Hearing Loss: Why Does It Matter for Nursing Homes?

Over the past decade, hearing loss has emerged as a key issue for aging and health. We describe why hearing loss may be especially disabling in nursing home settings and provide an estimate of prevalence using the Minimum Data Set (MDS v.3.0). We outline steps to mitigate hearing loss. Many solutions are inexpensive and low-tech, but require significant awareness and institutional commitment.     

Why Do Women Douche? Results from a Qualitative Study

Objectives: To explore women's attitudes and practices related to douching. Methods: We conducted focus groups between July and December 1999 with 34 black and 27 white women enrolled in a managed care plan in Memphis, Tennessee. Participants were at least 18 years of age and had douched at some time in their lives. Five groups were held with black women and five with white women. Results: The focus groups identified 13 themes that fell in four broad categories: general perceptions about feminine hygiene, douching behavior, factors perpetuating douching, and health information. Each of these categories is briefly discussed with supporting evidence. Conclusions: First, women have deeply-rooted beliefs about the critical role of douching in making them feel clean. Second, douching generally starts at a young age and is reinforced by family, friends, and the media. Third, douching is a very difficult behavior to change; any efforts to influence this behavior must consider women's beliefs and the media marketing efforts that promote douching. Finally, simplistic interventions that only provide risk information about douching are not likely to result in behavior change.     

Adolescents' Food Preferences in China: Do Household Living Arrangements Matter?

Family circumstance has long been considered one important factor that shapes children's eating habits including preferences for particular foods. However, less scholarly efforts have been devoted to understanding children's food preferences in extended family households. Drawn on data from the China Health and Nutrition Survey (CHNS) 2006 (n = 662), this exploratory study compares food preferences of adolescents living in extended families with those residing in nuclear families. T-test results show that adolescents living in extended families (n = 202) had unhealthier food preferences compared with those living in nuclear families (n = 460). They showed more liking for fast food, salted snack food, and sugared drinks, and less liking for vegetables and fruits. Regression results present that controlling for other relevant variables, household structure was significantly associated with adolescents' food preferences (p < .01). These results, albeit exploratory, shed light on possible nutritional education and intervention in the cultural context of China.     

Eliciting Children’s Perspectives of Risk and Protection in Liberia: How to Do It and Why Does It Matter?

Background

After 14 years of civil war and two rounds of democratic elections, Liberia is working to reduce child abuse and exploitation. Young children’s perceptions on protection and risk are rarely elicited to inform program planning and intervention.

Objective

The aim of the present study was to explore young children’s perceptions of child protection and risk in a post-conflict setting and how visual methodologies may facilitate this process.

Methods

Six group discussions using visual methodologies were conducted with 59 children aged 7–11 years living in family and residential care in rural and urban settings in Central and Western Liberia. Data were analysed using inductive coding.

Results

There was no unanimous concept of ‘child’, which included people with limited capabilities between the ages of 5–46 years. Children identified a number of risk and protective factors. Normative knowledge (e.g., smoking) elicited unanimous reactions whereas survival-related life experiences (e.g., violence or food) yielded ambivalent understandings of risk and protection. Visual methods facilitated active and thoughtful participation among young children.

Conclusions

These findings add to the scarce literature on child participation in public decision-making in child protection. They also have practical implications. Children’s own and community transmitted perceptions of life experiences need to be taken into account to inform service planning and implementation. Visual methods are recommended to that end as they increase participation among young children and help avoid pre-conceived notions of dangerous and protective practices.     

Disagreement Over Vaccination Programmes: Deep Or Merely Complex and Why Does It Matter?

This paper argues that significant aspects of the vaccination debate are ‘deep’ in a sense described by Robert Fogelin and others. Some commentators have suggested that such disagreements warrant rather threatening responses. I argue that appreciating that a disagreement is deep might have positive implications, changing our moral assessment of individuals and their decisions, shedding light on the limits of the obligation to give and respond to arguments in cases of moral disagreement, and providing an incentive to seek alternative ways of going on in the face of intractable moral disagreement. Non-coercive, non-reasoned strategies have been used or recommended to increase vaccination rates. Such strategies look problematic when judged by the standards of ideal moral and rational argumentation, but more acceptable if seen as responses to deep disagreements.     

Why yeast?

Yeast is an apparently strange "model" for the human genome, but it works because of the high degree of conservation in evolution between the primitive eukaryote and mammals. Moreover, the genic concentration in yeast--with almost no noncoding introns--packs the entire yeast genome into 16 chromosomes with only 10% of the DNA of one human chromosome.     

Silence and Cancer: Why Do Families and Patients Fail To Communicate?

This study examined the phenomenon of avoidance of family communication about cancer. Thirty-seven Stage III or IV lung cancer patients and 40 caregivers, including 24 primary and 16 secondary caregivers, were interviewed; a total of 26 families were studied. The interviews were audiotaped and transcribed. Analysis of the interviews indicated that two thirds of the families (65%) experienced communication problems. The avoidance of family communication was associated with several underlying thought processes: avoidance of psychological distress; desire for "mutual protection;" and belief in positive thinking. Family communication was further hindered by the increasing difficulty of issues inherent to late-stage cancer. The adverse impact of communication avoidance and the implications of our findings are discussed.     

Marital Quality and Divorce Decisions: How Do Premarital Cohabitation and Nonmarital Childbearing Matter?

This study used the 1979 cohort of the National Longitudinal Survey of Youth (N = 3,481) to test whether the association between marital quality and divorce is moderated by premarital cohabitation or nonmarital childbearing status. Prior research identified lower marital quality as a key explanation for why couples who cohabit or have children before marrying are more likely to divorce than other couples. Using event history and fixed‐effects models, we found that the effect of marital quality on divorce is similar for cohabitors and noncohabitors, with cohabitors more likely to end both high‐ and low‐quality marriages. In contrast, the relationship between marital quality and divorce is weaker for women with nonmarital births; they are less likely than others to dissolve low‐quality marriages. We discuss how commitment norms and self‐efficacy might explain these differences in the association between marital quality and divorce.     

Inequalities in Under-5 Mortality in Nigeria: Do Ethnicity and Socioeconomic Position Matter?

Background

Each ethnic group has its own cultural values and practices that widen inequalities in child health and survival among ethnic groups. This study seeks to examine the mediatory effects of ethnicity and socioeconomic position on under-5 mortality in Nigeria.

Methods

Using multilevel logistic regression analysis of a nationally representative sample drawn from 7620 females age 15 to 49 years in the 2003 Nigeria Demographic and Health Survey, the risk of death in children younger than 5 years (under-5 deaths) was estimated using odds ratios with 95% confidence intervals for 6029 children nested within 2735 mothers who were in turn nested within 365 communities.

Results

The prevalence of under-5 death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The risk of under-5 death was significantly lower among children of mothers from the Igbo and other ethnic groups, as compared with children of Hausa/Fulani/Kanuri mothers, after adjustment for individual- and community-level factors. Much of the disparity in under-5 mortality with respect to maternal ethnicity was explained by differences in physician-provided community prenatal care.

Conclusions

Ethnic differences in the risk of under-5 death were attributed to differences among ethnic groups in socioeconomic characteristics (maternal education and to differences in the maternal childbearing age and short birth-spacing practices. These findings emphasize the need for community-based initiatives aimed at increasing maternal education and maternal health care services within communities.Key words: ethnicity, under-five mortality, soci-economic position, inequalities