1,720,965 research outputs found
Impact of Sex and Gender on Metabolic Syndrome in Adults: A Retrospective Cohort Study From the Canadian Primary Care Sentinel Surveillance Network
No full textObjective: Metabolic syndrome (MetS), a cluster of 5 interconnected factors, is the main contributor to cardiovascular disease. Although sex- and gender-related elements have been linked to MetS and its components, this association has not been explored among Canadians with or without MetS. In this study, we aimed to identify sex and gender differences in characteristics of MetS in the Canadian population. Methods: This retrospective cohort study used data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database. The CPCSSN contains de-identified electronic health records of >1.5 million Canadians (2010-2019). Individuals 35 to 75 years of age who had a primary care encounter formed the study sample (N=37,813). Multiple logistic regression models were used to estimate adjusted odds ratios for sex and gender differences among Canadians with and without MetS, which was the primary outcome variable. Results: The estimated prevalence of MetS was 41.9%. The risk of developing MetS was significantly lower among females compared with males (odds ratio 0.73, 95% confidence interval 0.70 to 0.76). However, the risk was higher in females who used antidepressants (odds ratio 1.53, 95% confidence interval 1.42 to 1.65). An equal distribution of deprivation indexes was observed between males and females with MetS, with risk slightly higher for those with material deprivation. Females were found to be the most socially deprived. Conclusions: This study provides important sex- and gender-specific differences in MetS among Canadians. Targeting sex- and gender-specific risk factors could assist in reversing the trend of adverse cardiovascular outcomes associated with MetS
Sex and Gender Determinants of Vascular Disease in the Global Context
No full text: Globally, vascular diseases are a leading cause of morbidity and mortality. Many of the most significant risk factors for vascular disease have a gendered dimension, and sex differences in vascular diseases incidence are apparent, worldwide. In this narrative review, we provide a contemporary picture of sex- and gender-related determinants of vascular disease. We illustrate key factors underlying sex-specific risk stratification, consider similarities and sex differences in vascular disease risk and outcomes with comparisons of data from the global North (ie, developed high-income countries in the Northern hemisphere and Australia) and the global South (ie, regions outside Europe and North America), and explore the relationship between country-level gendered inequities in vascular disease risk and the United Nation's gender inequality index. Review findings suggest that the rising incidence of vascular disease in women is partly explained by an increase in the prevalence of traditional risk factors linked to gender-related determinants such as shifting roles and relations related to the double burden of employment and caregiving responsibilities, lower educational attainment, lower socioeconomic status, and higher psychosocial stress. Social isolation partly explained the higher incidence of vascular disease in men. These patterns were apparent across the global North and South. Study findings emphasize the necessity of taking into account sex differences and gender-related factors in the determination of the vascular disease risk profiles and management strategies. As we move toward the era of precision medicine, future research is needed that identifies, validates, and measures gender-related determinants and risk factors in the global South
Impact of biological sex and genderrelated factors on public engagement in protective health behaviours during the COVID-19 pandemic : cross-sectional analyses from a global survey
No full textGiven the main objective of this study was to examine whether sex and gender-related factors were associated with the public’s adherence to COVID-19-recommended protective health behaviours. Design This was a retrospective analysis of the survey that captured data on people’s awareness, attitudes and behaviours as they relate to the COVID-19 policies. Setting Data from the International COVID-19 Awareness and Responses Evaluation survey collected between March 2020 and February 2021 from 175 countries. Participants Convenience sample around the world.Fil: Dev, Rubee. University of Alberta; Canada.Fil: Raparelli, Valeria. University of Alberta; Canada.Fil: Raparelli, Valeria. University of Ferrara; Italy.Fil: Bacon, Simon L. Montreal Behavioural Medicine Centre; Canada.Fil: Bacon, Simon L. Concordia University; Canada.Fil: Lavoie, Kim L. Montreal Behavioural Medicine Centre; Canada.Fil: Lavoie, Kim L. Université du Québec à Montréal; Canada.Fil: Pilote, Louise. McGill University; Canada.Fil: Norris, Colleen M. University of Alberta; Canada.Fil: Losada, Analía Verónica. Universidad de Flores; Argentina
Impact of biological sex and gender-related factors on public engagement in protective health behaviours during the COVID-19 pandemic: cross-sectional analyses from a global survey
Full text linkOBJECTIVE: Given the role of sociocultural gender in shaping human behaviours, the main objective of this study was to examine whether sex and gender-related factors were associated with the public’s adherence to COVID-19-recommended protective health behaviours. DESIGN: This was a retrospective analysis of the survey that captured data on people’s awareness, attitudes and behaviours as they relate to the COVID-19 policies. SETTING: Data from the International COVID-19 Awareness and Responses Evaluation survey collected between March 2020 and February 2021 from 175 countries. PARTICIPANTS: Convenience sample around the world. MAIN OUTCOME MEASURES: We examined the role of sex and gender-related factors in relation to non-adherence of protective health behaviours including: (1) hand washing; (2) mask wearing; and (3) physical distancing. Multivariable logistic regression was conducted to determine the factors associated with non-adherence to behaviours. RESULTS: Among 48 668 respondents (mean age: 43 years; 71% female), 98.3% adopted hand washing, 68.5% mask wearing and 76.9% physical distancing. Compared with males, females were more likely to adopt hand washing (OR=1.97, 95% CI: 1.71 to 2.28) and maintain physical distancing (OR=1.28, 95% CI: 1.22 to 1.34). However, in multivariable sex-stratified models, females in countries with higher Gender Inequality Indexes (GII) were less likely to report hand washing (adjusted OR (aOR)=0.47, 95% CI: 0.21 to 1.05). Females who reported being employed (aOR=0.22, 95% CI: 0.10 to 0.48) and in countries with low/medium GIIs (aOR=0.18, 95% CI 0.06 to 0.51) were less likely to report mask wearing. Females who reported being employed were less likely to report physical distancing (aOR=0.39, 95% CI: 0.32 to 0.49). CONCLUSION: While females showed greater adherence to COVID-19 protective health behaviours, gender-related factors, including employment status and high country-wide gender inequality, were independently associated with non-adherence. These findings may inform public health and vaccination policies in current as well as future pandemics
Developing a Family Planning Counseling Intervention for Women and Adolescent Girls in Resource-Limited Settings
Full text linkThesis (Ph.D.)--University of Washington, 2018University of Washington Abstract Developing a Family Planning Counseling Intervention for Women and Adolescent Girls in Resource-Limited Settings Rubee Dev Chair of the Supervisory Committee: Pamela Kohler School of Nursing Introduction: Unintended pregnancy, including both mistimed and unwanted pregnancies, is associated with negative health outcomes for women and children including maternal depression, increased risk of physical violence, premature deliveries, and low birth weight among children. Adolescents, postpartum, and HIV-infected women are key populations at risk of unintended pregnancy, with unique unmet contraceptive needs. Despite contraceptive guidelines and recommendations, underuse and discontinuation of effective contraception remains a great challenge. The studies within this dissertation address gaps in understanding of contraceptive use behavior and counseling experiences of adolescents and women in resource-limited settings to inform development of FP interventions in Kenya. Methods: To inform contraceptive use behavior of postpartum women, we conducted a systematic literature review and meta-analysis on postpartum contraceptive use, including predictors and barriers among women in resource-limited settings. Using survey data from 109 HIV care and treatment programs in Kenya, we further examined the correlates of receipt of contraceptive counseling among HIV-infected women to determine whether there were differences in who was offered FP services and whether methods offered matched women's preferences. Finally, to improve FP counseling services, we developed an interactive mobile application for contraceptive choice (iMACC) to guide women through the FP decision-making process. We evaluated the feasibility, acceptability, and utility of our FP decision-aid among postpartum adolescent girls and women, as well as FP providers, in Kenya. Results: Through the systematic review, we found an overall pooled prevalence of modern contraceptive use among postpartum women of 41.2%. Low uptake was related to low perceived risk of getting pregnant and inadequate contraceptive counseling. In the surveys of HIV-positive women, those who were already using FP, and those who desired to delay pregnancy more than two years, were more likely to receive FP counseling by their health provider. Married women with higher education and other children were more likely to receive counseling on benefits of birth spacing and limiting. Findings from qualitative interviews support the feasibility, acceptability, and utility of the FP counseling decision-aid to tailor counseling to women's unique needs and facilitate decision-making among women with their FP providers in resource-limited settings. Conclusions: The studies within this dissertation aim to overcome gaps in contraceptive counseling and improve contraceptive use, satisfaction, and continuation among adolescent, postpartum, and HIV-infected women who have unique needs for contraception in resource-limited settings. Uptake of FP services may be improved by providing high quality, individualized FP counseling and by better integrating FP counseling for all women in primary, postpartum, and HIV care
Topographical Differences of Infant Mortality in Nepal: Demographic and Health Survey 2011
No full textThesis (Master's)--University of Washington, 2014University of Washington Abstract Topographical Differences of Infant Mortality in Nepal: Demographic and Health Survey 2011 Rubee Dev Chair of the Supervisory Committee: Marcia F. Williams, PhD, MPH Epidemiology Objective: Infant mortality is a major problem in Nepal, particularly for residents in remote rural areas. Lack of roads and absence of hospitals and health facilities in remote areas contribute to the problem. The objectives of this study were to assess infant mortality rate (IMR) in the three ecological zones of Nepal (Mountain, Hill and Terai) and to examine the effect of distance to health facility on the association between ecological zone and infant mortality. Methods: The Nepal Demographic and Health Survey (NDHS) conducted in 2011 was used to calculate infant mortality rates for the Mountain, Hill and Terai zones of Nepal. Infant mortality was compared across three ecological zones in a sample of 5,306 live births in the five years preceding the survey. Logistic regression was used to assess the association between ecological zones and infant mortality focusing on distance to health facility and adjusting for potential confounders including maternal age at first birth, education level, total children ever born, birth interval and infant size at birth. Results: The weighted IMR in each ecological zone was calculated to be 59 (95% CI: 36-81), 44 (35-53), and 40 (33-47) infant deaths per 1000 live births for the Mountain, Hill and Terai zones, respectively. Residing in the Mountain zone was associated with a greater risk of infant mortality compared to those in the Terai zone (OR=1.42, 95% CI: 1.01-2.02, p=0.04). The risk of infant mortality in the Hill zone did not differ significantly from risk in the Terai zone (OR=1.17, 95% CI: 0.86-1.57, p=0.30). The elevated risk of infant mortality in the Mountain Zone compared to the Terai zone was observed only among mothers who perceived distance to health facility as a major problem (OR=1.55, 95% CI: 1.01-2.40, p=0.04). There was no significant difference in IMRs in the three ecologic zones among births to women who did not perceive distance as a big problem. In addition, a greater percent of women in the Mountain zone reported that distance to health facilities was a big problem (70.8%) compared to 60.0% in the Hill zone and 45.6% in the Terai zone. Conclusions: The excess risk of infant mortality in the Mountain zone of Nepal is due to both 1) the higher risk of infant mortality in the Mountain zone vs. the Hill and Terai zones among births to women who perceived distance to health facilities as a big problem; and 2) the higher proportion of births in the Mountain zone where distance to health facilities is perceived to be a big problem. These findings highlight the importance of accessibility of health services, particularly in the Mountain zone of Nepal. Going forward it will be important to develop intervention strategies and programs that will target remote populations. Keywords: Infant mortality, ecological, region, developing countr
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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