903 resultados para medicalization of birth


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With an increasingly diverse, multicultural society in many countries, it is timely to look more closely at the current literature on arts marketing, ethnic identity and segmentation issues. The growth of diverse, multicultural societies in many countries warrants a closer examination of arts marketing and the use of ethnicity as a basis for segmentation, as these issues have implications for attracting and retaining arts audiences and other consumers of arts related activities. Researchers in the arts industry have stressed the importance of understanding the fundamentals of audience development and the ability to focus on satisfying the needs and wants of their audiences. The focus on marketing activities comes at a time when there is greater pressure on arts organisations to move beyond their traditional role as subsidized non-profit organisations in order to become more self-supporting. Internationally, audience development in the arts industry has focused on segmentation dimensions such as youth, mature aged individuals, geographic location (rural), individuals with disabilities, low income earners, and individuals with culturally diverse backgrounds. Most of these potential segments are under represented in the population of arts consumers in Australia, the United Kingdom, Singapore, and North America. Of those dimensions, segmentation of arts markets by cultural differences such as ethnic identity appears to be a somewhat under researched area. Hofstede's (1980) model of national cultural differences continues to be widely used as a basis for strategic and marketing decisions in international business. However, the cultural characteristics attributed to individuals in their country of birth are likely to change through immigration to another country. In this situation, the ability to predict the consumption behaviour of various ethnic groups is complicated by acculturation processes in which arrivals attempt to adapt to their new environment. Over time, this process has resulted in the emergence of bicultural individuals who are able to switch, at will, between their ethnic identity and an identity aligned with their host country, or a combination of both at any time. Ethnic identity and affiliation with ethnic groups can also change over time, suggesting challenges for arts marketing approaches, and the application of market segmentation theory in particular.

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Objective: To determine the relationship between personal, hormonal and lifestyle risk factors and surgically treated benign prostatic hyperplasia (BPH). Materials and methods: A population-based case–control study was conducted in Western Australia (WA) on men aged 40–75 years who were surgically treated at public and private hospitals for BPH during 2001–2002. Controls were recruited from the WA electoral roll. Cases and controls were compared with regard to demographic and lifestyle factors and proxy measures of hormonal status using logistic regression. Data were available for 398 cases and 471 controls. Results: No associations with BPH were found for family history of prostate cancer in father or brother, serving in the military in a combat area, pattern of baldness, smoking status, obesity, alcohol intake and occupational physical activity. The only inverse relationship was observed with heavy alcohol drinking (>30 g/day), however, this was not statistically significant. An increased risk of BPH, not statistically significant, was observed for British-born men compared to Australian born and for history of vasectomy. The analysis was repeated after excluding 28% of controls with moderate and severe symptoms of BPH and 7% of cases with mild symptoms prior to surgery, and our results remained essentially unchanged. Conclusions:The results suggest that there are few risk factors for BPH although perhaps country of birth, vasectomy and heavy alcohol consumption may be considered further.

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Contents:  Ideas of knowledge in practice / Struan Jacobs -- Information, knowledge, and wisdom in medical practice / P. B. Greenberg -- The practice of the psychiatrist / Alex Holmes -- Social work knowledge-in-practice / Heather D'Cruz -- Disability : a personal approach / Lisa Chaffey -- Knowledge in the making : an analytical psychology perspective / Joy Norton -- Knowledge to action in the practice of nursing / Alison Hutchinson, Tracey Bucknall -- The risky business of birth / Frances Sheean and Jennifer M. Cameron -- Skills for person-centred care : health professionals supporting chronic condition prevention and self-management / Sharon Lawn and Malcolm Battersby -- Knowledge and reasoning in practice : an example from physiotherapy and occupational therapy / Megan Smith ... [et al.] -- Using knowledge in the practice of dealing with addiction : an ideal worth aiming for / Peter Miller.

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The study, carried out within an infertility support group, concern disclosure of donor conception and its possible effects upon our constructions of conception, kinship and identity. It also examines perceptions of rights, information and its access or denial, knowledge/power, secrecy and the medicalization of reproduction.

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This study juxtaposed women's experiences of birth at home in rural Ethiopia where it is 'safe' with that in a modern health care setting where it is 'unsafe' because the distance from international maternal health policy to its implementation is vast and the 'pathway to maternal survival' can be circuitous.

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Background : Although the association between lower socioeconomic status (SES) and obesity in women in developed countries is well-documented, current evidence regarding the relationship between obesity in men and area-based SES (equivalised for advantage and disadvantage) is inconsistent. Therefore, we aimed to examine obesity, lifestyle behaviours, physical activity in different domains and demographics in men using area-based SES.

Methods :
We performed a descriptive cross-sectional study of 1467 randomly selected white men (mean age 56 year (inter-quartile range (IQR) = 39–73 year)) recruited from the Barwon Statistical Division, South Western Victoria, Australia between 2001–06.

Results :
Age-adjusted BMI, waist circumference, % fat and lean mass and blood pressure were inversely associated with SES, with differences between low and upper SES (P for difference <0.05), independent of country of birth. Age-adjusted lifestyle behaviours associated with obesity and/or adverse health (especially cardiovascular disease), were also associated with lower SES.

Conclusions :
Subjects from lower SES had greater measures of obesity despite being more physically active at work, but were less likely to be physically active in the domains of sports and/or leisure. These findings suggest the possible influence of lifestyle behaviours and occupation upon obesity in men and should be investigated further.

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The database contains the following clinical, questionnaire and socio-demographic data suitable for cross-sectional and longitudinal analyses:
-Body composition: dual-energy x-ray absorptiometry (DXA) measures of the lumbar spine (posterior-anterior projection), proximal femur, whole body and forearm (ultradistal forearm and distal 33%)
-Other clinical assessments: body weight, height, arm span, waist and hip circumferences, blood pressure, visual acuity, muscle strength, functional reach test and timed ‘up-&-go’ test.
-Mental health: Major axis psychiatric disorders diagnosed using a Structured Clinical Interview.
-Blood and urine collections: blood and urine collected after an overnight fast.
-Questionnaires: exposure to disease, use of medications and supplements, diet, mobility, physical activity, sleep, sun exposure, falls and fractures, alcohol and tobacco use, reproductive history, family history of fractures and disease, quality of life, pain, anxiety and depression.
-Socio-demographics: Country of birth, ethnicity, marital status, education, housing and employment status, occupation, socioeconomic Index for Areas (SEIFA) scores.

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Purpose – Baby boomers (people born between 1946 and 1964) are approaching retirement and there is concern about their preparation for their future health and wellbeing. Food shopping is likely to play a major role in their future lives. The purpose of this paper is to examine their reasons for choosing to buy food from particular shops and whether demographic characteristics and health status were associated with them.

Design/methodology/approach – A questionnaire survey was conducted among a random sample of 1,037 people aged between 40 and 71 years in Victoria, Australia. Respondents were asked to indicate, from a list, their reasons for choosing to shop at particular food outlets. Regression analysis was used to examine the relationships between respondents' demographics and health status and their reasons for shopping at the food stores.

Findings – Multivariate analysis showed that the reasons the respondents reported in choosing shops fell into four groups: saving, convenience, quality and healthy foods, and user-friendly environment. Saving was negatively related to income, age, level of education and also linked with country of birth, religious affiliation, and marital status. Convenience was negatively associated with age and also related to health status and religious affiliation. Quality/healthy food products were positively related to age but negatively associated with body mass index, and also linked to country of birth. User-friendly environment was negatively associated with income and education and related to gender and religious affiliation.

Originality/value – The paper's results show that stores could provide more information, perhaps as signage, to their recycling and health information facilities, particularly in low socio-economic status areas. Furthermore, the social status and religious associations confirm the view that shopping reflects broad societal affiliations among baby boomers. Shopping centres can be used to provide support for health and environmental sustainability promotions.

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Dataset includes patient demographics (gender, age, date-of-birth, language spoken at home, ATSI status), diagnosis (type-2 diabetes, heart disease), biophysical measures (height, weight, waist, BMI, cholesterol including LDL and HDL, hbA1c), depression and depression treatment, exercise, and patient goals.

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Aims To assess the role of migration from high-incidence countries, HIV/AIDS infection, and prevalence of multi-drug resistant organisms as contributors to tuberculosis (TB) incidence in New Zealand (NZ) relative to ongoing local transmission and reactivation of disease.

Methods TB notification data and laboratory data for the period 1995 to 2004 and population data from the 1996 and 2001 Census were used to calculate incidence rates of TB by age and ethnicity, country of birth (distinguishing high and low -incidence countries), and interval between migration and onset of disease. Published reports of multi-drug-resistant TB for the period 1995 to 2004 were reviewed. Anonymous HIV surveillance data held by AIDS Epidemiology Group were matched with coded and anonymised TB surveillance data to measure the extent of HIV/AIDS coinfection in notified TB cases.

Results Migration of people from high-TB incidence countries is the main source of TB in NZ. Of those who develop TB, a quarter does so within a year of migration, and a quarter of this group (mainly refugees) probably enter the country with pre-existing disease. Rates of local TB transmission and reactivation of old disease are declining steadily for NZ-born populations, except for NZ-born Māori and Pacific people under 40. HIV/AIDS and multi-drug-resistant organisms are not significant contributors to TB incidence in NZ and there is no indication that their role is increasing.

Conclusion TB incidence is not decreasing in NZ mainly due to migration of TB infected people from high-incidence countries and subsequent development of active disease in some of them in NZ. This finding emphasises the importance of regional and global TB control initiatives. Refugees and migrants are not acting as an important source of TB for most NZ-born populations. Those caring for them should have a high level of clinical suspicion for TB.

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Background: The effectiveness of lifestyle interventions in reducing diabetes incidence has been well established. Little is known, however, about factors influencing the reach of diabetes prevention programs. This study examines the predictors of enrolment in the Sydney Diabetes Prevention Program (SDPP), a community-based diabetes prevention program conducted in general practice, New South Wales, Australia from 2008–2011.

Methods:
SDPP was an effectiveness trial. Participating general practitioners (GPs) from three Divisions of General Practice invited individuals aged 50–65 years without known diabetes to complete the Australian Type 2 Diabetes Risk Assessment tool. Individuals at high risk of diabetes were invited to participate in a lifestyle modification program. A multivariate model using generalized estimating equations to control for clustering of enrolment outcomes by GPs was used to examine independent predictors of enrolment in the program. Predictors included age, gender, indigenous status, region of birth, socio-economic status, family history of diabetes, history of high glucose, use of anti-hypertensive medication, smoking status, fruit and vegetable intake, physical activity level and waist measurement.

Results:
Of the 1821 eligible people identified as high risk, one third chose not to enrol in the lifestyle program. In multivariant analysis, physically inactive individuals (OR: 1.48, P = 0.004) and those with a family history of diabetes (OR: 1.67, P = 0.000) and history of high blood glucose levels (OR: 1.48, P = 0.001) were significantly more likely to enrol in the program. However, high risk individuals who smoked (OR: 0.52, P = 0.000), were born in a country with high diabetes risk (OR: 0.52, P = 0.000), were taking blood pressure lowering medications (OR: 0.80, P = 0.040) and consumed little fruit and vegetables (OR: 0.76, P = 0.047) were significantly less likely to take up the program.

Conclusions: Targeted strategies are likely to be needed to engage groups such as smokers and high risk ethnic groups. Further research is required to better understand factors influencing enrolment in diabetes prevention programs in the primary health care setting, both at the GP and individual level.

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This chapter develops themes providing insights into the meaning of play-based learning and what it means to practitioners working in a range of contexts with early learners in the age range of birth to eight years. Play-based learning is defined as young learners constructing knowledge as they explore, experiment, discover and solve problems in playful and unique ways. Development is linked to play and viewed as a pattern of continuous, interrelated changes that begins at birth and continue through life span whilst learning is a change in behaviour. In the early years it is through experience in play that learning occurs. The definition of curriculum in this chapter presents a context for young learners demonstrating how play-based learning is fundamental to the well-being of young learners, be they infants, babies, toddlers, pre-schoolers or school aged children.

The diversity of backgrounds of young learners is recognised and provision has to be made in the curriculum for a rich diversity of learners. The Chapter also considers how a socio-constructivist theoretical orientation in the curriculum can be created with children and adults co-constructing knowledge with play-based learning as the framework.

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Background:
Ethnic diversity is increasing through migration in many developed countries. Evidence indicates that 
type 2 diabetes mellitus (T2DM) prevalence varies by ethnicity and socio- economic status (SES), and that in many settings, migrants experience a disproportionate burden of disease compared with locally-born groups. Given Australia’s multicultural demography, we sought to identify groups at high risk of T2DM in Victoria, Australia.

Methods:
Using population data from the Australian National Census and diabetes data from the National Diabetes Services Scheme, prevalence of T2DM among immigrant groups in Victoria in January 2010 was investigated, and prevalence odds versus Australian- born residents estimated. Distribution of T2DM by SES was also examined.
Results:
Prevalence of diagnosed T2DM in Victoria was 4.1% (n = 98671) in men and 3.5% (n = 87608) in women. Of those with T2DM, over 1 in 5 born in Oceania and in Southern and Central Asia were aged under 50 years. For both men and women, odds of T2DM were higher for all migrant groups than the Australian-born reference population, including, after adjusting for age and SES, 6.3 and 7.2 times higher for men and women born in the Pacific Islands, respectively, and 5.2 and 5.0 times higher for men and women born in Southern and Central Asia, respectively. Effects of SES varied by region of birth.
Conclusions:
Large socio-cultural differences exist in the distribution of T2DM. Across all socio-economic strata, all migrant groups have higher prevalence of T2DM than the Australian-born population. With increasing migration, this health gap potentially has implications for health service planning and delivery, policy and preventive efforts in Australia.

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As a child of Chilean migrants I have always felt a strong affinity with the displaced and vulnerable. It would be as difficult to change this as it would be to change my place of birth for this is my inheritance. By this i mean the physics of who I am - woman, non- white, Chilean born; the social milieu and economic conditions that I was born into - Catholic and working class; and the politics that i have adopted - a commitment to social and political reform.

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Background: Much of the quantitative research on maternal mortality in developing countries focuses on the need for health service interventions such as skilled attendants at birth and emergency obstetric and newborn care. A growing number of studies document the need for a more comprehensive perspective and include the macrostructural, that is, the social, cultural, economic and political determinants of health.
Objectives: To examine the salient aspects of birth at home and variables that influence decision making around transfer to a health facility during prolonged/obstructed labor.
Methods: Ethnography using participant observation and semi-structured interviews was conducted in 2007. A total of 56 mothers in Kafa Zone were selected: 20 in-depth interviews with women who gave birth at home; four who gave birth in a health facility; and 32 during antenatal care. Interviews were also conducted with health staff from Bonga Hospital and 15 health centers or health posts. Analysis followed a process of data reduction, data display and conclusion drawing/verification with the data organized around key themes.
Results: Most women gave birth at home assisted by their neighbor, mother, mother-in-law, or husband. It is likely women who gave birth at home feel ‘safe’ because that is where birth normally takes place and where they feel supported by close relatives and neighbors. Prolonged labor or ‘waiting-to-see’ if the baby would come was somewhat normalized and resulted in considerable delays to seeking assistance. Women felt it was ‘unsafe’ to go to a health facility because of the very real possibility that they would die on the way.
Conclusion: The findings highlight the importance of educating the local communities to recognize pregnancy related risks and to develop and implement appropriate responses, especially early referral, as communities play an important mobilizing role to health services.