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A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno‐specific nursing homes create the ideal social condition for residents to express their care needs and preferences in a language of choice. In nonethno‐specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences. [ABSTRACT FROM AUTHOR]

Background: Depression among older adults is a frequent and underdiagnosed condition. However, there is a paucity of research on mental health problems among elderly people in Arab countries. The purpose of this study was to describe the risk of depression among a representative sample of older Lebanese adults living in rural areas and to identify gender‐specific factors associated with depression risk. Methods: This study included a randomly selected sample of 823 rural elderly people aged ≥65 years without cognitive decline. Data, including sociodemographic characteristics, living condition, health and functional status, were collected during face‐to‐face interviews. Depression was assessed by the five‐item Geriatric Depression Scale. Results: Risk for depression was significantly higher in women than in men (39.5% vs 26.2%, P < 0.001). Among men, reporting a higher versus a lower income (adjusted odds ratio (AOR) = 0.299) and being physically active significantly decreased the odds of depressive symptoms. In addition, physical disability (AOR = 3.03) and a high level of loneliness (AOR = 41.76) were significantly related to an increased risk of depression. Among women, daily or occasional physical activity was related to a reduced risk of depression compared to sedentary lifestyles (AOR = 0.35; AOR = 0.50). Furthermore digestive symptoms (AOR = 1.98), poor nutritional status (AOR = 1.99), and strong feelings of loneliness (AOR = 10.86) were significantly related to an increased odds of depression. Conclusion: Elderly Lebanese people, especially women, were at high risk for depression. Among other gender‐specific factors, loneliness was strongly associated with depressive disorders in both genders, with a four times greater odds ratio in men than in women. [ABSTRACT FROM AUTHOR]

Aim: Neuroendocrine tumors (NETs) are an uncommon cancer and difficult to diagnose and treat. Treatment is complicated by debilitating side effects, impacting quality of life. This Australia‐wide survey aimed to increase our understanding of the impact and burden of NETs on patient quality of life (QoL) and to assess the benefit of a patient support program (eSHINE). Method: Consented patients from the eSHINE mailing list (n = 267) were invited to participate in an electronic self‐reported survey comprising 29 questions on clinical characteristics, diagnosis, sociodemographics, impact of living with NETs and benefits of a patient support program. No formal sample size was calculated. All analyses were descriptive. Results: A total of 144 participants (54%) responded. A total of 129 (48%) completed all questions. Approximately half of respondents were female, from metropolitan and rural areas, aged over 65 years and had a primary diagnosis of gastrointestinal NETs. Fifty‐eight percent had been diagnosed over 5 years ago. Twenty‐seven percent reported seeing four or more healthcare professionals prior to being diagnosed. Living with NETs had a large impact on patients' QoL. 83.5% reported fatigue, 76% felt their emotional health was impacted by NETs and 75% reported reduced ability to participate in leisure activities. Access to a supportive network to manage and treat NETs was extremely important to participants. Eighty‐five percent of respondents reported the eSHINE program had a positive impact on their QoL. Conclusion: Patients value support from healthcare professionals and patient support programs such as eSHINE in managing NETs. The eSHINE Patient Support Program has a positive impact on patient QoL. [ABSTRACT FROM AUTHOR]

Objective: To describe the epidemiology, critical care resource use of and outcomes from an intensive care admission for a skin or soft tissue infection in Central Australia. Design: Retrospective database review of prospectively collected data identifying all patients requiring admission for a life‐threatening illness related to a skin or soft tissue infection. Setting: Intensive care unit Alice Springs Hospital. Participants: All patients admitted with a primary diagnosis of skin or soft tissue infection between 2010 and 2016. Main outcome measure: Annualised incidence of skin or soft tissue infection requiring intensive care. Secondary outcomes examined resource use (length of stay, mechanical ventilation) and a description of the microbiology of skin or soft tissue infection in Central Australia. Results: There were 80 admissions to the intensive care unit over the sampling period, yielding an annualised incidence of 24.2 intensive care unit admissions per 100 000 population. Eighty‐five per cent were Indigenous with high rates of co‐morbid disease including poorly controlled type 2 diabetes, haemodialysis‐dependent chronic kidney disease and co‐infection with human T‐cell lymphocytic virus. The predominant type of skin or soft tissue infection was abscess, predominantly below the waist. Gram‐positive cocci comprised 50% of the organisms cultured, and 20% of organisms were multi‐resistant. Mortality was 0% and 1.3% at 28 and 90 days respectively. Conclusion: The annualised incidence of skin or soft tissue infection requiring intensive care support in Central Australia is higher than expected. This probably reflects the high burden of chronic disease and poor living conditions. While there is no mortality burden associated with skin or soft tissue infection in Central Australia, there is substantial morbidity. The data from this study adds weight to the call for improved primary health resources for this group. [ABSTRACT FROM AUTHOR]

This paper presents a conceptual and methodological approach for researching social conditions to understand how urban change and development affects a community and its residents. Manaus, in Brazil's Amazonia region, received much criticism after US$300 million that was spent on a 40,000+ seat (upgraded) stadium in a city with no regular sporting tournaments. This paper positions the need to look beyond tangible features and assess social impacts based on community perceptions using ethnography to locate local meanings of social transformation. Attention is needed in communities adjacent to new stadium developments in Manaus to understand inclusion, exclusion and social leveraging. [ABSTRACT FROM AUTHOR]

In this paper, I discuss the question of partiality and impartiality in the application of triage. Triage is a process in medical research which recommends that patients should be sorted for treatment according to the degree or severity of their injury. In employing the triage protocol, however, the question of partiality arises because socially vulnerable groups will be neglected since there is the likelihood that the social determinants of a patient's health may diminish her chance of survival. As a process that is based on the severity of a patient's injury, triage will be unfair, and hence negatively partial, to socially vulnerable people. Thus, I aim in this paper to show that the triage protocol fails as an impartial evaluative process because its only aim is to maximize survivability. I contend that: (i) triage would lead to the neglect of the social condition of patients or victims, and (ii) it will only serve the utilitarian purpose of maximization of outcomes which may not be justified in some cases. [ABSTRACT FROM AUTHOR]

To take up the AJCP editor's call to think forward in this article, I offer up three challenges that revolve around further contextualizing our understandings of diversity, i.e., reconsidering the notion of "difference" between discrete categories; more fully emphasizing diversity as socially situated; and further delving into local, setting-specific practices that shape the meanings of diversity. Enhanced attention to these three challenges can transform theory, research, and action about diversity as we move into community psychology's next 50 years. [ABSTRACT FROM AUTHOR]

This position paper outlines the areas of competence and learning outcomes of 'The Graduating European Dentist' that specifically relates to Dentistry in Society. In addition to treating individual patients, a Dentist must be able to focus on promoting health, monitoring interventions and implementing effective strategies of care at community and population levels. This necessarily involves understanding population demography and health trends, engaging with health policy and promoting health. A Dentist must also understand population demography and health trends, in the context of the healthcare system within which they work. [ABSTRACT FROM AUTHOR]

AJSI had its genesis in the Department of Social Work at the University of Sydney in 1961. Since that time both social work and the AJSI have developed and drifted apart. This paper charts this journey and points to a future where social work and AJSI will function as partners in critiquing social policy and social issues. [ABSTRACT FROM AUTHOR]

Today, most persons with Down syndrome (DS) survive into middle age, but information on their social conditions as adults is limited. We addressed this knowledge gap using data from national registers in Denmark. We identified a national cohort of 1,998 persons with DS who were born between 1968 and 2007 (1,852 with standard trisomy 21, 80 with Robertsonian translocations and 66 with mosaicism) using the Danish Cytogenetic Register. We followed this cohort from 1980 to 2007. Information on social conditions (education, employment, source of income, marital status, etc.) was obtained by linkages to national registers, including the Integrated Database for Longitudinal Labor Market Research. For those aged 18 and older, more than 80% of persons with DS attended 10 years of primary school, with about 2% completing secondary or post-secondary education. About 4% obtained a full-time job, whereas the remaining mainly received public support from the government. Only a few (1-2%) of persons with DS were married or had a child. No significant differences in these social conditions were seen between males and females. More persons with mosaic DS attended secondary or post-secondary education, had a full-time job, were married, or had a child (18%, 28%, 15%, and 7%, respectively), compared with persons with standard DS (1%, 2%, 1%, and 1%, respectively). These data may provide families with better insight into social conditions and society with a better understanding of the social support needed for persons with DS. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective To describe the spatial distribution of lymphatic filariasis and its relationship with the socioenvironmental risk indicator, thus identifying priority localities for interventions in endemic urban areas. Methods The study area was the municipality of Jaboatão dos Guararapes, State of Pernambuco, Brazil. The data sources were a parasitological survey and the 2000 demographic census. From these data, a socioenvironmental composite risk indicator was constructed using the 484 census tracts (CT) as the analysis units, based on the score-formation technique. Census tracts with higher indicator values presented higher risk of occurrences of filariasis. Results Six thousand five hundred and seven households were surveyed and 23 673 individuals were examined, among whom 323 cases of microfilaremia were identified. The mean prevalence rate for the municipality was 1.4%. The indicator showed that 73% (237/323) of the cases of microfilaremia were in high-risk areas (third and fourth quartiles) with worse socioenvironmental conditions (RR = 4.86, CI = 3.09–7.73, P < 0.05). Conclusions The socioenvironmental composite risk indicator demonstrated sensitivity, since it was able to identify the localities with greater occurrence of infection. Because it can stratify spaces by using official and available data, it constitutes an important tool for use in the worldwide program for eliminating lymphatic filariasis. [ABSTRACT FROM AUTHOR]

The author uses an anthropological perspective to consider how certain social conditions of training institutes, through the stresses they evoke, render trainees susceptible to the instruction of seniors. And depending on that which seniors advocate –‘inclusive’ or ‘closed’ therapeutic adherence – trainees will be influenced in that direction as practitioners. In this sense the internalization of clinical perspectives is facilitated by certain exacting conditions of psychotherapeutic training which generate this anxiety. This argument exposes for those desiring clinical reform two sites at which it might be profitably directed: at the social conditions of the training institute which arouse susceptibilities, or else at the instruction, which, by capitalizing on such susceptibilities, inculcates particular clinical values and perspectives. He concludes that if changes are to be brought to such perspectives then it is the social conditions of the training institute that need to be altered. [ABSTRACT FROM AUTHOR]

The article provides an analysis of three historical forms of political subjectivity in South-Central Peru: the montoneros, the gamonales and the post-conflict politicos. Based upon a historical sociology of puna–valley relations, the article suggests that subjectivities should be read not as emanating from either side of the racialised misti– Indio divide, but instead as fractals of this. [ABSTRACT FROM AUTHOR]

The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-of-life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end-of-life is essential. There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end-of-life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general . [ABSTRACT FROM AUTHOR]

Aim: With the increasing incidence of HIV and TB, motherless children are becoming a rapidly growing problem in Africa. However, few studies describe the survival patterns of these children. The aim of this study was to investigate the mortality of motherless children in urban and rural areas of Guinea-Bissau. Methods: A historical cohort study was set up in urban and rural areas in Guinea-Bissau. Motherless children were selected from two study cohorts under demographic surveillance since 1990. The relatives of 128 motherless children from the rural cohort and 192 from the urban area, as well as a total of 807 controls, were examined and interviewed. Results: Controlling for significant background factors revealed that motherless children had a markedly higher mortality than that of controls in both urban (mortality rate ratio (MR) 2.32 (95% confidence interval 1.11-4.84)) and rural areas (MR = 4.16 (2.79-6.22)). Virtually all the excess mortality occurred among children under 2 y of age when their mother died. Few motherless children had been provided with surrogate breastfeeding. Conclusions: Since nearly all children in Guinea are breastfed until 2 y of age, premature weaning may be one of the major causes of the higher mortality rates observed among motherless children. [ABSTRACT FROM AUTHOR]

Three hundred French 14-l 5-yr-old adolescents were randomly selected. They were examined clinically and caries experience was determined by using the DMFS index. The aim of this investigation was to evaluate children's habits using a self-administered questionnaire, to clarify the actual influence of well-known factors such as fluoride exposure, diet, oral hygiene and socioeconomic factors on caries experience and to stress those factors of primary importance. A multiple regression analysis revealed the variables which significatively contributed to explain DMFS scores in a final model: Age, sex, frequency of sweet consumption, use of standard or high fluoride toothpastes, bleeding during toothbrushing, living in St Yorre (F - =0.45 mg/l). At at time when caries experience is decreasing, it seems that fluoride supply, snacking and oral hygiene are still independent and significant determinants of caries experience in French adolescents. [ABSTRACT FROM AUTHOR]

A study of caries experience and gingivitis prevalence in 6-, 9- and 12- yr-old children attending primary schools in Brisbane was undertaken in November/ December 1983. Children from high socioeconomic level (SEL) schools exhibited lower dmft and DMFT scores at all ages. At age 6 yr the proportion of children with caries-free primary dentitions was for high SEL Schools 70%, for middle SEL schools 52% and for low SEL Schools 23%. At 12 yr DMFT scores were 1.8 (high), 2.1 (middle) and 3.3 (low). Similar differences in gingivitis prevalence occurred, children from high SEL schools displaying a much lower proportion of bleeding sites than those from middle and low SEL schools. For selection of children at "high risk" to gingival disease for intensive prevention programmes, an increased emphasis on probing techniques is indicated to achieve diagnostic consistency. [ABSTRACT FROM AUTHOR]

The records of 350 consecutive patients referred 2½ years previously were examined retrospectively for clinical findings, diagnoses and observations related to treatment. There was a good correlation between the severity of symptoms reported by the patients in a questionnaire at the first visit and the clinical dysfunction index. The female patients had higher dysfunction index values than the men, while the occlusal index was equally distributed in both sexes. The most frequently used treatment methods were bite planes, occlusal adjustment and jaw exercises. There was a wide variation in the length of the treatment period and number of visits but the median values for these variables were 3 and 4 months, respectively, which is encouraging in view of the fact that the duration of the symptoms before the start of treatment was more than 6 months in two-thirds of the patients. Patients who had reported severe symptoms and those who were in a "poor social situation" had higher clinical dysfunction index values at the first visit, had more visits to the clinic and required a longer treatment period than others but they did not differ regarding the evaluation of the clinical situation at termination of treatment. [ABSTRACT FROM AUTHOR]

All 350 patients referred to the Department of Stomatognathic Physiology during a 4- month period were given a self-administered questionnaire intended to give a review of the patients' history. The questions concerning general somatic and psychic health, education and social conditions are dealt with in this article. Twenty-five percent of the patients, more women than men, considered their general state of health to be impaired or poor. Seventy-two percent of the patients denied having had nervous or psychic disorders while 9% were currently being treated for such symptoms. Patients who had answered with alternatives indicating a "poor social situation" had, for instance, more pain in the Lace and,jaws, poorer general health, more nervous or psychic disorders and more symptoms of TMJ disorders than the other patients. When the influence of education was considered, the patients with low education reported more severe symptoms of TMJ disorders than those with higher education. The general level of somatic and psychic health of the patients in this study did not differ markedly from that of the general population, but a negative influence on the health of the masticatory system of poor social conditions and low educational level could be demonstrated. [ABSTRACT FROM AUTHOR]

The relationship between background characteristics, stress, reported symptoms and clinical findings was studied in a group comprising 333 patients with Myofascial Pain Dysfunction Syndrome (MPD) . Three-quarters of this clientele were women, most of them of young or middle age. The stressors most frequently reported were pressed working conditions, anxiety and frustration deriving from disease, and family problems. Of the symptoms, pain was reported by 78 % of the patients, clicking by 53 %, limitation of movement by 44 % and feeling of stiffness and fatigue of masticatory muscles by 41%. Significant correlations were found between a number of variables, of which the close relationship between perceived pressors and muscle groups painful to palpation was considered to be of paramount importance. The data were combined into a hypothetic model postulating causal relations. The model was intended for testing and modification in coming studies. [ABSTRACT FROM AUTHOR]

Objective: To explore how medieval living conditions, occupation, and an individual's role within society impacted their risk of skeletal trauma., Materials: The skeletal remains of 314 individuals from medieval Cambridge that were buried in the parish cemetery of All Saints by the Castle (n = 84), the Augustinian friary (n = 75), and the cemetery of the Hospital of St John the Evangelist (n = 155) were analyzed., Methods: Macroscopic examination and plain radiographs were used to classify fracture type. The causative mechanisms and forces applied to a bone were inferred based on fracture morphology., Results: The skeletal trauma observed represents accidental injuries, likely sustained through occupational or everyday activities, and violence. The highest prevalence rate was observed on the individuals buried at All Saints by the Castle (44%, n = 37/84), and the lowest was seen at the Hospital of St John (27%, n = 42/155). Fractures were more prevalent in males (40%, n = 57/143) than females (26%, n = 25/95)., Conclusions: Skeletal trauma was highest in All Saints parish burial ground, indicating that the poor, whether working urban or rurally, had the highest risk of injury. The pattern and types of fractures observed suggests that males experienced more severe traumatic events than females. However, females that were routinely involved in manual labor were also at increased risk of injury., Significance: This article enhances our understanding of how traumatic injuries differed by age, sex, and burial locations in the medieval period., Further Research: Additional comparative studies in different geographical regions are needed to determine how representative these findings are., (© 2021 The Authors. American Journal of Physical Anthropology published by Wiley Periodicals LLC.)

Abstract In today’s modern, industrialized and affluent countries, like Japan and Australia, better living conditions and hygiene, plentiful nutritious food and rapid advances in biology and medical technologies have helped to bring about dramatic improvements in child health. The previous heavy burdens of infections and undernutrition have been eliminated or can now be controlled or effectively treated. In these countries, child health standards are higher than ever and expectation of life at birth is much higher than in the past. Some of the technological advances that have helped bring about this transformation are immunization, antimicrobial therapy, successful treatment of childhood leukemias, transplantation of vital organs and implementation of genetic diagnosis and gene therapy. The use of genetically modified foods and the prospects for cloning of humans are areas of intense interest and controversy. However, these advances have their disadvantages (e.g. antibiotic-induced drug resistance). Urbanization has encouraged the ‘westernization’ of dietary patterns and the long-term ‘lifestyle diseases’ that can follow in adults. Accidents, violence and drug abuse are major problems in many parts of the world. Changes in attitudes to sexuality and the spread of HIV/AIDS is another major problem, especially in Africa and Asia. Environmental pollution and the degradation of agricultural lands, rivers and seas are also important. Ironically, standards of child health and the prospects for long life in countries like Japan are better than ever before, but social and environmental changes are presenting children and their carers with new and unanswered challenges as we enter the 21st century and the new millennium. [ABSTRACT FROM AUTHOR]

Rationale, Aims, and Objectives: Consumer-based activity trackers aim at quantifying physical activity in a wide range of contexts. Nevertheless, they need to be validated before they are confidently used. This study assessed the concurrent validity of the Nokia Go against reference devices, according to different sensor locations, in two measurement conditions: during a walking task and during a 24-hour free-living condition., Methods: We examined the agreement between devices and between locations in the number of steps and total sleep time by using intraclass correlation coefficient and Bland-Altman method., Results: In the walking task, the agreement is good to excellent for steps between the Nokia Go and the reference device. In the free-living condition, there is a systematic underestimation of steps in comparison with the ActiGraph. Excellent agreement was found between locations. The device worn at the hip indicated the lowest number of steps, and the device located at the dominant wrist indicated the greatest number of steps., Conclusions: There are high discrepancies in step count between devices because of the different types of activities in daily life. The Nokia Go may be confidently used for step counting during pure walking tasks, at different locations. However, the lack of concurrent validity with ActiGraph call for caution regarding their use in daily living conditions., (© 2019 John Wiley & Sons, Ltd.)

Objective: To analyze potential biosocial factors in consanguineous unions according to the level of consanguinity and its spatial distribution in South America., Methods: The data used came from the Latin American Collaborative Study of Congenital Malformations. Information on 126,213 nonmalformed newborns out of 6,014,749 births was used. This information was collected between 1967 and 2011 at 204 hospitals in 116 cities in 10 South American countries. The spatial scan statistic was performed under a model of nonhierarchical k-means segmentation, based on statistically significant clusters, areas with levels of high, medium, and low consanguinity were determined., Results: Consanguinity in South America is heterogeneously distributed, with two groups of high consanguinity, in northwestern Venezuela and southeast of Brazil, and two clusters of low consanguinity located in the south of the continent, mainly Argentina. The socio-demographic factors associated with consanguinity influence the population structure in areas of high consanguinity., Conclusions: This study demonstrates that consanguinity in the South American continent is strongly associated with a greater magnitude of poverty in the area of high consanguinity. Am. J. Hum. Biol. 28:405-411, 2016. © 2015 Wiley Periodicals, Inc., (© 2015 Wiley Periodicals, Inc.)

Aims: To examine the barriers and facilitators to effective operation of a regional tobacco control coordinator working within and across criminal justice and public health, whose goal was to raise tobacco control awareness and support the development of smoking cessation treatment for offenders., Design: A reflexive, mixed-methods case study approach using in-depth interviews, project reports and observation of advisory board meetings., Setting: The coordinator worked with prisons, probation and police custody, where there are high levels of social disadvantage and smoking., Participants: Interviews (n = 34) at different stages of project with the coordinator, project advisers and local stakeholders from criminal justice and public health., Measurements: Analysis of facilitators and barriers and the coordinator role from different perspectives., Findings: Readiness to develop cessation services was a critical predictor of different criminal justice settings' engagement with the coordinator role. The coordinator enhanced cessation service delivery in individual prisons where there was a requirement and infrastructure in place to provide such services. In police custody, where there was no central guidance or pre-existing requirements, efforts to establish smoking cessation on the local agenda proved ineffective. In probation settings, the coordinator documented examples of good practice and supported brief intervention training. Variability in willingness to engage limited the project's ability to create joined-up working across criminal justice settings., Conclusions: In the English criminal justice system, the prison service appears to provide a favourable context for development of smoking cessation support and a means of accessing hard-to-reach groups. Other criminal justice settings, most specifically police custody, appear less responsive to such activity. A coordinator role can improve smoking cessation support in the prison setting, and develop local improvements in tobacco control interventions in other settings such as probation, but as configured here, does not have the capacity to effect change across the criminal justice system., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

Kinship systems which tend to be based on ecologies of subsistence also assign differential power, privilege, and control to human connections that present pathways for manipulation of resource access and transfer. They can be used in this way to channel resource concentrations in women and hence their reproductive value. Thus, strategic female life course trade-offs and their timing are likely to be responsive to changing preferences for qualities in women as economic conditions change. Female life histories are studied in two ethnic groups with differing kinship systems in NE India where the competitive market economy is now being felt by most households. Patrilineal Bengali (599 women) practice patrilocal residence with village exogamy and matrilineal Khasi (656 women) follow matrilocal residence with village endogamy, both also normatively preferring three-generation extended households. These households have helpful senior women and significantly greater income. Age at first reproduction (AFR), achieved adult growth (height) and educational level (greater than 6 years or less) are examined in reproductive women, ages 16-50. In both groups, women residing normatively are older at AFR and taller than women residing nonnormatively. More education is also associated with senior women. Thus, normative residence may place a woman in the best reproductive location, and those with higher reproductive and productive potential are often chosen as households face competitive market conditions. In both groups residing in favorable reproductive locations is associated with a faster pace of fertility among women, as well as lower offspring mortality among Khasi, to compensate for a later start., (2009 Wiley-Liss, Inc.)

The present article identifies how social determinants of health raise two categories of philosophical problems that also fall within the smaller domain of ethics; one set pertains to the philosophy of epidemiology, and the second set pertains to the philosophy of health and social justice. After reviewing these two categories of ethical concerns, the limited conclusion made is that identifying and responding to social determinants of health requires inter-disciplinary reasoning across epidemiology and philosophy. For the reasoning used in epidemiology to be sound, for its scope and (moral) purpose as a science to be clarified as well as for social justice theory to be relevant and coherent, epidemiology and philosophy need to forge a meaningful exchange of ideas that happens in both directions.

The purpose of the study reported here was to investigate two important assumptions used in a recently reported new method of estimating inbreeding in large, relatively isolated populations over historic times. The method, based on modeling the genealogical "paradox," produces values of Pearl's coefficients, Z, a measure of inbreeding or genealogical coalescence, as a function of time. In this study, the effects on inbreeding of two important assumptions made in earlier studies, namely those of using a constant generation length and of ignoring migration, have been investigated for the population of Britain. First, by relating the median age of women at childbirth to the development level of various societies, the variation of the generation lengths for different periods in historic Britain were estimated. Values of Z for two types of varying generation lengths were then calculated and compared with the case of constant generation length. Second, the population curve for Britain used in earlier studies was modified to obtain the subpopulation at any time during the past two millennia that was descended from the pre-Roman British Celts. Values of Z for the case with migration were then calculated and compared with the case for no migration. It is shown that these two assumptions may be taken into account if and when required. Both the effect of a varying generation length and the effect of migration on Z were found to be 20-40%, when no known value of inbreeding was used, and 2-5%, when a known value of inbreeding was used.

Objective: To study the portrayal of mental illness (especially psychosis) in Hindi films since 1950 and to study the influence of prevalent social, political and economic factors on each portrayal., Method: Using two encyclopedias and one source book, films that had mental illness affecting one of the protagonists were identified. The social, economic and political factors were identified using history texts., Results: In the 1960s after India became a Republic, the political climate was one of idealism and as a result the portrayal of mental illness was gentle, more international in its outlook, and used psychoanalytic techniques. In the 1970s and 1980s, as a result of increased political and bureaucratic corruption and an unstable political climate, the portrayals became harder and psychopaths were portrayed more often. In the 1980s, the trend continued with female psychopaths, and avenging women emerged as a major force because the political and judicial systems were seen as impotent in delivering justice. In the 1990s, following economic liberalization, the women were seen and used as possessions in society and the cinema, and portrayals of stalking and morbid jealousy increased., Conclusion: Hindi films since the 1950s appear to have been influenced by changing cultural norms which in turn affected the way mental illness is portrayed.

We examined the link between drug use stigma and use of drug treatment services in a sample of 292 heterosexually identified, methamphetamine (meth) users. Participants who had ever been in treatment for their meth use (N = 82) were compared with those who had never been in treatment (N = 210). Three dimensions of stigma proposed by Link et al.(1) were examined. In univariate analyses, participants who had never been in treatment for meth use reported significantly more expectations of rejection and endorsed more stigma coping strategies as compared to those who had ever been in treatment. Regression analysis revealed that all three dimensions of stigma distinguished between participants who did and did not receive treatment for their meth use. Stigma is discussed as a potential barrier to drug use treatment.

Objective: To assess the societal costs and quality of life of patients suffering from bipolar disorder in the Netherlands., Method: Forty persons with a lifetime diagnosis of bipolar disorder (SCID/DSM-IV) and representative for the Dutch general population were interviewed to collect data on direct (use of medical resources) and indirect (productivity losses because of absence from work and reduced efficiency at work) costs of illness. Respondents' quality of life was also assessed. Prevalence (5.2%) of bipolar disorder was used to estimate total costs., Results: Total costs of bipolar disorder were estimated at US 1.83 billion dollars (total direct costs = US 454 million dollars; total indirect costs = US 1.37 billion dollars). Participants' quality-of-life scores were lower than those of the general population., Conclusion: The societal costs form patients suffering of bipolar disorder in the Netherlands were high, especially the indirect costs because of absence from work. The quality of life of bipolar patients was lower than the general population.

An increased clinical interest in shame has been reflected in the growing number of research studies in this area. However, clinically orientated empirical investigation has mostly been restricted to the investigation of individual differences in dispositional shame. This study reviews recent work on dispositional shame but then argues that the primacy of this construct has been problematic in a number of ways. Most importantly, the notion of shame as a context-free intrapsychic variable has distracted clinical researchers from investigating the management and repair of experiences of shame and shameful identities and has made the social constitution of shame less visible. Several suggestions are made for alternative ways in which susceptibility to shame could be conceptualized, which consider how shame might arise in certain contexts and as a product of particular social encounters. For example, persistent difficulties with shame may relate to the salience of stigmatizing discourses within a particular social context, the roles or subject positions available to an individual, the establishment of a repertoire of context-relevant shame avoidance strategies and the personal meaning of shamefulness.

Objective: Previous studies associating neighbourhood context with mental health service use typically included limited sets of confounders., Method: A data set including patients registered in a Case Register and population controls was subjected to multilevel analyses, including neighbourhood exposures and individual level confounders. In addition, days of care consumption of patients was addressed., Results: The association between socioeconomic deprivation and social capital on the one hand and mental health service use rates on the other could be attributed to individual level differences. However, number of days of service consumption was higher in neighbourhoods with more informal social control. In residentially stable neighbourhoods only, socioeconomic deprivation was associated with lower levels of service consumption., Conclusion: Higher levels of social control may induce patients to remain in contact with mental health services. Furthermore, higher levels of deprivation in neighbourhoods with little population mobility may result in reduced expectations of recovery and/or increased tolerance.

The objective of this research was to document and explore British university students' immediate understanding of the events of September 11th. A network analysis of lay causal perceptions procedure was employed to capture the social perceptions and sense-making of respondents at a time when they and the world struggled to impose meaning and coherence on the events. The study also examined the possible effects of 'belief in a just world' and 'right-wing authoritarianism' on the pattern of perceived causes. The results suggest that most participants perceive cultural and religious differences, the history of conflict in the Middle East, unfairness and prejudice as being the distal causes of the individual agent's emotions and actions. There is also some evidence that right-wing authoritarianism and belief in a just world have an interactive effect on the strength of the perceived link between some of these causes.

Objective: To investigate the relationship between the prevalence of schizophrenia and measures of social deprivation in varying areas in the city of Malmö., Method: A case-finding study of schizophrenia was combined with a victimization survey. Data was factor-analysed and visualized using geographical information system software., Results: The schizophrenic patients lived predominantly in socially disorganized areas characterized by high levels of disorder, fear of crime and victimization. The local prevalence of schizophrenia covaried significantly with all indices of social disorganization. In addition, a significant but weak association was obtained between prevalence of schizophrenia and fear of specific persons in the neighbourhood., Conclusion: In spite of enormous changes in social conditions, psychiatric knowledge and organization of treatment, and political ambitions, schizophrenic patients still aggregate in socially deprived areas. This segregation may result in worsening of the illness as well as increasing the social disorganization in the local domicile.

Recent progress in developmental neurobiology and neuroimaging can be drawn together to provide new insight into the links between genetically specified processes of embryonic brain development and adult human brain structure and function. We used magnetic resonance imaging (MRI) to show that individuals with aniridia and deficits in executive and social cognition, due to heterozygous mutation of the neurodevelopmental control gene PAX6, have structural abnormalities of grey matter in anterior cingulate cortex, cerebellum and medial temporal lobe, as well as white matter deficits in corpus callosum. Functional MRI demonstrated reduced activation of fronto-striato-thalamic systems during performance of overt verbal fluency and nonsense sentence completion; the most consistent abnormality of verbal executive activation was located in the thalamus. These results provide the first evidence for brain functional differences in humans with PAX6 mutation that are compatible both with anatomical abnormalities in the same subjects and, more circumstantially, with the known roles of murine Pax6 in regional differentiation, axonal guidance and other aspects of early forebrain development. Highly conserved homeobox genes may be critical for normal ontogenesis of large-scale neurocognitive networks supporting phylogenetically advanced mental functions.

Objective: Emotional expression is an important means of coping with stressful experiences such as cancer. Social barriers to expression may have adverse effects. Research has suggested that men are less likely to express their emotions and have different patterns of social support compared to women. We examined whether male cancer patients have a lower tendency to express emotions, are less likely to perceive social barriers to expression, and are differentially affected by social barriers from different support sources as compared to women., Design: Questionnaires were administered to 41 women and 41 men using a cross-sectional study design., Method: Patients diagnosed with gynaecological or prostate cancer within the past 5 years completed questionnaires on moods, intrusive thoughts, social constraints and emotional expressivity., Results: There was a trend towards greater emotional expressivity in women as compared to men, but no significant gender differences in perceptions of social constraints from spouse/partner or others. Multiple regression analyses revealed that men experienced significantly greater distress in association with social constraints from their spouse/partner than did women., Conclusion: Men may be more vulnerable to social barriers to expression than previously assumed. Gender differences in emotional expressivity may be less important than the social context in which expression takes place.

Objective: This study explored contemporary understandings of the psychosocial costs and benefits associated with learning one's HIV status within a purposive sample of Scottish gay men. It seeks to provide insight into the psychosocial factors associated with decision-making processes relating to the HIV antibody test., Method: Transcripts of one-to-one interviews (N = 19) and four focus groups (N = 18) were analysed using Interpretative Phenomenological Analysis. Participants had varied HIV testing histories, and the sample included men who identified their HIV status as positive, men who identified it as negative, and men who did not know., Results: The HIV test could resolve doubt and anxiety for some men, but only when 'not knowing' was experienced as less tolerable than an imagined positive result. Many participants were deterred from seeking an HIV test because of their fears of the implications of a positive result. The decision to take an HIV test could be understood as a choice between living with uncertainty and the perceived impact of ascertaining HIV status., Conclusion: For the participants in this study, the decision to test or not involved many complex medical, psychological and social factors. It is argued that the development of HIV testing policy must start with a perspective grounded in an understanding and appreciation of these complexities.

Objectives: This study aimed to assess the level of body dissatisfaction and dieting awareness in young children., Method: A sample of 135 children aged between 5 and 8 years old were individually interviewed. Body dissatisfaction was assessed by means of figure preference ratings, and dieting awareness by responses to a brief scenario., Results: The difference between boys' ratings of current and ideal figures was not significant at any age; nor was that of 5-year-old girls. However, 6-, 7- and 8-year-old girls rated their ideal figure as significantly thinner than their current figure. For dieting awareness there was no significant gender effect, although level of dieting awareness increased with age. Multiple regression analyses showed that body dissatisfaction was predicted by gender and perception of mothers' body dissatisfaction, while age was the only significant predictor of dieting awareness., Conclusions: A substantial proportion of young children have internalized societal beliefs concerning the ideal body shape and are well aware of dieting as a means for achieving this ideal. In particular, the desire for thinness emerges in girls at around age 6.