHOR]

Background: This paper explores the heterogeneities in antenatal care (ANC) utilization in India's most populated state, Uttar Pradesh. Taking an intersectionality lens, multiple individual- and district-level factors are used to identify segments of any antenatal care usage in Uttar Pradesh Objective: This paper seeks to understand the multilevel contexts of ANC utilization. The planning and programming challenge is that such knowledge of contextual specificity is rarely known upfront at the initial stages of planning or implementing an intervention. Exploratory data analysis might be needed to identify such contextual specificity. Methods: Tree-structured regression methods are used to identify segments and interactions between factors. The results from the tree-structured regression were complemented with multilevel models that controlled for the clustering of individuals within districts. Results: Heterogeneities in utilization of any ANC were observed. The multiple segments of ANC utilization that were developed went from a low utilization of 23.7% for respondents who were not literate and did not have home ownership to a high of 82.4% for respondents who were literate and at the highest level of wealth. Key variables that helped define the segments of ANC utilization include: woman's literacy, ownership of home, wealth index, and district-level sex ratio. Based on the multilevel model of any ANC utilization, cross-level interactions also were obtained between sex ratio and ownership of home as well as between sex ratio and literacy. Increases in sex ratio increased the influence of ownership of home on any ANC, while increases in sex ratio reduced the impact of woman's literacy on receiving any ANC. Conclusion: We argue that a focus on heterogeneous segments of utilization can help build knowledge of the mechanisms that underlie inequities in maternal health utilization. Such knowledge of heterogeneity needs to be incorporated in contextualizing interventions to meet a variety of recipients' needs. [ABSTRACT FROM AUTHOR]

In this paper we examine the nature of loss in the context of environmental disasters. When the places people call home are irrevocably changed by disasters, people experience a profound sense of loss—loss that includes both tangible and intangible elements. Tangible aspects of loss include the loss of homes and infrastructure. Intangible losses are less evident but are associated with a loss of identity, of social cohesion, of belonging and community, and of health and wellbeing that are so integrally linked to one’s place. Social work academics across the world are developing environmental and ecological theories for practice that signal the need for social workers to be more engaged with the physical environment and the significance of place. Drawing on research conducted following the Black Saturday bushfires in Victoria, we highlight the nature of loss in the context of damaged “places”. IMPLICATIONS Social workers and others involved in disaster recovery need to be aware of both tangible and intangible losses and their impact on post-traumatic stress and growth. In the immediate postdisaster period, tangible losses such as homes and infrastructure are often the focus of disaster recovery efforts. Intangible losses of identity, community, and a sense of place and belonging may be of equal or greater significance than tangible losses for those affected by disasters. [ABSTRACT FROM AUTHOR]

At the foundation of most inequalities in expression of sexuality lie social constructions of gender. In this paper, sex education is considered as a possibility to challenge sexism and promote healthy and self-affirmative sex lives. In the past decade, the discourse of sex education in India has become a ‘battle of morality’ where concerned citizens condemn sex education on the grounds it may encourage sexual activity and immoral conduct (e.g. promiscuity or infidelity). The work of non-governmental organisations (NGOs) is an alternative to the governmental national curriculum plan. This paper discusses NGO potential in terms of sexual empowerment by examining beliefs and understanding, choices of information, strategies and methods, and approaches apparent in sex education programmes and projects. Through qualitative data, findings were analysed by constructing a sexual empowerment model that divides components of sex education into four parts and utilises theories of empowerment. The main findings include that all four components of sex education – foundation, content, strategies and approaches – show great potential to challenge gender inequalities in regard to sexuality. Sexual health programmes and projects are seen to be highly participatory, deliberative and encouraging of critical thinking. Some concerns are highlighted: the strong focus on girls as the main actors of change, and external limitations such as parents and institutions. [ABSTRACT FROM PUBLISHER]

Polish birthrates during the state socialist period, 1948–1989, stayed above replacement level but since 1989 fell dramatically to one of the lowest in Europe, at 1.29 in 2010. The Polish Catholic Church and the newly-elected nationalist government of Lech Wałęsa reacted by escalating pronatalist rhetoric calling on women to increase childbearing in the name of economic and nationalist causes. Reflecting the renewed dominance of the Church, Wałęsa implemented restrictions on family planning, including abortion, contraception, and sex education, justifying them in moral and demographic terms. Plummeting fertility has been portrayed by the Church, media, and state as dangerous and unreasonable – a sign of Polish women's rejection of motherhood and the embrace of selfish priorities. Simultaneously however, the state cut back motherhood-friendly policies established by the socialist regime, including subsidized childcare, maternity leave, and healthcare. This paper draws on 19 months of fieldwork between 2000 and 2007, using interviews with 55 women in four healthcare clinics in Gdańsk area, and participant-observation at the social services offices in Krakow. This paper shows that far from irrational rejection of motherhood, Polish middle-class women are guided by pragmatic reasons when delaying parenthood in order to navigate the new political landscape marked by job insecurity and gendered discrimination in employment. Yet, rather than implementing work-family reconciliation policies that have stimulated fertility elsewhere in Europe, the Church and state insist on blaming women for ‘irrational’ non-reproduction, thus betraying a lack of political commitment to gender equity in employment, reproductive health, and in the family. [ABSTRACT FROM PUBLISHER]

One of the obstacles to understanding the links between social inequality and mental health distress is the reliance on heterogeneous diagnostic categories. In this paper, it is argued that a solution to this problem is to explore more homogenous experiences of distress. This paper investigates one particular form of distress: paranoia. The relationship between social inequality and paranoia is then examined, focusing on two aspects. Firstly, it is argued that social inequality might affect the experience of paranoia itself since the experience of the surveillance encountered in the everyday use of public space may vary depending on one's location in social categories like gender, 'race' and culture and class (these social categories are, of course, themselves stratified by social inequality). Secondly, mental health service users' locations in these categories may influence the way that the plausibility of ostensibly paranoid claims are evaluated by mental health professionals. Within the discussion of each category, links are drawn between community and clinical samples to understand how the experience of paranoia may be influenced by these social categories. The paper concludes with implications for research and policy. [ABSTRACT FROM AUTHOR]

This paper seeks to contribute to social capital research and its applicability to social work practice and social policy. It provides an examination of the complexity of social capital and strategies used to build it in local communities. Drawing on data collected from a large quantitative study collected in a rural city in Australia, experiencing rapid population growth, it reports on levels of social, civic, and community participation related to a range of demographic variables. Results highlight the significance of gender, life stage, socioeconomic status, and the influence of neighbourhood connected to different types of participation. Findings presented in this paper draw attention to the unevenness of participation in social, civic, and community life linked to key demographics. The author concludes by arguing that community-building approaches have some merit, so long as critical differences accessing bonding and bridging social capital are acknowledged, and opportunities to promote participation are facilitated. [ABSTRACT FROM AUTHOR]

There is limited research in India to understand young people's decision-making processes about intimate relationships before marriage. This paper, adopting a life course perspective, explains relationship choices and diachronic trajectories of relationships from adolescence to young adulthood. Retrospective data were collected from 1240 never married 20–29-year-old men and women living in Pune using a relationships history calendar. All the relationships from 10 years of age onwards were plotted on the calendar, and information on predictor variables was collected through structured questionnaires. Data were analysed using descriptive statistics. Sequence analysis approach was used to identify different typologies. Overall, 76% of the participants reported having at least one relationship. More women compared to men (84% vs 70%) ever had a relationship. The median age of starting the first relationship was 17 years for women and 18 for men. Different relationship types were reported, such as "serious", casual, "friends with benefit", and "exploring". The level of emotional involvement, commitment, and physical intimacy significantly differed in different relationship types with significant gender differences. Four typologies of relationships were observed, labelled as (1) Commitment–No sex (N = 187); (2) Commitment–Sex-Some exploration (N = 189); (3) No commitment–Exploration (N = 281), and (4) No relationship (N = 583). Compared to men, women were more likely to follow the trajectory of "Commitment-No sex" (RR 2.13, CI 1.5–3.03). Family environment was significantly related to young people's relationship choices. The findings strongly suggest the need to adopt a developmental perspective towards intimate relationships to understand and address the vulnerabilities of young people across the life course. [ABSTRACT FROM AUTHOR]

A prolonged working life is crucial for sustaining social welfare and fiscal stability for countries facing ageing populations. The group of older adults is not homogeneous; however, differences within the group may affect the propensity to continue working and to participate in continuing education. The aim of this paper is to explore how participation in work and education vary with gender, age, and education level in a sample of older adults. The study was performed in Sweden, a context characterized by high female labour-market-participation rates and a high average retirement age. The participants were 232 members of four of the major senior citizens’ organizations. We found no differences in participation in work and education based on gender. People older than 75 years were found to be as active as people 65–75 years old in education, but the older group worked less. There were positive associations between education level and participation in both work and education. Hence, this study implies that socio-economic inequalities along these dimensions are widened later in life. This highlights the importance of engaging workers with lower education levels in educational efforts throughout life. It also emphasizes the need for true lifelong learning in society. [ABSTRACT FROM AUTHOR]

Background: There has been little research that provides a comprehensive account of the nature and aspects of information needs of informal carers. The authors have previously developed and validated a framework that accounts for major underlying states of information need. This paper aims to apply this framework to explore whether there are common demographic and socioeconomic characteristics that affect the information needs states of carers. A questionnaire about the information needs states was completed by 198 carers above 18 years old. We use statistical methods to look for similarities and differences in respondents' information needs states, in terms of the demographic and socioeconomic variables. At least one information needs state varies among carers, in terms of seven demographic and socioeconomic variables: the age of the patient(s) that they are caring for; the condition(s) of the patient(s) that they are caring for; the number of patients that they are caring for; their length of time as a carer; their gender; the country that they live in; and the population of the area that they live in. The findings demonstrate the utility of the information needs state framework. We outline some practical implications of the framework. [ABSTRACT FROM AUTHOR]

Background: Though college students have high rates of heavy drinking, few studies have examined the various pathways through which risks affect drinking and whether this varies by institution. We examined whether alcohol expectancy mediates the relationship between social factors (i.e., hooking up, friends drinking, Greek affiliation, entitlement) and drinking behavior comparing college students from one Midwestern and one Southeastern university.Methods: In the 2013–14 academic year, 1,482 college students (51% female) enrolled in undergraduate courses at two public universities completed a paper and pencil survey of attitudes and experiences about dating, sexuality, and substance use. Multiple group path analysis was used to compare two institutions.Results: Drinking behavior was positively associated with hooking up more often, Greek affiliation, being male, having close friends who consume more alcohol, and greater alcohol expectancies. We found unique differences in the mediating pathways for the two campuses.Conclusion: This study provides a more nuanced understanding of risk factors for heavy drinking. Moreover, it adds to the scarce body of literature concerning entitlement and drinking and the unique pathways between two college campuses. Finally, the results could lead to the development of more specific intervention strategies to reduce risky drinking among U.S. college students. [ABSTRACT FROM PUBLISHER]

Objectives: Metabolic Syndrome (METs) definitions vary and diagnosis takes into account consumption of medications commonly prescribed for conditions defining METs. This paper evaluates the potential differences in population characteristics using two different methods of defining METs, with and without the adjustment of the effects of pharmacotherapy on biochemical and blood pressure (BP) measurements Methods: This was a cross-sectional study utilizing the Malaysian Elders Longitudinal Research (MELoR) cohort comprising urban community-dwellers aged ≥55 years. Participants were interviewed using a structured questionnaire during home visits where medications were reviewed. Health impacts assessed included heart disease, stroke, body mass index (BMI), peptic ulcers, arthritis, and number of medications and comorbidities. Risk factors and health impacts associated with METs were determined by Poisson multivariate regression models using a binary and count dependent variables.Results: A total of 891 participants with a mean (SD) age of 68.6 (7.3) years were included. The prevalence of METs vary from 52.7% to 35.1% depending upon the definition used. The risk factors associated with METs were increasing age, ethnicity, lower education levels, BMI, stroke and medication use. Male gender was considered a risk factor following modification for medication usage using a count model. The drug-modified model removed marginal candidates prescribed medications used for specific conditions which defined METs who did not meet the criteria once their BP or biochemical parameters were modified for the effects of medication-use.Conclusion: The IDF definition for METs that makes allowance for treatment for each specific condition can lead to an overestimation in the prevalence of METs in population studies. Not including those medicated with normal results conversely underestimates the prevalence of METs. We have therefore proposed adjustments to BP and lipid measurements based on pooled mean effects from published systematic reviews to mitigate bias in future research on prevalence of METs. [ABSTRACT FROM AUTHOR]

Purpose:This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process. Methods:The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n = 3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death. Results:Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women. Conclusions:Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender.Implications for RehabilitationThe disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico.Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico.One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging.Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability. [ABSTRACT FROM AUTHOR]

Understanding barriers and facilitators of healthcare for people with mental illness is essential for healthcare and mental healthcare organizations moving towards patient centered care. This paper presents findings of a measure on barriers and facilitators of healthcare completed by 204 patients being served at a co-located wellness center (primary healthcare clinic) located in an urban mental health center. The top 10 results show important findings for planning healthcare services that are responsive to the needs of people with mental illness. Basic structural issues as a result of poverty are extremely important (transportation, housing, payment) as well as difficulty with public healthcare that often involves long wait-times for appointments and at the doctor's office and hours that might not be convenient. Healthcare services that want to meet the needs of people with mental illness need to address these issues. What facilitates healthcare is not just removing the barriers to receiving healthcare services but instead involves more interpersonal aspects of healthcare such as liking your provider, being able to talk with your provider, feeling your provider cares about you and listens to you. Structural supports such as also being in mental health services, having systems for remembering appointments, and/or having appointment times that are convenient also facilitate seeking healthcare. Facilitating healthcare seeking also seems to involve a sense of agency—looking forward to taking charge of your health and feeling capable of following healthcare provider instructions. Healthcare systems for people with mental illness need to support these facilitators to give care-seekers the support they need. Key points are provided on how organizations and staff can work more effectively in implementing patient centered care. [ABSTRACT FROM PUBLISHER]

This paper aims to (1) determine the rate of (full- and part-time) caregiver leave-taking in Spain, (2) identify the reasons conducive to a more intense use of this resource, and (3) ascertain the main obstacles to its use, as perceived by caregivers. All 896 people covered by the sample were engaging in paid work and had cared for dependent adults in the last 12 years. This resource, in particular the full-time alternative, was found to be a minority option. The data showed that legal, work-related, and family and gender norm issues are the four types of factors that determine the decision to take such leaves. The most significant obstacles to their use are the forfeiture of income and the risk of losing one's job. Our results suggest that income replacement during a leave would increase the take-up of these resources. Moreover, enlargement of public care services would promote the use of leave as a free choice of caregivers. [ABSTRACT FROM AUTHOR]

Background: Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population. Methods: Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n=5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual). Results: SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among non-manual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes. Discussion: Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health. [ABSTRACT FROM AUTHOR]

Sexuality education forms part of the national school curricula of most sub-Saharan African countries, yet risk-related sexual behaviour among young people continues to fuel the HIV pandemic in this part of the world. One of the arguments put forward to explain why sexuality education seems to have had little impact on sexual risk-taking is that existing curricula have neglected to take into account the complexity of the social, cultural and gender norms that influence the behaviour of school-going young people in sub-Saharan Africa. Over the past few years, the Department of Basic Education in South Africa has recognised the need to provide guidance to teachers on the content, pedagogical processes and messages that are relevant to their specific context. This paper critically reflects on findings from a literature-based study conducted to identify the cognitive and social factors influencing the behaviour of school-going young people in South Africa and the risk and protective factors that might be particular to their circumstances. The findings provide helpful guidelines about the development, content and implementation of sexuality education curricula more likely to be relevant in contexts of serious poverty and disadvantage. Although based on the South African literature, the findings may also offer useful lessons for curriculum designers in other developing countries. [ABSTRACT FROM AUTHOR]

This paper presents the results of the qualitative phase of Healthy Foundations, a study that groups people according to their motivations to live healthily or otherwise, their lifestyles, and the circumstances that affect this. These segments are ‘Health Conscious Realists’, ‘Balanced Compensators’, ‘Live for Todays’, ‘Unconfident Fatalists’ and ‘Hedonistic Immortals’. The aim was to explore people’s attitudes and motivations to live healthily or otherwise and the targeted healthcare interventions appropriate for each segment. The qualitative phase involved two strands: (i) focus groups and immersion in-depth interviews and (ii) video ethnographic ‘pen portraits’. It provides robust insight into the five segments’ motivations and behaviour and how these are constructed within and influenced by the wider environment. It also enabled the segments to give their views of and design appropriate interventions aligned to their individual requirements, lifestyles and structural environments. It demonstrates the usefulness of the qualitative approach to health segmentations and enhances the case for methodological pluralism, and a critical perspective, to enable development of health-related behaviour change interventions and policy more widely. [ABSTRACT FROM PUBLISHER]

Background: Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population. Methods: Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n = 5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual). Results: SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among nonmanual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes. Discussion: Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health. [ABSTRACT FROM AUTHOR]

Recent research has highlighted the importance of parental involvement in sexuality education, and studies of sexuality education sometimes take place through national sexual health surveys. This paper aims to identify key parental characteristics that predict parental involvement in sexuality education while also encouraging a debate on how this topic is optimally investigated. Data used in this study comprised a subset from a nationally representative cross-sectional telephone survey of adults (18–45 years) living in Ireland (N = 3002). Parents (21–45 years) of a child/children aged 6 years or older at the time of the study (n = 966) were included in analyses. Results using propensity score analysis found that parents who reported engaging in sexuality education with their children were more likely to be women, aged 36–45 years, and also were more likely to have a larger number of children. Advancing the field of sexuality education research could be facilitated by the application of survey method and the advanced statistical techniques used here. Furthermore, a stand-alone national survey assessing parental involvement in sexuality education would be a worthy contribution to this knowledge base. [ABSTRACT FROM PUBLISHER]