Fitting a linear model to survey data when the long-term average daily intake of a dietary component is an explanatory variable
Titelübersetzung:Verbesserung eines linearen Modells von Längsschnittdaten zur Nahrungsmittelaufnahme von diätetischen Komponenten als erklärende Variable von Gesundheit
Autor/in:
Kott, Phillip S.; Guenther, Patricia M.; Wagstaff, David A.; Juan, WenYen; Kranz, Sibylle
Quelle: Survey Research Methods, 3 (2009) 3, S 157-165
Inhalt: "The National Health and Nutrition Examination Survey (NHANES) collects information on both dietary intake and health conditions from a complex sample of individuals in the US. Instrumental-variable regression can be used to model an individual's health-related attribute as a linear function of explanatory variables including the average daily intake of dietary components. This overcomes the apparent limitation of the NHANES collecting dietary intake data on only two days per sampled individual because the averages of two days per individual exhibit considerable intra-individual variability. Readily available software routines can perform survey-sensitive instrumental-variable regression with data like that collected by the NHANES, but the relevant quantitative literature is not clear about what parameters these routines are actually estimating. The authors fit the long-term (usual) serum beta-carotene level of a population of women aged 20-64 to a linear function of each woman's long-term average (usual) daily beta-carotene intake from food and other explanatory variables using survey-sensitive instrumental regression and provide two interpretations of the results." (author's abstract)
Schlagwörter:nutrition; Gesundheit; North America; regression analysis; Nahrungsmittel; ernährungsbedingte Krankheit; health consequences; nutrition-related illness; Nordamerika; remuneration for members of parliament; Lebensalter; United States of America; Verhalten; food; Lebenserwartung; behavior; Regressionsanalyse; life expectancy; Lebensmittel; Mittelwert; USA; woman; Ernährung; gesundheitliche Folgen; mean; Diäten; age; health
SSOAR Kategorie:Forschungsarten der Sozialforschung, Erhebungstechniken und Analysetechniken der Sozialwissenschaften, Gesundheitspolitik
Involvement of first-time mothers with different levels of education in the decision-making for their delivery by a planned Caesarean section: women's satisfaction with information given by gynaecologists and midwives
Autor/in:
Kolip, Petra; Büchter, Roland
Quelle: Journal of Public Health, 17 (2009) 4, S 273-280
Inhalt: Aims: We investigated the involvement of first-time mothers, who had a planned Caesarean section, in the decision to have a Caesarean section, taking into account their different educational levels. Subjects and methods: A self-assessment questionnaire was sent in July 2005 to women who had undergone a Caesarean section in 2004. Participants were 2,685 members of a statutory health insurance fund who had given birth by Caesarean section (response rate: 48.0%). Included were primiparae with planned Caesarean section (n = 352). Results: The women in this cross-sectional study felt well informed about the procedure of a section but not its consequences. They used several sources of information and were most satisfied with the information provided by doctors and midwives. Of the women in this study 20% did not have a midwife. No major differences were observed between different educational levels. Conclusion: Although most women were satisfied with their decision, they felt that they did not receive enough information about the consequences of a Caesarean section. This information need could be met by a further involvement of midwives in maternity care.
Schlagwörter:Caesarean section; Shared decision-making; Information needs; Birth
Community stroke knowledge: a new information strategy using a joint project of the public health service and the hairdressers' guild of the Wesel district
Quelle: Journal of Public Health, 17 (2009) 6, S 371-376
Inhalt: Objectives: The public health programme “Healthy Lower Rhine…against Stroke” is aimed at improving the population’s knowledge about stroke and thus at reducing the prehospital phase in patients with suspected stroke. First evaluation results indicate that apart from providing information through the mass media, there is an urgent need to further develop the face-to-face communication approach. This has to be achieved by efficient but also effective means, given that financial and personnel resources are scarce. Study design: In cooperation with lögd Bielefeld, the Lower Health Authority of the Wesel District (health department) developed a postcard-sized quiz card containing exclusively correct answers on the issue of stroke, risk factors as well as symptom and action knowledge. For face-to-face communication, the hairdressers could be convinced to be included in the project. The hairdressers posed the corresponding questions and marked those answers of the clients that were identical with the quiz card answers with a cross. Answers not given by the clients were read out loud to them by the hairdressers, who were thus “styling up” the knowledge of their clients. To increase participation in the project, prizes were offered for the hairdressers with the most filled-in quiz cards as well as for three of the participating clients (drawing of prizes 1–3). More than 380 hairdressers in the Wesel district were sent a letter inviting them to participate as facilitators in this project, which is probably the first of its kind worldwide. Methods: The machine-readable quiz cards were collected and statistically evaluated including data regarding age and gender of the participants. Results were to be presented in the form of a descriptive statistic. Results: Thirty-three hairdressers from 12 cities and municipalities of the Wesel district participated in this joint action of the Wesel district Department of Health and the Wesel hairdressers’ guild, dealing with the monitoring and imparting of basic knowledge on the issue of stroke. Almost 2,000 clients were interviewed by the participating hairdressers, and knowledge gaps were closed by information read out to them. Discussion: This innovative approach of imparting knowledge can be regarded as the model of an effective and economical way of communicating health information to the broader public.
Schlagwörter:Stroke prevention; "Healthy Lower Rhine ... against Stroke"; Hairdressers imparting health information
Adapted Traditions: The Case of Traditional Palestinian Women Healers in Israel
Titelübersetzung:Adaptierte Tradition: Traditionelle palästinensische Heilerinnen in Israel
Autor/in:
Popper-Giveon, Ariela
Quelle: Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 10 (2009) 2, 24 S
Inhalt: Dieser Beitrag beschäftigt sich mit traditionellen palästinensischen Heilerinnen in Israel und mit den Wandlungsprozessen, denen ihre Rollen und Praktiken unterworfen sind. Verglichen werden biografische Erzählungen von Heilerinnen, die in Städten mit jüdisch-arabischer Bevölkerung in Zentral-Israel leben mit denen in Beduinen-Gemeinschaften in der Wüste Negev. Dabei wird deutlich, dass traditionelles Heilen im Zuge von Modernisierungsprozessen nicht einfach verschwunden ist, sondern spezifische Transformationen vollzogen hat. So befassen sich städtische Heilerinnen z.B. weniger mit "physischen" Problemen, für die eine "natürliche" Ursache und Behandlung angenommen wird, sondern eher mit allgemeinen Lebensproblemen bzw. mit Problemen, die als "übernatürlich" verursacht erachtet und die mit magischen und religiösen Mitteln behandelt werden. Auf diese Weise bleiben die Heilerinnen trotz erkennbarer Wandlungsprozesse Agentinnen des Bewahrens von Tradition und von Konservatismus, eine Rolle, die ihre zentrale Position in ihren Gemeinschaften fortschreibt.
Inhalt: This article examines transformations in the roles and treatment practices of traditional Palestinian women healers in Israel. Comparing narratives of women healers residing in Jewish-Arab mixed cities in central Israel with those of their counterparts in the Bedouin community of the Negev reveals that traditional healing has not disappeared as a result of modernization but rather has transformed. Urban women healers are abandoning treatment of physical problems in favor of addressing life hardships; they distance themselves from problems whose cause and treatment are considered natural and prefer those perceived as derived from supernatural causes and treated through supernatural, magical and religious means. Despite these transformations, traditional Palestinian women healers appear as agents of preservation and conservatism, a role that imbues them with a central position in their community. Hence, their place is currently secured and expected to remain so as processes of modernization and acculturation increase in intensity.
Schlagwörter:Gesundheit; female profession; modernization; role; cure; Transformation; Frauenberuf; conservatism; Heilung; Israel; Palästinenser; Konservatismus; transformation; Tradition; Israel; comparison; Palestinian; woman; sozialer Wandel; traditionelle Kultur; traditional culture; Rolle; Religion; religion; social change; tradition; health; Vergleich; Modernisierung; traditionelle Heilerinnen; Palästinenser/innen in Israel; Beduinen; Anthropoloyg, Medical Anthropology; traditional healing; women healers; social change; Palestinians in Israel; Bedouin
SSOAR Kategorie:Frauen- und Geschlechterforschung, Gesundheitspolitik
Private individual ambulatory health care providers in Madhya Pradesh province, India
Autor/in:
Costa, Ayesha; Eriksson, Bo; Diwan, Vinod K.
Quelle: Journal of Public Health, 17 (2009) 4, S 235-241
Inhalt: Background: Ambulatory health care services are a major contributor to the large and inequitable health financing burdens (largely out-of-pocket) faced by households in India. The private sector has a virtual monopoly over ambulatory curative services in rural and urban India. Despite this, there is little knowledge about who these providers are, their numbers, distribution, and activities. Aim: This study describes the numbers, gender, distribution, and characteristics of private individual ambulatory care providers in Madhya Pradesh (60.4 million people), one of India’s largest provinces. It discusses the suitability of this provider mix to deal with maternal and child health, a major health priority in the province. Method: A survey enlisting all health care providers was conducted in the 52,117 villages and 394 towns of the province. Results: There were 14,046 private qualified physicians (12.5% women), 57,684 qualified paramedics (3.4% women), and 89,090 unqualified providers (10% women) providing ambulatory services in individual setups. In addition, 55,393 traditional birth attendants provided home-based intranatal care. The macro organization of these providers in this setting is presented. Given the high levels of maternal and child mortality in the province, excessive reliance is placed on less than competent providers as these present lower access barriers. Conclusion: Given the public health priorities in this province (maternal and child health), the provider mix is not optimally suited to the populations’ needs. There is a lack of competent qualified care required to deal with the major causes of morbidity and mortality, particularly in rural areas. Access to qualified women providers is low. The lack of a cadre of qualified midwives possibly contributes to some of the high maternal mortality observed in this province.
Schlagwörter:gender; Gender; Human resources; Maldistribution; Health services India
Predictors of work ability in occupations with psychological stress
Titelübersetzung:Vorhersage der Arbeitsfähigkeit in Berufen mit psychologischem Stress
Autor/in:
Seibt, Reingard; Spitzer, Silvia; Blank, Matthes; Scheuch, Klaus
Quelle: Journal of Public Health, 17 (2008) 1, S 9-18
Inhalt: Aim: This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW). Method: Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable). Results: Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken. Conclusion: The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.
Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients
Quelle: Journal of Public Health, 17 (2008) 1, S 3-7
Inhalt: Aim: This study examined modifications in secondary preventive medication between the time of hospital discharge (HD) and during a 6-month follow-up treatment of outpatients with acute coronary syndromes (ACS) and stroke. Subjects and methods: During a 6-month period, a health diary was completed on a weekly basis by 98 patients who were initially hospitalised with ACS and 29 patients with strokes in the Cologne area (Germany). Changes in medication between the time of HD and follow-up treatment (weeks 2, 12, and 24) were recorded. Results: On average, patients with ACS took six medications, whereas patients with stroke took five medications per day. ACS patients received beta-blockers (96%), lipid-lowering agents (80%), and angiotensin-converting enzyme (ACE) inhibitors (64%) at HD, and no changes in medication were made during follow-up treatment. However, there was a significant decrease in prescriptions of clopidogrel among ACS patients within 6 months, and about 13% of ACS patients did not receive an antiplatelet agent at any time. Stroke patients received beta-blockers (50%), lipid-lowering agents (67%), and antiplatelet agents, such as acetylsalicylic acid (57%) or clopidogrel (27%), at the time of HD, and no significant changes in medication were instituted during follow-up treatment. Conclusion: Treatment of ACS patients with the combination of acetylsalicylic acid and clopidogrel was insufficient, although it has been shown that this combination is highly effective in secondary prevention of ACS. Besides medical reasons, the cost-containment restrictions (“medication budget”) for German physicians might explain the observed failure of guideline-oriented medication. Furthermore, no changes in medications occurred regarding blood-pressure- and lipid-lowering agents.
Die besonderen Lebenslagen von Frauen mit Behinderung im Alter
Titelübersetzung:The special living arrangements of elderly handicapped women
Autor/in:
Strupp, Julia
Quelle: Sozialwissenschaftlicher Fachinformationsdienst soFid, (2008) Frauen- und Geschlechterforschung 2008/2, S 11-21
Inhalt: 'Erstmals erreichen Kohorten lebenslang behinderter Frauen und Männer das Rentenalter, da infolge des Euthanasie-Programms in der NS-Zeit von 1943 bis zum Ende des Regimes im Mai 1945 behinderte Menschen systematisch ermordet wurden. Die Erfahrungen mit älter werdenden und alten behinderten Menschen sind daher noch recht begrenzt. Geschlecht und Alter behalten eine zentrale Bedeutung für die Charakterisierung der Lebenslage behinderter Menschen, eine Mehrfachdiskriminierung behinderter Frauen ist in vielen Lebensbereichen nachweisbar. In der wissenschaftlichen Literatur zeigen sich Forschungsdesiderata: besonders Frauen mit Behinderung im Alter werden noch nicht angemessen wahrgenommen, ihre Problemlagen weitestgehend vernachlässigt, dabei ist evident, dass Benachteiligungen behinderter Frauen (und Mädchen) im Lebensverlauf kumulieren und durch die Betrachtung der Dimension Alter an Stärke zunehmen. In diesem Artikel werden die besonderen Bedürfnislagen von Frauen mit Behinderungen im Alter anhand vereinzelter Studien dargestellt. Des Weiteren wird die Relevanz dieser Thematik für die Forschung und Praxis herausgearbeitet.' (Autorenreferat)
Schlagwörter:need; Bedürfnis; gender; discrimination; alter Mensch; Benachteiligung; Behinderung; Behinderter; Alter; Diskriminierung; woman; old age; disability; elderly; handicapped; gender-specific factors; deprivation
SSOAR Kategorie:Frauen- und Geschlechterforschung, Gesundheitspolitik, Gerontologie, Alterssoziologie
A 'little world of your own': stigma, gender and narratives of venereal disease contact tracing
Autor/in:
Kampf, Antje
Quelle: Health, 12 (2008) 2, S 233-250
Inhalt: As in other countries, in order to protect the public from venereal disease (syphilis and gonorrhoea), contact tracing in New Zealand has been a public health strategy since the mid-20th century. So far, scholars have predominantly focused on the aspect of control of the cases traced. Based on a rare interview with a female contact tracer, together with a range of archival material, this article aims to expand the scholarship by focusing on the tracer instead of the patient. Using Erving Goffman's original concept of 'courtesy stigma', the article will show that his idea can be nuanced to take into account contact tracers and the ways in which this stigma can be refracted through gender. Working as a tracer had a distinct impact on her life and possibly even her marital status, which were compromised by secrecy, stigma, morality and the demands of public health policies — aspects that were, paradoxically, quite similar to those she traced. The courtesy stigma that contact tracers for venereal disease acquired limited their professional options, as well as isolated them in the non-stigmatized social world.
Schlagwörter:Stigma; gender; stigma; Gender; contact tracing; New Zealand; venereal disease
Machtspiele im Krankenhaus: "doing gender" oder "doing profession"?
Titelübersetzung:Power Games in the Hospital—Doing Gender or Doing Profession?
Autor/in:
Sander, Kirsten
Quelle: Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 9 (2008) 1, 15 S
Inhalt: Anhand einer Situationsbeschreibung aus einer ethnographischen Studie wird die Interaktion von Krankenschwestern und Ärzten nach den darin erzeugten Geschlechter- und Professionskonstruktionen untersucht. Für die mikrosoziologische Rekonstruktion der szenischen Beschreibung aus dem Alltag der Zusammenarbeit von Pflege und Medizin werden die von Erving GOFFMAN (1977) entwickelten rahmenanalytischen Konzepte genutzt. Durch eine dem situierten Vollzug der Interaktion folgende Interpretation sollen die von den AkteurInnen wechselseitig wahrgenommenen und dargestellten Handlungen nach ihrer Wirksamkeit für die Hervorbringung von Geschlechter- und Professionsunterscheidungen befragt werden. Es wird gezeigt, dass die Interaktionen von Schwestern und ÄrztInnen zweiseitig gerahmt sind und prinzipiell Wechsel sowie Verknüpfungen von professionellen und geschlechterstereotypisierenden Rahmungen möglich sind. Ausgangspunkt für die beispielhafte Szene aus einer Chefvisite ist die "unklare" Rahmung der Situation. Die Deutungs- und Entscheidungsmacht der Medizin scheint kurzfristig durch die Intervention einer Schwester infrage gestellt zu ein. Durch die von der Schwester angefragte körperliche Selbstpräsentation des männlichen Stationsarztes transformiert die Szene in einen Geschlechterrahmen. Der Chefarzt "klärt den Rahmen" mit einem vieldeutigen Scherz. In der Interpretation wird ausgeführt, dass die besondere körperliche Sichtbarkeit des Arztes eine Inkongruenz zwischen Professions- und Geschlechterrahmen herstellte. Zur Lösung der bereits in der Intervention der Schwester liegenden Rahmenspannung wird das Geschlecht offensiv durch den Chefarzt "ins Spiel" gebracht. Dass es sich um ein "Machtspiel" handelt, wird am Ergebnis des Interaktionsprozesses verdeutlicht: Durch das gemeinsame Lachen der Ärzte werden die Werte und Bestrebungen der Pflegenden und/oder der Frauen disqualifiziert.
Inhalt: This paper discusses findings from a study of inter-professional interaction between doctors and nurses in a surgical ward. The aim of the research is to analyze the construction of gender, profession and hierarchy in the context of the everyday interactions between members of the professions of nursing and medicine in the hospital. Participant observation was undertaken in two medical and two surgical wards in three hospitals. The present paper provides a microanalysis of ethnographic data in which Erving GOFFMAN's "frame analysis" (1974) is used as a central analytical resource. Gender and profession are interpreted as ongoing accomplishments. Stereotyping impacts of gender and profession are discussed as different "frames," which change or are linked in the social situation. In this particular case, an outspoken nurse is shown as she disrupts the frame of the doctor's rounds by displaying the assistant doctor as an embodied male person, thus "keying" the professional frame in a gender frame. The senior doctor "clears the frame" by making an ambiguous joke. I argue that doing subordination and doing domination in nursing and medicine are enacted by such gender displays. The interpretation shows the "doctor-nurse game" (STEIN, 1967) as a gendered power game.
Schlagwörter:Professionalisierung; Arzt; Krankenhaus; power; nurse; interaction; Handlungsspielraum; hospital; professionalization; decision; Krankenschwester; Federal Republic of Germany; Handlungsorientierung; intervention; man; Intervention; scope of action; nursing staff; Stereotyp; Macht; Entscheidung; physician; Pflegepersonal; Doing Gender; stereotype; woman; Mann; doing gender; Interaktion; gender-specific factors; action orientation; Rahmenanalyse; Geschlechterkonstruktion; Medizin-Pflege-Interaktion; Ethnografie; frame analysis; construction of gender; interaction of doctors and nurses; hospital; ethnography
SSOAR Kategorie:Industrie- und Betriebssoziologie, Arbeitssoziologie, industrielle Beziehungen, Frauen- und Geschlechterforschung, Gesundheitspolitik