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PubMedDate not supplied

Potentially modifiable factors associated with disability among people with diabetes.

OBJECTIVE: This article seeks to identify potentially modifiable factors associated with disability among people with diabetes. STUDY DESIGN AND SETTING: Among people with diabetes (N = 4357) in a large health maintenance organization, disease severity, psychologic and behavioral risk factors for disability were assessed. Disability was evaluated by the WHO Disability Assessment Scale (WHO-DAS-II), the SF-36 Social Functioning scale, and days of reduced household work. RESULTS: Depression was associated with a tenfold increase in elevated WHO-DAS-II and low SF-36 Social Functioning scores, and a fourfold increase in 20+ days of reduced household work. Minor depression and the presence of three or more diabetic complications were associated with approximately a twofold increase in disability risk. Diabetic symptoms, chronic disease comorbidity, and reduced exercise were also associated with disability. CONCLUSION: Among people with diabetes, depression, diabetic complications, and exercise are potentially modifiable factors associated with disability. This suggests that integrated, biopsychosocial approaches may be needed to understand and to ameliorate disability among people with diabetes.

Activities of Daily Living↗
PubMed1996

The social organization of nutritional inequities.

An institutional ethnography, a qualitative research methodology grounded in critical social science, was undertaken with the purpose of explicating the social organization of nutritional inequities among socially/economically disadvantaged women and their families living in an urban centre in Nova Scotia, Canada. Methods included participant observation of food and nutrition practices in the homes of five socially disadvantaged families and at a community drop-in center in a low-income neighborhood; in-depth individual interviews with family members; and group interviews with an additional 28 participants at the community center. Tape recordings and field observation notes were analyzed thematically, preserving the perspectives of the research participants. The explication began with the examination of the everyday household work of feeding the family which provided an entry point to broader social relations working outside of the households, but evident within them. At the household level, the gendered, 'invisible' nature of feeding work became readily apparent. The class context of feeding work became particularly evident upon examination of the practice of procuring food. The apparently simple act of buying groceries was complicated by limited access to inexpensive stores. The families developed innovative strategies to enhance their abilities to procure food within their limited means. However, because of inadequacies of subsistence welfare policies, they frequently were sufficiently short of funds to necessitate reliance on charity for food. Analysis of such social policy revealed that public and professional discourses organizing nutritional inequities were informed by individualistic ideology. Yet, individualistic discourses could not provide an adequate understanding of the experiences of the research participants. The impact of individualistic professional discourse included the irrelevance of nutrition education practices based upon information dissemination. In sum, the research revealed nutritional inequities as embedded within social constructs such as gender, class, commerce, policy and discourse. The educative nature of the participatory research process empowered study participants to initiate structural change in commercial pricing practices. Through making the analysis available to others, including policy makers, it may be possible to work toward changing the oppressive social organization which perpetuates inequities. The research calls for a reorientation in community educational practice from the dominant individual orientation to a social orientation.

Adolescent↗
PubMed1998

The history of the family in Spain: past development, present realities, and future challenges.

"The article presents a brief overview of the historical study of the family in Spain, and deals with household work patterns, labor migration, adaptive strategies of households, and property devolution. From a belated and rater timid beginnings in the early part of the 1980s, the growth of this field in recent years has been noteworthy. The articles included in this volume are fitting testimony to the maturity achieved by this discipline in a very short amount of time. There are many important methodological and conceptual challenges facing family historians in Spain today. If they are able to respond to them successfully, the future of the discipline will be a bright one indeed."

Demography↗
PubMed2006

Social environment and depression among pregnant women in urban areas of Pakistan: importance of social relations.

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts' opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants of depression were grouped into themes of social conditions and social relations and pregnancy-related concerns. In the study's quantitative phase, the relative power of the identified themes and categories, based on their scores for predicting depression (determined by the Center for Epidemiological Studies-Depression Scale (CES-D scale)), was determined through multivariate linear regression. Social environmental determinants of pregnant women were described under the themes and categories of (1) social relations: involving husband, in-laws and children; (2) social conditions: involving the economy, illness, life events, household work, environmental circumstances and social problems; and (3) pregnancy-related concerns i.e. symptoms of pregnancy, changes during pregnancy, dependency and concern for unborn baby. Multivariate analysis found that among these themes, social relations and pregnancy-related concerns were significantly associated with total CES-D scores. Among the categories besides increasing age and less education, husband, in-laws, household work and pregnancy symptoms were significantly associated with total CES-D scores. The study highlights the importance of social relations compared to social conditions for determining depression in pregnant women.

Adult↗
PubMed1982

III. One year after stroke: a follow-up of an experimental study.

The long-term effect of an early activation programme in nursing care (APN) during the first four weeks after a stroke was studied in 33 survivors one year after the stroke. Twenty-six patients formed a control group. Functional capacity was tested with an Activity Index (AI). All patients except three were interviewed concerning household work, locomotion, and psychosocial and intellectual activities before and after the stroke. There were no significant differences in functional capacity between the experimental (E) and control (C) groups one year after the stroke. In both groups AI had improved considerably compared with the values on admission. Comparison of the pre- and post-stroke performance revealed that the decrease in median scores was most prominent in household work and psychosocial functions in both groups. A long-term effect of the APN was not proved. The ADL part of the AI had a strong predictive value for one-year survival.

Activities of Daily Living↗
PubMed2004

Strength, mobility and falling in women referred to a geriatric outpatient clinic.

BACKGROUND AND AIMS: Mobility impairment and falling have a multifactorial etiology in frail older people. Muscle weakness is one of the risk factors and is accessible to intervention. The aim of this study was to determine the most important contributors of mobility and indicators of fall occurrence in women referred to a geriatric outpatient clinic. METHODS: Mobility was assessed using the Timed 'Get-Up-and-Go' test (TGUG) and the modified Coopertest (COOP). Falling was assessed retrospectively and isometric knee extension force was measured using fixed dynamometry. Habitual physical activity was quantified using a questionnaire for the elderly. Height, weight, medical conditions and current medication were recorded. RESULTS: Isometric knee extension strength and habitual physical activity, which consisted predominantly of household work, were independent variables of performance on TGUG and COOP and together explained 57% of the variance in TGUG (r=0.75, p<0.001), and 64% of that in COOP, (r=0.80, p<0.001). Age, total number of medical conditions, and presence of cardiovascular disease were not significant in the model. Women in the lowest tertile of knee extension strength had a significantly higher probability of falling (0.75, 95% CI 0.56-0.91) compared with women in the highest tertile (0.27, 95% CI 0.14-0.50). CONCLUSIONS: Knee extension strength remains a strong determinant of mobility and fall occurrence in women referred to a geriatric outpatient clinic. Performing light to moderate household work remains independently associated with functional mobility.

Accidental Falls↗
PubMed1999

Pathways to a third child in Sweden.

The transition from two to three children is investigated, using data on Swedish women's fertility behavior and labor force participation over a period of some 20 years ending in 1992/93. Two questions are examined: what is the relationship between working life and childbearing of two-child mothers? Are there differences in fertility between cohabiting and married couples? Several paths to the third child are identified, one of women with a university education and another of women with preference for more children, reflected by marriage after having the first or the second child or by persistent working experience followed by household work.

Birth Order↗
PubMed1999

Reliability of the migraine disability assessment score in a population-based sample of headache sufferers.

BACKGROUND: The Migraine Disability Assessment (MIDAS) score is used to quantify headache-related disability. In a previous study, we showed that the MIDAS score was highly reliable in population-based samples of migraine headache sufferers in two countries. OBJECTIVES: To examine the test-retest reliability and internal consistency of the five items comprising the MIDAS score and the overall MIDAS score in a population-based sample of both migraine and nonmigraine headache sufferers. METHODS: Using a clinically validated telephone interview, a population-based sample of migraine and nonmigraine headache sufferers was identified in Baltimore, Maryland, USA. A total of 97 migraine cases and 80 nonmigraine subjects completed the MIDAS questionnaire on two occasions an average of 3 weeks apart. The MIDAS score is derived from five questions about missed time from work (or school) and household work (one question each about missed days and days with at least 50% reduced productivity) and missed days of nonwork activities. RESULTS: Among all headache sufferers the test-retest Spearman's correlations of individual MIDAS questions ranged from 0.67 to 0.73. The Spearman's correlation for the MIDAS score (i.e., sum of lost days and reduced effectiveness days in each domain) was 0.84. Cronbach's alpha, a measure of internal consistency, was 0.83. Mean and median item values and the overall MIDAS scores differed between migraine and nonmigraine cases. Even after adjusting for differences in headache frequency, the mean MIDAS scores differed substantially (i.e., 10.3 points) between migraine cases and nonmigraine cases. CONCLUSIONS: The reliability and internal consistency of the MIDAS score are high, as tested in a population-based sample of headache sufferers. MIDAS scores are substantially higher in migraine cases than in non-migraine cases, supporting the validity of the measure.

Adolescent↗
PubMed2006

Gender differences in work-home interplay and symptom perception among Swedish white-collar employees.

OBJECTIVE: To analyse gender differences in paid and unpaid workload and symptoms in matched groups of Swedish white-collar workers with children. DESIGN AND SETTING: Paid and unpaid workload and perceived stress from paid work, conflict between demands and control over household work were measured by a total workload (TWL) questionnaire. Some symptoms were rated with regard to frequency and severity as a measure of health. Cross-sectional analyses were performed. PARTICIPANTS: Matched groups of male (n = 440) and female (n = 529) well-educated white-collar workers in full-time employment, aged 32-58 years and living with children in the home. RESULTS: Women in higher positions in Sweden are healthier than the average population of women, but report more symptoms than men in the same position as well as more stress from paid work, more conflict between demands and a greater TWL. However, women also reported more control over household duties and TWL was not associated with more symptoms. The men were mainly focused on their paid work role and perhaps even more so than men in the general population as they were fairly resistant to feelings of conflicting demands. CONCLUSION: Even among matched groups of full-time employed, well-educated men and women, traditional gender differences in division of responsibilities and time allocation were found. Even though the women were healthy at this stage, they might risk future ill health, owing to high workload, stress and feelings of conflicting demands.

Adult↗
PubMed1994

The influence of reproductive status on rural Kenyan women's time use.

To determine the effects that pregnancy and infant care have on Embu women's commercial, agricultural and household activities, time use patterns were studied for women at different stages of pregnancy and lactation. Time allocation data were collected from 169 households, visited at random intervals over a year, by use of the spot observations technique. Detailed reproductive data were collected monthly, and household socioeconomic data quarterly. Analyses of Embu women's time use by reproductive status reveal that the demands of pregnancy and lactation require women to decrease the amount of time spent on subsistence agriculture, commercial activities, housework, and tending animals; and to devote more time to resting, breastfeeding, and child care. Agricultural and economic activities are curtailed especially in the 3rd trimester of pregnancy and the 1st period of lactation. This data provide insight into how pregnancy and lactation require women to adjust their time allocation between reproductive and farm labor activities. This decrease in time spent on subsistence agriculture, commercial activities, and household work increases the risk of household economic insecurity during the woman's reproductive years.

Activities of Daily Living↗
PubMed1985

Adolescents' contribution to household production: male and female differences.

This study develops a model to predict the contribution adolescent males and females make to household work, based upon family characteristics, human capital of the adolescent, geographic location, and societal expectations. Only adolescents in two-parent, two-child households were studied. Separate analyses were run for first-born and second-born males and females. School day was the only variable that explained variance in each of the four prediction equations. Adolescent females worked longer than adolescent males, regardless of birth order. Time use for household work was largely unaffected by family characteristics.

Adolescent↗
PubMed1992

Double exposure: the combined impact of the home and work environments on psychosomatic strain in Swedish women and men.

This study investigates the relative distribution of home responsibilities and psychosocial work environment characteristics and their associations with psychosomatic strain in a random sample of the female and male working population of Sweden (N = 12,772). Occupational variables investigated were psychological and physical demands, job control, social support, and job hazards. Home characteristics included measures of household work, number and age of children, and child care resources. A sex-pooled logistic regression analysis was performed to detect sex differences in the effects of the variables upon strain. Gender was no longer associated with psychosomatic strain after adjusting for work and home characteristics and their interactions, and while there were some similarities between the sexes with respect to the main effects of the home and work characteristics, in 52 of 60 combined effect comparisons women had a greater combined odds ratio for strain than men.

Adult↗
PubMed1983

Care of disabled children and women's time use.

Previous research has estimated the effect of children's health care needs on women's market and nonmarket roles. This article reports the results of a study on the impact of health care for disabled children on women's nonmarket work. (Effects on women's market work are reported elsewhere.) Data from 369 families of disabled children and 456 randomly selected families were analyzed. Disabled children increase the time spent in household work by married mothers. Single mothers do not show significant effects. Estimates are also presented of parents' time spent in administering therapy to the disabled child and in escorting the child to the site of medical care.

Adolescent↗
PubMed2005

Misreporting of energy: prevalence, characteristics of misreporters and influence on observed risk estimates in the Malmö Diet and Cancer cohort.

The present study investigates the prevalence of misreporting of energy in the Malmö Diet and Cancer cohort, and examines anthropometric, socio-economic and lifestyle characteristics of the misreporters. Further, the influence of excluding misreporters on risk estimates of post-menopausal breast cancer was examined. Information of reported energy intake (EI) was obtained from a modified diet history method. A questionnaire provided information on lifestyle and socio-economic characteristics. Individual physical activity level (PAL) was calculated from self-reported information on physical activity at work, leisure time physical activity and household work, and from estimates of hours of sleeping, self-care and passive time. Energy misreporting was defined as having a ratio of EI to BMR outside the 95 % CI limits of the calculated PAL. Logistic regression analysed the risk of being a low-energy reporter or a high-energy reporter. Almost 18 % of the women and 12 % of the men were classified as low-energy reporters, 2.8 % of the women and 3.5 % of the men were classified as high-energy reporters. In both genders high BMI, large waist circumference, short education and being a blue-collar worker were significantly associated with low-energy reporting. High-energy reporting was significantly associated with low BMI, living alone and current smoking. The results add support to the practice of energy adjustment as a means to reduce the influence of errors in risk assessment.

Alcohol Drinking↗
PubMed2006

Symptom reporting and self-rated health among women in mid-life: the role of work characteristics and family responsibilities.

This study investigated how socioeconomic factors and psychosocial conditions are related to self-reported health among 43-year-old women representing the general Swedish population (N = 569). Odds ratios and multiple logistic regression analyses were used for associations and effect modification, adjusted for symptom reporting in adolescence. Poor self-reported health was predicted by low income, financial worries, and job strain, as well as combined exposure to a high level of unpaid household work and job strain (double burden). In conclusion, poor psychosocial conditions related to working life, as well as to the combined impact of paid and unpaid work were revealed to be risk factors for poor self-reported health among middle-aged women. These results highlight the need for improving women's work conditions, as well as designing family policies that promote a better sharing of unpaid household tasks and responsibilities between spouses.

Employment↗
PubMed2003

[Wage labor, housewifery, and health: qualitative and quantitative differences between men and women].

This article presents the relationship between wage labor, housewifery, and health from a gender perspective. The relationship between the two types of work determines the characteristics and meaning of daily life. The methodology combined quantitative and qualitative techniques. An individual questionnaire was applied to 256 male and 121 female workers (n = 377) in a modern pharmaceutical factory in Mexico. In addition, seven in-depth interviews were performed with selected employees. Despite important similarities between female and male wage-earners, there were two key differences: gender segregation in the workplace and the division of household work. The social determinants of this uneven situation result from a complex gender relationship, leading to different disease profiles and health concepts.

Adult↗